#OTalk 23rd July 2019 An exploration of the application of the Vona du Toit Model of Creative Ability (VdTMoCA) in contemporary Occupational Therapy practice: the challenges, the positives, service developments, advances in practice, the future.

This weeks OTalk will be hosted by Tori Wolfendale, MSc, BSc (Hons) Research Director for the VdT Model of Creative Ability Foundation (UK) and Lead Occupational Therapist in the Secure Division at Mersey Care NHS Foundation Trust. Tori’s role within the foundation involves supporting the engagement in research activities on the Vona du Toit Model of Creative Ability (VdTMoCA).

What is the Vona du Toit Model of Creative Ability?

The VdTMoCA is an Occupational Therapy practice model originating from South Africa.  The model as presented by de Witt (2005, 2014), is founded upon the theory of creative ability developed by Vona du Toit (Occupational Therapist) in the 1960s and early 1970s.  The term ‘creative’ does not refer to artistic flair but to one’s ability to bring into existence something that did not exist before – one’s ability to bring about change within oneself and in one’s world.

The model has a developmental frame of reference combined with existentialism, phenomenology and motivation theory.  The central belief is that volition and motivation govern action and action is the manifestation or expression of motivation. Volition, motivation and action are inextricably linked, and therefore one can identify an individual’s motivation by observing the person’s action.

The model describes stages or levels of creative ability – that is, levels of volition, motivation and corresponding action (behaviours and skills – occupational performance).  These levels are sequential and there can be progression and regression through the levels. Vona du Toit believed that human beings progress through developmental levels of behaviour and skill development and are motivated to develop these in a sequential sequence. That is, we are motivated to develop a variety of skills as environmental/social/relationship/occupational demands change and influence us throughout the lifespan.  In the event of illness, trauma, injury or in response to changing life demands, we can regress to a lower level of ability.  This is recognisable in clients that prior to developing a mental illness were ‘high functioning’ or living effective daily lives.  However, with the onset of a psychotic or other illness, appear to be functioning at a lower level than previously.  For people with dementia, a continuing regression through the levels is evident.  Creative ability develops in relation to four occupational performance areas: social ability, personal management, work ability and use of free time.

What service user population can the Vona du Toit Model of Creative Ability be used with?

The model can be used with any diagnosis and severity of illness or trauma.  The model is recovery and ability focused – therefore, it seeks to identify and develop existing ability rather than identify dysfunction or deficit. In the UK, the model is used in mental health and learning disabilities services, with a significant rise in forensic mental health and learning disabilities during the last four years (VdTMoCAFoundation UK, 2013, 2016). 

How can the Vona du Toit Model of Creative Ability inform practice?

The model provides a means of performing an assessment to identify the level of creative ability and the phase of the level.  In addition, the model uniquely provides a detailed guide to treatment/intervention for the selection and use of activity, the environment and the therapeutic use of self in order to provide the ‘just right challenge’ for growth through effort in activity participation.  This guide brings together the core occupational therapy skills and enables therapists to use activity as a powerful therapeutic tool i.e. provide occupational therapy.

In the UK, the VdTMoCA is particularly valued for enabling Occupational Therapists and support workers to understand clients who are significantly limited in motivation and occupational performance and are difficult to engage and provide effective therapy for (VdTMoCA Foundation UK, 2013, 2016; Hosier et al. 2011).  Subsequently, the use of the model’s intervention guide has improved client engagement in therapy (Harvey & Fuller 2009; VdTMoCA Foundation UK, 2013, 2016; Wilson & White, 2011).  The model is also valued for improving Occupational Therapists’ and Occupational Therapy students’ confidence in their clinical reasoning (VdTMoCA Foundation UK, 2013, 2016; promoting Occupational Therapy professional language and identity (VdTMoCA Foundation UK, 2013, 2016); increasing MDT understanding of Occupational Therapy and its value to services, and improving therapists’ confidence and job satisfaction (Wilson & White 2011).

Question during the chat will include.

Q1) What is your experience of using the Vona du Toit Model of Creative Ability in practice? Please specify what area of practice you are currently working in. #OTalk #VdTMOCA

Q2) In your experience, what have been the barriers/challenges to implementing the Vona du Toit Model of Creative Ability in your practice #VdTMoCA? How have you overcome this? What strategies did you utilise? #OTalk.

Q3) How do you think the implementation of the Vona du Toit Model of Creative Ability has changed your practice? Think around assessment, developing treatment, evidencing effectiveness of 1:1/Group interventions, report writing, service user engagement, profile of the #OccupationalTherapy profession. #OTalk #VdTMOCA

Q4) What have been your particular highlights since implementing the Vona du Toit Model of Creative Ability into your practice? Please share your experiences on what has worked well, best practices! #OTalk #VdTMOCA

Q5) Has treatment been effective since you have implemented the Vona du Toit Model of Creative Ability? If so, how have you evidenced this? How have you shared with within your service user/service/clinical team? #OTalk #VdTMOCA

Q6) How useful is the #VdTMoCA when making decisions on clinical intervention? #OTalk #VdTMOCA

Q7) Next Steps: What are your future plans around the use of the Vona du Toit Model of Creative Ability? Think in terms of your service, research, quality improvement projects, training needs. We would love to hear from you, particularly around plans to contribute to the evidence base for the #VdTMOCA.

References:

de Witt, P. (2005). Creative ability: a model for psychosocial occupational therapy IN R Crouch and V Alers (2005) Occupational Therapy in Psychiatry and Mental Health. 4th edition. London: Whurr Publishers Limited

de Witt, P. (2014). Creative ability: a model for individual and group therapy for clients with psychosocial dysfunction IN R Crouch, V Alers (2014). Occupational Therapy in Psychiatry and Mental Health. 5th edition. London: Wiley Publishers.

Harvey H, Fuller K. (2009). Changing practice through MoCA. OT News, Dec, p41.

Vona du Toit Model of Creative Ability Foundation. (UK) (2013). Perspectives of the Vona du Toit Model of Creative Ability: a survey of occupational therapists and occupational therapy support workers. Vona du Toit Model of Creative Ability Foundation (UK).

Vona du Toit Model of Creative Ability Foundation. (UK) (VdTMoCAF (UK)) (2016). Gaining Momentum: The VdTMoCA Foundation (UK) Research Strategy 2016-2021. Northampton: Vona du Toit Model of Creative Ability Foundation (UK).  Available at: http://www.vdtmocafuk.com/assets/images/documents/gaining_momentum/Gaining_Momentum_VdTMoCAF_Research_Strategy.pdf (accessed on 08/07/2019).

Wilson S, White B. (2011). The journey to service redesign. OT News, August, p36-37.

 

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#OTalk 16th July – The Role of occupational therapy in safeguarding

This week Sophie Grantham @OTSophie will be hosting the chat, here is what she has to say. 

In light of recent experience in my own work setting of increased occupational therapy input in safeguarding enquiries, I felt an OTalk about the topic may help develop my own knowledge, as well as find out more about what is going on in other Occupational Therapy settings.

Safeguarding is a term used in the UK to denote measures to protect the health, wellbeing and human rights of individuals, which allow people to live free from abuse, harm and neglect (Care Act, 2014).

Safeguarding offers a framework used to put appropriate measures in to place to protect people, but if this is the case, why do we as therapists not view it quite in the same way?

Whilst our Social Work colleagues have always been involved in safeguarding, it is something Occupational Therapists appears to be increasingly involved in, and with this in mind, how can we do this, whilst keeping our Occupational values at the core?

This OTalk therefore plans to explore this topic, with the aim of learning from each other.

 

Questions:

-What is your current involvement with safeguarding? (any? Explain).

-How do safeguardings affect current practice?

-Do you feel safeguarding should be part of the Occupational Therapy role, why?

-What systems (if any) are in place currently for you to prevent safeguardings?

-How can we as Occupational Therapist’s positively prevent safeguardings?

#OTalk 9thJuly – Age Appropriate Occupations

This weeks #OTalk is on the topic of “Age Appropriate Occupations” and will be hosted by Kirstie Hughes (@Kirstie_OT).

Over the years when I have told people I enjoy building Lego I am met with responses such as “but its for Kids” or “Really, why?” and my answer is always why not?!

At this years Royal College of Occupational Therapist Annual Conference I presented an occupation station to share my love of Lego. I was hugely overwhelmed by demand for my session and the positive feedback with one attendee commenting on how he felt calm and relaxed engaging in occupational flow amongst the busy few days of conference

The queries have often left me thinking about age appropriate occupations in Occupational Therapy and the wider Health and Social Care context. Activities such as Easter bonnet making in residential homes, nursery rhymes in Learning Disabilities and Coloring in mental health services were often looked upon as “not appropriate”. As research in these areas have progressed we have an evidence base for their benefits to health and well being and they are now seen as mainstream activities, but why were they ever seen as inappropriate in the first place?

This chat aims to encourage discussion around age appropriate occupations, what impacts on them and why we stop engaging within adulthood.

Some questions to consider;

1: Do you engage with or participate in any occupations that may not be deemed as “age appropriate”? In addition to Lego building I also play PokemonGo.

2: What was your favourite occupation as a child? What did you gain from it? Do you still participate in it now? If not why not?

3: As OTs we know the importance of meaning in occupation, so does age really matter to us?

4: Is the need to provide a group activity impacting on the options available to us? Does catering for the many reduce meaningful options?

5: Are there any types of occupation based activities you would like to try within your service but have concerns around justifying them? Maybe you have tried some and was successful in your clinical reasoning?

6: Are the any new occupations you would like to try as an adult? Why barriers are there to your participation?

Post Chat

Host and On OTalk Account; @kirstieot

Online Transcript

#OTalk Healthcare Social Media Transcript July 9th 2019

The Numbers

2.351M Impressions
336 Tweets
36 Participants
269 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants