OTalk

#OTalk – 16th February 2021 – Occupational Therapy and Substance Use

This week #OTalk will be hosted by Rachel Rule @_rachelOT.

Opp (2021) states that people who engage in substance use, or are recovering from addictions to substances could benefit from interventions focusing on re-establishing the roles and identities that are most meaningful to them. Occupational therapy considers a person’s identity, hopes and aspirations, their roles in life, their relationships and their individual ability to fulfil these within their physical and social existence (Duncan, 2011). Considering this, Occupational Therapists are in a unique position to work therapeutically with people living with, or recovering from, addiction to substances (Opp, 2021).

When considering Dual Diagnosis, in the United Kingdom, NICE Guidelines (2016) recommend the input of Occupational Therapists as one of the core professions to include in the care planning for people living with a Dual Diagnosis. Further, in exploring the self-identified occupational competencies of people recovering from
addiction, Davies and Cameron (2010) found that three of the four top items that people wanted to change were skills based; particularly focusing on financial management, domestic tasks and personal care.

Occupational Therapists are equipped to meet people ‘where they are at’ and utilise tools in Motivational Interviewing when people remain in the contemplative stage of change (Prochaska, 1983), or to utilise skills in Identity Transformation when people reduce, or stop their substance use (Best et al., 2015). Wasmuth et al., (2014) considered addiction as an occupation, which links to the concept of the Dark Side of Occupation (Twinley, 2013), and considers how addiction is a central component of people’s everyday occupational lives. Addiction can provide routine in daily life and a sense of stability in a person’s identity (Wasmuth et al., 2014), but it can also lead to occupational imbalance (Wanigaratne et al., 1990). Therefore, when people begin their journey of recovery from substance use, they can be left with an occupational deficit. Recovery from addiction is said to involve re-engaging with a person’s meaningful occupations, supporting the development if an identity away from substance use (Stoffel and Moyers, 2004, Strickler et al., 2009).

Working as an Occupational Therapist in an Assertive Outreach Team, I meet many people living with a Dual Diagnosis. I hope to use this #OTalk to discuss the role of Occupational Therapy in working with people living with addictions in other areas of the UK (and the world!) and make connections.

Questions:

  1. What brings you to this #OTalk about Occupational Therapy and Substance Use today?
  2. In your experience of working with people who use substances, are Occupational Therapists common within your teams?
  3.  Substance use can raise judgements in society and practice, what helps you to keep these judgements in check personally, in your MDT and in wider society?

References:
Best, D. et al. (2015) ‘Overcoming alcohol and other drug addiction as a process of social identity transition: the social identity model of recovery (SIMOR)’, Addiction Research and Theory, (2), pp. 111-123.
Davies, R. and Cameron, J. (2010) ‘Self identified occupational competencies, limitations and priorities for change in the occupational lives of people with drug misuse problems’, British Journal of Occupational Therapy, 73(6), pp. 251-260.
Duncan, E. (2011) Foundations for Practice in Occupational Therapy. (5th ed.) China: Elsevier Ltd.
NICE (2016) ‘Coexisting severe mental illness and substance misuse: community health and social care services’. Available at: https://www.nice.org.uk/guidance/ng58/chapter/Recommendations (Accessed
14.1.2021)
Opp, A. (2021) ‘Recovery with purpose: Occupational Therapy and Drug and Alcohol Abuse’. Available at: https://www.aota.org/About-OccupationalTherapy/Professionals/MH/Articles/RecoveryWithPurpose.aspx (Accessed: 14.1.2021)

Prochaska, J. O. and DiClemente, C. C. (1983) ‘Stages and processes of self- change of smoking: toward an integrative model of change’, Journal of Consulting and Clinical Psychology, 51(3), pp. 390–395.
Stoffel, V. and Moyers, P. (2004) ‘An evidence based occupational therapy perspective of interventions for people with substance-use disorders’, American Journal of Occupational Therapy, 58(5), pp. 570-586.
Strickler, D. C. et al., (2009) ‘First person accounts of long-term employment activity among people with dual diagnosis’, Psychiatric Rehabilitation Journal, 32(4), pp. 261-68.
Twinley, R. (2013) ‘The dark side of occupation: a concept for consideration’, Australian Occupational Therapy Journal, 60(4), pp. 301-303.Wanigaratne, S. et al., (1990) Relapse prevention for addictive behaviours: a manual
for therapists. Oxford: Blackwell Science.
Wasmuth, S, Crabtree, J. and Scott, P. (2014) ‘Exploring addiction-as-occupation.
British Journal of Occupational Therapy’, 77(12), pp. 605–613.

POST CHAT

The Numbers

1.123M Impressions
400 Tweets
71 Participants
8 Avg Tweets/Hour
6 Avg Tweets/Participant

OTalk

#OTalk 9th February 2021 – Feminism and Occupational Therapy

This weeks chat will be hosted by Dr Heather Baglee @HeatherBaglee.

I have started writing this blog about feminism and occupational therapy so many times… The reason I
think for stopping and starting has been that I was starting to write an academic piece and each time it
didn’t feel genuine. I don’t feel ‘academic’ about this subject! The underlying philosophy of feminism
and occupational therapy are part of who I am. I have made conscious choices to work with women
including leading groups for women in mental health settings, and more recently making a commitment
to develop leadership skills for women in the University setting. In my research I chose to use a feminist
methodology, and as the poem says, ‘took the road less travelled by, and that has made all the difference.’

I don’t believe that I am alone in holding both philosophies close to my heart – so I have questions… –
‘Where is the conversation about feminism and occupational therapy? Where is the ongoing dialogue
about feminism in a profession that is 96% women?

I want to use the #OTalk session to develop a conversation about Feminism and occupational therapy.

Questions:

  1. What brings you to this #OTalk about feminism and Occupational Therapy?
  2. Where do you see the links between feminism and occupational therapy?
  3. Where is the conversation about feminism and occupational therapy?
  4. How might we move forward with bringing life to this subject?

POST CHAT

The Numbers
840.981K Impressions
344 Tweets
65 Participants
14 Avg Tweets/Hour
5 Avg Tweets/Participant

OTalk

#OTalk Research – 2nd February 2021 – Participatory Research

This week’s Research #OTalk will be hosted by Bev Goodman @OTBev, who is a PhD student and
part-time lecturer at the University of Essex.

I am currently working collaboratively with a group of disabled people as co-researchers to design and carry out a research project. Together we are exploring how disabled people’s participation in sport and physical activity could be evaluated in a more accessible and inclusive way. The project I’m involved with is Participatory Action Research, and it also draws on principles of co-production.

Rather than put a name on a specific method or methodology, this #OTalk is a chance to discuss any
type of research where issues are investigated by the people they most affect. Research is undertaken ‘with’, not ‘to’ or ‘on’. Rather than being a passive participant, co-researchers have control of the research process itself and can be involved in as many parts of this process as they wish, from determining the research questions to choosing methods and determining what counts as data, to analysis and dissemination (Koch and Kralik, 2006) .

Within our project we are drawing on our existing skills, experience and networks to develop our research with the hope of creating beneficial and meaningful change (Koch and Kralik, 2006; Bryant, Coetzee and Pettican, 2016) . This is a type of research that aligns with a community-based practice approach to occupational therapy. It also benefits from a wide range of occupational therapy skills and is congruent with our profession’s focus on meaningful occupation, client-focused practice, action and collaboration (Trentham and Cockburn, 2005; Kramer-Roy, 2015) .

There are many challenges to this approach; it takes time and it can be complex. Everyone involved must reflect on the decision-making process: what is being decided, by who and why (Herr and Anderson, 2015) . It challenges traditional approaches to research and aims to make change, so it is political – which can be both a challenge and a strength.

Questions:

1) Do you have any experience of participatory research, as a researcher, participant or as a student writing about it?

2) How might the new knowledge produced from participatory research differ from the knowledge produced from other, more dominant and conventional, approaches to research?

3) What can our occupational therapy knowledge and skills bring to participatory research?

4) How might the knowledge produced from participatory research benefit the occupational therapy profession?

5) What are the challenges of participatory forms of research?

References
Bryant, W., Coetzee, S. and Pettican, A. (2016) ‘Designing Participatory Action Research To Relocate
Margins, Borders And Centres’, in Occupational Therapies Without Borders: Integrating Justice with
Practice. 2nd edn. Elsevier, pp. 73–81.
Herr, K. and Anderson, G. L. (2015) The Action Research Dissertation. Thousand Oaks, CA: SAGE. Koch, T. and Kralik, D. (2006) Participatory Action Research in Health Care. Oxford: Blackwell Publishing Ltd.
Kramer-Roy, D. (2015) ‘Using participatory and creative methods to facilitate emancipatory research
with people facing multiple disadvantage: a role for health and care professionals’, Disability and
Society. Routledge, 30(8), pp. 1207–1224. doi: 10.1080/09687599.2015.1090955.
Trentham, B. and Cockburn, L. (2005) ‘Participatory Action Research. Creating New Knowledge and
Opportunities for Occupational Engagement’, in Kronenberg, F., Simo Algado, S., and Pollard, N.
(eds) Occupational Therapy without Borders. Learning from the Spirit of Survivors. Edinburgh :
Elsevier, pp. 440–453.

POST CHAT

The Numbers

1.033MImpressions
399Tweets
54Participants
17Avg Tweets/Hour
7Avg Tweets/Participant

OTalk

#OTalk – 26th January 2021 – Anxiety and stress: what words matter to clients?

This weeks chat will be hosted by Sam Pywell, Lecturer in Occupational Therapist at the University of Central Lancashire  ‪@smileyfacehalo  

This year I am coming toward the end of a research project on anxiety and stress, and wanted to open up a debate which hasn’t been done before in our profession.  My research, which included answers from qualified occupational therapists in palliative care, has led me to believe there can be many ways to talk about anxiety and stress (regarding occupation) which have potential to impact clinical practice. Most importantly, we need to reflect on what our clients need and what words are important to them, and why. 

In rebuilding the world beyond the pandemic, with potentially more clients experiencing anxiety and stress and the option for remote consultations, it could be argued listening to the clients meaning and use of emotion words regarding their meaningful activities are even more important.  Even though telehealth has many benefits, several cues are missing within this environment compared to face to face (Srivastava, 2020).  Words, therefore, can hold significant meaning when considering what is said, and not said, within a therapeutic conversation (Archer et al., 2012).  Therefore when listening to a client (or colleagues) talk about anxiety and stress – what words have they stated and what have you assumed? 

Questions 

  1. How do your clients talk about their anxiety and stress…what are their preferred words (and why?) 
  2. How do we help clients communicate their understanding and relationship of anxiety and stress with occupation (especially in a videocall or phone call) 
  3. What can we do to help clients when speaking about anxiety and stress? 

References 

Archer, D., Aijmer, K., & Wichmann, A. (2012). Pragmatics: An advanced resource book for students. Routledge. 

Srivastava, R. (2020) https://www.theguardian.com/commentisfree/2020/oct/14/there-is-a-poverty-of-body-language-in-telehealth-appointments-but-there-is-tenderness-too  

Thanks also to: The Institute of Social Psychiatry, UCLan, RCOT and OPC/ Major health conditions specialist section, the Elizabeth Casson Trust, The Constance Owens Trust, UCLan, Professor Dawn Archer (MMU), Dr. Hazel Roddam (UCLan), Professor Louise Connell (UCLan) and colleagues. 

POST CHAT

The Numbers

1.739M Impressions
352 Tweets
63 Participants
15 Avg Tweets/Hour
6 Avg Tweets/Participant

OTalk

#OTalk – 19th January 2021 – Creating an OT Service Twitter

This weeks chat will be hosted by Jade Nixon, and the BCHC Paediatric Occupational Therapy Team @BCHC_Childot

We are a team of Paediatric Occupational Therapists based in Birmingham, as part of the Birmingham Community Healthcare NHS Trust. We have recently moved to virtual working during the COVID-19 pandemic and decided to set up a service twitter account to promote our new ways of working! Our #OTalk aims to create reflective thinking around the use of a service twitter account, including the benefits and possible barriers.

Twitter is a growing platform that allows for discussion around best practice and improvement of patient-centred care across the NHS and Social Care. As a free resource, twitter can be used to network with professionals across the World to expand learning, CPD or just as an information source. As a team, we decided to create a service twitter to make use of the existing Occupational Therapy networks to promote our service and to enhance our learning.

We would love to hear the opinions of everyone on twitter, to improve our understanding of the impact a service twitter can make, the benefits, the barriers, and how other social media platforms compare.
Thank you!

Questions

  1. Do you have a twitter account for your clinical team or follow any other services twitter accounts?
  2. Do you regularly engage with other service accounts on twitter (such as liking, tweeting or retweeting)?
  3. What do you believe are the benefits of using a service twitter account or engaging with one?
  4. Do you think other platforms may be beneficial for services to share on? How do these compare to twitter?

Post Chat

The Numbers

562.837K Impressions
263 Tweets
44 Participants
11 Avg Tweets/Hour
6 Avg Tweets/Participant