OTalk

#OTalk – 16th March 2021 – OT Time Out – A Virtual Support Network for Newly Qualified OTs

This weeks chat will be hosted by Laura Rossiter @OTTimeout1

It is understandable that upon entering clinical practice we can experience a plethora of emotions. These can range from excitement and pride to anxiety and fear. Working in the healthcare sector can be challenging and exhausting for anyone, regardless of how long they have been in the role. Limited experience and that little word beginning with C and ending with 19, can certainly exacerbate any concerns that newly qualified OTs (NQOTs) have.

In these uncertain and unprecedented times, many NQOTs are starting new posts working remotely, interacting with not only service users that they have never met but colleagues too. They are working in psychologically demanding, traumatic situations with reduced opportunities for supervision and support, and without a point of reference for knowing what that setting was like pre-COVID. How much does real-life Occupational Therapy practice during a pandemic differ from services pre-COVID and then again from the theory and models we are taught in our training?

The Elizabeth Casson Trust has awarded a grant to The University of Southampton to create a virtual support network for the 1,120 NQOTs across the UK. We have called this network OT Time Out. On two dates each month, OTs can attend meetings for free over Microsoft Teams with up to seven other OTs. Meetings are facilitated by members of the OT Teaching team at the University of Southampton. OTs can discuss any concerns – do they feel happy and well? Do they have a good work-life balance? Do they feel supported? Are they able to manage stress? Are they enjoying their role? This is a place for honest and supportive listening and discussion where every OT is welcome.

We invite you to attend our OTalk on 16th March to talk about the needs of NQOTs and the network that we have set up.

  1. What did it feel like when you entered practice as an OT?
  2. What does it feel like (or what do you think it feels like) to enter practice during COVID-19? 
  3. What would you like from a virtual support network for newly qualified OTs?
  4. What can workplaces do to support newly qualified OTs?

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OTalk

#OTalk – 9th March 2021 – The role of occupational therapy in the charity sector

This chat will be hosted by Dr Naomi Graham @growinghopeuk.

The COVID-19 pandemic seems to have heightened the awareness of health and wellbeing needs across our nation and the need for intervention, particularly for the most vulnerable. Researchers such as Horridge et al. (2019) and Stuckler et al. (2017) discussed the impact of austerity on health and wellbeing for various populations. Horridge et al. (2019) reported that families of children with additional needs have experienced a cut in therapy services across the past ten years. The National Autistic Society (2020) found in a survey during COVID-19 that 1 in 5 families had to reduce their work during lockdown so that they could care for a family member who has autism.

As a children’s occupational therapist experiencing first-hand the service cuts for the families I was working with I decided to found a charity in 2017 – Growing Hope (@growinghopeuk). Growing Hope provides free therapy for children and young people with additional needs in partnership with local churches across the UK. We aim to grow hope for children, hope for families and hope in Jesus. Growing Hope is open to all individuals regardless of their background and beliefs. We have set up a model which aims to use local communities existing resources (such as space within churches) to provide free healthcare services for families of children with additional needs. We are trying to provide a holistic approach and therefore run groups for siblings and parents and carers to discuss and process their experience.

We now have two local clinics in King’s Cross and Brockley, London, and we have potential clinics in cities outside of London in the pipeline to launch in 2021. As a charity we want to be working with children’s occupational therapists, physiotherapists, speech and language therapists and other members of the MDT so that we can support the families who are currently missing out. We want to find out about other charities who are providing occupational therapy and how charities can work with existing NHS therapy teams in order to best support the clients we work with.

Questions:

Are there other charities who are providing occupational therapy for free to meet a gap for their client group?

  1. What are the benefits of responding to client needs through the charity sector?
  1. What does the occupational therapist role in the charity sector look like?
  1. How can therapists working within the charity sector connect with NHS teams to provide further intervention for individuals who need support?
  1. What has the impact of COVID-19 been on your client base? How have you seen austerity play out for clients that you’re working with?

References:

Horridge, K.A., Dew, R., Chatelin, A., Seal, A., Macias, L.M., Cioni, G., Kachmar, O., Wilkes, S. and (2019), Austerity and families with disabled children: a European survey. Dev Med Child Neurol, 61: 329-336. doi:10.1111/dmcn.13978

National Autistic Society. 2020. Left stranded: The impact of coronavirus on autistic people and their families in the UK.  [Online] . [29 September 2020]. Available from: https://s4.chorus-mk.thirdlight.com/file/1573224908/63117952292/width=-1/height=-1/format=-1/fit=scale/t=444295/e=never/k=da5c189a/LeftStranded%20Report.pdf

Stuckler, D., Reeves, A., Loopstra, R., Karanikolos, M., McKee, M., (2017) Austerity and health: the impact in the UK and Europe, European Journal of Public Health, Volume 27, Issue suppl_4, October 2017, Pages 18–21, https://doi.org/10.1093/eurpub/ckx167

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OTalk

#OTalk Research – 2nd March 2021 – Are failure and rejection an inescapable aspect of research or an opportunity for learning?

Hi, my name is Sarah (@SLawsonOT) I am an occupational therapist, PhD Candidate and lecturer @GlyndwrOT. Before I begin I would like to say a huge thank you to Dr Jenny Preston (@Preston_Jenny) for her time, support and encouragement in writing this blog.

In this #OTalk Research I’d like to explore what often seems to be a taboo subject – failure and rejection within research. That feeling of disappointment that I’ve let myself and others down, that I did not present the best of myself, that I could have, should have done better, that I and my research is not good enough.  

Evidence based theories of interpersonal acceptance-rejection theory acknowledge that some people are better able to cope with experiences of perceived rejection than are other individuals (Rohner, 2016).  Rejection is frequently perceived as a rite of passage as we transition into research careers.   

Since I began my part time PhD in 2017, I’ve been inspired by people like @NHopUTS whose pinned Tweet is a picture of his office door with copies of all his rejection letters for everyone to see.  On his website (NickHop.wordpress) Nick also includes a whole section of blogs about rejection. Then I saw a tweet from @raulpacheco also talking about rejection.  

Like many others I know that I have experienced rejection and a sense of failure in many aspects of my life, jobs I applied for and didn’t get, failed relationships, failed exams and viva’s.  This also extends to my research career with abstracts rejected, an unsuccessful grant funding application, presentations that didn’t go as well as expected, or aspects of my research that have challenged me.  Just as we use our life experiences to learn, grow and build resilience, how can we access strategies and resources to help us cope within our research careers and activities?  It may take a while, and with a lot of reflection but how do we use our experiences of each failure/rejection to enhance our opportunities and deepen our understanding of ourselves as both a researcher and a person.

Whichever term you prefer to use, rejection, failure, disappointment, frustration are all common features of engaging in research but they are often the areas which are rarely, publicly talked about – not only in research but in any walk of life.

  1. What are your experiences of rejection or failure within research? 
  2. Thinking about your research, how do you overcome the rejection? Did you respond, if so how? What was the outcome? 
  3. How do you pick yourself back up and carry on? What strategies have you developed?
  4. What have you learnt from your experiences of rejection or failure within your research?
  5. What is your fear of rejection or failure stopping you from doing? 
  6. What are you going to now? When are you going to do it? Who can you contact for support? What is your plan? 

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OTalk

#OTalk 23 February 2021 – The challenges and opportunities of delivering occupation-focused interventions in secure mental health services

This week’s chat is hosted by @ForensicOT_ELFT, the Official Twitter account for the East London Foundation Trust Forensic Occupational Therapy teams working at the John Howard Centre in Hackney and Wolfson House in Haringey.

Service users admitted to secure mental health services are typically defined as forensic patients. Based on the determination of what is both clinically appropriate and safe, forensic patients may be detained in mental health facilities or in the community. Forensic mental health services have a dual responsibility, to both treat the person with mental illness and protect the community, with a significant focus on safety (Whiteford G at al., 2019).

Forensic patients can be subject to lengthy admissions and may also experience stigma associated with their forensic status. Key outcome measures in current forensic mental health service provision include limiting the risk of relapse, readmission and engagement in unsafe behaviours. However, these foci may come at the expense of opportunities for occupational engagement and can result in occupational deprivation. Research suggests that the long-term effects on people living in occupationally restricted environments include social isolation and exclusion (Whiteford G at al., 2019).

The role of occupational therapy in any mental health setting is to enable people to maximise their independence in productivity, self-care and leisure through occupation. The ultimate aim of occupational therapy in a forensic mental health setting, however, is to enable patients to experience occupational enrichment and achieve optimal occupational functioning (RCOT, 2019). 

The focus of the occupational therapy teams working at the John Howard Centre and Wolfson House is to provide occupation-focused interventions which ensure occupational enrichment and reduce the risk of occupational deprivation, and the negative long term effects this can have on patients. 

Questions to consider

  1. What are your perceptions of, or experience of working in, forensic occupational therapy?
  1. What is your understanding of occupational deprivation?
  1. What is your understanding of occupational enrichment?
  1. What do you think the challenges may be working in a forensic mental health setting?
  1. What do you think the occupation-focused opportunities are working in this setting? 

References

Whiteford G at al. (2019) Combatting occupational deprivation and advancing occupational justice in institutional settings: Using a practice-based enquiry approach for service transformation. British Journal of Occupational Therapy. Volume: 83 issue: 1, page(s): 52-61

Royal College of Occupational Therapy (2019) Occupational therapists’ use of occupation-focused practice in secure hospitals Practice guideline (Second edition)

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OTalk

#OTalk – 16th February 2021 – Occupational Therapy and Substance Use

This week #OTalk will be hosted by Rachel Rule @_rachelOT.

Opp (2021) states that people who engage in substance use, or are recovering from addictions to substances could benefit from interventions focusing on re-establishing the roles and identities that are most meaningful to them. Occupational therapy considers a person’s identity, hopes and aspirations, their roles in life, their relationships and their individual ability to fulfil these within their physical and social existence (Duncan, 2011). Considering this, Occupational Therapists are in a unique position to work therapeutically with people living with, or recovering from, addiction to substances (Opp, 2021).

When considering Dual Diagnosis, in the United Kingdom, NICE Guidelines (2016) recommend the input of Occupational Therapists as one of the core professions to include in the care planning for people living with a Dual Diagnosis. Further, in exploring the self-identified occupational competencies of people recovering from
addiction, Davies and Cameron (2010) found that three of the four top items that people wanted to change were skills based; particularly focusing on financial management, domestic tasks and personal care.

Occupational Therapists are equipped to meet people ‘where they are at’ and utilise tools in Motivational Interviewing when people remain in the contemplative stage of change (Prochaska, 1983), or to utilise skills in Identity Transformation when people reduce, or stop their substance use (Best et al., 2015). Wasmuth et al., (2014) considered addiction as an occupation, which links to the concept of the Dark Side of Occupation (Twinley, 2013), and considers how addiction is a central component of people’s everyday occupational lives. Addiction can provide routine in daily life and a sense of stability in a person’s identity (Wasmuth et al., 2014), but it can also lead to occupational imbalance (Wanigaratne et al., 1990). Therefore, when people begin their journey of recovery from substance use, they can be left with an occupational deficit. Recovery from addiction is said to involve re-engaging with a person’s meaningful occupations, supporting the development if an identity away from substance use (Stoffel and Moyers, 2004, Strickler et al., 2009).

Working as an Occupational Therapist in an Assertive Outreach Team, I meet many people living with a Dual Diagnosis. I hope to use this #OTalk to discuss the role of Occupational Therapy in working with people living with addictions in other areas of the UK (and the world!) and make connections.

Questions:

  1. What brings you to this #OTalk about Occupational Therapy and Substance Use today?
  2. In your experience of working with people who use substances, are Occupational Therapists common within your teams?
  3.  Substance use can raise judgements in society and practice, what helps you to keep these judgements in check personally, in your MDT and in wider society?

References:
Best, D. et al. (2015) ‘Overcoming alcohol and other drug addiction as a process of social identity transition: the social identity model of recovery (SIMOR)’, Addiction Research and Theory, (2), pp. 111-123.
Davies, R. and Cameron, J. (2010) ‘Self identified occupational competencies, limitations and priorities for change in the occupational lives of people with drug misuse problems’, British Journal of Occupational Therapy, 73(6), pp. 251-260.
Duncan, E. (2011) Foundations for Practice in Occupational Therapy. (5th ed.) China: Elsevier Ltd.
NICE (2016) ‘Coexisting severe mental illness and substance misuse: community health and social care services’. Available at: https://www.nice.org.uk/guidance/ng58/chapter/Recommendations (Accessed
14.1.2021)
Opp, A. (2021) ‘Recovery with purpose: Occupational Therapy and Drug and Alcohol Abuse’. Available at: https://www.aota.org/About-OccupationalTherapy/Professionals/MH/Articles/RecoveryWithPurpose.aspx (Accessed: 14.1.2021)

Prochaska, J. O. and DiClemente, C. C. (1983) ‘Stages and processes of self- change of smoking: toward an integrative model of change’, Journal of Consulting and Clinical Psychology, 51(3), pp. 390–395.
Stoffel, V. and Moyers, P. (2004) ‘An evidence based occupational therapy perspective of interventions for people with substance-use disorders’, American Journal of Occupational Therapy, 58(5), pp. 570-586.
Strickler, D. C. et al., (2009) ‘First person accounts of long-term employment activity among people with dual diagnosis’, Psychiatric Rehabilitation Journal, 32(4), pp. 261-68.
Twinley, R. (2013) ‘The dark side of occupation: a concept for consideration’, Australian Occupational Therapy Journal, 60(4), pp. 301-303.Wanigaratne, S. et al., (1990) Relapse prevention for addictive behaviours: a manual
for therapists. Oxford: Blackwell Science.
Wasmuth, S, Crabtree, J. and Scott, P. (2014) ‘Exploring addiction-as-occupation.
British Journal of Occupational Therapy’, 77(12), pp. 605–613.

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