#OTalk Tuesday 30th July – Occupation v’s Activity? Intervention of doing v’s Diversion of doing. Is Occupational Therapy misunderstood and how do we counteract this?

This week one our own @OT_rach will be hosting the chat

Occupational therapy can often be difficult to describe to others. One reason for this might be some of the language we use to describe the interventions we undertake, words like occupation and activity can have different meanings to different people and other professionals.

We are sometimes challenged by what people see us doing, for example engaging people in activities. To others the reasons why this activity has been chosen, might be misunderstood or not understood in the first place. Also there is limited recommendations within NICE Guidelines and government white papers that describe the level of occupational therapy expected and how this should be delivered.

In my experience in working within acute mental health wards. There is often a presumption we are there to engage and entertain patients rather than deliver therapy. For me this is an ongoing battle as a recent CQC, report stated service users did not have enough to do, this was seen as the occupational therapist role and responsibility by the organisation I work for, and we were asked to offer activity for more hours than we currently do.

Those that work in physical settings can often be seen as discharge facilitators, perhaps not completing a comprehensive occupational therapy assessment due to the restraints and expectations of the organisation they work for.

The above are just examples of my experience but the questions below aim to provoke discussion during the chat to hopefully generate ideas on how we improve understanding of Occupational Therapy to our colleagues, organisations and service users.

Question 1) How do you describe occupational therapy to your colleagues, service users and organisations?

Question 2) What is the difference between occupation and activity?

Question 3) Have you come across a lack of understanding of what occupational therapy is? If so please give examples?

Question 4) What resources have you used to explain Occupational Therapy better to your patients, colleagues and organisations?

Question 5) What more could be done to ensure that organisations understand the role of occupational therapists?

Looking forward to the chat see you Tuesday 8pm on twitter.

Rachel

References

Nice Guidance -Mental wellbeing in over 65s: occupational therapy and physical activity interventions Public health guideline Published: 22 October 2008 nice.org.uk/guidance/ph16

Nice Guidance- Parkinson’s disease Quality standard Published: 9 February 2018 www.nice.org.uk/guidance/qs164

 

POST CHAT

Online Transcript

#OTalk Transcript July 30th 2019

The Numbers

2.448M Impressions
489 Tweets
86 Participants
39 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

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#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.

POST CHAT

HOSTTori Wolfendale, MSc, BSc (Hons) Research Director for the VdT Model of Creative Ability Foundation (UK) @VdTMoCAFUK

OTALK SUPPORT@helenotuk

Online Transcript

#OTalk Transcript July 23rd 2019

The Numbers

697.581K Impressions
193 Tweets
19 Participants
154 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

#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?

Post Chat

Host: Sophie Grantham @OTSophie

OTalk Support: Carolina @colourful_ot

Online Transcript

#OTalk Healthcare Social Media Transcript July 16th 2019

The Numbers

1.281M Impressions
253 Tweets
22 Participants
202 Avg Tweets/Hour
12 Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed

Tuesday 18th June 2019 – Reflections from #RCOT2019

This years Royal College of OT Conference is being held at the ICC in Birmingham on Monday 18th and Tuesday 19th June, 2019.  As always delegates are encourage to share their learning and impressions of conference on twitter using #RCOT2019, so if you not at the conference you can still join in the learning.   As most of the #OTalk crew will at this years conference our student intern Carolina will be leading the chat reflecting on what happened, for those travels home or those who joined in the conference via Twitter.

Question will include

Q1 Did you attend this years RCOT conference or follow it on Twitter?

Q2. What was your highlight?

Q3. Will you be changing your practice at all after something you saw or read on Twitter at the conference?

Q4. Did you meet anyone in real life that you only knew on Twitter? How was that?

Q5.  Is there anyone you think we should approach to host a #OTalk chat that you saw at conference?

Q6. What is your take home message?

POST CHAT

Host and OTalk support- Carolina

Online Transcript

#OTalk Transcript June 18th 2019

The Numbers

1.188M Impressions
259 Tweets
69 Participants
10 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

Here are the OTalk Crew at this years Conference.

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#OTalk (Research), 7th May “Developing an Occupational Therapy Research Network”

This week’s #OTalk is hosted by the Royal College of Occupational Therapists (RCOT). The chat will be co-hosted by @TheRCOT and @DrGillianWard

As part of the development of a new RCOT vision, strategy and action plan for research and development that is fit to guide the profession’s progress and direction of travel over the next 10 years we’ve held 2 previous #OTalk chats to help inform and direct this work.

One of the key themes emerging from the R&D Review and a discussion point with several contributors was a real need to invest in building the occupational therapy research community and network, with the Royal College taking a strong lead in doing this for the profession. Currently, there is no opportunity for occupational therapy researchers to come together to develop a community of practice to share their passion for research and learn how to do it better. Our last #OTalk in September 2018 was focused on Creating a vibrant occupational therapy research community – the way forward. This led to an invited networking and think tank event held at RCOT at the beginning of April 2019 where we used a co-design approach to scope out the “feel, form and function” of an Occupational Therapy Research Network (OTRN).

The purpose of the RCOT OTRN is to support the development of a research community for networking, mentoring, information sharing and to advance research capability and capacity in the occupational therapy profession across the UK. It aims to enable occupational therapists to support each other to develop and use the research evidence base to improve services we are able to offer to the individuals, groups and communities we work with. How might it work? What would it do? We need your help to expand the discussion, and that’s what we’d like to chat with you about during the #OTalk.

We are really looking forward to hearing your thoughts and ideas, which will be a very welcome contribution to the development of the RCOT Occupational Therapy Research Network. If you get a chance ahead of the #OTalk session, it would be really helpful if you could give some thought to the type of network you’d want to join and what would help you engage with it. We’d really love to hear all of the creative ideas that you can come up with as we move into the development phase of the Occupational Therapy Research Network.

The questions forming the basis of our #OTalk discussion are:

1. How do we best support the aim of the network; to support each other to develop and use the research evidence base to improve services we are able to offer?”.  How might it work? What would it do?’
2. What would be the advantages of joining an RCOT Occupational Therapy Research Network? How can we encourage people to join?
3. Many people join networks, but how can we encourage active contribution and participation?
4. The OTRN is likely to be based around a virtual network, what should we consider when designing this?

 

Thank you, I look forward to chatting with you.

Gill Ward, Research and Development Manager, Royal College of Occupational Therapists.

Post Chat

Host: Gill Ward, @DrGillianWard  Research and Development Manager, Royal College of Occupational Therapists.

Otalk Support: @hooper_ek

#OTalk Healthcare Social Media Transcript May 7th 2019

Online Transcript

The Numbers

1.054 M Impressions
257 Tweets
26 Participants
206 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

 

 

 

 

 

 

 

 

 

 

 

 

 

#OTalk 30th April 2019 – The Equality Act 2010

equality-act-2010

The OTalk. Team thought it might a good for our CPD to explore and understand UK government, legislation and acts that might impacted on our practise or could inform our knowledge and understanding better,  over the year we will host a number of chat’s looking at these sort of documents,  Please do suggest some for future chats.  

This week Rachel Booth aka @otrach will host a chat, looking at the Equality Act 2010 which cover all areas of the UK however both Scotland and Wales has devotion rights and you can find out more about them at below links.  

I’m not an expert on the equality act but here is a brief over,  and below are the questions that I will be asking during the chat,  followed by a reflect log to fill in after the chat that you can use as some evidence you have engaged in some CDP.

The Equality Act 2010 legally protects people from discrimination in the workplace and in wider society.

It replaced previous anti-discrimination laws with a single Act, making the law easier to understand and strengthening protection in some situations. It sets out the different ways in which it’s unlawful to treat someone.

It is against the law to discriminate against anyone because of:

  • age
  • gender reassignment
  • being married or in a civil partnership
  • being pregnant or on maternity leave
  • disability
  • race including colour, nationality, ethnic or national origin
  • religion or belief
  • sex
  • sexual orientation

These are called ‘protected characteristics’.

You’re protected from discrimination:

  • at work
  • in education
  • as a consumer
  • when using public services
  • when buying or renting property
  • as a member or guest of a private club or association

You’re legally protected from discrimination by the Equality Act 2010.

You’re also protected from discrimination if:

  • you’re associated with someone who has a protected characteristic, for example a family member or friend
  • you’ve complained about discrimination or supported someone else’s case.

You can do something voluntarily to help people with a protected characteristic. This is called ‘positive action’.

Taking positive action is legal if people with a protected characteristic:

  • are at a disadvantage
  • have particular needs
  • are under-represented in an activity or type of work

Disability and the Equity Act

You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities.

  • ‘substantial’ is more than minor or trivial, eg it takes much longer than it usually would to complete a daily task like getting dressed
  • ‘long-term’ means 12 months or more, eg a breathing condition that develops as a result of a lung infection

There are special rules that apply to fluctuating conditions. eg arthritis.

Discrimination can come in one of the following forms:

  • direct discrimination – treating someone with a protected characteristic less favourably than others
  • indirect discrimination – putting rules or arrangements in place that apply to everyone, but that put someone with a protected characteristic at an unfair disadvantage
  • harassment – unwanted behaviour linked to a protected characteristic that violates someone’s dignity or creates an offensive environment for them
  • victimisation – treating someone unfairly because they’ve complained about discrimination or harassment

It can be lawful to have specific rules or arrangements in place, as long as they can be justified.

More detail at https://www.gov.uk/discrimination-your-rights/how-you-can-be-discriminated-against 

Questions during the chat 

  1. Before tonights chat what was you knowledge and understanding of the equity act?
  2. Ok over to you now all please ask one question to hopefully further your knowledge and understanding (everyone is welcome to answer)
  3. How if at all do you think this act impacts on or influences you’re clinical practise?
  4. Is there anything not cover by the act that you think should be considered for future updates of the act?
  5. How can we as occupational therapist influence future acts of parliament?
  6. Don’t forget to fill in the reflective log and do you have any suggestions for future chats about government Policy, legislation and or acts.

Link to Scottish act https://www.gov.scot/publications/scottish-governments-equality-duties/

Link to welsh act http://www.legislation.gov.uk/wsi/2011/1064/pdfs/wsi_20111064_mi.pdf

References 

 https://www.gov.uk/guidance/equality-act-2010-guidance#history

https://www.legislation.gov.uk/ukpga/2010/15/pdfs/ukpga_20100015_en.pdf

Equality Act 2010

POST CHAT

Host and OTalk Support: @otrach

Online Transcript

#OTalk Healthcare Social Media Transcript April 30th 2019

The Numbers

1.542M Impressions
227 Tweets
23 Participants
182 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed

19th March 2019 #OTalk Gaming a meaningful occupation or a Damaging occupation?

This week our very own Rachel Booth @otrach will be hosting a chat looking at gaming a meaningful occupation or a Damaging occupation?

In 2018 the World Health Organisation added gaming disorder to its list of mental health conditions.

It stated

‘Gaming disorder is characterised by a pattern of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’), which may be online (i.e., over the internet) or offline.

Manifested by: 

  1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context); 
  2. 2) increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; 
  3. Continuation or escalation of gaming despite the occurrence of negative consequences. 

The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. 

The pattern of gaming behaviour may be continuous or episodic and recurrent. 

The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are severe.’

What I thought was interesting about this definition was the use of occupation functioning.

So for this week’s #OTalk I through it might be interesting to explore the use of this occupation, as a treatment tool and how as an occupational therapist we might work with someone who is given this diagnosis.

Question 1 

Do you game? If so what type and why?

Question 2

How much time do you spend gaming in an average week? 

Question 3 

What are you thoughts on the world health organisation adding addiction to gaming as category of mental disorder?  

Question 4

Do you used gaming, as an intervention/treatment? If so how and why?

Question 5

How might an occupational therapist work with someone who’s gaming behaviour pattern is of sufficient severity to result in significant impairment occupational functioning?

Question 6 

On the whole do you feel Gaming is a meaningful or damaging occupation?

Ref 

https://www.who.int/features/qa/gaming-disorder/en/

POST CHAT

Host: Rachel Booth @OT_rach

Support on OTalk account: @Colourful_OT

Online Transcript

#OTalk Healthcare Social Media Transcript March 19th 2019

The Numbers

980.895K Impressions
323 Tweets
29 Participants
162 Avg Tweets/Hour
11 Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed