#OTalk Research – 10th January 2017

The first #OTalk of 2017 is an #OTalk Research Chat.  We hope you can join us on Tuesday 10th January between 8pm-9pm.


Hosted by: Dr. Mary Birken, Post-doctoral Research Fellow in Occupational Therapy, Plymouth University

Supported by:  Jenny Preston

“Occupational therapy practitioners enter the profession to help improve people’s lives, but how do we know that our treatments work?” – Lin, 2013.

To test if occupational therapy works we need to do research, ultimately randomised controlled trials to evaluate the effectiveness of occupational therapy.

The need to demonstrate robust evidence of clinical and cost effectiveness of occupational therapy in mental health has been identified by commissioners of services, occupational therapists and managers as highlighted by the review of the Recovering Ordinary Lives Strategy (Smyth, 2014).

Other areas of occupational therapy practice have carried out successful randomised controlled trials and as a result feature in NICE guidance in that practice area. As an OT researcher in mental health I would like to discuss with OTs how we -occupational therapists in mental health- can pool resources, knowledge and skills to carry out research and feature in NICE guidance in mental health?

Questions to be discussed during this OTalk Research session are:

 

  1. OTs, commissioners & managers identified the need to demonstrate cost & clinical effectiveness of OT in mental health- what next steps do we need to take to do this?

 

  1. Are there existing forums/networks that can help us to do this research?

 

  1. Is the concept of community of practice a useful one that could support this?

 

  1. Who else do we need to collaborate with to make this happen?

 

  1. Following on from the previous qs, what is the next step for us?

 

References:

Lin, S.H. (2013) Special Issue on the Accelerating Clinical Trials and Outcomes Research (ACTOR) Conference. American journal of Occupational Therapy. 67 (3) 135-137.

Smyth G (2014) Recovering ordinary lives: the successes, challenges and future. OTNews 22(9) 22-23.

Post Chat

Online Transcript

The Numbers

2,181,238 Impressions
593 Tweets
45 Participants
474 Avg Tweets/Hour
13 Avg Tweets/Participant

#OTalk Participants

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#OTalk 13th December – Personality Disorder, not just mental health.

This weeks #Otalk is on the topic of Personality Disorder and will be hosted by Keir Harding (@Keirwales).

We all have personality traits that can cause problems for us or other people. When these traits are problematic, pervasive and persistent we could label these traits as a personality disorder. Personality Disorder is prevalent in around 5 to 13 per cent of the population (Coid et al 2006). In mental health this figure increases depending upon the specialist nature of the service with up to 30 per cent in primary care, up to 50 per cent in secondary care, up to 70 per cent in drug and alcohol and eating disorder services and up to 78 per cent in prison (Moran 2003) . In physical health there is a similar trend with, for example 30% in the field of chronic pain (Sansone & Sansone 2015) while “the presence of borderline personality disorder was significantly associated with arteriosclerosis or hypertension, hepatic disease, cardiovascular disease, gastrointestinal disease, arthritis… and ‘any assessed medical condition’” (El-Gabalawy R et al 2010)

My point is that if you are working with people, you are working with personality disorder. There is widespread acceptance that within the already stigmatised area of mental health, Personality Disorder comes with an extra level of negative attitudes towards those who experience it. No Longer A Diagnosis of Exclusion was published in 2003 to try to address this. Still A Diagnosis of Exclusion (2009) suggests that it didn’t. It’s true that services for people living with Personality Disorder have improved over the past years but anecdotally people still struggle to get help with their difficulties, there are large inequalities as to what is available in different areas and staff often feel very deskilled when working in this area.

The area of Personality Disorder can be hugely challenging to clinicians. This can be due to high levels of self harm and suicidality that we might feel responsible for. It can be due to people dropping out of treatment or not seeming to engage with what’s on offer. It could be due significant difficulties in the relationship between client and clinician. My preparation for these challenges in university was non existent. One of my first lessons in how to work with this client group was a staff nurse pointing out a service user and telling me “He’s a PD. There’s nothing we can do for him”.

This chat aims to explore OTs views on the experience of working with people with personality disorder. Some points to consider consider:

-What preparation/training have you had for working with Personality Disorder? Was it enough?

-What are the challenges you experience/anticipate when working with Personality Disorder?

-How do you understand/formulate the difficulties people with PD present with?

-How relevant is OT in the area of Personality Disorder? Can we make a difference?

-How do we look after ourselves and colleagues when working in this area?

References

El-Gabalawy R1, Katz LY, Sareen J (2010) Comorbidity and associated severity of borderline personality disorder and physical health conditions in a nationally representative sample. Psychosom Med. 2010 Sep;72(7):641-7. doi: 10.1097/PSY.0b013e3181e10c7b. Epub 2010 May 27.

Kalira, V., Treisman, G.J. & Clark, M.R. (2013)Borderline Personality Disorder and Chronic Pain: A Practical Approach to Evaluation and Treatment Curr Pain Headache Rep (2013) 17: 350. doi:10.1007/s11916-013-0350-y

Sansone R, & Sansone L (2015) Borderline Personality in the Medical Setting Prim Care Companion CNS Disord. 2015 May 28;17(3). doi: 10.4088/PCC.14r01743. eCollection 2015.

Coid, J., Yang, M., Tyrer, P., Roberts, A. & Ullrich, S. (2006). Prevalence and correlates of personality disorder in Great Britain. British Journal of Psychiatry188 (5), 423–431.

Moran, P. (2003). The Epidemiology of Personality Disorders. http://www.dh.gov.uk (last accessed: 5.2.2016).

National Institute for Mental Health for England (2003). Personality Disorder: no Longer a Diagnosis of Exclusion. Policy Implementation Guidance for the Development of Services for People with Personality Disorder, Gateway Reference 1055. London: NIMH(E).

Raven C (2009) Borderline personality disorder: still a diagnosis of exclusion? Ment Health Today. 2009 Jun:26-31.

 

POST CHAT

Transcript Here

The Numbers

1,602,594 Impressions
781 Tweets
62 Participants
625 Avg Tweets/Hour
13 Avg Tweets/Participant

#OTalk Participants

#OTalk Research 6th December 2016 – In-depth Interviews

The chat will be hosted by OTalk research team member Lynne Goodacre  (@lynnegoodacre) supported by OTalk research team member Emma Hooper (@hooper_ek).

Conducting in-depth interviews is one of the most common approaches to data collection utilised by qualitative researchers. The underlying rationale for using this method is to explore in detail the experiences and perspectives of others, the meaning people attribute to their experiences and how people make sense of the world. This weeks OTalk will provide an opportunity to explore this method of data collection and share experiences and expertise.

Some points we will be exploring during the chat will be:

To get us started – what research context are you using or planning to use interviews in?

How do you decide what questions to ask to inform your interview schedule?

How do you decide who to include in your sample?

What practical factors need to be considered when planning to conduct interviews?

What ethical issues need to considered when undertaking interviews?

Whether you are in the process of planning your research, in the midst of collecting data or interested in understanding more about this method we have a lot to learn from each other. So I hope you will join in.

 

POST CHAT

transcript here

The Numbers

1,065,126 Impressions
313 Tweets
41 Participants
13 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants