Making Your Own Wellbeing #OTalk 28th February 2017

This Tuesdays #OTalk will focus on how making something can have a positive impact on your wellbeing and that of your service users. I was recently doing some coaching with a friend and this process encouraged me to stop putting it off, stop finding reasons not to do it and find more life balance and resume crafting with a view to improving my own wellbeing. I have started #ThisMonthsMake with the view to making one thing each month and if you would like to join please do.

When planning this talk I searched the definition of “Making” and found more than just the process of producing something. There were words like: ingredients, potential, invention, forging and so on. I particularly like the idea of possessing the right ingredients to forge one’s own well being. What I like about making things is the process of learning, getting lost in flow and having something tangible as an end result.

I haven’t hosted a chat in a while so I may be a little rusty! I’m also noting that its pancake day, so if you’re making pancakes please reflect on how this process made you feel,

Some interesting pre reading-

https://academic.oup.com/jpubhealth/article/34/1/54/1550848/The-relationship-between-quilting-and-wellbeing

http://www.atwb.org/

https://www.theguardian.com/healthcare-network/2017/feb/15/creativity-improves-wellbeing-art-transforms-mental-health-ward

Questions

Do you engage in “making” or creative occupations? If yes what do you do? If no, why?
How does making something make you feel?
What are the barriers and enablers to making things?
What are some of the skills “ingredients” needed to forge our own wellbeing? How can we build this in OT?
Are you able to use “making” in your practice as an OT? How? Why? Why not?
Do you think you could try to make something every month and reflect on whether this improves your wellbeing?
How do you think we could measure improvement?

Post chat

Online transcript

The Numbers
1,040,826 Impressions
456 Tweets
46 Participants
365 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

#OTalk 21st February – Stress and burnout.

This weeks chat is on the topic of stress and burnout and is hosted by Samantha Tavender (@SamOTantha).

Burnout is a stress-related syndrome that often affects professionals working in emotionally loaded and highly interpersonal environments (Volpe et al, 2014).

The term ‘Burnout’ is a multidimensional concept which was originally introduced by Freudenberger (1974), which consists of emotional/ physical exhaustion, depersonalization and a lack of feelings of personal accomplishment following a prolonged exposure to stress in the workplace.

Burnout is associated with low job satisfaction, higher staff turnover rates, sickness absence and poorer consumer outcomes (Scanlan and Still 2013). It is therefore in everyone’s vested interest for occupational therapists to make themselves aware of stress and burnout and how to reduce stress and what factors in the work environment may induce stress or burnout.

“One of the main coping strategies for managing stress and burnout is recognizing stress – to develop coping strategies we must first understand stress and burnout” (Scanlan & Still 2013).

Stress inducing factors:

Seeing little positive change or no change in service users over time:

Caseload Size:

Organizational Procedures:

Team Climate:

Stress reducing:

Strong Professional Identity and Professional Resilience:

Supervision:

Reflection and Recognizing signs of stress:

The first aim of the chat will be to address this issue and allow participants a chance to reflect on there own stress levels/ early warning signs.

What is does stress and burnout mean to you?

what are the signs of stress and how can you tell that you are stressed?

The second aim of the chat will be to focus on ways in which occupational therapists can reduce stress, and prevent burnout.

How do you manage stress inducing factors such as large caseloads and organizational procedures?

How do you maintain your professional identity within the MDT?

How do you look after emotions after a difficult day?

How do you make the most out of supervision?

What are your self care top tips

References and relevant articles:

Ashby, S.E., Ryan, S., Gray, M. and James, C., 2013. Factors that influence the professional resilience of occupational therapists in mental health practice. Australian Occupational Therapy Journal, 60(2), pp.110-119.

Brice, H.E., 2001. Working with adults with enduring mental illness: Emotional demands experienced by occupational therapists and the coping strategies they employ. The British Journal of Occupational Therapy, 64(4), pp.175-183.

Brown, G.T. and Pranger, T., 1992. Predictors of burnout for psychiatric occupational therapy personnel. Canadian Journal of Occupational Therapy, 59(5), pp.258-267.

Edwards, D. and Burnard, P., 2003. A systematic review of the effects of stress and coping strategies used by occupational therapists working in mental health settings. The British Journal of Occupational Therapy, 66(8), pp.345-355.

Freudenberger, H.J., 1974. Staff burn‐out. Journal of social issues, 30(1), pp.159-165.

Scanlan, J.N. and Still, M., 2013. Job satisfaction, burnout and turnover intention in occupational therapists working in mental health. Australian occupational therapy journal, 60(5), pp.310-318.

Volpe, U., Luciano, M., Palumbo, C., Sampogna, G., Del Vecchio, V. and Fiorillo, A., 2014. Risk of burnout among early career mental health professionals. Journal of psychiatric and mental health nursing, 21(9), pp.774-781.

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The Numbers

1,502,522 Impressions
570 Tweets
44 Participants
456 Avg Tweets/Hour
13 Avg Tweets/Participant

#OTalk Participants

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#OTalk 14th February – Media Club “Beyond Winning”

This week #OTalk is a media club and is being hosted by Bill Wong (@BillwongOT).

The subject is “Beyond Winning By Janet O’Shea at TEDxUCLA” and the video can be accessed below

https://youtu.be/MWrRkzluCPo

Here is what Bill had to say about his topic;

For you #otalk regulars, some of you might have read that I will be doing a TEDx Talk for a second time in March 2017. In preparation for the vibe of this historic moment in OT, I have decided to go on a listening binge on non-OT TED Talks. By doing so, I thought it will be awesome to do a change of pace of my typical media club content, as I will use a TED Talk by a non-OT and use our OT lens to discuss the topic shared by these speakers.

For those of you who know me, I am a highly competitive person, especially in things I believe I am either at least decent at or I want to be good at. In my early OT career, I dreaded losing, as I only had winning in mind. Losing gracefully was very hard for me. (Some of you might have noticed my bitter Facebook statuses I made when I lost out on a meaningful opportunities in OT at that point of time.) The fact that I lose or got rejected more often than not in such situations made things worse. At that time, I remembered I wished, “If someone can just give me an opportunity, it will erase all the disappointments I accumulated over the years.” Not surprisingly, because of how I handled losing relatively poorly (since I vented on social media a lot back then), I got a fair share of constructive criticism from my peers.

Fast forward to now, I still am a competitive person. However, I have learned to handle losing more gracefully when I miss out on meaningful opportunities in OT. Instead of lamenting and expressing my disappointments on social media, I have learned to put things in perspective. Sure, having some awesome accomplishments since then has helped. But, I began to accept sometimes that moral victories are just as good, if not better than physical victories. I also have learned that great champions not only know how to win, but also how to lose.

An example of which was a difference in how I viewed opportunities from AOTA to further my CPD and CV. As recently as 2 years ago, I heard quite a bit of peers saying that I deserved to make the Emerging Leaders Development Programs because they believed I was a strong candidate for it. In addition, some of my friends who made that program wondered why I got snubbed by the process 3 times. As I am a competitive person, my mindset was “Emerging Leaders or bust”. Each time I received a rejection letter, I would almost cry in disappointment and wondered I wasn’t good enough. Although I would get over such disappointments in a day, I would make posts on Facebook about how disappointed I was.

Looking back, I realized I focused too much on the near-sighted results. Because of that, I completely overlooked the process I went through to put myself in position to compete for such things. I also overlooked that I was very resilient in trying to come back for more, in terms of going for opportunities in OT that don’t always have 100% success rate. Finally, I realized that the actual outcomes have little or no bearing on whether my peers view I am successful. Simply put, I was like a beauty conscious peacock.

Now, although I still feel some disappointment whenever my peers have opportunities to do things I wanted to do in OT, I have learned to move on without letting my disappointments dwell in my mind instead. I also constantly reminded myself that my attempts were already moral victories. One example of which was that I had none of my conference abstracts accepted for the 2017 AOTA conference, which is probably the AOTA conference with the most historical significance in this generation for OT students and practitioners. The old me would have been throwing tantrums on Facebook. The new me simply just told myself, “All I can do is try. There is always next year. Besides, since I go to so many conferences nowadays, you have more chances to succeed.” I was really proud of myself on handling such disappointments with grace in this instance, and my peers have noted my improvements in handling such situations now than a few years ago.

Bottom line, winning is not everything! Enjoying the process and experience is far more important. So, here are some discussion questions.

On a scale of 1-10 (with 1 = not important at all; and 10 = it means the world), how much do you value winning as a kid? Why?

Using the same scale, has anything changed now? If so, why so? If not, why not?

What do you think of play’s significance across our lifespans?

As OT students and practitioners, what can we do to help our clients to not get too caught up with winning across the lifespan?

Post Chat

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The Numbers

1,222,059 Impressions
428 Tweets
57 Participants
342 Avg Tweets/Hour
8 Avg Tweets/Participant

#OTalk Participants

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#OTalk Research – 7th February 2017 – Complex Interventions

February’s #OTalk Research is being hosted by Niina Kolehmainen and supported by Lynne Goodacre

Complex Interventions

As a therapist, do you know what your interventions are? What they consist of? What the different components are (who does what to whom to what end)? What their benefits are, as well as the harms?

Or do you doubt your interventions, question yourself, feel unclear about what it is you are actually providing? Do you wonder what your interventions are really made of, even question whether they are doing much good at all? Quite a while ago I found myself in this second group. Feeling like a non-believer, a doubter (dare I say, a fraud?).

If you too find yourself in this second group, take solace: “The problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.” (Bertrand Russell).

Today, over a decade after my doubting started, I find myself in a world where the most credible thinking around non-drug interventions starts with a strong appreciation that we need to question our interventions. As a field, we have increasingly come to realise that we have tended to gloss over some key questions about our interventions, and just jump in to using them. We use them before we even really knew what they are. We don’t pay enough attention to questions like “what is this intervention actually made of?” and “how do I believe this intervention will lead to the outcomes I am trying to achieve?”.

In 2000, the UK Medical Research Council published its first guidance on how the international multidisciplinary research community should approach non-drug interventions [1]. This guidance recognises that non-drug interventions are complex: they have many moving parts that can be difficult to pin down and define, the relationships between the parts can be messy, and the pathways from the parts to the outcomes can be difficult to specify. The MRC guidance is also very clear that despite these challenges we must try to be clearer about our interventions.

Since its publication, the MRC guidance has been elaborated [2], and additional parts have been added (e.g. the process evaluation guidance [3] ). From when I first read the guidance in 2005 to today, I consider it and its added parts as the most fundamental and important methodology document for anyone doing any research into therapy interventions. I also think that if we as a clinical community took on board some of its basic tenets the quality of our thinking around our interventions would hugely improve – and would put us in a genuine position to lead health interventions across research and practice.

One key element of the guidance is the development of cumulative theory. In the simplest way this means we need to be very clear about our ideas before we start applying them. This may be ideas about the problem, e.g. being specific and having evidence about who exactly is affected, in what way, and the factors playing a role). This may be ideas about the solution, e.g. specific solutions that might make things better, the use of these solutions in different situations, and barriers to implementing the solutions. So all quite practical questions.

The MRC guidance argues we need to take these questions as seriously as the question of “does this intervention work?”. This is so that we have clarity (a good theory!) about the problem and possible solutions, and a good foundation for thinking about out intervention. So for those who think theory has little benefit for practice, keep in mind that “There is nothing more practical than a good theory.” (Kurt Lewin).

So, here is the stall set up. Below is a running order for the haggling – but feel free to bring your own goods along and offer them up too so we’ll get a lively discussion =).

Running order for questions:

1) How clear do you feel on your interventions: what they are made of, and what ideas and evidence there is about the problems and solutions?

2) Have you come across the MRC guidance? Have you used it? What do you make of it?

3) How much, and in what ways, do you currently think about and seek evidence about the problems you are trying to address (as opposed to evidence about the interventions)?

4) How much do you consider each component within your intervention (how specific are you?), and form hypotheses about how each component targets the outcome?

5) What one thing can you do to become clearer about the interventions you use? How will this help you and the patients?

References:

[1] Medical Research Council. A framework for development and evaluation of RCTs for complex interventions to improve health. London: Medical Research Council; 2000.

[2] Craig P, Dieppe P, Macinture S, Michie S, Nazareth I, Petticrew M, et al. Developing and evaluating complex interventions: new guidance. London: Medical Research Council; 2008.

[3] Moore G, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. London: MRC Population Health Science Research Network; 2014.