Category Archives: Occupational Therapy
Tweeting from #UDMH2011 a CPD opportunity for me and #OT ?
Tweeting from #UDMH2011 a CPD opportunity for me and #OT ?
Today I attended the new University Department of Mental Health’s first conference: ‘Engagement in Life: Promoting Wellbeing in Mental Health’ and I was inspired and frustrated in equal measure. The buzzword used throughout was recovery and it was highlighted that this word often means different things to clinicians and service users. For example with anorexia nervosa, recovery is often measured by clinicians in terms of weight gain, restarting menstruation etc when for a number of service users weight gain has been and is still is associated with failure (see tweets from Ciaran Newell’s session). The service user turned peer support worker who opened discussed a plateau in recovery when without having something to do symptom relief alone is all but meaningless (my analysis). This also links to the ideas of the perils of recovery, something that is often under acknowledged which may lead to lower recovery rates. Now I’m not going to rehash everything that I heard here because I live tweeted during the conference sessions. A lone tweeter on this occasion. I used the hashtag #UDMH2011 so please search out this on twitter or a collation sire such as whatthetrend.
So, what did I find inspiring. Terry Bowyer’s eloquently presented story of his path to recovery and the fact that all of the presenters after him showed that health professionals are finally getting and acting on this message about the importance of working towards what the client sees as important and giving them hope that things will change.
But what was frustrating is that as Occupational Therapists this has been our guiding philosophy for years so why is it not us leading this debate? It was a nursing researcher colleague of mine who has worked with OTs in the past that asked in one of the concurrent sessions can the suggestions from CHIME and REFOCUS (see hashtag timeline for more detail and speaker info) not be mapped to occupational science models. Of course they can. Three elements of the REFOCUS model for example were ‘Understand Value, Assess Strengths and Support Goal Striving’. Immediately I can see that CMOP-E, MOHO, KAWA and the new to me Model of Creative Ability (http://www.otstudent.info/home/models/model-of-creative-ability) would all address this.
Take the CMOP-E (Canadian Model of Occupational Performance and Engagement) for example, which was developed alongside CPPF (Canadian Practice Process Framework) and the CMCE (Canadian Model of Client-Centred Enablement) (Turpin and Iwama, 2011). A client’s spirituality (which includes their values, beliefs, desires etc) is as the centre , the person is assessed in terms of both their deficits and strengths in relation to Affective, Cognitive and Physical Skills (along with their environment and their occupational performance in self-care, productivity and leisure activities. Goal setting is something to be agreed between client and therapist and if using the COPM tool (Canadian Occupational Performance Measure) they re framed under occupational performance headings rather than symptom related ones (Turpin and Iwama, 2011).
So the question remains, why when our theory and philosophy matches current thinking in Mental Health care are we not leading this revolution and how now can we ensure that our role is recognised and valued during the ongoing process of proposed NHS reform. Of course recovery depends on health professionals working together so we need to highlight our profession’s unique role in this process. There are no clear cut answers and I’d be interested to hear your views but here are some of my personal suggestions.
Encourage explicit implementation of occupational therapy models in practice (whichever works best for your setting or indeed each individual client). Share this with your MDT colleagues.
Research, publish and disseminate not only at OT conferences but setting related or medical or at any conferences where we can raise the profile of our profession (I need to take note of this to).
Promote, promote, promote OT, talk about it whenever you have an opportunity to anyone and everyone you meet.
As a lone tweeter did I feel I wasted my time? It’s true I got a little hand cramp and I’m not going to lie it is hard to multitask and I inevitably lost the track of the talks at times. But I have followers who aren’t OTs and hopefully something will have made its way into their consciousness whilst scanning my tweets. After all societal stigma and misunderstanding of mental health conditions is one of the challenges to recovery. But what tweeting did was make me think about what were some of the key messages and summarise these into concise 140 character tweets (minus the characters needed fir #UDMH2011). I can now go back and collect these tweets as a lasting record which is far more legible than my handwriting.
Now as the HPC audit of CPD fast approaches I would like to ask my Twitter/Blog/Facebook followers or friends a favour. If you’re not an OT I hope you didn’t find the influx of messages too annoying, can you tell me if you learnt anything or if anything struck you on reading/scanning the tweets?
If you are an OT, for a CPD activity for your own audit, either having already read the timeline for #UDMH2011 or taking the time to review it now, reflect on what you learnt or picked up that you might be able to implement in your practice, what insight it gave you to making sense of past experiences etc. Please share them with me in the comments in the blog being sure to maintain confidentiality (I moderate comments and will not approve comments that break this so no patient identifiable information). I look forward to seeing some of your responses to the key messages from the sessions I attended.
I will be live and delayed tweeting/blogging from both the College Of Occupational Therapists conference 29th/30th June/1st July and the Occupational Science Conference in Plymouth on 8th/9th September. Before these events I will put up a timetable of the sessions I am attending so you can follow my tweets on those you are interested in.
Sadly the COT session on tweeting was cancelled but if you were planning to attend session 115 and you are interested in meeting up informally please let me know.
Thanks for reading and hopefully reflecting, even if it’s only on one or two points.
Kirsty
Reference
Turpin, M. and Iwama, M. K. 2011. Using Occupational Therapy Models in Practice: a field guide. Edinburgh: Churchill Livingstone/ Elsevier.
Useful Resources
100 ways to support recovery http://www.mentalhealthshop.org/document.rm?id=8914
REFOCUS project http://www.researchintorecovery.com/refocus/refocusprogramme.html
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U is for… (#atozchallenge)
U is for…
Understanding
Today’s post relates to occupational therapy, creative writing and life in general.
To understand: To perceive the meaning or explanation of, grasp the idea of, or comprehend: to be thoroughly acquainted with or familiar with.
(Polatajko 2010, p. 59)
For me, when I was practicing, the most important meeting I had with my clients was the first one. The one where I completed the initial interview, found out what the reason for referral was and what the difficulties for that client were, and also, most importantly, what they wanted to achieve. When first seeing a client I would allow plenty of time for this, time to get to know them. I would often “only” see two new clients in a day (working in a community setting seeing people in their own homes). Now when you have to fill in stats for how many clients you see and when these are compared with the stats of other professions this can possibly look a little lax. I have heard students commenting on facing the same challenge, and believe me it is a challenge. We don’t have unlimited time, budget or resources, sometimes we can cut client meetings a little shorter but do we then really get to understand them or their needs?
Take for example a time when you have had to complain to someone about something. When were you satisfied that the person dealing with your issue understood what it was? Was it when they went, ‘yeah, yeah, have your refund.’ or when the person listened to what you had to say and reflected it back to you. Even if the outcome of the latter wasn’t what you desired I reckon most of us would still consider that to be the more positive outcome.
So why does it take an occupational therapist so much time to understand their clients?
Because we are dealing with their occupations, the things that they do everyday and the activities that form their identity. Polatajko (2010, p.58) suggests that:
Constructing an understanding of occupation requires a careful examination of the doing, the doer, the context or situation in which the occupation is found, and the relationships among these elements.
Could you do this in 30 minutes? Can you even do it in 2 hours (the average length of my first meetings)?
You need to understand a person on their own terms, understanding about their past and present, about their beliefs, values, culture, religion, family, etc. etc.
One thing about social media that has been really interesting for me has been communicating with my friends using facebook, twitter and more recently blogging. The latter has been a revelation and reading my friends’ blogs (their stories) has really helped me understand them a little better. People write about things we don’t talk about. I have suggested to students that blogs can be useful sources of information for understanding the impact of a particular health or social condition on a client. On Twitter at the moment there is a hashtag discussion on the use of social media (generally) in the NHS, #nhssm. Why not check it out.
Understanding a client’s narrative is an important part of clinical reasoning (Boyt Schell and Schell, 2010). I think it helps us connect to our clients by forming trust, they trust that we know them and we can trust that we are providing the best intervention for their needs and in their best interests.
In creative writing I think it is just as important that we get to know and understand our characters. A number of writers create detailed character sheets identifying a whole host of characteristics that may never make it into a completed story. They do this to understand the psyche of their character, to know how they would respond in different situations, what another character’s words might make them feel, what choices they would make when faced with the challenges we throw at them. I have just ordered a Kindle copy of Psychology for Screenwriters: Building the Conflict in Your Script
Returning to the example I gave earlier of you getting someone to address your complaint, if you knew that the person saying, ‘yeah, yeah, have your refund’ had just been made redundant does that make their reaction anymore understandable?
How often do you spend time listening to people, getting to know your characters, reflecting on why people react or live in the way they do? What insights has this given you?
Thanks for reading
References
Boyt Schell, B.A., Schell, J.W. 2008. Clinical and Professional Reasoning in Occupational Therapy. Philadelphia: Wolters Kluwer/Lippincott, Williams & Wilkins.
Polatajko, H.J. 2010. The Study of Occupation. In: Christiansen, C.H., Townsend, E.A., 2010. Introduction to Occupation: The Art and Science of Living, 2nd ed. New Jersey: Pearson, 57-79.
(I have a feeling that a closer read of this chapter will be very useful to my PhD)
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S is for… (#atozchallenge)
S is for…
Studying
I have a confession…I love learning.
It’s good to get that out; I think it’s an addiction. I know that there are others of you out there.
I went to a Grammar School and I’m not convinced that it was there that inspired me. In fact when I was applying to university one course told me to take a year out and I decided not to because I didn’t think I’d be able to get back into learning if I’d had time out (ha, little did I know). It obviously helps when you are learning things that interest you and I still have examples of school projects where clearly I had been engrossed in the subject. I really enjoyed Sociology at A-Level and won a school prize for it. I studied English and did consider dropping it because I felt we were told to concentrate purely on the words of a text without always considering context.
I do, however, have a tendency to be a little flighty and get more excited about my next course or the next topic to learn. I was initially going to complete my dissertation at uni on autism but then on my mental health placement came across a young man who had drug induced psychosis (caused by cannabis consumption) so I applied to change my topic.
In 2004 I decided that I wanted to go back to study and enrolled on a few Open University courses, An Introduction to the Humanities and Start Writing Fiction and Start Writing Poetry. I was hooked. I then completed: Approaching Literature, Start Writing Plays, Perspectives on Leonardo da Vinci, Creative Writing, Advanced Creative Writing, 20th Century Literature: texts and debates. I got my first class BA (Hons) Literature in 2009 and had to hold myself back from signing up for another course, they have one on Children’s Literature where you can study Harry Potter and the Philosopher’s Stone!! (I did have a year out in 2006-7 to complete my PG Cert in Health and Social Care Education when I started my new job lecturing).
I’m now working towards a PhD and am finding the lack of deadlines challenging (I did sign up to the Writer’s Bureau course years ago and never finished because I didn’t have set deadlines). My supervisor has just suggested one though so hopefully that will push me to stop floundering and get on with it.
Academia then is actually a pretty good place for me to be, I really enjoy attending conferences and seminars and training sessions at work, always coming away with ideas but sadly not enough time to implement them all. I find this frustrating because my body can’t keep up with my mind, and there are only so many hours in a day. I think if I didn’t have to earn money I’d make a good eternal student, alongside my writing of course.
I have always been a strategic learner and learnt with a specific purpose, e.g. To write an assessment or to write a lecture to deliver. I need to set myself goals to work toward otherwise I don’t get anywhere.
I hope that my love for learning comes across to my students and that I inspire them to want to read more and find out more than I tell them. One of the biggest skills I learnt distance learning with the OU was that you need to learn yourself and that as you grow older it is less about being taught and more about picking up a book and reading and applying it to what you know or what you see around you (maybe that’s why although I enjoyed school it didn’t completely grab me then). I think that’s probably why yesterday’s topic of reflection appeals to me too, because it is generally a self managed process.
My learning plans
My friend Stacey has completed some Science courses with the OU and she mentioned a course introducing Forensic Science. As my NaNoWriMo novel is a police story I am sorely tempted to sign up. The next presentation starts in May and there is some flexibility about when you complete it (in 6-8 weeks or 5 months). I just need to check if I’ve got enough Tesco vouchers to help pay some of the cost.
I have a few conference presentations coming up and plan to write journal articles on the topics I will be presenting on so that’s going to be a lot of reading and learning.
I would love to learn how to play the guitar
I would love to learn how to paint
I keep putting off the above two because they are ‘physical’ skills, something that you have to learn to do rather than understand. I know that they will be more difficult for me but I still want to try.
I want to keep learning about writing, I’m going to do that by doing it.
What are you/do you need to be learning at the moment?
Does a love of learning start in school or after? What was it that inspired you? Or turned you off?
kirstyes 