Thinking OT

Thoughts from Harrison Training and the occupational therapy world

Posts Tagged ‘communication

Blogging and Social Networking in the NHS – Change Needed

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OTNews have a brief and dispiriting article this month on page 10, entitled Blogging and social networking.  I am grateful that this article was brought to my attention as I prepare for a very popular workshop on Social Media Usage at next week’s COTSS Independent Practice conference next week.  I think we can have some fun with this…

The article runs off a litany of reasons why blogging and social networking is bad.  To summarise they are

  • breaches of confidentiality
  • information leaks
  • defamation
  • damage to organisational reputation
  • information to be used for social engineering and identity theft
  • viruses and other malware
  • bandwidth consumption resulting in degrading services and wasting time for other users
  • intimidation of NHS staff leading to investigations.

The article goes on to state that you can download the full checklist (what, there’s more?!) here.

I am not sure what the motive behind the article was, not least because the College is actually quite active in this field itself.  It just pops up in the news pages, even though the guidelines referred to date back to December 2009.

The disappointment in it is that it reads in the most reactionary terms.  It comes across as being anti-progress by only listing the woebetides and the why nots.

Where is the debate about how we can manage risk and progress?  Where is the discussion on the opportunities that become available?

For all your threats above I give you my own list.

Watch out for social media and blogging.  It can result in:-

  • collaboration
  • innovation
  • education
  • integration
  • creativity
  • community
  • encouragement
  • support
  • development
  • efficiencies
  • knowledge management
  • best practice…

Written by harrisontraining

October 7, 2010 at 3:14 pm

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

Join Harrison Training for Free Online CPD Training

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Here at Harrison Training we have been looking at using online training facilities as another way of delivering our range of continuing professional development courses for occupational therapists.

We now invite you to join us for a complimentary CPD training session on Thursday 30th September.  We shall be running the presentation twice, at 1pm and again at the early evening slot of 7pm.

The topic will be a new 1 hour course “Communication in Occupational Therapy” exploring how we communicate with our clients and colleagues and the problems we encounter.

This  presentation is packed with stories and practical advice and will enable you to communicate more effectively to save time and improve relationships in your practice.

Attendees will be sent a 1 hour CPD certificate to confirm their participation and supporting notes.

If you would like to join us, at no cost, then contact us for more details.OK

We look forward to sharing this session with you.


What Is Narrative Medicine?

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As I was reviewing the Mayo Clinic’s various social media channels (see my earlier blog post here) I came across this blog post by former patient/client Jillayn Hey.

Click through on the picture to read the blog in full

That in turn led me to this interview of Lewis Mehl-Madrona and his thoughts on Narrative Medicine.

The article suggests that “Narrative Medicine…asserts the importance of an individual’s whole life story to the person’s health-not just the medical history, but a story that includes ancestors and friends, interests and spiritual orientation.”

Given that the subtitle to this blog is “Thoughts, observations and provocations from the occupational therapy world” I thought this would make for good debate.

To what extent do we agree the premise?

The narrative movement can be seen in many disciplines other than medicine.  Another example can be found in narrative mediation, for example, as a dispute resolution process.

Allow me to break out of the OT silo for a moment, and look over to see what they do there.

Within narrative mediation the conflict that disputants find themselves in is held up as being a story that they are involved in.  Referring to the dispute, or, here, the question of illness or wellbeing, as a story is not intended to diminish how real that situation is.

The “Story” label, however, allows mediators, or maybe practitioners, to deconstruct the story.

  • Who are the players in this story? 
  • Who else is effected by it?
  • What is the plot? 
  • Crucially, what is the outcome?
  • How are we using language to tell this story?
  • How else might we re-tell the story, perhaps to a different audience?

A powerful part of narrative mediation, and I can see no reason why it would not have an impact here, is to set up the problem – the dispute or illness – as an entity within the story.  that in turn enables us to ask questions such as

  • How did this thing called conflict lead you to feel or react?
  • When conflict was around, did you notice anything different?
  • How did the pain invite you to respond to others?

That line of questioning can be developed further

  • What was your relationship like before conflict arrived on the scene?
  • How did you imagine your career progressing before the illness?
  • Can you think of a time when the illness didn’t have stop you from doing something?

and further still by asking

  • Am I right in thinking that you would rather this conflict was not ongoing, that you would like to see an end to it?
  • If so, what other ways might you react when conflict appears? What might you do differently?

and so on.

As the dialogue is developed, conflict, or illness, is first recognised as having an impact on our lives and behaviour.  We then go further and look at how we can explicitly recognise the grasp that it has upon us and how we can start to loosen its grip. 

In the words of Winslade and Monk, authors of Narrative Mediation, we then allow room for alternative, newly created and more helpful narratives, or stories to be constructed by ourselves and retold to others. 

In the words of Jillayn Hey herself “Through telling our personal stories of illness and disease, we assist in creating a new story of wellness that facilitates healing and in turn directs a person towards recovery.”  Note how Jillayn explicitly speaks of her new wellness.  In doing so she brings her new symptoms of being well to the foreground.  If she had not done so, then the grasp, or the narrative, that her former condition had on her own expectations of what it is to live day to day might have continued and therefore limited her activities and perceptions.

What are your thoughts?


I’m An OT. Let Me Out Of Here!

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Does the NHS internet firewall inhibit communication, innovation and effectiveness?

Here at Harrison we are very keen to see OTs and other health care professionals be all that they possibly can.

Our response to that, in part, is to work within social media and develop community.  It’s an attempt to share ideas and insights, encouragement and, as the tagline to this blog says, provocations for greater debate.  We believe firmly that increasing communication leads to development and progress.  As we increase our communication with one another, across our specialisms, and as we bring in ideas from other professions altogether, then we will find areas that we can learn from.

We also believe that for training to have real meaning and impact for you (and value for the people who are paying) that it is important to supplement our face to face delivery with associated online resources.  And that is where we suspect we are going to encounter problems.

Early feedback from people attending courses suggests that they very much wanted to see and use unique online communities to accommodate those people who are on a course.  People want to be able to see the material in advance, and to keep in touch with one another after the event.

The challenge that they have is getting through that great paternalistic guardian, the NHS firewall.

Industries in the private sector have all wrestled with this policy of internet access and use.  The restrictions and filters that appear within the NHS are restrictive and more onerous than many within other sectors.

To what extent does protectionism inhibit communication and innovation?  And to what extent is the NHS policy, ultimately, useless?  After all, many of us will increasingly have smartphones, such as the iPhone to communicate with the big world outside, as well as the big world inside the firewall.

So we came up with the idea of launching the “I’m An OT. Let Me Out Of Here!!” – a tongue in cheek campaign, to collect thoughts and stimulate debate.

Is the NHS firewall a hindrance and a frustration, or does it help you to feel safe and secure in the warm protective embrace of the digital overseer?

Would chaos ensue if there was open access?  Would everyone start Facebooking and Twittering instead of doing their work?

How would you govern online access and behaviour?

How would a more relaxed online regime benefit you, your practice, team and clients?


Managing Conflict in Occupational Therapy

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Harrison Training rolled out their Managing Conflict in Occupational Therapy course earlier this week.  This continues the development of Harrison’s interest in NHS and health care management skills training.

It became apparent that we all experience conflict within our work.  That is not surprising.  Conflict is in all that we do, whether professionally or socially.  We need to recognise where the potential for conflict lies and what our likely responses to it will be.

The mindmap shown above is one of the training resources that we used.  We highlighted nine types of conflict and then explored how they might arise within healthcare work, whether between colleagues, different levels of organisational hierarchy or with our clients.

We were able to explore typical responses and strategies to unblocking conflicts and also explore how our own actions often contribute to the conflict at hand.  The language we use, how we perceive ourselves within a conflict and who we speak to about it can all shape the destiny of any given situation.

The shift from blaming one another to an appreciation of how we might all be contributing to a problem is often a very powerful.  It makes the conflict safer to discuss and resolve.

By providing conflict awareness skills, team members can understand and anticipate possible conflict and where it might arise.  The result is that when it does emerge we are not taken by surprise and we have a range of lenses through which to perceive the problem.  That, coupled with practical strategies for resolution can help to cut the cost of conflict within our teams and organisations.

The course was very well received and prompted a great deal of discussion – the whole day felt like one massive conversation.


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