#OTalk 26th June 2018- Mental Capacity Act and Deprivation of Liberty Safeguards.

This weeks chat is on the topic of the Mental Capacity Act (MCA) and The Deprivation of Liberty Safeguards (DoLs) and will be hosted by Sarah Sharland (@SarahSharland19).  Here is what Sarah had to say…

The Mental Capacity Act 2005 came into force in 2007. It was designed to protect those who were deemed vulnerable or who may have an impaired ability to make decisions for any reason that affects the functioning of their minds. It can also be used to support those who do have capacity and are planning for their future care needs. Everyone working within the MCA should feel confident in applying the principles and supporting people to make decisions for themselves. Should the person be assessed as lacking capacity, then any decision regarding their care should be made in their best interests.

The Deprivation of Liberty Safeguards (DOLS) were brought in as a result of a Supreme Court ruling, as an amendment to the MCA 2005, and apply in only England and Wales. They ensure that when restraints and restrictions are used under the Act, that the person is protected and represented. They also ensure that any implementations are the least restrictive possible and are regularly reviewed. DOLS can only be used if the person is being deprived of their liberty in a care home or hospital. As part of the legislation, the person must have an advocate or representative, and they also have the ability to challenge or appeal the authorisations within the legal system.

Questions for the OTalk chat:

  1. How does the Mental Capacity Act affect your practice?
  2. Are you involved in mental capacity assessments, and what is your role/setting?
  3. How confident do you feel in your knowledge of the Mental Capacity Act? Please give reasons for this (training, experience etc)
  4. How confident do you feel in your knowledge of the Deprivation of Liberty Safeguards? Please give reasons for this (training, experience etc)
  5. What do you think are the benefits of involving occupational therapists in MCA and DOLS assessments?

#OTalk 19th June 2018 – Can you meet the RCOT strategic Intentions and keep occupation at the focus of your practise?

This week our own Rachel Booth @OT_rach will host the chat, following on from a pledge she made at this years Royal College of Occupational Therapists (RCOT) annual conference. #RCOT2018

During the conference we were asked to make a pledge about how we would do our part to ensure the new strategic intentions are met.

RCOT’s Strategic Intentions represent their leadership response to the challenges of the changing landscape of health and social care.

They position occupational therapy as a key contributor to the health and wellbeing of UK citizens and provide a framework for how the Royal College will support its staff, members and the wider profession.

Strategic intention 1

Position the profession, and our members, for the 21st century

Strategic intention 2

Enhance the profile of the profession to a range of audiences

Strategic intention 3

Ensure RCOT is a thriving membership organisation within which members flourish. 

You can watch the launch video here. https://www.youtube.com/watch?reload=9&v=bFF5PoVngKM

One of the things that struck me about lots of the pledges and the conference its self was the idea we need to ensure ‘occupation’ is central to our work.  I’m guilty of losing the occupation as I concentrate on all the daily tasks we are told we need to compete, and want to learn from others as to how to reintroduce this focus. 

We are the experts in ‘occupation’ and need to ensure that our practise holds this at its heart. My pledge was to host a #OTalk on what do we really mean by occupation? Hence tonights chat. 

The Questions 

Question 1 : Before tonight’s chat had you heard of RCOT’S strategic intentions? If so what are your thoughts? How do you think they could be met?

Question 2: What is you’re understanding of ‘occupation’ and it’s meaning with occupational therapy?

Question 3 How do you describe occupation to your colleagues and users of your service?

Question 4: How do you or can you ensure you are ‘occupation’ focused in your interventions?

Question 5: What if anything will you do differently to put ‘occupation’ at the heart of what you do?

Question 6: What is your pledge to meet the RCOT strategic intentions?

Post Chat

Hosting the chat Rachel Booth @OT_rach

On the @OTalk_ account for support Kirstie @kirstie_OT

Online Transcript

#OTalk Healthcare Social Media Transcript June 19th 2018

The Numbers

1.843M Impressions
516 Tweets
45 Participants
413 Avg Tweets/Hour
11 Avg Tweets/Participant

#OTalk Participants


#OTalk 29th May – Implementing the recovery approach in OT practice.

This weeks #Otalk is on the topic of “the recovery approach” and will be hosted by Jenny Hong (@OTJennyH).

Here is what Jenny had to say…

I’m currently in my last year of an OT course at Brunel University London. I have a range of interests in occupational therapy, from forensic and pediatrics settings to green care, animal-assisted therapy and recovery approaches. I’m continuously exploring every area I am exposed to in order to gain understanding, both personally and professionally. As most of my research currently focus on OT and the recovery model within mental health, I want to host a OTalk session to discuss and understand the different perspectives members within this profession have in regards to this area. I also hope this session provides opportunities for members to reflect on their practice and future work.

The recovery model applied to psychiatric settings is comparatively recent. The National Institute for Mental Health in England (NIMHE) guiding statement on recovery includes guiding principles to deliver recovery-oriented mental health services (2005). At the beginning of the 21st century, the United Kingdom’s government policy and guidance took a recovery and hope approach to mental health and illness, as described by Rankin’s (2005) Rethink press release. Themes in this approach include recovery, employment, social inclusion, equality, and health improvement (COT, 2006). Mental health services are currently being redesigned under new policy and legislation to focus on integrating recovery, vocational opportunities, and social inclusion within communities to meet the needs of patients and in turn, providing equal opportunity and better mental and physical wellbeing (COT, 2006).

These recovery ideals closely align with values of occupational therapy in using a holistic, client-centred and client-led approach, highlighting strengths, monitoring outcomes, and emphasising hope towards recovery (COT, 2006). The Royal College of Occupational Therapists (RCOT) defines autonomy to be “the freedom to make choices based on consideration of internal and external circumstances and to act on these choices” for occupational engagement and participation to lead a meaningful life (ENOTHE, 2004). Therefore, occupational therapy is pivotal and valuable to empower patient autonomy-promoting occupational engagement and supporting patient recovery. As the recovery approaches/principles are currently expected in occupational therapy practice, I’d like to explore how qualified OTs/prospective OTs perceive this.

So my questions to you are:

  1. Have you used recovery approaches/principles in your work as a qualified OT? If so, did these approaches originate from the recovery model or OT frameworks/models? If not, why?
  2. If you’re a prospective OT, how would you include recovery principles in your future OT practice?
  3. What are your thoughts in using recovery principles in OT work?
  4. How do you think your clients/service users understand your therapy work? Are recovery principles explicitly demonstrated in your interventions?
  5. Currently, there is no guidance for OTs to apply recovery approaches by RCOT. What are your thoughts about this? Should RCOT follow the AOTA and OTAustralia by releasing explicit guidance on this for OTs in the UK?

Post Chat

The Host Jenny Hong @OTJennyH

On the OTalk account Rachel @OT_rach

Online Transcript

#OTalk Healthcare Social Media Transcript May 29th 2018

The Numbers

740.102K Impressions
233 Tweets
26 Participants
186 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants


#OTalk 22nd May 2018 – The role of Occupational Therapy in compulsive hoarding

This weeks #Otalk is on the topic of “hoarding” and will be hosted by Orla Hughes (@Orlatheot).

What is compulsive hoarding?

Compulsive hoarding, or hoarding disorder, is a pattern of behaviour that is identified by the following characteristics:

  1. Having difficulty or an inability to discard possessions (NHS Choices, 2015).
  2. Excessively acquiring objects, regardless of their monetary value, which prevents use of living and work spaces (Tolin, Frost, and Steketee, 2014).
  3. As a result, considerable impairment or distress in occupational, social, or other critical areas of functioning is present (American Psychiatric Association, 2013).
  4. The hoarding symptoms are not restricted to symptoms of another mental or physical condition, for example, food storing issues as a symptom of Prader-Willi Syndrome (Mataix-Cols et al., 2010).

This condition was formerly recognised to be a symptom of obsessive–compulsive disorder (OCD) but due to recent research, it is now classed as a separate diagnostic entity by healthcare providers and in the Diagnostic and Statistical Manual of Mental Disorders (Pertusa et al., 2010; Royal College of Psychiatrists, 2016).

The prevalence of compulsive hoarding

Clients who have the behaviours of hoarding and acquiring are common issues faced by staff in health, social-care, housing and environmental services (Dissanayake, 2012). A prevalence rate of 2-5% in the population have been found through studies in Europe and the United States (Bratiotis, Schmalsich and Steketee, 2011). Yet, when analysing these figures, in studies such as Samuels et al. (2008), it is not clear whether the 4% of participants who were found to compulsively hoard would have met the new diagnostic criteria outlined for the condition in this study. As a result, more research is needed in this field to quantify the population who compulsively hoard.

Current MDT practice

Although guidance is provided for working with hoarding symptoms within OCD, there is no specific guidance for working with compulsive hoarding (NICE, 2005). However, the NHS Choices website describes the condition and recommends Cognitive Behavioural Therapy (CBT) as the common treatment for the condition (NHS, 2015). A comprehensive search of the literature, from the fields of psychology and psychiatry, revealed that compulsive hoarding is mainly treated with both CBT and medication (Tolin D.F. et al., 2015). Serotoninergic drugs, such as fluvoxamine, have seen benefits for clients, yet no medication is currently advertising to treat compulsive hoarding (Saxena, 2008; Soares, Fernandes, and Morgado, 2016). CBT can include motivational interviewing, psychoeducation, developing cognitive techniques highlighting dysfunctional beliefs, and the graded discarding and sorting of items (Steketee and Frost, 2014). This combination has shown modest clinically-significant results for clients finishing treatments and therefore papers call for further studies to investigate the issues these clients confront and how to improve their well-being (Tolin D.F. et al., 2015; Vilaverde, Gonçalves, and Morgado, 2017).

Compulsive hoarding and occupational therapy

Compulsive hoarding can decrease occupational engagement in many areas of life, appropriate for occupational therapy input, such as functional independence, roles, and the social and physical environment (Dissanayake, 2012). Recent quantitative research, conducted by Dissanayake, Barnard, and Willis (2017), investigates the role of occupational therapy in the assessment and treatment of compulsive hoarding and calls for further research involving occupational therapy and this population which can begin to inform clinical practice.

Here are the questions we will be discussing:

  1. How would compulsive hoarding affect a person, how they perform their occupations, and interact with their environment?
  2. Do you feel equipped to work collaboratively with this population?
  3. What ethical issues do you predict you would encounter with this population?
  4. What occupational therapy interventions could be utilised?
  5. Finally, what could the role of occupational therapy be in this setting (the assessment and treatment of compulsive hoarding)?


American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders. 5th edn. Arlington, VA: American Psychiatric Publishing.

Bratiotis, C., Schmalisch, S., and Steketee, G. (2011) The Hoarding Handbook: A Guide for Human Service Professionals. Oxford: Oxford University Press.

Dissanayake, S. (2012) ‘Clearing the Clutter,’ in OT News, February 20 (2) pp.24-25 published by The Royal College of Occupational Therapists: London, UK

Dissanayake, S., Barnard, E., & Willis, S. (2017): “The emerging role of Occupational Therapists in the assessment and treatment of compulsive hoarding: An exploratory study”. New Zealand Journal of Occupational Therapy, 64 (2) 22-30.

Mataix-Cols D, et al. (2010) ‘Hoarding disorder: a new diagnosis for DSM-V?,’ Depression Anxiety, 27(1), pp. 556–572.

NHS Choices (2015) Hoarding Disorder. Available at: https://www.nhs.uk/conditions/hoarding-disorder/ (Accessed on 2nd December 2017).

NICE (2005) Obessive-compulsive disorder. Available at: https://www.nice.org.uk/guidance/cg31/evidence/cg31-obsessivecompulsive-disorder-full-guideline2 (Accessed on 22nd February).

Pertusa A, et al. ‘Refining the diagnostic boundaries of compulsive hoarding: a critical review,’ Clinical Psychology Review, 30(1), pp. 371–386.

Polkinghorne, D.E. (1989) ‘Phenomenological research methods,’ In R.S Valle and S. Halling (Eds.), Existential phenomenological perspectives in psychology. New York, NY: Plenum Press, pp.41-60.

Royal College of Psychiatrists (2016) Hoarding. Available at: http://www.rcpsych.ac.uk/healthadvice/problemsanddisorders/hoarding.aspx (Accessed on 2nd December 2017).

Samuels J.F. et al. (2008) ‘Prevalence and correlates of hoarding behavior in a community-based sample,’ Behav Res Ther, 46(1), pp. 836–844.

Saxena S. (2008) ‘Neurobiology and treatment of compulsive hoarding,’ CNS Spectrum, 13(14), pp. 29–36.

Soares, C., Fernandes, N., and Morgado, P. (2016) ‘A review of pharmacologic treatment for compulsive buying disorder,’ CNS Drugs 30(4) pp. 281–91.

Steketee, G., and Frost, R. O. (2014) Compulsive hoarding and acquiring: Therapist guide. 2nd edn. New York, NY: Oxford University Press

Tolin, D.F., Frost, R.O., and Steketee, G. (2014) Buried in Treasures. Help for Complusive Acquiring, Saving, and Hoarding. Oxford: Oxford University Press.

Tolin D.F. et al. (2015) ‘Cognitive behavioral therapy for hoarding disorder: a meta-analysis,’ Depression Anxiety, 32(3), pp. 158–66.

Vilaverde, D., Gonçalves, J., and Morgado, P. (2017) ‘Hoarding Disorder: A Case Report,’ Frontiers in Psychiatry. Available at: https://www.frontiersin.org/articles/10.3389/fpsyt.2017.00112/full (Accessed on 10th November 2017).

Post Chat

Chat Host: Orla Hughes @Orlatheot

On the #OTalk Account: Kelly @otonthetracks

Online Transcript

#OTalk Healthcare Social Media Transcript May 22nd 2018

The Numbers

900.755K Impressions
329 Tweets
34 Participants
263 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

#OTalk 8th May 2018 – Podcasts as a Tool for CPD

This weeks #OTalk is on the topic of “Podcasts as a Tool for Continuing Professional Development” and will be hosted by Stephanie Lancaster (@TheOutLoudOT).

Stephanie Lancaster has practiced as an OT for over 25 years.  She is currently an assistant professor in the Department of Occupational Therapy at the University of Tennessee Health Science Center in Memphis. Stephanie blogs at www.stephanielancaster.com and hosts a podcast for people interested in OT called On The air (www.OnTheAir.us). She is currently pursuing a doctorate in education in the field of Instructional Design & Technology and is writing a dissertation on the impact of podcasting on the education and growth of occupational therapy students.

Here is what Stephanie had to say… A podcast is generally described as a series of digital audio files that can be accessed online and downloaded and listened to on an electronic device. The term podcast was coined in 2004 by British journalist Ben Hammersley through a combination of the words iPod and broadcast.  Since that time, podcast carriers such as iTunes have helped to propel this type of media file into popularity, with millions of downloads and live or on-demand daily across the globe. Podcasting has begun to be explored in formal education settings as an educational technology tool that has been used at an increased frequency in recent years for a variety of reasons. The range, flexibility, ease of use, accessibility, and affordability (most podcasts can be accessed for free) of podcasts make this medium a viable platform for learning not just for students but also for individuals seeking professional development, including occupational therapy practitioners. With a variety of learning opportunities available through listening to podcasts, this technology opens up options for learning about a wide variety of topics related to the practice of occupational therapy.

Questions for the OTalk Chat:

Q1: How often do you listen to podcasts?

Q2: What do you see as the benefits of listening to podcasts?

Q3: Do you feel that listening to podcasts helps you to learn and grow professionally?

Q4: How often you reflect on, think about, and/or talk about things you have heard on podcasts after you listen?

Q5: What podcast and/or podcast episode do you recommend that others in the field of OT listen to and why?

Post Chat

Chat Host: Stephanie Lancaster @TheOutLoudOT

On the #OTalk Account: @helenotuk

Online Transcript

#OTalk Healthcare Social Media Transcript May 8th 2018

The Numbers

514.598K Impressions
219 Tweets
29 Participants
175 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants



#OTalk 24 April – Occupational therapy and volunteering


This weeks #Otalk is on the topic of “volunteering” and will be hosted by Orla Hughes (@Orlatheot).

At the RCOT 2018 conference in June, I will be presenting a personal reflection on how I used my occupational therapy skills when volunteering last year. The aim of the presentation is to encourage others (especially students) to develop their professional skills by taking up volunteering roles at home or abroad. I hope this Twitter chat can help us recognise and reflect on the value we bring to our volunteer roles.

Here are the questions we will be discussing:

  1. Hello! Please introduce yourself and answer Q.1 which is ‘Have you ever volunteered, or do you currently volunteer with an organisation? Tell us about it.’
  2. What barriers stop you from volunteering?
  3. What do you enjoy about volunteering? Does it benefit you?
  4. What occupational therapy skills have you used in a volunteer role? Tell us about how you used them. What do occupational therapists bring that others do not?
  5. Do you think it is useful to volunteer abroad or is it better to volunteer locally where you are ‘culturally relevant’?
  6. Do you record your volunteer experience as CPD evidence? If so, how?
  7. Can you identity new roles for occupational therapy in the organisations that you have or still volunteered with?
  8. Finally, sharing is caring! Please share any opportunities where organisations are looking for volunteers. Do you know any organisations that provide funding for volunteer projects? Or even any literature on the topic of volunteering?


Leading the chat Orla Hughes (@Orlatheot) 

On the @OTalk_ account Carolina Cordero @colourful_ot  

Online Transcript

#OTalk Healthcare Social Media Transcript April 24th 2018

1.337M Impressions
329 Tweets
32 Participants
263 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

















#OTalk 17th April – OT and personality disorder.

This weeks #Otalk is on the topic of “OT and personality disorder” and will be hosted by Keir Harding (@KeirWales).

Here is what Keir had to say…

April the 16th is the first ever conference for Occupational Therapists working within the field of Personality Disorder.  We thought it would be good to take some of the learning from the conference and take it outside of the room so on April 17th, #Otalk is dedicated to exploring the themes of the conference.

Personality disorder is a highly contentious diagnosis associated with high levels of stigma and exclusion from services.  Staff often find the difficulties around self harm and suicide difficult to work with.  The challenges of working with people who find others to be threatening and untrustworthy can also impact on clinicians feeling effective.  Often the environment around people with this diagnosis adds to the stigma by labelling them as attention seeking and manipulative.

While there is a temptation to think that this is particularly related to the field of mental health, it’s worth remembering the people who get this diagnosis are over represented in physical health, particularly in the areas of fibromyalgia, chronic pain, diabetes and arthritis.  With a prevalence of around 1 in 10 of the population, the chances are high that we are working with people who might meet the criteria for this diagnosis – whether as our patients or colleagues.   As OTs, we could argue that we are less likely to be affected by stigma due to our tendency to be less focused on diagnosis.

The questions for the night might well be subject to change but for now….

1 – Should the diagnosis of Personality Disorder have any impact on how we work with people?

2 – Are standardised assessments useful for working with this client group (What do you use?)

3 – Specific OT or Manualised treatment done by OTs.  Where should we lean?

4 – What it the future of OT for people who are given this diagnosis?

Post Chat

Online Transcript from the #OT4PD on 16th April 2018

Online Transcript from the #otalk chat

PDF. #OTalk Healthcare Social Media Transcript April 17th 2018

The Numbers

1.883M Impressions
455 Tweets
49 Participants
364 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants