This weeks #Otalk is on the topic of “Participation” and will be hosted by Tori Wolfendale (@Tori_Doll).
Tori Wolfendale is a Specialist Occupational Therapist working within an intensive rehabilitation mental health environment. At present, she is involved as the Research Director for the VdT Model of Creative Ability Foundation UK and is also a member of @MOT1ON_Research – she has a keen interest in contributing to the evidence base for Occupational Therapy interventions, focusing predominantly on the implementation of the VdT Model of Creative Ability within adult mental health services.
What is the Mental Health Occupational Therapy Interventions and Outcomes Network (MOTION)?
@MOT1ON_Research was set up by Dr. Mary Birken in April 2017 to bring together Occupational Therapists interested in adult mental health intervention effectiveness research in the UK. This was as a result of the review of “Recovering Ordinary Lives: the strategy for occupational therapy in mental health services 2007 to 2017”, (College of Occupational Therapists, 2006) whereby it was identified that a key concern for Occupational Therapists working in mental health is the lack of quantitative evidence of effectiveness of sufficient rigour to be included in clinical guidelines, such as those produced by the National Institute of Clinical Excellence (Smyth, 2014). Commissioners also identified that demonstrating evidence of effectiveness and cost effectiveness is a priority for Occupational Therapy in mental health. To respond to the need to carry out rigorous research to test the effectiveness and cost effectiveness of Occupational Therapy in mental health, MOTION was developed. The aim of MOTION is to bring together Occupational Therapists interested in researching this topic to tackle the common barriers to carrying out effectiveness research in this area, for example, lack of agreement on outcomes and outcome measurement, and Occupational Therapists working generically in community mental health services.
MOTION has recognised that the concept of ‘participation’ is increasingly becoming an important outcome for assessment in many fields, including development, disability and policy implementation. However, selecting specific instruments to measure participation has been a significant problem due to overlapping conceptual definitions and use of different theories. Furthermore, following the first meeting of the MOTION working groups, which focuses on participation as an outcome measure and measures of participation. The aim of this particular working group is to explore the literature on participation and outcome measures within adult mental health services. As a result, in order to obtain an understanding of what the term ‘participation’ means within mental health services from an occupational therapy perspective, MOTION decided to explore this topic within the #OTalk forum.
For more information about MOTION, please visit:
How is participation recognised within existing literature?
Occupational Therapy is a client-centred health profession concerned with promoting health and wellbeing through occupation. The primary goal of Occupational Therapy is to enable people to participate in the activities of everyday life. Occupational Therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do, or by modifying the occupation or the environment to better support their occupational engagement (WFOT, 2012).
Rice (2011) states that Occupational Therapy is concerned with the meaning that individuals’ place on activities and occupations that are carried out in their daily routines. Participation in these activities is influenced by an individual’s motivation, experience, abilities and limitations. Occupational Therapists are therefore trained to evaluate a person’s abilities and limitations in a variety of life spheres in order to establish a baseline performance which is used to plan for treatment and is then evaluated using a specific outcome measure – within the current service that Tori is working in, the Activity Participation Outcome Measure (APOM) is used to measure the outcome of specific domains, including; processing skills, communication and social interactions skills, life skills, role performance, balanced life style, motivation, self-esteem and affect.
Clinically, a person’s role participation becomes the focus of the Occupational Therapist when disability-related limitations affect a person’s capacity to participate in desired and meaningful roles. Occupational Therapists aim to assure that persons with a disability have the motivation, opportunity, and capacity to overcome disability-related limitations and participate in social life. The International Classification of Health, Disability and Function (ICF) defines participation as “involvement in life situations” different than it defines activities which are “the execution of a task or action by an individual”. Furthermore, the ICF states that participation naturally occurs when clients are actively involved in carrying out occupations or daily life activities they find purposeful and meaningful. More specific outcomes of Occupational Therapy interventions are multidimensional and support the end result of participation. Despite the difference in definition, the ICF places both activities and participation together within existing literature – this ambiguity has resulted in an entire thread of literature as rehabilitation researches seek to identify ways to approach the measurement of participation.
Questions to consider within the #OTalk chat:
Q1: What does the term ‘participation’ mean to you/your service users?
Q2) Is participation an important measure within mental health services, if so how?
Q3) Do you consider occupational participation throughout the occupational therapy process, if so how?
Q4) How does the physical, social, cultural environment impact on participation within inpatient and community mental health services?
Q5) How do mental health services define ‘participation’ in meaningful occupation?
College of Occupational Therapists. (2006), Recovering Ordinary Lives –the strategy for occupational therapy in mental health services 2007-2017. London: COT.
Rice, C., M. (2011). The development of an assessment protocol for activity participation in those suffering from mental illness The development of an assessment protocol for activity participation in those suffering from mental illness.
Smyth, G. (2014), “Recovering Ordinary Lives: the success, challenges and future”, Occupational Therapy News, Vol. 22, No. 9, pp. 22-23.
World Federation of Occupational Therapists. (2012). Definition of Occupational Therapy. Available: http://www.wfot.org/AboutUs/AboutOccupationalTherapy/DefinitionofOccupationalTherapy.aspx. Last accessed 15th January 2018.
#OTalk Healthcare Social Media Transcript March 13th 2018
299 Avg Tweets/Hour
7 Avg Tweets/Participant
Data for #OTalk can be up to 15 minutes delayed