Thinking OT

Thoughts from Harrison Training and the occupational therapy world

Archive for the ‘Occupational Therapy as a Profession’ Category

What Does Occupation Mean? This.

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The Chilean miners stranded down their mine gives an example that OTs can use to communicate the value of occupation.

In a recent BBC article, here, Dr James Thompson, a psychology lecturer at University College London made the point that the priority was not to send anti-depressants to manage a situation but rather that;

“What they need is food and supplies and then systems building up and then to be given tasks to keep them busy.

“Maybe send down some equipment to give them something to do and to keep them involved.”

What a succinct and dramatic way of demonstrating the therapeutic role of occupation.

Written by harrisontraining

September 9, 2010 at 10:51 am

We make sense of the world depending upon our experiences of it.

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There are a great couple of posts over at the A Voice In The OT Wilderness blog.

Part one is here.

Part two is here.

The story revolves around a conflict arising from a client’s non-compliance with a specified art exercise.  When asked to create a collage, one user, instead, created a 3D model.

This was used by one observer as evidence of that client’s “defiance” – a chilling thought redolent of One Flew Over The Cuckoo’s Nest.  There was a fascinating reason however for the deviation between the expectation of the observer and the interpretation and actions of the client.

The story reminds us that although we might be absolutely clear about communicating what we are asking clients to do, they, being the recipient of the message, receive the message and interpret it through their own filters.

Those filters are, in turn, shaped and coloured by their life experiences.

Go to Allie Hafez’ A Voice In The OT Wilderness blog now and read the story for yourself.

Online Training? Your Thoughts…

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I am looking at what people’s preferences are regarding accessing training online. Can you help?  The more information we have, the better we can tailor our courses to suit your needs.

There are 7 very short multiple choice questions here which will take literally seconds to complete.

Thank you.

Challenge What I Think

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Changing What We Think

I thought was going to write about the NHS Confedration’s consultation paper, and looking in particular at the consortia that service purchasers, previously known as GPs, will be obliged to join.  I might get onto that later.

Instead I got distracted by a curious search that has come up on the blog stats.  It read;

“Challenge what I think”

Someone had searched for “Challenge what I think” and Google, in its infinite algorithmic wisdom sent them here.

That set in motion a chain of thought.  How readily do we open ourselves to being challenged in what we think?

The two topics are not entirely disconnected.  The angle I was contemplating on NHS reform was that it is easy to get stuck in resistance, anger and opposition.  We might rail against the system on the basis that it is

  • Wasteful
  • A broken promise
  • Unnecessary
  • Politically motivated
  • Unworkable
  • Meddling
  • Unwelcome change

or we can recognise that the march of this reform is inevitable.  Once we do that then the challenge is not to change the system or the political tide, but to look to ourselves and change how we are going to respond to it and engage with that change.

Note the word “Respond” as opposed to “React”

For those who are employed within the NHS, then we need to consider our roles within our teams.  How can we bring greater value, not just in pounds and pence, but in contribution?  What skills can we tap into to make our contributions more meaningful?

This has motivated the previous posts about self-effectiveness, or self leadership.  How can we position ourselves as being central to a team’s effectiveness, but not in a destructive way that undermines others, but constructively, helping to support and improve the whole.

For independent practitioners, how are you going to position yourselves in order to market your services to a larger number of smaller purchasers?  What do you need to do to demonstrate utility, effectiveness and ensure (to use the current buzzword) improved outcomes.

The current uncertainty needs us to remain adaptable.  It might mean getting to grips with social media – and the momentum that is now seen within social media and occupational therapy is very exciting.

It might mean, depending on how the consultation goes, that we need to be much more commercial in selling ourselves.

For some, let’s be realistic, it might mean looking for new roles altogether.

All of this needs us to be open to be challenged about the way we think.

We need to break the well worn patterns of X leads to Y and therefore Z applies. Experience shapes our responses so that if we find ourselves facing a situation we anticipate the outcome will the same as last time.  That can often drive how we respond.

And yet the outcome, to some extent, is shaped by our intervening response.  What if we choose, therefore, a different response?

What options have we got to select from?

What responses have we not tried previously and how might they serve us, and our service users and clients, better?

What new responses can we create for ourselves?

For more on this consider the issue of heuristics – there is a good summary on Wikipedia, right here.

Will NHS Reform Change You?

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The dust has settled to some extent following the announcement of the Liberating the NHS program for reform.

The political explosion has subsided and we will now enter a period of calmer appraisal and acceptance, with varying degrees of willingness.

If you have not yet read the government white paper then click here

Two issues stand out as they may relate to occupational therapists upon our brief initial reading, namely

  1. The Government will devolve power and responsibility for commissioning services to the healthcare professionals closest to patients: GPs and their practice teams working in consortia
  2. To strengthen democratic legitimacy at local level, local authorities will promote the joining up of local NHS services, social care and health improvement.

How do you think occupational therapists will we be employed, or if we work independently, to whom are we offering our services, and how will we do that?

Will it be the various GP consortia?  How will they be run?  Will they be self governing, as a local collective, or will they be administered by external, out-sourced services from the privte sector?

How will we be required to work between local authorities and these new consortia?

And what of this passage, for those who work with adults?

We want a sustainable adult social care system that gives people support and freedom to lead the life they choose, with dignity. We recognise the critical interdependence between the NHS and the adult social care system in securing better outcomes for people, including carers. We will seek to break down barriers between health and social care funding to encourage preventative action.

Bland rhetoric or meaningful promises?

Let us know your thoughts about what might happen.

Are you anxious, calm, indifferent, angry?

Perhaps you can see opportunity ahead.  Tell us in the comments.

Over to you.

Written by harrisontraining

July 15, 2010 at 11:54 am

Award Winning Accolade For Therese Jackson, Harrison Training Associate.

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Harrison Training Associate and leading stroke care practitioner, Therese Jackson, has been awarded the Excellence in Stroke Care award by the Stroke Association.

Congratulations!

This is an auspicious award, recognising “exceptional service in the provision of stroke care.”

You can read Therese’s full associate details here, on the Harrison Training website.

We recommend visiting the Stroke Associations website.  They have produced a very impressive set of videos paying tribute to all of their award winners.  To see all the videos, click here,  to see Therese’s award winning video, click here.

How Do You Solve A Problem Like Absenteeism?

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Upon reading through our Twitter account this morning, I spotted this comment from Alyson Fennemore

How Much Does Absenteeism Cost Organisations? What About The NHS?

Reading the summary  report from XpertHR reveals that the cost of absenteeism within the public sector is “significantly higher” than in the private sector.

That is perhaps no surprise.

Further reading around the issue suggests that represents about 6 days sick leave every year in the private sector, per employee.

An earlier article, from the same source, puts public sector absenteeism, in 2009, at a whopping 9.7 days per year.

That might be a surprise.  Many people will read that and think “I haven’t been sick in years.”  Others are less fortunate though and find their working life and aspirations beset with absence.

I have recently been presenting to several NHS teams for Harrison Training, both to OT and mixed discipline teams, and they are invariably affected with absenteeism.

I’ll write later about how absenteeism ties in with the current economic climate.

I would love to hear, in the comments below, how absenteeism impacts upon your teams and your own ability to carry out your work effectively.

And what is your answer to the problem?

Thanks to Alyson for providing the original link in her tweet.

Written by harrisontraining

July 8, 2010 at 9:35 am

The Emergency Budget and the Need For Effective Leadership

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The press are becoming increasingly frenzied as they build up to the new coalition government’s emergency budget next week.

The news is  – cuts, deeper than ever, no-one gets out alive and the like.

There can be no doubt that the health service will be challenged, along with everyone else.  Resources will become increasingly stretched.  These are going to be testing times.  The question is; how are we, and our teams going to respond?

Many will be feeling despair and fear.  For many of us the spectre of work cuts might be very real.

The climate is ripe for self destructive behaviour.

People clamour to make themselves indispensible so that if the axe falls it will not fall upon them.  This in turn can lead to an individualistic approach which is ill suited to healthcare provision.  Organisations experience politicisation of teams, where individuals look to recruit alliances, mutual support and canvass for themselves and their chosen candidates.

Gossip, rumour and finger pointing can increase just as morale decreases.

And yet this is a time that calls for leadership on both an individual and a team level.

How will we discipline ourselves so that we do not fall into the above patterns of behaviour?

Will we get support?  Consider personal coaching or, at the very least, reading some books that might help – Stephen Covey’s 7 habits of Highly Effective People is a world leader.  If some of the contents seem cheesy and clichéd then that is only because it is the leading book in its field.  It is only cheesy in the same way that Romeo and Juliet is.

How we govern ourselves, in a responsible and principled fashion, will enable us to remain focussed upon our roles and goals as we travel through the turbulence ahead.

The qualities and skills we develop as individual position quite naturally to be considered for future leadership roles.  What is more, leadership is not only a question of appointment or job title.  It is a question of character, skills, restraint and behaviours.  Many of those can be learnt.

If you can keep your head and hopes, keep your dreams and orientation true, then you will keep heading in the right direction, come what may.  Hopefully you will take others with you, both colleagues and those we are providing services to.

If we can help with leadership, conflict or team communications training then please do get in touch with us at Harrison Training or speak to us at the conference next week.

Is The Wii Useful?

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There is an article in this month’s OT News magazine (click here) discussing a pilot scheme using the Nintendo Wii games console with individuals who have mild learning difficulties.

It is an interesting article even though the pilot scheme was unsuccessful.  There were only eight proposed members of the group, only six turned up and, of those, only one turned up regularly.

The experiences of the group, or rather those who were leading it, highlight some serious shortfalls in the Wii hardware.  These are not critical, I think, but do need to be recognised.

The Nintendo Wii has caused quite a stir with it’s motion sensitive controls.  Rather than pressing a button to control an on screen character, you physically move and manipulate a controller held in your hand.   Other developments include the Wii Fit board which measures weight, balance and shifts in balance.

There are several games including the ubiquitous Wii Sports which are designed to be played in a more physical fashion, even standing up and leaping around your immaculately tidy and hyper-lifestyle designed living room if the TV ads are to be believed.

This physicality has led to the Wii being applied in various settings to motivate individuals to become more active.

The current project though failed on a couple of fronts.

Users became frustrated with the time it took to swap between players using the Wii Fit program.  It is a time consuming task which entails clicking through several screens.  This can sometimes take longer than it takes to play the activity itself.

Wii Fit is largely an individual system, which may well be better suited to one on one sessions.  The sequel, Wii Fit Plus, has got usability improvements which remove some of the time taken to change between participants which might alleviate issues within group sessions.

The other problem which the Wii presents stems directly from the motion control technology.

The promise of direct control over your on-screen character is an abstracted illusion.

By this I mean that you do not, despite all the hype, have direct control over your character, but only elements of their actions.

Take the famous tennis game from Wii Sports, for example.  You cannot direct where you hit the ball by changing the angle of the controller, as you would with a tennis racquet.  The direction is, instead, determined by how early or late you strike the ball – early plays it to the left of the court, later to the right.

For those of us who game as a hobby this is not a problem, but non-experienced gamers will perceive that they are being offered direct control.  The result can be very frustrating.

Again, the Wii technology continues to evolve and you may well well want to look at the Wii Sports sequel called Wii Sports Resort.  This comes complete with a new widget to attach to the original controller which brings your physical actions closer to the on-screen representation.

A word of warning though;  Do not get started on the Table Tennis service return game.  It is incredibly, marriage threateningly, addictive!

Another problem is highlighted by the original article, namely frustration at a perception that “The machine is not working properly.”  The controls on the Wii, and especially the Wii Fit balance board, are incredibly sensitive and actually require quite a high degree of balance shifting, stability and control.  This can be underestimated.

The Wii should not be abandoned as a possible device for therapy or motivation activity.  Once its limitations are recognised, acknowledged and accommodated the Wii can be great fun, social and energetic.  This will require practitioners to become fully familiar with the system before introducing it to service users, but, hey, there are worse home work assignments.

Do be aware that Sony and Microsoft are both bringing out new motion sensing systems for their Playstation 3 and Xbox 360 which might provide a more seamless interface.

Also be sure to read this excellent blog, albeit not updated since March on WiiHabTherapy.

Headley Court – A Powerful Testimony To Hope

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Yesterday morning I was in a hotel room, going through my final preparation for an Enablement team training day.  As I got dressed, the BBC were covering Headley Court and the amazing work that they do there.

Headley Court is treating many soldiers returning from Afghanistan with amputations.

Throughout the program, and on replays throughout the day, were stories of heroism both on the front line, and now back home in England.

It was good to see an OT being interviewed (sorry I didn’t make a note of her name), which helped to explain the OT role within rehabilitation.

The BBC’s article, with some of the video footage can found here.

Tissues might be needed, or maybe that’s just me.

Written by harrisontraining

May 27, 2010 at 1:14 pm