E-nableOT

Ripfa OT and Personalisation Event - Personalisation, Bob the Builder and me

2010-03-17T22:33:00.007+14:00

As the Mum of a very nearly three year old I am surrounded by the world of Cbeebies. It never ceases to amaze me that I see occupational themes throughout this pre school programming. Thomas the Tank Engine - only happy (occupational satisfaction?) when being a very useful engine (occupational competence?), Timmy the lamb who learns through play...... I know, I know I need to get out more!

What has this got to do with Personalization you ask? Well I found my mind wandering to Cbeebies during the event. Not that I was loosing interest - far from it, it was one of the most though provoking events I have been to in a while. Let me try and explain.....

Firstly for a Personalisation 101 read this information from SCIE and look at this great selection of resources from Ripfa.

Personalisation, broadly speaking is the freeing up of funding streams and resources to allow clients to draw up a specification for support from social care services which is tailored to their individual needs. There was lots of discussion at the event that this creates huge opportunities for OTs to move to a position of "practicing what we preach". That is to say enabling clients to use the resources available to them in creative and flexible ways to facilitate occupational outcomes.

Back to Bob the Builder.....having worked as a senior practitioner in social care I often felt that the basic organization of social care was flawed. Clients were offered limited choices for support, occupational therapists were rarely involved in first line decision making about care packages and I often felt that the "care" offered had the effect of disabling rather than enabling the client ("here have a ready made meal delivered to your door vs here have support to be able to do this for yourself"). As someone who likes to think about how things could be changed for the better I asked myself "Can we fix it?" (see I told you we would get back to Bob!).

To be honest my initial response was that I wasn't sure it could be fixed. The juggernaut of public services has huge momentum which is very hard to redirect, in this case to strive rebalance power between client and gatekeeper. However my knowledge of the personalization agenda before the event started to give me some hope (Can we fix it?" Lofty - "Erm, yeah I think so").

The idea of individual budgets, self directed supported, support brokers etc sounded like it could be very exciting. But to be honest it all felt a bit nebulous. Pilots were happening in other parts of the country, but not where I was. I didn't really know whether the rhetoric about these opportunities would ever materialize into real change.

At the Ripfa event I was reassured to hear that other people were struggling to know how to take action on the opportunities offered by this agenda.

In order to try and fix something, pure rhetoric is insufficient, you need tools (as an Bob the Builder fan will know). Personalisation gives the Occupational Therapist a range of tools for the job of facilitating meaningful occupation. Our challenge is not to know right now everything about the options and mechanisms for personalisation, but the task is to think about clients who would benefit, and fire them up to make it happen. Ask difficult questions - why can't this happen? Be confident in our professional opinion. Make it happen. Practice what we preach.

Can we fix it? Yes we can.

(I will write another blog post next week about the impact of the personalization agenda for assistive technology)

Well hello there world!

2010-03-06T10:34:00.003+14:00

I know, I know, I said last time that I was back but this time I really mean it! I haven't been just sitting there you know, I have been doing more work for my MSc at Salford and plotting with TechOT among other things.

Its an exciting year with presentations at the COT annual conference, participating in a workshop for the WFOT congress in Chile.

Starting this blog was one of my first forays into web 2.0 in relation to my career. I was shocked to see how long it has been since I posted last. On tuesday I am helping out at the ripfa event in Birmingham which is looking at the impact of the personalisation agenda on the role of OT. I'm really looking forward to it, both because of the content and the social media that ripfa will be using to add value to the day. As part of that support I agreed to write about the event on my blog - only to find myself a bit red faced at the length of time since my last post.

So what has changed since I started the blog? Why has it fizzled? I think in part my greeness in launching into a series of posts, then realising I couldn't keep up the pace. Instead of making the blog a tool for me, I slipped into thinking it was a chore - something I had to do but wasn't really motivated to do.

Over the past few months I have used two channel - facebook and twitter. I find that facebook offers deeply personal interactions, while I have facebook friends who I have never met, I screen them carefully. In contrast on Twitter, I chat to anyone and everyone - follow and unfollow on a whim. So in effect Facebook is my "inner circle", my inward facing social media self. So if Twitter is by contrast my outward face then where does it leave my blog?

Well for things like this, reflections on issues that I want to post about. Post as opposed to short tweets, professional issues which would bore the pants of many of my fb friends.

I need to balance my online and offline life, and to recognise that I can't be everywhere at the same time!

Anyway I look forward to sharing my experinces and learning from Tuesday. Since first working as a senior practioner in social care when I came back from the US I have been a fan of ripfa, its a forward thinking and common sense response to the need of practioners on the ground to have a sifted and appraised source of up to date information. I also think that personalisation holds huge opportunities for our profession. So I guess they both fit my spec for "things to blog about".

Be right back!

Getting back into gear.....

2009-06-03T11:00:00.005+14:00

I've been a bit absent from my usual web life for the past couple of weeks. Sadly my beautiful Mum has been diagnosed with breast cancer. She's going through some surgery at the moment and hoping to start chemo in the next few weeks. Being on patient and family side of the healthcare equation for a change is not really where we wanted to be but I suppose its just a case on putting one foot in front of the other for now.....

Anyway life plods on and I have some new and exciting things happening.....

I'm really looking forward to doing a session on the MSc in Assistive Technology course at Coventry university in a couple of weeks. I'm talking to the students about assessment in my area of practice and what I'm hoping they will get out of it is the importance of all the contextual factors beyond the client themselves. By that I mean the ability of the persons environment (social and physical) to support their needs, and the influence of cultural aspects. Anyway this is a very brief post and I will write more after the session and maybe post the powerpoint.

Last week I was down at UK OT HQ aka COT/BAOT offices in London. I was recently appointed to one of the professional practice seats on the Membership and External Affairs board. I've been a member of BAOT for 12 years but never really taken an active role. Following the Disability Forum networking day I attended last year I really felt motivated to get involved, so after a gentle (and much appreciated!) shove from a OT colleague I applied for the role.

I had a really interesting day learning more about the board and the work of the OTN, BJOT and the website progress. It was good to be able to comment on the excellent projects underway. I was excited to be able to offer some opinions on how the organisation could make the most of media such as blogs, twitter and facebook to promote OT and membership. I was really pleased that people were very positive about my intention to use these channels to relate my experience as a new board member. As you might have guessed I think it will be so important to BAOT to use these tools to help current and potential OTs feel connected to their professional colleagues and their professional organisation.

Are there any BAOT members out there reading the blog? Leave a comment or tweet me to let me know your thoughts about how web2.0 could help you connect.

Occupational Therapy Blog carnival call for submissions

2009-04-22T09:35:00.001+14:00

Your Therapy Source Inc. is the host for the next Occupational Therapy Blog Carnival. A blog carnival is a collection of articles on a specific topic. There have been two previously done on occupational therapy. All you have to do is submit your favorite OT blog post to the carnival at http://blogcarnival.com/bc/submit_6317.html. You must submit your blog article by Friday, May 1st. The OT Blog Carnival #3 is set to publish on May 4th.

I don't want to make people independant: occupational heresy?

2009-04-04T08:37:00.008+14:00

Occupational Therapists often talk a lot about independence and this often touted as being the goal of our intervention

"Occupational therapy is skilled treatment that helps individuals achieve independence" AOTA (don't get me started on how much a disagree with this statement!)

Independence is defined as "the state or quality of being independent" and independent as:

in·de·pen·dent

adj.

1. Not governed by a foreign power; self-governing.

2. Free from the influence, guidance, or control of another or others; self-reliant: an independent mind.

3. Not determined or influenced by someone or something else; not contingent: a decision independent of the outcome of the study.

If we (or more importantly our commissioners and clients) base goals on this definition I believe that occupational therapy directed at independence is both outdated and naive. In reality I dont think the occupations in which we participate are rarely, if ever, truly independent.

Rather that what matters is the extent to which we have control over interdependace we share with others. I like (part of) the current wikipedia entry:

Interdependence is a dynamic of being mutually and physically responsible to and sharing a common set of principles with others... Two states that cooperate with each other are said to be interdependent. It can also be defined as the interconnectedness and the reliance on one another socially, economically, environmentally and politically.

Whats needed, in my humble opinion, is a review of our usage of the word independance an view shared with the authors of this paper who state:

"Independence has long been a key concept. A review of the literature shows that the term's meaning has shifted throughout the past century. However, despite its significance, the word's meaning has never been deeply analysed, and it is left to the interpretation of the individual practitioner; consequently, there is a conceptual confusion surrounding the term"

Thankfully I'm not alone in this viewpoint, Rosemary Hagedorn in her student staple textbook Foundations for Practice agrees but I'm not sure most OT have really evaluated the term.
You have to ask whether semantics really matter at all but to me it is important. Surely using the right language to define what we do must be key given the eternal OT struggle to explain our profession.

In light of the reverence the profession appears to give "independence" is it not well overdue that we make sure this is what we believe our intervention is aimed at?

Guest Blogger - "How can you save the world when its ideal path to salvation is different from yours? "

2009-03-26T01:34:00.006+14:00

Jouyin Teoh is a occupational therapy student in Malaysia and one of my Facebook friends. She is an outstanding advocate of occupational therapy: dynamic, passionate, not to mention great fun! Here is her post on the importance of evaluating the impact of cultural differences in our approach as occupational therapists:

"Recently I had the privilege of being part of a team of student occupational therapists organizing a community-based rehabilitation (CBR) programme in a predominantly Malay Muslim kampung. It was a one-day event, aiming to educate the community about the opportunities available in Malaysia for people with disabilities (PWDs), indirectly setting the local PWDs and their carers on the path to empowering themselves and leading purposeful, meaningful lives in line with World Health Organisation objectives:

“… To ensure that PWDs are empowered to maximize their physical and mental disabilities, have access to regular services and opportunities, and become active, contributing members of their communities and societies.”

Unfortunately what I saw transpiring on the day itself was a picture of pure disengagement: disappointingly low participant attendance, organizers and participants eating lunch in separate, distinct groups … What was going wrong?

It wasn’t until the post-mortem that I realized that we were actually facing blatant outright disregard and opposition from the community – My colleagues reported cases of kampung residents responding when approached on the morning of the event, “Oh yes, I know about that health rehab thing. I’m not going.” And they shut their doors on us without further explanation. To them, we were an intrusion: They knew of our existence, and we weren’t welcome. To us, this was incomprehensible: What could possibly be wrong with an activity which seeks to empower the community to empower individuals to empower themselves?

The answer came to me via discussion with Japanese occupational therapist Michael K. Iwama on cultural contexts and occupational therapy which took on a form parallel to my CBR experience. We were both of East Asian origin and shared a similar fusion of Confucian/Buddhist values together with the Westernised philosophies that defined our profession, yet we operate in vastly different environments. He talked about the difficulties of transplanting occupational therapy identity in a meaningful way to the people of his native racially/religiously/lingu

istically homogenous Japan whereas I had my own problems articulating the core construct of occupational therapy to suit the diverse cultural contexts which sum up Malaysia.

As occupational therapists, we are importing a foreign set of beliefs in the form of occupational therapy and CBR into our respective homelands. Should we be successful in deconstructing these “alien”, Western concepts and adapting them to our local realities, it would be possible to upgrade the health & wellness sectors in our respective countries to a whole new level altogether with emphasis on better quality of life which no longer discriminates and labels patients as “sick” or “disabled” but which views them as individuals with their own right to be active participants in the great circle of life. Occupational therapy does not aim to “treat the disease”. Rather, it “enables the person”.

However, the danger of this sort of intercultural exchange can best be summed up by Michael Iwama in his essay Situated Meaning: An Issue of Culture (Occupational therapy without borders, 2005). “There is always the danger of importing our own culture and thereby standards of behaviour and meanings that can disrupt people’s way of life … In this way (health & wellness interventions) can oppress rather than empower, encumber rather than emancipate, and disable rather than restore.”

How can you save the world when its ideal path to salvation is different from yours? How can you save the world when its idea of salvation differs from yours? Only by making culture a primary concern and allowing target client groups to understand and dictate the terms by which these foreign ideals should be introduced, then only will cross-cultural, international cooperation reap benefits for all."

Diffidence, geekery, occupational therapy and me

2009-03-21T03:23:00.008+14:00

Earlier today I *almost* tweeted that I had just been reading my shiny new copy of The British Journal of Occupational Therapy in the bath and thinking how interesting the articles were this month (OK I would have to have condensed it down a bit but you get the idea!). But then I stopped. "Cant tweet that!" I thought, "I'll sound like a right geek!".

But its true I am a geek, or so I keep telling people. What is a geek anyway?

"a peculiar or otherwise odd person, especially one who is perceived to be overly obsessed with one or more things including those of intellectuality, electronics, etc."^[1]

Hmmm, not sure I like that, so my do I keep saying it?

Well I do love my job, and I'm passionate about occupational therapy, and freely admit I spend lots of my free time doing work related stuff. But given that OT is about facilitating other people to achieve optimum well being I should be proud, right?

All this got me to thinking about a presentation I went to from Jennifer Creek at the Cheshire Occupational Therapy Conference. She was talking about celebrating achievement in occupational therapy and pointing out that, on the whole, occupational therapists aren't too hot at blowing their own trumpet. She gave a great quote from Dr. Thelma Cardwell, former CAOT president, and reflected though we have made much progress, we are still a bit backward in coming forward as a profession.

dif·fi·dent
adj.
1. Lacking or marked by a lack of self-confidence; shy and timid. See Synonyms at shy¹.
2. Reserved in manner.

Now I'm not sure I'm diffident as such. I'm highly likely to be the person in the room to put my hand in the air and give and occupational therapy slant on a discussion, to volunteer for a project which I believe will further the profession, and to try my hardest to find innovative ways to develop OT services.

So why do I term myself a geek? Maybe despite all my gusto I'm still not as confident in myself as I am in my profession. Being the outwardly confident person I describe above doesn't always come easily to me, but if something scares me I'm compelled to try it. Maybe it's a grown up extension of risk taking behaviors in my earlier life? Who knows, but I think what I will take from this reflection is that its OK to be true to my Gemini starsign and be at once unconfident and self doubting if this propels me to action, but at the same time a vocal advocate of my profession.

Some people might say it's a bit of a risk posting this on a publicly accessible blog but I'm quite an open person, and fine with talking about my flaws. In fact I think some of the most interesting blog posts come when people reflect with honesty on a situation. What are your thoughts, how confident are you in promoting OT? Would you critique yourself in a similar way in a public forums?

P.S. I'll do another post about the great articles in BJOT!

Occupational Blog Carnival #2 - Call for submissions

2009-03-21T01:23:00.002+14:00

This months the carnival is hosted by Bronnie Thompson over at Health Skills Weblog

The topic is ‘clinical reasoning and occupational therapy’

The closing date for posts is the 3rd April so get going now!
The carnival will be published on the 6th April.

Click here to submit a post

Don't for get to subscribe to the carnival visit its permanent home here.

Please publicize the carnival on your own blog or through other channels such as Twitter, Facebook etc.

Blogging as a voice for the therapists "gut"

2009-03-14T10:01:00.010+14:00

This post reflects my thought process following the hotly debated thread on the use of models on the Salford Road blog.

I was rambling on to my husband about how exciting it is to be engaged in a debate about OT with some of the most prominent and influential therapists in the world through web based media. I'll be honest with you - it can be a bit intimidating! This in turn got me thinking about some of the barriers that people have to blogging or engaging in these type of debates. Some of this anxiety may be related to a lack of confidence about articulating ones opinion in such a public way. Making your professional thoughts and opinions known on the web constitutes a type of risk taking in opening you up to critique and comment.

Practicing therapists often feel a gulf between critically appraised, peer review research or theoretical tomes. I then started thinking about how this online debate compares to writing or reading an article in a journal concluded that blogging and online debate offers such an exciting voice for the anecdotal, experimental "gut" professional opinion of practitioners. It provides such a responsive and engaging way to capture and communicate these types of thoughts and opinions.

So for me the internet offers a potential solution to the transmission of that knowledge which falls between practice and research.

As I tetter on the deg of confirming my MSc funding I feel these posts have been a "spa for the mind" and have both refreshed and really inspired me. This reflection galvanizes me in promoting the benefits of web based communication for therapists!

Let me know what you think!

Cheshire Occupational Therapy Conference

2009-03-12T08:59:00.002+14:00

I had a great time at the conference today which looked at celebrating the achievements in the past ten years, and considering how OT services can be modernised in times to come.

I really enjoyed giving a presentation on "E"nabling and talked about the ways in which web2.0 can be useful to occupational therapists and our service users.

I will post a more thorough summary and reflection on the day but as part of the talk I urged people to "dip their toe in" and have a look at one of the resources I mentioned. As such I wanted to put a quick post up and invite any of the people who were at the presentation today who might stop by the blog to just leave a quick comment.

At the bottom of this post just click "comments" and fire away. I would really welcome your feedback - and feel free to be honest (you can leave anonymous posts!)

Occupational Therapy Blog Carnival Edition #1!

2009-03-09T03:07:00.006+14:00

Welcome to the March 9, 2009 edition of occupational therapy. This is the inaugural edition so it's very exciting! Thanks so much to the contributors and those people who have offered to host upcoming editions.

I was a bit worried about not specifying a topic for this first edition but I didn't want to scare people off submitting a post. I'm really pleased to say that we have a great series of posts which capture the exciting range and diversity of the profession.

Theory

Angela Hook presents Core Values or Core Skills ?........... You decide posted at Salford University Occupational Therapy Education Blog. Not only was it a fascinating post tackling a central issue for OTs, but created lots of discussion, both on the blog and on Facebook. Defining what we do, our skills and beliefs has always been one of the great challenges for our profession. On Twitter @HeatherOT and I wondered about asking OT twitters to define OT in a tweetable 140 characters. Heather came up with

"PTs will teach you to walk, OTs will teach you to dance. We focus on higher level functioning to be able to perform all ADL"

Building on this theme Adiemusfree (Bronnie Thompson) presented Talking about roles in pain management posted at HealthSkills Weblog, saying, "Thanks for starting this carnival!" Bronnie highlights the importance of balancing core skills with the ability to share skills as part of a cohesive team. Interdependence, as opposed to independence as a strength in a team approach.

Frontiers of practice
Andy Levy presents The best book I never read posted at Gosh, that's neat! which he describes as "A pseudo-review of Occupational Therapy Without Borders: Learning from the Spirit of Survivors" The book he describes is written by Frank Kronenburg, the daddy of looking outside the OT box. As Andy underlines, his inspirational view of OT serves as a call for all OTs to "go forth and occupy"!

Alece Kaplan is someone who seems to have taken Frank's advice and writes for the OT Advocacy blog. She presents the Death With Dignity Act Implemented on March 4th All OTs working with people facing terminally illness should be aware of the legal and political drivers in their country of practice, as well as their own feelings, prejudices and anxieties around the complex area of suicide/euthanasia.

Alvaro Fernandez presents Centre for Brain Fitness at Baycrest: Interview with Dr. William Reichman posted at SharpBrains: Your Window into the Brain Fitness Revolution, saying, "we have an opportunity to make major progress in Brain Health in the XXI century, similar to what happened with Cardiovascular Health in the XX, and technology will play a crucial role". OTs are have excellent skills in using technology to meet our clients goals and we should consider the expanding role we may be able to play in the area of "brain fitness". OTs are already engaging well with the concept of Wiihabilitation and the benefits it can play in a range of practice areas.

Learning in Practice

Margaret Rice presents 10 Things They Don't Teach You In School - Learning on the job as a school based therapist posted at Your Therapy Source. Although Margaret has a background in Physical Therapy her practical advise is great for all therapists and therapy students starting work in an educational setting.

And another thing......

I thought it might be good to also feature a news article related to OT which caught my eye. Take a look at this dutch study which showed the effectiveness of OT interventions for people with Alzheimers.

"The Dutch folks found, first, the OT treatment program was considered a substantial success about one-third of the time. Next, they found the average cost of care of the group that had the OT program was about $2,600 less than the regular treatment group."

I think that OT's (in the UK at least!) often worry a lot about marketing and evidencing their service. This encouraging research demonstrates that good quality therapy can also be cost effective. We shouldn't be afraid to "describe by the dollar", in fact we must to ensure the future of OT in an increasingly financially pressured world.

That concludes this edition. Submit your blog article to the next edition of occupational therapy using our carnival submission form. Past posts and future hosts can be found on our blog carnival index page.

The next edition of the carnival will be hosted by Bronnie Thompson at the Healthskills Weblog.
The closing date for submission is 3rd April and the carnival will be published on 6th April.

Subscribe to the carnival at it's permanent home here

Technorati tags:
occupational therapy, blog carnival.

Widening the support for AAC

2009-02-25T09:43:00.001+14:00

I had a great time at the AAC SIG yesterday. Being the only OT there it was interesting to reflect on what OTs can bring to the AAC table, especially as I plan for the roundtable I am co-chairing at the BAOT conference.

Much of the discussion was about how difficult it is for people who use AAC when they transition from education and the disparity between support in education and "black hole" of services and funding when they leave.

We also talked about the use of the Internet for people who use AAC including the importance of social networking and web based video conferencing media such as Skype.

My recent background is in social care and this led me to think more about how AAC and social care could fit together. It seems to me that AAC has traditionally been though of as sitting in health and education but in actual fact communication is pretty fundamental to securing and maintaining a productive place in society. I know some other AAC services are part funded by local authorities but this isn't common practice. There are some parts of the Chronically Sick and Disabled Persons Act (1970)

(b) the provision for that person of, or assistance to that person in obtaining, wireless, television, library or similar recreational facilities;
(c) the provision for that person of lectures, games, outings or other recreational facilities outside his home or assistance to that person in taking advantage of educational facilities available to him;

which might provide a good avenue to start discussions with local authorities. In the same way that health would provide a wheelchair and then social care would facilitate its use in the home and community so you could argue for support with communication?

Direct payments and individual budgets are aimed to empower people with disabilities to make their own choices about what and how to fund the things they need to support them. This could also open up interesting opportunities to source support for people who use AAC.

I might have good patient to see if we can develop a case for communication support through social care so I will keep you posted.

Taking AAC beyond words and phrases to truly functional communicative interaction is something that really fascinates me!

Talking to people with complex communication needs

2009-02-17T12:13:00.000+14:00

Last Friday was a great day for me. I was exhausted, fed up and not looking forward to a long drive to see a patient for what looked like a really complex assessment.

When I got to the appointment I met a young woman with Cerebral Palsy who has very complex communication needs. She used a low tech coded eye pointing AAC system with her personal assistant to communicate with me during the appointment. I wont bore you with the details but we chatted away and, in collaboration with the equipment rep, came to a decision about how to move forwards.

At the end of the assessment the pateint thanked me for holding the conversation directly with her and not with the PA. She explained how degraded and angry she felt when interacting (or not) with other people and in particular health professionals.

I later had a converstaion with another patient, her communication aid had broken down. As you would expect, her communication difficulties meant conveying this problem to the people who needed to know to fix it was a real challenge. The really sad part was that her sister had recently died and throughout the last days of her sisters life she had experienced a constant battle with health care staff trying to contact her to update her on her sisters condition but being thrown completey by her significantly dysarthric speech. The callers had had differing responses ranging from shouting on the phone, asking if they could call her carer and even hanging up.

She asked me how our service educated other health professionals about how to talk with people with communication difficulties. The challenge is that as a regional service we dont have that day to day contact with local teams to be able to convey this information as we might like. This continues to be source of frustartion for me so I urge anyoen reading this to take the time to take a look at the excellent leaflet from Communication Matters to get more information. The feel good factor was that, despite her speech disorder we were able to chat, to get to the bottom of the problem she called about and I was motivated to publish this post.

An Occupational Therapy Carnival - call for submissions

2009-02-08T06:58:00.000+14:00

So rather than just post about it I've decided we should do it! So I'm announcing the inaugural edition of the Occupational Therapy Carnival which will be published on the 9th March.

For those of you who don't know:

A blog carnival is a type of blog event. It is similar to a magazine, in that it is dedicated to a particular topic, and is published on a regular schedule, often weekly or monthly.^[1] Each edition of a blog carnival is in the form of a blog article that contains permalinks to other blog articles on the particular topic.

But why have one? As more and more OT bloggers appear using a carnival offers an opportunity to harness our collective enthusiam and knowledge in one place. For people who dont use the internet so much it can be a great digest of recent OT blog activity and gives a way to connect. Blog Carnival explains:

There is so much stuff in the blog-o-sphere, just finding interesting stuff is hard. If there is a carnival for a topic you are interested in, following that carnival is a great way to learn what bloggers are saying about that topic. If you are blogging on that topic, the carnival is the place to share your work with like-minded bloggers.

For this first edition I welcome any submissions on any topic to get us going. I would also like people to nominate themselves to host subsequent editions, and suggest topics to focus on.

Please help make this a success by contributing and publicizing the carnival. I really look forward to your thoughts.

Use the blog carnival widget on the right hand pane to submit an article and refer to the blog carnival FAQs for more information. If you need any help or information just leave me a comment or get in touch via Twitter.

Is there anybody out there? Talking into the wind

2009-02-06T07:12:00.000+14:00

Blogging is great but I sometimes wonder - is anyone actually reading this stuff or finding it interesting? I know trying to get people to comment on your blog is a common affliction for bloggers, and that the web is smothered with lurkers.

Having a blog about OT means that my blog might not get as much traffic as others on say celebrity gossip but hopefully the posts get read by people who have a real interest the the things I blog about.

It almost feels like talking into the wind.................. That said talking into the wind can be quite cathartic and useful in itself. Worst care scenario it's a great tool for reflection and getting some thoughts down.

So I'm going to try a different tactic and propose this as a delurking post. Maybe thats a bit mad because if no-one comments I'm going to feel a bit silly but oh well sometimes you've just to put yourself out there. So go on lurkers (lets hope there are some) dip your toe in the blogging water and say hi!

webSIG

2009-02-05T11:21:00.000+14:00

Following discussions at RAatE this year I have attempted to contact services who assess for and provide electronic assistive technologies to create an online networking space to further improve communication between similar services. I’m sure we are all discussing similar issues of service inclusion/exclusion criteria, keeping pace with technological advances and adapting to funding challenges. As the services we work for are spread across such a broad geographical area creating a viable SIG for face to face meetings can be a challenge. So I set up a webSIG using Ning and a we already have a few members from different services which is exciting. I quite Ning as its easy to use, add features and rearrange. That said......

I must temper my enthusiasm with the knowledge that it may not be so well embraced by the people I am trying to reach. For numerous reasons people may not feel they have the time, inclination, skills or desire to share information to want to join in. However I am by nature blindly optimistic so I'm sure it will be a resounding sucess :-)

If you work for a EAT service please get in touch for details of how to join.

High expectations of EAT

2009-02-05T09:01:00.000+14:00

I was having an interesting chat with a visiting SPR today about the high expectation of EAT he had found when visiting patients in our service. We discussed the impact of the constant media stream of technological advances which he termed "Bill Gates Syndrome" so that when we visit a person they often expect us to be able to provide star trek level controls of their home and beyond.

The reality of course is that EAT is often well behind mainstream technology. Costs incurred for necessary hoops like MHRA regs and a comparably small market make for often lower tech solutions that service users envisage.

A common misconception is always that throwing lots of technology in to the mix will in some way enhance a patients underlying skills and abilities. I always try to explain that we can use the tech factor to support and enhance but if a person doesn't have the often critical cognitive abilities and motivation we are often limited. Starting an assessment by talking about expectations cab be an effective way to get an idea of a starting point to negotiate.

As an Occupational Therapist I feel I have special skills to be able to breakdown the skills needed to use EAT and I hope I can then convey these in a sensitive and meaningful way to my patients. It might seem contradictory to underplay the role of technology when working in an EAT service but it serves to remind us that the focus should be on skills of the individual and the technology as a means to harness those abilities.

The personal touch adds value to online networking?

2009-01-29T11:02:00.000+14:00

I've been reflecting over the past few weeks about how different online networking and contact feel from similar face to face connections.

I started my professional networking on Facebook but my Facebook history and profile had previously been used for purely social purposes. That meant that anyone could see photos of my family, what music I like etc etc. Far more information than I would normally be sharing during a chat over coffee at a conference.

Maybe its the fact that I work in, and blog/network about healthcare which might seem a little more friendly and less cutthroat than say share trading?

There are lots of comments and opinions out there about the blurring of professional and personal lives through social networking but I began to wonder about how this might affect the quality of those interactions?

I have observed that my contact with people I have "met" through web 2.0 is more relaxed and I feel more able to ask questions about others person and work lives. All this makes me hypothesize that online contacts seem to be richer and more productive as a result of the interweaving between personal and professional parts of my life.

So if this eroding the personal/professional boundries and I'm doing work related tasks while checking my personal contacts on facebook does this mean I'm working more? Maybe but as it feels more like an extension of my normal social interaction it doesnt seem to matter. So maybe this helps my worklife balance too - I can be more productive as I interweave my personal and professional. Others would disagree!

So I'm asking the questions:

Do you feel that your online contacts are more productive that face to face and do you think that the personal knowledge you have shared with those people is a factor?

Do you think online contacts enhance or detract from your worklife balance

An Occupational Therapy Carnival?

2009-01-23T12:30:00.000+14:00

I keep hearing this term being bandied about and I had no clue what it was so turned to wikipedia for a definition. This seems like it might be a great way to link together the OT bloggers and get some publicity in some hard copy publications and increase the awareness of the great ideas and expertise sharing that is happening through our blogs?

I would be interested to hear your thoughts!

For your own safety

2009-01-23T06:21:00.000+14:00

I wouldn't search for posts on health care professionals or OTs on here..........

A few recent finds

2009-01-23T04:56:00.000+14:00

This wiki has been set up as a service to the community of visionaries, entrepreneurs, intrapreneurs, policy makers, and professionals who are working on fundamentally redefining the healthcare industry along the lines of "Web 2.0".

Online communities for healthcare - a paper by John Sanders at the Univerity of Leeds

An NHS article on health2.0 and a resource I want aware of.

Backtype

2009-01-23T04:43:00.000+14:00

In the interest of improving my blog and blogging skills I am trying to comment more on other blogs. Problem is I have a toddler and a full time job so my brain aint what it used to be and I'm having trouble keeping track of what I said where!

In order to address this challenge I've been taking a look at Backtype. I've sorted the link to the blog and now seem to have it posting my comments in OK. Any thoughts? Anyone use this?

The old buckeye: how do we define what we do as OT's

2009-01-23T03:16:00.000+14:00

Thought I would post this here, its my response to the Frederick Road post and ensuing debate about core values/core skills of OT. It seems to follow on from the thoughts on my previous post......

" It's an oldie but a goodie (great students by the way Salford!). Here is the link to Jennifer Creeks "OT as a complex intervention".

My personal feeling is that we apply our core skills (which may in part be generic) to our core belief which is unique (humans as occupational beings, occupation as central to wellbeing).

The thorny issue of how OTs define the profession is inherent in its own exisistance. To understand OT you have to be involved in the occupation of occupational therapy. Lost yet? I was fortunate enough to be at a study day with Jennifer just before Christmas and she made a simple but impactful observation. The only clear way to explain is for someone to try to mimic the work of an OT, or to be the recipient, or to sit alongside the process. In other words to use engaging with the occupation of occupational therapy.

Is that too much to ask? How can pragmatically do that to promote the profession?

Would it be a pushing it so say that many people have a more clear view of say of the profession of medicine and the work of a GP as everyone has seen a GP at some point, they know when they would go and the gist of what will happen. They have sat alongside and been a recipient of that care. They have experienced the occupation of a GP appointment/intervention.

Hope that makes some sense and isn't too garbled - I'm trying to hold a baby on my knee and type at the same time!"

Occupational Therapy as a way of seeing the world

2009-01-22T11:07:00.000+14:00

Now I have been known to be a bit fluffy about OT but this post might be pushing the envelope a touch so stay with me. I was pondering today about how many OTs I talk with really feel that the importance of occupation is something that really speaks to them, that they really believe in it. I'm talking not just about saying all the right things about the importance of occupation when at work but about seeing the world from an occupational perspective.

I responded to a post on Facebook a few weeks ago from someone who was complaining that people kept asking her since she changed to a job that didn't have OT in the title, whether she missed being an OT. Her response - I'm still an OT! I wondered whether that though process applied outside the work environment and through some highly reliable research (chatting with green trousered friends) it would appear that we are all at it!

I see OT everywhere, from thinking about how to develop my blog to keeping to my new years resolution (or not) of healthy food and exercise. Rather than the famous line from the Sixth Sense, I see occupational beings!

Whilst all these thoughts are washing about up pops the excellent post from the Fredrick road crew. This throws much of my thought processes into chaos! Is it an OT specific thing to see things through the bottle green tinted glasses of occupation as central to identity, activity analysis and grading and holism?

Blogging and the day job

2009-01-19T03:02:00.000+14:00

Heres a question for you all. If you have/start a blog which will be talking about your experiences as a professional should you inform your employer? I've done quite a lot of reading about confidentiality and professionals blogs and the general guidance seems to be a healthy dose of common sense.

I have a "disclaimer" in my "about me" section which attempts to clarify that I am blogging my own views, not those of my employer of my profession. Is that helpful or does it detract from the posts?

I was discussing the joys of blogging with a friend who informed me that the organisation he works for asks that its employees do not blog at all about their work irrespective of the level to which they anonymise it. Is that right? Apparently its so prospective employees, clients and the general public don't read anything negative about the organisation. Seems to be more than a little contrary to the concept of free speech!

For more thoughts on blogging and confidentiality in general take a look at these two posts from top blog Sarah's Musings, firstly "Getting our knickers in a twist" and "An ethics question"

Any thoughts?

Many thanks to Possum!

2009-01-14T09:52:00.000+14:00

Who have agreed to sponsor my fees for the 2009 BAOT/COT conference. Maybe it was the temptation of publicity through my blog :-) anyway it made me day to know I would definitely be able to attend the conference and I am really excited about doing the roundtable session. I attended the conference in 2006 in Cardiff and really found it an inspirational event. One of the most interesting and though provoking sessions was one I sat in on by accident which had a mental health focus. One presenter talked about CBT and how she saw that this fitted to OT, it made me really reflect on the impact on psychological/psychiatric implications of the long term (and often progressive) conditions of the clients I work with. So thanks Possum, I look forward with great enthusiasm to the opportunity you have given me!

Why blog?

2009-01-13T01:04:00.000+14:00

So I'm broaching the idea of our service having a blog an I'm sure I will have to sell it so I had a look at why other people might think its a good, or bad, idea and found this interesting post.

OTmeetingspace gets a home!

2009-01-06T01:23:00.000+14:00

The idea that started out as a tiny spark has now become a full blown towering inferno! Thanks to a very unusual Christmas gift the project now has a website for us to try out features. We wanted initially to create an opportunity for OTs to volunteer their skills online using the best of web 2.0 technology but quickly recognised the projects potential. We started out on a Facebook group and things snowballed from there! For me this is so exciting, but also a bit daunting! I'm only really a web 2.0 rookie and although I'm an experienced therapist I'm not used to working on global projects for sure! Luckily OT's (I've found) are a friendly, helpful and dedicated bunch on the whole and I've been lucky enough to have the support of lots of international colleagues. However I would like to say a special thank you to Sarah Bodell from Salford Uni for her motivation and help with getting so far in such a short space of time.

I'm naturally a "yes" person so I need to make sure I temper my enthusiasm for the project with the day job and home life but I like to think that though my "yes" tendencies can be a logistical nightmare it opens up the world to me.

For me, like the techno kit I use in the day job, technology is a means to an end. That end might be increasing a patients sense of self worth through the creativity of Internet access or voice output communication or the end might be finding ways to promote the profession I really believe in. Anyway come on over and have a look at the site and get excited!

Now on OTblogs.org

2008-12-24T01:34:00.000+14:00

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

Practicing what we preach

2008-12-18T10:36:00.000+14:00

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.

RAatE 2008

2008-12-09T10:49:00.000+14:00

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.

Assistive technology as a psychological marker of change

2008-12-08T10:17:00.000+14:00

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.

Conferences, conferences and more conferences!

2008-12-01T06:47:00.000+14:00

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!

2008-12-01T01:15:00.000+14:00

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.

About me

2008-03-28T02:10:00.000+14:00