#OTalk 10th Sep 2019 – Supervision – what’s the point?

My name is Margaret Spencer @margaretOT360 I have been qualified for almost 35 years, and I am as passionate, motivated and enthusiastic about the profession as I was when I started my training in 1982.

I work a couple of days a week as a Senior Lecturer at Sheffield Hallam University, and the rest of the time I provide occupational therapy professional supervision. I also run relationships and sexuality workshops for Love2meetu a dating agency for people with learning disabilities. It’s safe to say occupational therapy is the lens through which I view life.

In the early years of my career, I spent a whole year without seeing or talking to another occupational therapist(it was before technology arrived). I delivered occupational therapy in a day centre in Peterborough. After a year as a band 5, all the other qualified Occupational Therapy staff (3) moved on and I was left to manage 15 occupational therapy support staff, delivering a service to 50 people with a learning disability. I was 22 and it was a baptism of fire that I survived.

When I finally had professional supervision I had been qualified for over five years, had moved jobs and locations 3 times.These days thankfully we should all be having regular supervision, I now pay for my own invaluable supervision.

I deliver professional supervision to over 60 occupational therapists, from every different clinical background you can think of, right across the country from Aberdeen to Guernsey. They include newly qualified band 5’s to Directors of Services. Each supervision session is unique, in frequency, duration and content. At the heart of every session is the high standard delivery of occupational therapy.

I use the Proctor model of supervision which covers the normative, formative and restorative aspects of professional life. So supervision for my occupational therapists is a safe space to reflect, off load, regroup, explore problems, identify solutions, explore work life balance, review current standards of practice and guidelines and have their clinical work linked to HCPC standards.

Working with Occupational Therapists, undertaking on the University of Derby and Sheffield Hallam University APPLE placement educator training course, as part of the workshop activity we looked at the use of supervision within placements, the educators were asked to identify, from their personal experiences, what they saw as positive supervision experiences and best practice and then to identify poor experiences and things to be avoided. This information was gathered from educators over three courses and was reviewed to identify themes.

The themes relating to best practice identified were the need for it to be positive

and motivating, organised, to be developmental, for there to be good communication, for it to be given dedicated time and take place in an appropriate environment.

The themes relating to poor supervision, with themes identified around supervision being negative and critical, unstructured, not being prioritised and given time or being cancelled, there being poor communication and taking place in inappropriate environments. Further issues included breaches of confidentiality and an imbalance of power.

Questions

  1. How often do you have professional supervision, and how long does your session last?
  1. What is the most important thing to you about having professional supervision?
  1. What do you see as the difference between mentoring and supervision?
  1. Do you use a model to underpin your supervision?

 

  1. How does having regular supervision make a difference to your practice?
  1. Does it make an difference having supervision from another person who is not an occupational therapist?
  1. How do you link the outcomes of supervision to your HCPC requirements?

Post chat updates

Online transcript here

PDF of transcript:

#OTalk Healthcare Social Media Transcript September 10th 2019

The Numbers

1.457MImpressions
432Tweets
63Participants

#OTalk Participants

References

Davys A and Beddoe L (2010) Best Practice in Professional Supervision A Guide for the Helping Professions Jessica Kingsley Publishers London

Hawkins P and Shohert (2012) Supervision in the Helping Professions fourth edition Open University Press Maidenhead

Health and Care Professions Council (HCPC) (2017) Continuing Professional Development and Your Registration. London: Health and Care Professions Council

Healey J and Spencer M (2008) Surviving your placement in Health and Social Care

A Student Handbook Open University Press Maidenhead

Thomas N T (2013) Solution-Focused Supervision A Resource-Orientated Approach to Developing Clinical Expertise Springer New York

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#OTalk Research 3th Sep 2019 A Contemporary Assessment of Occupational Therapy Research 2019

This weeks OTalk Research will be hosted by @CAOT2019

Research has to start somewhere.

Occupational Therapy like many AHP professions is a challenging area to start a research journey within. This talk aims to look at where people get their ideas for research from, as well as the overall process of making their research a reality.

Do you have experience of conducting Occupational Therapy research? Or is it something you would like to do in the future? If this is you, join Diane and Annie from Sheffield Hallam University (@CAOT2019) in next week’s #OTalkResearch! This is a chance for you to share your views on the practicalities of conducting Occupational Therapy research. So, with that in mind, here’s what we’ll be discussing:

1.       Research has to start somewhere.  A lot of OT knowledge is in people’s heads.  What kind of things are you investigating?

2.       How do you pursue this activity/knowledge and make it into research?

3.       Do you do this in your own time or do you get work time?

4.       Have you thought about how you could translate this work into something badged as research?

5.       What areas of OT practice don’t fit into conventional research practice?

This #OTalk Research chat forms part of a larger project conducted by Sheffield Hallam University on behalf of RCOT entitled A Contemporary Assessment of Occupational Therapy Research. The project will map the current position of contemporary occupational therapy research across the UK.

In addition to the OTalk If you have completed OT research since 2014 or are currently working on an on-going OT research we would like to hear from you via this survey link:

https://shusls.eu.qualtrics.com/jfe/form/SV_72kGJMjTFmBdXZX?Q_CHL=social&Q_SocialSource=twitter

Please note this is a separate project to the one undertaken by RCOT and the James Lind Association.

Post Chat Updates:

Online transcript from Healthcare Hashtags

PDF of transcript: #OTalk Healthcare Social Media Transcript September 3rd 2019

The Numbers

1.099M Impressions
262 Tweets
60 Participants

#OTalk Participants

#OTalk 27th Aug 2019 – Evidence based practice and approaches to intervention.

This week  Jamie Cardell @OTJme, Becca Shelton @BeccasheltonOT, and Lyndsay Court @LyndsaycourtOT, will be hosting the chat is what they had to say:

The three of us are excited to be hosting our first OTalk on Tuesday 27th Aug. We have recently attended a CO-OP training course and this has sparked a lot of debate within our Paediatric Occupational Therapy team about evidenced based practice and top down Vs bottom up approaches.

Collectively we are trained in Sensory Integration and Bobath (NDT). These approaches have informed a lot of our practice, however with our recent CO-OP training and evidence in the Novak (2019) systematic review we have begun to question the use of these approaches in practice and wonder whether we are truly providing evidence based interventions to our clients. The Novak (2019) paper highlighted that NDT and SI were in the red/do not do interventions, whereas task/goal focused interventions I.E. CO-OP are green and definitely do. There is a suggestion that Occupational Therapy practice can lag 20 years behind the research; we are therefore keen to gain further insight into how other Occupational Therapists are using these approaches and what implications the Novak (2019) research paper has for future practice.

Questions that will be asked during the chat include:

  1. What top down and bottom up approaches are you currently using within your settings?
  2. What are your thoughts on top down versus bottom up approaches in Occupational Therapy and how effective do you find these?
  3. Has the Novak (2019) systematic review changed your practice or thoughts about using approaches such as Ayres Sensory Integration and Bobath for certain client groups?
  4. How do you stay up to date with the latest evidence and how do you apply this evidence to practice?

@OTJme,  @BeccasheltonOT, @LyndsaycourtOT

POST CHAT

Online Transcript

#OTalk Healthcare Social Media Transcript August 27th 2019

The Numbers

906.018K Impressions
173 Tweets
22 Participants
138 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

 

 

 

#OTalk Tuesday 20th August 2019. Do Occupational Therapist routinely assess clients menstrual cycle, it’s affect on functioning and ability to engagement in occupations?

This weeks Rachel @OT_rach from OTalk is hosting the chat this is what she has to say,

I have recently listened to an audiobook call ‘Period Power’ by Melissa Hill.

The introduction starts with the following.
In my profession as a woman’s health specialist I get asked a lot of questions, questions that my clients have had since they were 13 that they still don’t have an answer for in their 30s. Questions that usually begin with why, such as

Why is my period so painful/short/light/long/heavy?
Why are they so frequent/irregular/rare?
Why have they stopped altogether?
Why do I feel so great one week and so bloody awful the next?
Why is my vagina sore dry/wet/sensitive?
Why does sex hurt sometimes/all the time?
Why don’t I want to have sex?
Why am I so horny?
Why am I so goddamn tired all the time?
Why do I get so bloated that my dress size jumps up two sizes?
Why do I feel anxious/stressed/depressed?
Why am I so full of rage.
The answer to all of these questions is it’s your hormones. ‘

In another chapter she goes on to describe.

Follicular Phase: Menstruation to Ovulation.
Your period and your cycle are a reflection of your overall health and can be affected by little and large life events. Those gallons of wine and platefuls of delicious stinky cheesy cheese you devoured over Christmas, the crazy work project that nearly broke you, the relationship issues that keep you up all night, the death of a loved one, weight gain or loss, travelling, finally quitting smoking, the supplements you been taking, the Yoga class you’ve been going to, the new job that you love, the great sex you’ve been having, – they all have an impact on whether your period is early or late, light or heavy, short or long and painful or pleasurable.

Period Power – Maisie Gill Greentree 2019

What struck me as I listen to this book was how a lot of what she described were occupations that we engage in, and it got me thinking, Do Occupational Therapists routinely assess clients menstrual cycle, it’s affect on functioning and ability to engage in occupations they need to or want to do?

As I listened I tweeted out some of my thinking, got some great responses and had some interesting discussions from the OT community. Including Katie Major @KatieCMajor, who kindly agree to co host this chat.

Below are some questions that I plan to ask during the chat on Tuesday to generate discussion.

Question 1) Do you routinely ask about, assess for or provide interventions relating to your clients menstrual cycle? If so please give examples.

Question 2) From your own experiences of having a menstrual cycle or from knowing someone that does, what impact does it have on engagement in occupations that you need to or want to do?

Question 3) What assessment tools could we use as occupational therapist to understand the impact a clients menstrual cycles may be having on their functioning?

Question 4) What are the possible interventions we could engage our clients in to enable them to manage the occupation of their dealing with their period?

Question 5) What are the possible interventions we could work on with clients to enable them to manage and understand the impact of the menstrual cycle on their ability to engage in occupations?

Loving forward to the chat, Rachel

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`POST CHAT

Host Rachel Booth @OT_rach

Support on OTalk about @helenotuk

Online transcript

#OTalk Healthcare Social Media Transcript August 20th 2019

The Numbers

1.310M Impressions
523 Tweets
54 Participants
21 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

#OTalk 13th August 2019 – Breaking the silence: involuntary childlessness in the occupational dark shadows

Alice Hortop @LaughingOT Senior Occupational Therapy Lecturer The University of the West of England (UWE Bristol) is hosting the weeks OTalk, here’s what she had to say.

According to the NHS (2017), 1 in 7 UK couples have trouble in conceiving a child. The charity Fertility Network UK (2019) disputes the NHS figure as an underestimation and proposes a more realistic figure is 1 in 6, equating to infertility affecting 3.5 million people in the UK. The World Health Organisation (WHO, 2019) state that female infertility is graded the 5th greatest, serious global disability in populations under 60. They describe infertility as a disease, a medical condition and disability, which means access to healthcare in relation to infertility, sits under the ‘Convention of the Rights of Persons with Disability’. In addition, Schmidt (2010) refers to infertility as a ‘social situation’; moving beyond the WHO medicalised definition. Childlessness is a major life theme deemed as a chronic stressor associated with low control and long lasting negative social and psychological consequences (Schmidt, 2010). Zandi et al (2017) support the need for health care to treat infertility broadly beyond the ‘mere’ individual and biological dysfunction.

Child bearing is an expected transition into adulthood both socially and politically, imperative to humankind survival. For many the failed aspiration to establish a family is an intense, recurring, chronic sorrow for an intangible loss (Tufford, 2009). Involuntary childlessness associates with emotional problems with higher depression scores over a 2-year period with a greater tendency towards catastrophizing. Both men and women reveal higher levels of depressive symptoms, women report highest levels (Kraaij, Garnefski and Vlietstra, 2008). 42% of people experiencing infertility describe feeling suicidal with 90% sharing feeling of depression and describing their experiences as traumatic (Fertility Network UK, 2019). People try to access parenthood through alternative means such as adoption reported higher depressive symptoms than those who chose not to.

In order to understand the lived experience of people who are involuntarily childless it is useful to identify if there is a shared understanding of their needs by health professionals. If their needs are understood and further addressed appropriately. Half of 129 gynaecologists interviewed recommended offering psychological counselling to clients following unsuccessful fertility treatment (Wischmann, 2007). The majority (90%) of women in a post fertility treatment follow up survey felt psychological counselling ought to be offered, particularly at the point of stopping treatment (Hammarberg et al, 2001). Health professionals demonstrate a significant underestimation of psychological need and the timing of its delivery. Psychological counselling and infertility treatments dominate literature for the intervention options in health and social care. The author’s experience of failing to access IVF, fostering and adoption did not include any signposting or offers of talking therapies, even when actively sought. If the lived experience of childless people was more fully understood would signposting to charities such as Fertility Network UK be more prevalent. Fertility Network UK offer a support line, support groups and a downloadable ‘More to life’ self-help guide.

This section examines if the research is relevant to occupational therapists and if so how. Occupational therapists are concerned with the occupations that people engage with, the influence of occupations on their identity and their roles in their lives. Being unable to experience being a mother or father may influence the variety of occupations engaged with, the roles played in the individual’s life and occupational identity. Twinley (2013) discusses the dark side of occupation, advocating occupational therapists need to understand occupations in the shadows. Twinley (2013) suggests historically occupational therapists focussed on the positive influences of occupations on health and wellbeing. The background literature indicates involuntary childlessness strongly associates with grief, alienation and loss. She argues a need for exploration into occupations not considered beneficial for health and wellbeing, that if understood would enable working effectively with diverse populations. Or in this case occupations associated with parenthood that are missing that need to be understood to realise their effect on health and wellbeing. This begins with understanding the lived experience of people who are involuntarily childless.

The host hopes to share insights into the lived experience of involuntary childlessness on people’s roles, occupational identity and occupational engagement. The profession needs to consider their role in addressing childlessness in their interactions, therapeutically and practically.

Post chat updates:

Online transcript Healthcare Hashtags Transcript

PDF Transcript #OTalk Healthcare Social Media Transcript August 13th 2019

The Numbers

928.418KImpressions
171Tweets
17Participants

#OTalk Participants

References:

Davidson, S. (2016) Factsheet: Employment Issues [online] available at: http://fertilitynetworkuk.org/wp-content/uploads/2019/02/Employment-Issues.pdf (accessed on 02/03/2019)

Hammarberg, K., Astbury, J. and Baker, H. (2001) Women’s experience of IVF: a follow-up study. Human Reproduction, 16, pp 374-383

Kraaij, V. Garnefski, N. and Vlietstra, A. (2008) Cognitive coping and depressive symptoms in definitive infertility: A prospective study. Journal of Psychosomatic Obstetrics and Gynecology, 29 (1) pp 9 -16

NHS (2017) Overview infertility. [online] available at: https://www.nhs.uk/conditions/Infertility/ (accessed 6/10/2018)

Schmidt, L. (2010) Psychological consequences of infertility and treatment. In: Carrell, D. and Peterson, M. (eds) Reproductive Endocrinology and Infertility. Switzerland: SpringerLink pp 93-100.

Tufford, L. (2009) Healing the pain of infertility through poetry, Journal of Poetry Therapy, 22 (1), pp 1-9

Twinley, R. (2013) The dark side of occupation: A concept for consideration. Australian Occupational Therapy Journal, 60, pp 301-303

Wischmann, T., (2009) Implications of psychosocial support in infertility-a critical appraisal. Journal of Psychosomatic Obstetrics and Gynecology, 29 (2), pp 83-90

Zandi, M., Mohammadi, E., Vanaki, Z., Shiva, M., Lankarani, N. and Zarei, F. (2017) Confronting infertility in Iranina clients: a grounded theory. Human Fertility, 20 (4), pp 236-247

#OTalk Research Tuesday 6th August at 8pm

Host: Chloe Kitto Specialist Occupational Therapist  RNOH Pain Rehab  UCL Hon Lecturer ‪@chloe_kitto ‬

I am excited for the opportunity to lead the #OTalk Research discussion for August.  This September, I am embarking on a clinical research pathway and when it comes to designing my project, I am determined to keep an occupation-based approach.  Why?  The article below, written eight years ago by Robinson et al inspired, challenged and concerned me.  Here is an excerpt –

“Descriptions of contemporary occupational therapy practice largely do not reflect the use of occupation as both ends and means. These gaps must be addressed if future practice is to embrace an occupational perspective of health. Occupational therapists urgently need to generate evidence of the efficacy of occupation-based interventions for people [with chronic pain] and become experts in using evidence to support practice. This article is a red flag to the profession; if occupational therapists do not act quickly to address the limitations of current practice, other professional groups will continue to develop expertise in the use of activity. If occupational therapists complacently continue to practice without attention to their professional domain, the

opportunities to develop occupational therapy in line with the occupational needs of people [with chronic pain] will eventually no longer exist.”

This article focuses on the role of OT within a chronic pain population (which is my field); however, I suspect the message has a wider application.  The caution that the authors pose – that other professions will continue to develop in the use of activity – is now very much a reality in chronic pain.  So much so that most pain management programmes in this country do not employ OTs, and physiotherapists, nurses, and psychologists are upskilling quickly to provide functional interventions.  This is a strong factor which has influenced me to pursue research now in my career.  How can I (we) be confident that OT research projects maintain an occupation-based focus?

I am interested in exploring with the #OTalk community the concept of occupation-based research by asking the following:

1. In your view, what is occupation-based research?

2. In your view, what is NOT occupation-based research?

3. What makes this distinction challenging?

4. Is it important that OT research be occupation-focused? Why?

5. How do we make occupation-based research interesting to the wider health world?

6. What key occupations need a research spotlight on them?

I am happy to continue networking with other OTs who are interested in occupation-based research – chloe.kitto@nhs.net

Thank you all for your interest and I look forward to discussing this topic with you next Tuesday evening.

Reference Robinson, K., Kennedy, N., & Harmon, D. (2011). The Issue Is—Is occupational therapy adequately meeting the needs of people with chronic pain? American Journal of Occupational Therapy, 65, 106–113.

Post Chat

Host: Chloe Kitto @chloe_kitto

Support on the OTalk account: Nikki Daniels @NikkiDanielsOT

Online Transcript

#OTalk Transcript August 6th 2019

The Numbers

1.033M Impressions
191 Tweets
21 Participants
153 Avg Tweets/Hour
9Avg Tweets/Participant

#OTalk Participants

#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