Wednesday, 24 December 2008

Now on

A huge thanks to TechnOT (aka Anita!) for including this blogs on the excellent aggregator!

Thursday, 18 December 2008

Practicing what we preach

Yesterday I attended a networking/learning day hosted by Coventry university. I had signed up to go as I was intrigued by the blurb, it was local and £35 quid so off I went not sure what to expect.....

Laraine Epstein, lecturer at Coventry University and lead for the COT disability forum introduced the day, and explained the background to the forum, which had been set up to give OTs with disabilities an opportunity to discuss and network. I began to question whether I was an outsider at this event and what I could bring to such a programme.

The day started with a deeply personal and insightful presentation from the ever interesting Jennifer Creek. She discussed the concept of identity, and introduced her theory of "bricolage" to describe how individuals create their own identity. She reflected that we all have a "dark shadow" which may be a physical or emotional limitation, or a character trait we do not like. The challenge of achieving a truly integrated identify which reflects who we really are is then to explore and accept our own shadows. Jennifer contended that trying to "fight" or "conquer" those less desirable or limiting parts of ourselves only serves to prolong our feeling of fragmentation. She then moved on to contemplate the identity of Occupational Therapy as a profession and the struggle that therapists face to explain what we do.

Dr Clare Taylor then gave us a review of the relevant research on the experiences of health professionals with disabilities, and the attitudes towards them of colleagues without disabilities. We then worked in groups to explore the highly complex issues of why, as OTs, we struggle with inclusion when we claim to be experts in this area.

Sarah Lewis, Equality and Diversity Manager at Coventry University talked us through the complex legislation framing these issues.

We then broke for lunch with a building sense of dissatisfaction and unease at the ability of our profession to welcome our colleagues with disabilities and act as the exemplars that we should for the inclusion agenda.

If I was in any doubt as to the depth of frustration, disillusion and at some points despair of many of the OTs with disabilities present I was left with my head pounding after the emotive presentation by Sarah Barratt. Sarah presented us with the following statement:

"People with disabilities are entitled to the same human rights as all other citizens. Occupational therapists attempt to help people with disabilities exercise control over their own lives. They believe that society could be modified to include and accommodate the needs of all persons. Occupational therapists also believe in equal opportunities and access to all of society’s resources for people with disabilities and try to facilitate the individual’s inclusion into all areas of society. They acknowledge that the right not to be discriminated against has to be complemented by the right to benefit from integration into the community. (COT’s Curriculum Framework for Pre-registration Education COT 2004)."

See Patrick Carrolls thread on the BAOT discussion forum and join the debate but a few notable points include the very half hearted and quite patronising language highlighted in bold above.

Colin Jones, one of the BAOT English Board reps reminded us that all BAOT members have the ability to input to these documents and that we should work, through our regional groups, to challenge this wording. For me this made me reflect on why I haven't been involved with BAOT so far and I'm not sure I have any good excuse!

Sarah went on to provide a moving and genuinely shocking account of her (mostly) terrible experiences as a qualified OT with a disability, she was applauded by colleagues who could clearly relate personally to her testimony.

For me the key themes raised by my colleagues were:
  • "Rabbit in headlights" syndrome by OT's without a disability - a feeling of knowing they needed to support (not help, therapy or treat) colleagues with a disability but didn't know how
  • A lack of recognition by the profession about the depth of the challenges faced
  • An overwhelming sense of being let down by a profession that appears not to practice what it preaches
  • The importance of acknowledging the unique contribution and perspective OTs with disabilities can bring to the profession
  • The urgent need for change, both to support therapists who are currently qualified and to encourage potential students
A part of me wonders (and maybe hopes?) that the OTs who make up the forum may have been particularly motivated by negative experiences to come together, and that there are OTs out there who have a disability, but on the whole feel they have been received positively into the profession?

I wholeheartedly support the members of the forum in bringing this fundamental issue to the attention of all OT's as an urgent issue. However I would also urge them to reflect on the positive experiences they have had and try to draw out what worked well and why so that this can be transfered to other situations.

In conclusion I feel this event has been one of the most thought provoking of my career and the questions it raised cut to the core of the profession I love. To be told by fellow therapists who also have a disability that my profession, which claims to be highly skilled at facilitating inclusion, has made them feel unwelcome and not valued was very hard to hear. So how to do I do something constructive with these extreme emotions? Well reflecting on it and sharing my thoughts through this blog. I will also feed back to the OTs where I work. I also plan to get involved with my regional BAOT group to ensure I have a say when documents such as the on mentioned above are developed.

Tuesday, 9 December 2008

RAatE 2008

RAatE - Recent Advances in Assitive Tecchnology and Engineering annual conference (see previous post "Conferences, Conferences, Conferences!") held at the Health Desgin and Technology Institute at Coventry University - Very brief post to link to the paper I presented at this event.

Monday, 8 December 2008

Assistive technology as a psychological marker of change

Whilst teaching on a recent course I think I surprised the attendees by talking about the psychosocial impact of electronic assistive technology. It always interests me to see how people often get so into the tech factor they struggle to reconnect to the holistic implications of a high tech medium.

Anyway and interesting discussion ensued about how we can often have the false impression that providing a patient with a bit of kit will be well received as its offers a "solution" to a problem. Sadly however the issue of a device can also be a clear a visible marker of an ability lost or never to be gained and may therefore be received with a distinct feeling of sadness, even anger.

With this in mind I talked with the group about making referrals and provision at appropriate stages not just of functional ability, but also of psychological readiness. The importance of choosing a bit of kit or access method which allows (for those with progressive conditions) for a degree of deterioration is not just pragmatic for cost/resource reasons but also to mask those changes where possible.

When the patient has a deteriorating condition there is a clear argument for demonstrating/providing devices before someone actually needs them. This could be justified to allow the patient some mental preparation for what is too come, to allow a period of learning whilst the patient doesn't solely rely on a device and so on. This approach however can also be detrimental - the patient may not wish to engage with, or contemplate a difficult future, and there may be little motivation to use said "kit" when other more "normal" ways of performing a task still be viable In those situations the contrasting approach may be more appropriate, patients may be more willing to engage with the device when it represents a renewal of ability lost.

The whole notion of the significance and timing of the introduction of AT interests me greatly. It relates so well to the occupational therapy approach of looking holistically at a patients needs and reminds us that, exciting though technology can be, it is only a means to a functinonal end.

Monday, 1 December 2008

Conferences, conferences and more conferences!

I've just come back from presenting at RAatE 2008 at Coventry University. I talked about the a unique scheme our team operates to optimise the flow of communication between ourselves (as a specialist tertiary service) and local community OTs. As with all public speaking in was a bit nerve wracking but very worthwhile. It was interesting to learn about similar services in Ireland and the developing AAC/PC access service in East Kent

In September I was fortunate enough to attention the Communication Matters annual symposium. I a newbie in the field of Augmentative and Alternative Communication and it was really useful to gain such up to date ideas and information. CM is a truly personal and friendly event with many AAC users and their families attending.

I'm looking forward to attending the COT/BAOT annual conference next year. I went in 2007 and found it a genuinely inspiring event. I'm sure the same will be true this year and I have the added excitement of hosting a round table session with a colleague looking at the current and potential input of OTs to Augmentative and Alternative Communication.

Also on the agenda for next year is a workshop at the Cheshire Occupational Therapy Conference. Having previously worked for Cheshire County Council it will be a good opportunity to catch up with old work friends. I'm still not sure of the exact focus of the workshop but there is plenty of time to decide! The conference is a great example of collaborative learning where therapists from health and social care from across the county gather.

If you had told me when I was training that in my OT future I would be presenting at conferences to large groups I would have laughed. It goes to show that being excited about OT and pushing yourself to do the things that interest you, but scare you at the same time can be really positive. I find attending conferences a great luxury, taking time out from the day job to indulge myself in learning!

Here I go!

Be gentle with me as this is my inaugural post! It would seem sensible to assume that working in a (predominantly) electronic assistive technology service I would be pretty tech savvy but it's fair to say my skills in making full use of, contributing to, and navigating all things web 2.0 is a work in progress! Nevertheless I have decided to jump in as I strongly believe these resources offer incredible opportunities we must grab with both hands to give our profession the best chance of surviving the huge changes occurring across health and social care.

Developing my knowledge and use of these media is directly linked to an exciting new project I am investigating. I have long harboured an ambition to work overseas in an area where OT is emerging. I think many other therapists who are passionate about OT also plan, at some point in their career, to do the same. However with a full time job, mortgage and young son that dream seemed a reasonable way off becoming a reality, to put it mildly.

I then thought about other volunteer opportunities which would be more feasible given my financial and family situation. Online volunteering seemed like a great solution so I looked into schemes such as the UN programme and Childline but couldn't find a way to do anything specifically OT. The WFOT affiliate OTION has some online forums (although barely used) and a searchable database of members but that wasn't really what I was after as it seemed to be aimed at developing links between OT's already working in those countries, or therapists who were planning to.

Thinking about this I had a spark of an idea: There are lots of opportunities out there for OT's to go and practice overseas for varying lengths of time. However the reality for many OT’s who might love to have this experience is that they are unable to do so. This may be for a variety of reasons: caring responsibilities for children or others, financial pressures, health reasons etc etc. Volunteering online could offer a unique opportunity to tap into the knowledge, skills of practitioners across the world by offering an online space to work with therapists in areas where the profession is emerging to promote and develop OT. This online space would also hold some applications/routes for online meetings, teaching etc so that the sharing of experiences could be done between small groups of interested clinicians. It could work so that clinicians/educators/students wanting to volunteer were matched via a "buddy" type of system or that OT’s in areas wanting support post ideas for the projects which they would like help with and OT’s looking for volunteer work "apply" to work on these projects. This could be a novel professional development opportunity for all involved; optimising the exciting possibilities web 2.0 has to offer. Projects could be around developing care pathways, designing groups, developing training and teaching resources etc. This webspace could also signpost to relevant supporting information (such as the open source information on the ENOTHE project . This concept could also work for therapists working in role emerging posts.

So I some proposed the idea to a few people and the facebook group OTmeetingspace was born to make more links to relevant groups and therapists and to explore the idea further. Clearly we need to establish if the target OT’s in countries with emerging practice feel there is a need for this type of project. We need to map, critique and evaluate existing resources to identify areas of overlap and where the gaps lie. I would ask anyone interested and reading this blog to join and help shape this project.

Friday, 28 March 2008

About me