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Blog Shots by Catherine Gray (@CGray_OT)

As someone who prefers life on two wheels, and whose husband is verging on MAMIL status (if you’re not sure, I’ll leave you to Google), I could not help but be drawn to this session. OT + cycling = a dream combo for me.

Michael Feignton of Devon Partnership NHS Trust opened the session by presenting his research on the value of cycling, and was rightly pleased to point out that he’d recently met the call to action from Diane Cox’s Casson lecture: to ‘publish, publish, publish’!

Michael’s opening message was that, despite being within the domain of occupation, physical activities have often been overlooked as a concern of occupational therapy. In fact, one audience member noted how a fellow professional had described this as a concern for physios alone.

Michael’s literature review had found much research into exercise, but little about sustaining engagement. Michael reported a lack of exploration into the meaning of physical activity, and identified a need for more evidence around adherence. Sustaining engagement is a universal theme in OT, and is particularly pertinent to physical activity, where it is common to sign up then give up: Michael referenced the tendency to sign up to a January gym membership, only to never attend.

Michael referred to five themes in the occupational science literature relating to the meaning of occupations: connecting with others; enjoyment; developing physical and mental wellbeing; achieving goals; providing structure and routines.

Seven people, all keen and regular cyclists, were recruited to Michael’s qualitative study, with the requirement that they were reflective in nature: people who could access and verbalise their thoughts, and tolerate being with him throughout the interview (Michael’s words!).

From semi-structured interviews, Michael identified three key findings on the value of cycling to these individuals. These focused on the feelings and thoughts surrounding cycling (sheer joy, enjoyment, sensory, freedom and release, and getting healthy); the experiences of belonging and community; and the occupational identity of being a cyclist.

One of the male interviewees expressed that cycling with a friend provided a space to talk about deep and meaningful issues – which may not have otherwise surfaced.

Michael noted that even talking about their occupation had people buzzing – this had me wondering whether this is something unique to cycling, to physical activity, or whether this reflects passion for an occupation?

A key factor in the analysis was that sustained participation relied on participants having a repository of meanings for their chosen occupation. It must be about more than just fitness – and beyond ‘prescribing’ exercise – this is not enough to keep people engaged. Other aspects must be present, whether it is the sense of community and belonging an occupation brings, or its contribution to occupational identity. A valuable insight that paves the way for further research and exploration.

Next up were two facilitated posters. Janet Paske, a student at Sheffield Hallam University, presented: The occupation of cycling: an intervention for patients in rehabilitation and recovery? Janet highlighted how cycling can help to mitigate impairment, citing a person with facial disfigurement who was ‘freed’ by this form of transport, rather than being stared at by other passengers on the bus.

Janet highlighted how cycling can be socially inclusive, and discussed the range of bicycle options out there, such as hand cycle attachments for wheelchairs, trikes and electric bikes. Janet relayed her own experiences working with service users on one to one lessons, group rides, map reading and road sign identification, and referenced cycling charities and support.

Finally came Laura Dickson of NHS Lothian and her poster Promoting cycling and walking in the psychiatric rehabilitation setting, which charted the creation of a cycling programme with mental health inpatients. Laura cited the generally reduced physical health and life expectancy of people with mental health issues.

Laura called in a local organisation to support service users with fixing up bikes that had been left abandoned in the grounds of the Royal Edinburgh Hospital, where she is based. This gave participants a stake in the activity – being able to use what they had fixed – which, in turn, encouraged participation.

Laura referenced her insight into the risk assessment involved in a cycling programme: not only considering road safety, but also safe use of tools. But challenges aside, cycling sessions within the confines of the hospital grounds led to increased physical activity, confidence and skills, and provided a gentle form of exercise that did not mimic symptoms of anxiety, as a gym session might.

Written by Bev Goodman
1^st year pre-reg MSc student at the University of Essex
@BevG_studentOT

This was a fascinating and energising session led by the team from the Elizabeth Casson Trust which obviously touched a topic close to the heart of many at conference. This was evidenced by over 150 delegates in the room.

The session was introduced by Anne Lawson Porter, a Trustee of the Trust, who outlined the work the Trust is undertaking with regard to supporting the development of leadership capability within Occupational Therapy.

Anne provided an insight into how the focus of the Trust’s work has evolved recently to include an emphasis on not only furthering occupational therapists (a focus on the individual through its individual awards) but also on ‘furthering occupational therapy’ (the profession). The Trust has recently undertaken a review of its strategy and has published 3 clear strategic intentions the second of which is as follows:

Anne went on introduce Caroline Waters who is working with the Trust on this strategic intention.  Phase one of the work involved talking with OTs from across the  profession about their leadership experiences and needs. Caroline talked for a short time on some of the challenges that were identified in this phase of the work. she also described some of the needs that were identified. These are summarised in the slide below.

The second half of the workshop was spent exploring some of the Trusts current thinking about the work it can undertake in this area. This includes

• The production of branded material about the value of OT
• Specific work focused on building capability with a focus on skills
• Providing support for the future – mentoring and coaching
• Network building to overcome personal and geographical isolation
• Creating hubs and spokes of leadership expertise

One of the challenges identified with regard to this work is how to create a model that is sustainable.

The second half of the session posed two questions central to taking this work forward into implementation:

• How could phase 3 (implementation) be delivered to meet your professional leadership needs?
• How could professional leadership be sustained over time?
  • would you be willing to invest in your professional leadership future by paying a fee?
  • what other suggestions can you propose?

Judging by the amount of discussion in the room there were lots of ideas about this. There was a long line of people at the microphone wanting to contribute their thinking which is always great to see.

This session is being written up and will be published in OTN and so if you are interested in this work and want to find out more keep an eye out for the article. It will also explain how you can become involved.  This is a really exciting piece of work relevant to every single one of us.

Written by @lynnegoodacre

The first time I’ve attended facilitated poster session, really interesting mix of posters and very proficient presenters.

First, was Claire Martin “Utilising the residential environmental impact scale (REIS) to increase patient participation in activities within a ward environment”.  Claire spoke eloquently about using the REIS to assess their ward environment that was in an old building not designed for its current purpose. Now used by people with severe and enduring mental health conditions, the ward had a very low initial score on the REIS, meaning that both the physical and human environment were not conducive to good care and wellbeing. Claire described how she worked with the whole staff team, including estates, to address the issues and then embed the REIS as a quality improvement measure, revisited on a three monthly cycle. The environment is now much improved and the team working cohesively to continue improvements.

Claire really made me wonder why we don’t use the REIS more in our practice as the environment is nowadays considered to play such a crucial role in people’s recovery from ill health. We often talk about the challenges of our inpatient environments and the need to improve them, but most of us don’t consider them in a structured or standardised way. I will be having discussions about this when I get back to Sheffield!

Second, was Jennimae Chouchelamane “Occupational therapists delivering Schwartz rounds to improve staff health and wellbeing in work”. Schwartz rounds are on the increase in the NHS and are implemented to address the variation in compassionate care received by service users. The idea being that if organisations invest in looking after their staff there will be organisational and patient benefits. Schwartz rounds involve up to four panellists sharing their story on a particular topic for five minutes to stimulate wider discussion within a staff group. The sessions focus on sharing emotions instead of problem solving. Staff say the benefits include helping them provide improved care for patients and work better with colleagues.

It is great that compassionate care is now considered important both for our staff and service users and exciting that occupational therapists have a role in this. I’d be really interested in seeing further evaluations of Schwartz rounds incorporating service user focussed outcomes.

Lastly, Sarah Carter “Does recover in mental health settings need professionals?”. Well, we have lots of discussion about this in Sheffield, so I was really looking forward to getting an answer! Sarah described recovery as the development of meaning and purpose beyond illness. She gave us a whistle stop tour through the history of the medical professions, the ownership of power and how civil rights movements have galvanised change. People with mental health conditions are amongst the most marginalised in society, many are now coming together to create societal change around mental health, often having been failed by professionals. Professionals acknowledge this and peer support is now integral to mental health care and most people who have experienced challenges to their mental health would describe peer support as beneficial to their recovery. So, is there a need for health professionals at all? Sarah’s conclusion was that recovery is the responsibility of society, but yes health professionals still have a role to play. We need to help service users build those connections with each other to develop supportive communities focussed on encouraging everyone to do, be and belong. Fascinating stuff!

Written by Laura Di Bona

STARTwork is a programme with an aim for people to return to work following a period of mental ill health.  As an Occupational Therapist who has worked in young people’s mental health services and early intervention psychosis services, this session appealed to me greatly.  I then found out that there was the added bonus of papercraft – I do origami outside of work so felt keen to be involved!

The session soon filled and proved to be very popular with people being turned away or observing from the outskirts.

In groups of 6 a paper flower was constructed in 5 stages of bloom and an opening title scene was created.

People expressed concern over their own ability but the groups supported each other and had to communicate so they got the colours of the flower in the same order for each stage. Rachel commented that this was the same pattern that happened in the groups she ran with service users.

Following this Rachel demonstrated how to use the stop-motion phone app to create a short stop-motion film of the flower blooming. Levels of concentration were high in order to line up the various flower stages up correctly, accounting for distance and height to each person. There was a great deal of laughter and commentary throughout the process.

After creating the stop-motion films, which were short and impressive, Rachel opened up the following question to the group:

• What are the benefits of this task to aiding work?
  • Answers included: team work, increasing confidence and self-esteem, concentration and focus, communication and coordination as well as group work.

We discussed the use of this type of intervention within our own practices – it was cheap to do with quick results or the potential to turn into a longer project as Rachel had done with her service users. Other suggestions included using it within learning disabilities services, with people with ADHD and for aiding emotional intelligence in a variety of patient groups.

The group lingered following the session, keen to discuss more about including this in their practice.  It seemed such a simple, effective and cheap way of incorporating technology into achieving a variety of occupation that are meaningful.

The stop motions that we created in this session will be available to view on Twitter: @startinsalford

Apps for stop motion animation:

iPhone: iMotion (free), Stop Motion Studio (free) StopMotion (free)

Android: StopMotion Maker (free), Claymation (£1.99), Stop-Motion (£1.25)

Rachel Jones (Start in Salford) @startinsalford @dobedobedo14

Blog post by Catherine Gray (@CGray_OT)