OTalk

#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

#OTalk -23 April 2019 – Continuing Professional Development

Hello #OTalk, this evening we thought it would a good idea to have a general chat about all things Continued Professional Development. It has been a little while since we had a general chat on this topic, but here are a few links to previous chats we have had to help get our thoughts flowing….

#OTalk 10th April 2018 – How to record your CPD

#OTalk 17th October – CPD and service quality

#OTalk 11th July – CPD is more than HCPC audit. How to strategically manage your Continuing Professional Development.

#OTalk 29th March OT – Shifting CPD Focus

The following are some posters and articles that are of course always worth a mention

#COT2017 Clicking your way through continuing professional development? Poster 26

the above poster was also followed up with this article 
Attitudes to social media use as a platform for Continuing Professional Development (CPD) within occupational therapy

and of course  The use of Twitter for continuing professional development within occupational therapy  (Open Access).

As a predominantly UK based chat most of those who join us will be either currently or due to register with the Health and Care Professions Council (HCPC). Whilst engaging in CPD is not all about audit it is wise to ensure that you utilise your CPD activity in a way that will support your profile if are are called for audit. Here is a link to the HCPC’s CPD resources https://www.hcpc-uk.org/cpd/

To aid us in answering your questions please fill in this quick form to help us keep track of the questions and  ensure that we don’t miss any of your questions during the chat My question about CPD for the general chat on 23rd April 2019.

We look forward to asking all your questions of the community and supporting another great chat.

POST CHAT

Host and on the OTalk : @helenotuk

Online Transcript

#OTalk Healthcare Social Media Transcript April 23rd 2019

The Numbers

1.096M Impressions
195 Tweets
27 Participants
156 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

 

 

OTalk

#OTalk – 8th January 2019 – ResOTlutions!

note notebook notes page

Hello and welcome to the 1st #OTalk of 2019, as requested by the community, the first chat of the year has become a regular resOTlutions chat. This not only gives us a good opportunity to have a nice relaxing chat to get us back into the swing of things after our Christmas and New Year break, but enables the community to share ideas of what they have planned for CPD in 2019 and/or ask the community for ideas if we are stuck for creative and interesting things to keep our CPD fresh.

With that in mind this weeks chat will be a informal relaxed discussion. But just to get you thinking we still have some questions to get things going…..

  1. How often do you review your CPD activities? Have you reviewed them recently?
  2. Do you have a strategic overview of your CPD activities?
  3. How do you decide you have covered a topic or need to cover a topic?
  4. What are your current CPD priorities?
  5. What CPD activities did you completed in 2018 that you really enjoyed? – This may give others some ideas of things to do.
  6. Do you have any topics that you feel you need to explore but don’t have a plan on how to do so yet? – Ask the community they may have some ideas to help you.

Please also feel free to ask questions and discuss anything you wish in relation to planning for your CPD and setting CPD goals.

Post Chat

Host and Otalk Support – @helenotuk

#otalk healthcare social media transcript january 8th 2019

Online Transcript

The Numbers

574.354KImpressions
131Tweets
20Participants
105Avg Tweets/Hour
7Avg Tweets/Participant

#OTalk Participants

 

 

OTalk

#OTalk 9th October 2018 – The #Iamchallengingbehaviour Campaign 

This weeks #OTalk is on the topic of “#Iamchallengingbehaviour” and will be hosted by the RCOT Specialist Section for People with Learning Disabilities along with support from Sam Sly (@RCOT_PLD and @SamSly2).

Here is what they had to say…

What is the I AM challenging campaign?

The I AM challenging campaign started in early 2017 with Nic Crosby (from Gather Build Work) and Sam Sly. They wanted to help professionals working with adults with learning disabilities to reflect on and question their practice, especially the terminology used. They their words they want to “help the wonderful people we worked with who were being treated in horrendous ways and incarcerated in Hospitals because professionals had labelled them with ‘challenging behaviour”.

Nic and Sam felt that everyone has ways, sometimes anti-social and undesired ways, of expressing when we are angry, frustrated, sad or anxious but because we are valued citizens it is a) often not seen as problematic and b) when we do show are feelings it is called what it is: anger, sadness or anxiety and we don’t get negatively labelled for the rest of our lives. 

But Nic and Sam both felt that for the people we work with who have learning disabilities or mental health needs and are not often seen as valued citizens, when they express their anger, frustration or anxiety they are slapped with a label of ‘challenging behaviour’ and their life written off.

This is when the campaign started, and Sam brought 100 ‘I AM challenging behaviour’ badges. ‘I AM challenging behaviour’ enabled the wearer to feel and show a commitment to challenging the real behaviour that needs to be changed; that of the people and professionals who think they know best, label others and whose behaviour stops people getting the great life they deserve.

OTalk and Specialist Section

Our OTalk on 9th October 2018 aims to start a discussion on the language we are using and start to reflect on our practice. 

We were lucky to have Sam present at the RCOT conference 2018 on the I AM challenging behaviour campaign and Sam has also agreed to join us for the OTalk on twitter, so please follow @SamSly2

With Sam’s help we will be asking five reflective questions:

  1. Why do we use language with the people we work with that we would not use to our loved ones?
  1. What are the ‘behaviours’ that stop people with LD and MH getting good lives?
  1. How can we rid ourselves of ‘serviceland’? 

(please look at Orla Hughes @orlatheot for an understanding of service land) https://otalk.co.uk/2018/06/15/rcot2018-blog-18-iamchallengingbehaviour-we-all-have-challenging-behaviour-lets-challenge-the-labels-in-serviceland/amp/?__twitter_impression=true 

  1. What behaviour are you going to challenge after tonight?
  1. Are you going to make any changes in your practice? Can you make a pledge?

Sam and her team are really keen to keep this campaign alive so if anyone wants to get involved in developing it, donating, or receiving a badge please message her on @SamSly2 or on Facebook page I AM challenging behaviour. All badges are still available. 

Post Chat

Host @RCOT_PLD and @SamSly2

OTalk support @helenotuk

Online transcript

#OTalk Healthcare Social Media Transcript October 9th 2018

The Numbers

1.244M Impressions
414 Tweets
42 Participants
331 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

OTalk

#OTalk 21st August 2018 – Influencing Equipment Provision, It’s within our gift.

This weeks #OTalk is on the topic of “Equipment Provision” and will be hosted by Adam Ferry (@AdamFerry3). This chat is one in a series of chats being hosted in collaboration with the OT Show (@TheOTshow).

Here is what Adam had to say…

The experience of equipment exhibitions for many Occupational Therapists working within the public sector (NHS/Local Authority) is likely to have been similar to my own.  The relatively undirected amblings of someone looking longingly at equipment they know will never be available to them.

That was certainly my experience some years ago until I dipped my toe into the private sector.  From that point exhibitions became a lot more interesting as I understood that my awareness and understanding of the market played a critical role in ensuring recommendations within that sector were current, accurate and exhaustive.

For this reason I can understand, based on my experiences, why manufactures/providers of healthcare products often appear to focus more on the private market and indeed why whilst making my way through exhibitions I hear Occupational Therapists saying to the exhibitor “sorry, I work in the NHS”.

However, working in both statutory and private services concurrently has afforded me opportunity to both expand my product knowledge and influence decision makers within the former.

At The OT Show 2017 I was shown a moving & handling product, a non-mechanised standing aid, very similar to a popular but more expensive model often used by my Occupational Therapy team.  The product we had been requisitioning in increasingly high numbers needed to be approved by a weekly clinical panel based on clinical reasoning and availability of reconditioned alternatives but was reducing significantly the need for mechanical standing hoists which were currently a standard stock item.  The approval process and subsequent ordering meant that clients were often waiting for 2-3 weeks for this piece of equipment with hospital discharges managed with alternatives that were not ideal.

On discussion with the exhibitor some recommendations were made for minor alterations to the product that would make it more flexible within the home environments we work in.  We discussed costs per unit and availability of stock.  Based on reduction of mechanical stand-aid provision and the lower cost of this new product I felt able to build a business case that suggested its inclusion as a standard stock item off-set by making the mechanical device a ‘special’ requiring panel approval.

This business case was approved, the equipment trialed and has now been ordered in bulk as a standard equipment store item.

My personal experience demonstrates how Occupational Therapists use of an exhibition is not dependent on which sector you work in but more about mind-set.  Wherever we work we are the expert in our clients and their needs.  Equipment providers need us to tell them what we need, so be brave and take control.

Exhibitors also need to take ownership; engage Occupational Therapists from every sector.  I may have ordered 1-12 of these products a year in my private sector role but have just influenced the order of more than 30.

Tell exhibitors what we need so that they can go and find or design it; that makes an exhibition a true collaboration of expertise.

So lets start a revolution and have the equipment our clients need on the approved list, not what is cheapest or what a non-clinical manager tells us we need.

Chat Objectives:

  • Participants will reflect on their potential impact on commissioning of equipment.
  • Acknowledge skills and demand for specialist knowledge within manufacturing & design.
  • Reflect on our use of exhibitions as a ‘2 way street’.
  • Develop an understanding of how we can influence change, both in design and procurement.

Questions to Consider:

  1. What do you want to get out of an OT conference exhibition?
  2. Is there a difference in mind set between private & statutory sector OTs within an exhibition?
  3. Have you had any experiences of influencing change to equipment procurement?
  4. What do you think that exhibitors want from us?
  5. Describe your perfect conference exhibition. How would it be different?

Keep your eyes peeled for some exciting news coming soon from The OTalk Team & The OT Show!

Post Chat

Chat host @AdamFerry3

On the #OTalk account @helenotuk

Online Transcript

#OTalk Healthcare Social Media Transcript August 21st 2018

The Numbers

293.969K Impressions
148 Tweets
15 Participants
118 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants