Thinking OT

Thoughts from Harrison Training and the occupational therapy world

Archive for February 2010

What Does Leadership in OT Mean?

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In an earlier article I wrote a review of other OT blogs that we, here, at Harrison Training read. 

One of my favourites is the Salford University OT Educational blog.  The blog works becasue it expands diverse thoughts into debates.  A great example is this article on a recent leadership event the University hosted.

The author, Heather, concludes that

“occupational therapists need to be encouraged to lead but that they should have greater awareness of the types of challenge they face in the NHS and Social Care so that they lead consciously and effectively overcoming professional and gender discrimination.”

The discussion, and debate grows within the comments attached to that blog and please do go and read them and contribute.

The challenge that is presented is trying to understand just what leadership means in an OT context?  What elements of leadership, if any, are relevant to NHS and Social Care in particular?

Indeed, what are we talking about when we talk about leadership?

Leadership is not something that only those in charge require.  We all display elements of leadership characteristics in various aspects of our life –  it would seem very difficult to have a successful therapeutic relationship without having a degree of leadership.  How can we, as a profession, further identify and refine those skills to benefit our clients, employers and also enable us to work in ways which are truer to ourselves?

I recommended, in my response to the original post, two books.

The first is “7 Habits of Highly Effective People” by Stephen Covey.  It is perhaps the book on leadership from within the individual. 

The second book I would recommend is “Self Coaching Leadership” by Angus McLeod.  This is a much slimmer and lighter introduction to the concept of leadership, but no less potent for it.

OT Blog Review

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Thanks to Flickr's Austinevan for the photo on Creative Commons

Have a look over there, no, not there, right over there on the far side.

There is a section called Blogroll. 

What does that mean?

A Blogroll is a collection of Blogs that we at Harrison read and that we think you might want to read in addition to our own.

We have some criteria that we apply when considering which blogs to add.

  1. They need to be actively updated.  Blogs need to be updated on a reasonably regular basis, even if only once a month or so.  Anything which has not been updated for 4 months is unlikely to be on there. 
  2. They need to be relevant to you.  They might not all be purely about OT but will be connected to elements of the healthcare industry relevant to us.
  3. They need to be well written.  Thankfully I have not yet come across a poorly written healthcare blog yet, but if I do, it will not make it onto the role.

We hope that you will enjoy the other contributors to the OT debate that can be found within blogs around the world.  We also hope that other practitioners will feel compelled to start theie own blogs or offer to write a guest blog article here on ThinkingOT.

All of the other blogs have their own voice and style.  Here is a very quick review of the ones that are there and why they have been chosen.

ABC Therapeutics Blog  Chris Alterio writes this blog and does so very well.  He has a good ear for a story and is generous with his time and knowledge, sharing insights backed up with book references for your own further reading.  He has been blogging and using social media to build community and discussion for four years, as he points out in this article.  Top of the list, and deservedly so.

A Voice In The OT Wilderness is written by Allie Hafez and is currently exploring the challenges of having to observe her own mother going through OT.  It makes for compelling, and sometimes, painful reading.

(B)e(LO)n(G), OT is an enjoyable blog written by a newly qualified OT making the transition from student to professional.  Short, experience based articles.

HealthSkills is written by Bronwyn Thompson from New Zealand.  It has a wealth of information, primarily but not exclusively, about chronic pain management. 

OTBlogs is not, in fact, a blog at all.  Instead it is a colelction of blog article titles from several months ago, right up to date.  I am not sure what criteria they use but if you want a lot more from the OT and health care blog world, then start here.

Salford University Occupational Therapy Education Blog is perhaps my current favourite.  It is written here in the UK and regularly updated.  It shares the thoughts, trials and tribulations of the OT education team at Salford University.  As such it gives fascinating insights into academic management and also the hopes and aspirations of the educators and students alike.  We’re intrigued to see that the department has done some work in Romania, a country that is close to our own hearts and integral to our social responsibility commitments.

TechnOT is Anita Hamilton’s blog, from Canada, on how technology is impacting upon the world of OT and enabling clients and faciliting function.  Fascinating stuff about which Anita has a clear passion.

If there are other blogs that you think we, or our readers should be reading, then please do let us know in the comments.

Written by harrisontraining

February 22, 2010 at 10:00 am

Reablement and Personal Care at Home

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There is an important role for occupational therapists in providing more reablement and rehabilitative services to local authorities, to ensure that clients do not find themselves marooned in hospital wards and longer term residential care.

Gordon Brown stumbled into a political storm last week when he spoke about his Personal Care at Home Bill.  The explanatory notes can be found here.

A key part of this was to provide extend reablement or rehabilitative support …

“…to help with the transition back home after a hospital stay, a residential care stay, or simply a fall or accident…” Source

The immediate political storm revolved around funding and the view held by many that this was cynical political grandstanding.  Regardless of the politics, reablement at home will be appropriate in many situations. 

It has to be unattractive that an admission to hospital for a minor issue results in a client not being discharged just because of a lack of rehabilitative care.  To appease the political wing, this is also likely to be uneconomical.

Some of the immediate criticism of the Personal Care at Home Bill was wide of the mark.  This letter in The Times, for example, states that

“Two, three, or even four hours of care a day does not help someone living with a neurodegenerative disease, who is immobile and has other serious health needs. Only 24/7 care can provide this.”  Source

That is, I believe, an extreme position and therefore a false argument to set up.  It does not disprove a role for reabling work.  It simply states the obvious that it would not be adequate for that particular client.

The feverish political baying that surrounds any health care announcement in the run up to an election should not drown out the substantive debate. 

How can the occupational therapy sector facilitate reablement, for example after a hospital visit, using the skills they already have in rehabilitation, adaptive technology, seating, gait and the like?

Neil Denny

Written by harrisontraining

February 18, 2010 at 11:06 am

Men Needed. Apply Here.

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Here is an interesting link to a National Public Radio program discussing the shortage of men in OT.

“Men make up only 10 percent of therapists. Historically, the profession has focused on recruiting women.”

Apparently there is now a push to bring more male candidates into the profession.

This report is from Los Angeles, but I’m curious…  Is there such a stark disparity here?

Mind you, the last comment in the article states…

“And the perks dont stop at steady work, whether you’re a man or a woman. Money Magazine recently listed occupational therapy as one of the least stressful jobs in the country.”

Now I know not everyone is going to agree with that!

Feel free to post your comments below.

Neil Denny

Written by harrisontraining

February 11, 2010 at 10:10 pm

More on Creative Writing as Therapeutic Intervention – A Reader Contributes…

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I have had some feedback over Twitter on this earlier article.  A reader has explained her experiences of using Creative Writing as therapy.

Helen Noble, author of the Formula For Change blog, and otherwise known on Twitter as Welshmermaid, commented as follows;

“Nice article – writing therapy was also recently shown to be more effective for relief of PTSD symptoms.

People tend to be more honest when writing as opposed to being engaged in conversation as per talking therapy.  I also think that writing about thoughts and feelings helps people objectify and therefore evaluate their internal processes much more effectively.  If you want to gauge someone’s level of emotional intelligence, ask them to write about their thoughts and feelings.”

Now, I’m reading an awful lot about narrative therapy, mediation and counseling at the moment.  I’ll gladly share that with anyone over the coming weeks.  Suffice to say for now that Helen’s comments resonate with a lot of narrative theory.

Thanks for the contribution.  What experiences do other people have of writing therapy?

Written by harrisontraining

February 11, 2010 at 8:57 pm

Creative Writing As A Therapeutic Intervention – An Introduction

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Picture accredited with thanks, to Pingu1963 Flickr Creative Commons

Earlier posts have started to touch upon the idea of art as a vehicle for therapeutic intervention.

Writing can work as such an intervention, bringing many benefits to clients such as;

  • Creating and expressing meaning
  • Developing ideas
  • Experimenting with new perspectives
  • Self esteem
  • Building trust within a group through sharing writing.

There are many more advantages but the above illustrate a few of the areas where profound change can be seen.

When we write, and particularly if we are writing a creative or fictional piece, then we give ourselves room in which we can say whatever we want.  Much writing is thought to be semi-autobiographical.  That is no bad thing for our purposes.  By encouraging and enabling creative writing we can create an outlet for clients to explore ideas or emotions that they might otherwise not feel able to.

Perhaps a client is anxious about causing offence, or revisiting an area that has been addressed many times before.  By creating and developing characters within a creative piece  the client can then explore and work through ideas using those characters as the protagonists.  There is no reason why a client could not set up dissenting perspectives between two characters within the one story.

The self-esteem that can be derived from having created a piece of writing is incredibly rewarding.  Don’t believe me?  Try it.

Furthermore by carefully encouraging authors to read out, or otherwise share, their writing, it will be possible to see trust grow within groups.

I have already touched upon the core need for us all to be able to create and express meaning in our lives here.  Creative writing is such an obvious way to do so that it is easily overlooked.  Many of us, for example, will not have done any creative writing since leaving school.  Perhaps we ourselves should take up creative writing and not just leave it in the intervention tool box.

As an aside there is an element of storytelling theory that states that communication works on two planes, namely the plane of experience and the plane of meaning.

The former is our collection of perceptions and experiences.  This shapes how we communicate what has happened, or is happening, to us – essentially how we tell the story.

How we tell the story, namely the meaning that we give to it, can reflect back and retrospectively shape the plane of experience.

Let me give you an example.

A mother, let’s call her Alice, overhears another couple of mothers gossipping about Alice and her sick young child.  She overhears them talking about her, how she is not coping and needs help. They do not know that Alice is stood nearby and can overhear all that they say.  Alice is furious that these other parents have nothing better to do than talk about her and her son.  She goes home, distressed, and recounts the situation to her husband who, subsequently shares her indignation and anger.  He resolves to sort this out right away…

Here the experience has shaped the story-telling.  The experience is then passed on and shared.

Now, let’s try that again, with the same events, but with different meanings attributed to them.

A mother, let’s call her Alice, hears a couple of other mothers talking about her and everything that she does for her sick child.  Between them they are trying to think if there is anything that they can do to help lighten the load, for a short while at least.  They do not know that Alice is stood nearby.  Alice is surprised that other parents had realised just how much extra she had to do in caring for Joel and is touched, even a little embarrassed, that they should find her efforts as a mother to be remarkable.  She goes home, feeling emotional and confides in her husband…

Here the meaning that has been attributed to the same events is radically changed within the retelling.  As a result, the story telling has totally changed the experience not only for the listener or reader, but for the story teller as well.

If you are attending the Creative Writing as a Therapeutic Intervention course on 10th February then please let us know how you feel you might be able to implement these approaches in your work.

If you are already working with writing, whether journalling, or creative writing, then again please let us know what your experiences are.

Neil Denny

Introducing the Thinking OT blog

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Well, much like an episode of Starsky and Hutch, or the James Bond films, I have set the scene with a couple of early posts before rolling the opening credits.

This is the blog for Harrison Training to share some thoughts on the OT profession generally.  Welcome.

It is designed to provide stimulus for debate and interesting conversation.

Thinking OT will write about the specific challenges that the occupational therapy and health care sectors are presented with, but also more general concerns.   There will be articles looking at specific practice areas, training and compliance issues , but also more conceptual areas as well.

This blog will also enable us to further support and add value to the training that we deliver.

We anticipate that articles will be written by staff and associates of Harrison Training, but also by a broad spectrum of practitioners and academics within and outside the OT profession.

I put myself forward as an example, and in the interest of full disclosure. 

I am not an Occupational Therapist.  Articles that I write are written from an outsider’s self-admittedly ignorant point of view.  My role, accordingly, is not to set down an authoritative line, but simply to provoke thought and discussion.

A few rules, but they’re really easy.  They’re more guidelines than rules…

  1. I will be blogging fortnightly at least so click on the RSS subscription button on the right to get notified of new articles.  You can watch this video for more details about how RSS works.  Alternatively, subscribe to be notified by email.
  2. Answer back.  Please do comment on any articles.  All comments are read but will be posted unmoderated unless, of course, they are offensive.  Or illegal.   
  3. Suggest areas or topics you would like us to explore.  We will be more than happy to follow your lead.
  4. Recommend other sites and blogs that you enjoy reading so we can list them in our list of other blogs you might like, the Blogroll, on the right.

It’s good to meet you all.  See you around!

Neil Denny

Written by harrisontraining

February 4, 2010 at 12:30 pm

Beauty and Art in OT

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In my first post I commented on the BAOT quote from Octavia Hill which stated;

“‘The poor should never be denied beauty.’

I ranted there about the judgments and relationships that such a comment represents, although I recognise that socially altruistic benefactors could get away with that kind of thing back then.

I want to look now at the choice of the word “Beauty” and what that means to the profession.  It is clear that the BAOT feel it applies or else they would not have chosen this quote.

The word “Beauty” itself can usher in subjective judgments, the eye of the beholder and all that, but I think that if we reduce it down to a very base meaning then it becomes more universal.

Let me give an example.  When I was speaking to colleagues here at Harrison Training about this, we felt that beauty could apply to several areas of what we do, including beauty of movement.  We are not necessarily talking about high-art concepts of balletic motion, but simply movement with function.

There is a request, for example, on the BAOT page on Facebook, for help on one handed hairwashing.  Now, the act of hairwashing itself is of course utterly urbane, but the enabling and delivery of this functional movement would be a beautiful thing for that client.

Beauty can also apply to the central notion of occupation, that sense of experiencing time as being useful or with meaning.

I suspect it was originally used in an artistic sense also, namely that beauty and art are synonymous. 

While Octavia Hill was talking about access to beauty and art as being the end goal the profession has moved forward.  Art is an integral part of our intervention tool kit, enabling our clients to create meaning and expression.

I am mindful of the use of various art mediums as intervention;

  • writing both, journalling and creative;
  • visual art;
  • physical art; and
  • musical and percussive art.

That creation of meaning and expression is central to our condition.  Just look to today’s news of the ongoing research into using scans of brain activity to enable communication with coma patients.  Consider, in particular, this excerpt;

“It is lawful to allow patients in a permanent vegetative state to die by withdrawing all treatment, but if a patient showed they could respond it would not be, even if they made it clear that was what they wanted.”

So, beauty, art and the creation of meaning and expression. 

On the other hand, we might all be so busy that the concept of beauty bears no relation to our day to day work?  Your thoughts?

Neil Denny

Written by harrisontraining

February 4, 2010 at 12:25 pm

She Said What?

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In a review of other OT bodies online material I found this remarkable quote from Octavia Hill, held up by the British Association of Occupational Therapists as being one of the founders or precursors to the occupational therapy movement;

“‘The poor should never be denied beauty, simply through accident of birth.’

I guess that you could get away with saying things like that in the 19th Century.

The comment sounds offensive to modern ears. 

There is a degree of pitying within it, of almost cloying paternalism.

The labelling of “The poor” calls in all manner of judgments and relative positions on the part not only of Octavia Hill – presumably not one of the poor – and those people she was referring to, but also of the listener. 

These words set me thinking about how the language we use shapes our relationships with those we come into contact with. 

There is something of a chicken and egg situation here.  Did Octavia Hill’s comments shape the nature of her relationship with her clients, or did the language reflect her pre-existing perception of them?

I suggest that there is a two-way stream here.

The ways in which we perceive our colleagues and clients may well be subconscious.  That in turn drives our choice of words, but the words we use reinforce the perception.  There is a lot of work in the filed of narrative theory that looks at this area that I may well write about later to explore how such thinking can help us within our work. 

The debate about political correctness rages on.  I do not think I am talking about that here, although some comments may disagree.  I am simply interested in how aware and reflective we are about our patterns of communication and how that communication might impact and block the work that we and our clients are trying to do.

In my next post I will revisit the quote above to consider this thing called beauty and what that might mean to an occuaptional therapist and her/his clients.

Neil Denny

Written by harrisontraining

February 4, 2010 at 10:06 am