Occupational Therapy and Literature

Middle Beach St Clair

Today I went to a lunch time seminar the speaker was Rosemary who had been a lecturer at our school of occupational therapy until her retirement last year. She is now finding time to do a PHD.  It was a really interesting talk on using popular literature to gain an understanding of Occupational Therapy – an understanding of occupation and an understanding of the human condition.

Two things I have taken from or thought about since the talk:

Occupational therapists recognise in all occupations the technical skill e.g. in baking a cake (the techniques such as creaming butter and sugar together, measuring ingredients, using the stove etc). But  when you read a popular literature story (or even a children’s story)  that involves baking a cake the reader realises as occupational therapists do when working with clients  that there is much more to baking a cake than the technical skills. Why is baking a cake important to that person?, why do you decide to bake a cake?, what do they gain from baking it?, how does doing it impact or affect who we are? As we work with our clients/patients as occupational therapists we believe that all of these things are implicit to why people choose to  engage in certain occupations.

So the occupation of baking a cake and most occupations are complex they are not just about the technical skill but also tell us about the human condition.  As we work with our clients/patients as occupational therapists we know that many things contribute to why people choose to  engage in certain occupations.

The other piece of food for thought as an educator is that occupational therapy students and occupational therapists need to know as much as they can about occupations and the human condition. How do we get this knowledge when we only have our own experiences. Rosemary suggests that ‘good’ popular literature is a way to come to a greater understanding.

The New Zealand Occupational Therapy Conference and the Australian Occupational Therapy Conference

Recently I had the opportunity to attend both of these conferences. The New Zealand Conference this year was in Palmerston North – not the easiest place to get to, but at the end of the day its being able to get together that matters. This was up there with the best of the New Zealand Conferences that I have attended. It seemed that people were all ready to do something about influencing the future of occupational therapy in New Zealand. There was a lot of celebrating  and showcasing the core values of our profession,  with an emphasis on occupation,  and an awareness that as a profession we bring a different perspective and approach to working with others.

You might argue that we did not have the well known names of the profession as key note speakers (we have had them in the past and value  their contributions) but there was something quite wonderful in having as key note speakers people who were researching but who were clearly still at the coal face engaging with clients or students, showing us that you can do both well.

The association continued its commitment to always have key note speaker who is a New Zealander. As a country of only 2,000 occupational therapists it has in the past been seen that conferences were a way to bring the experts from overseas in to tell us what they are doing. However in this decade we have seen the importance of not only learning and hearing from others, but celebrating what we are doing here, learning from each other and valuing this, alongside the insights from overseas.

So not only do we now always have a key note from a New Zealander but also no longer is our Frances Rutherford Award Lecture (for occupational therapists the New Zealand equivalent of the Eleanor Slagle Clark US or the Docker AUS) on the second or third day of the conference, but now on the first day of conference a true celebration of the contribution one of our own therapists has made to the New Zealand profession.

It was the first time that I have been to the Australian Occupational Therapy Conference and I have to say that this time round I think the New Zealand Conference was the better more focus, a greater pride and enthusiasm. So perhaps if you are an Australian occupational therapist or indeed from anywhere off shore next time the New Zealand Conference is on it might be worth thinking about coming across ‘the ditch’ (the pacific) and seeing what it is all about.

One of the highlights this year at the NZ Conference was Trish Egan’s call for us to develop our own model for occupational therapy practice. A suggestion that got everyone talking – so what is it that we do as occupational therapists here in NZ?, do we practice differently from elsewhere in the world?, are our  belief’s and values the same?

I do think we approach things differently, and work in a slightly different way than our colleagues elsewhere. Certainly because of New Zealand’s commitment to the Treaty of Waitangi, I think our understanding of identity, culture, cultural awareness, and cultural safety positions us a little differently to other countries. So watch out for a model in 2015 that gives an underpinning to NZ occupational therapy practice.

Top Occupational Therapy Blogs

The number of good occupational therapy blogs is growing. I thought it was time I shared with you some of my favourites. So first up is:

June 15th

Skills for healthy living: A resource blog for health providers this is a fantastic blog to learn about chronic pain, and to develop understandings about and skills in working with clients with chronic pain. Written by an occupational therapist it’s a great way to upgrade on this specialist area. And as a bonus it also has some fabulous photo’s.

16th June – No. 2 (please note these are currently not being ranked they are just coming in the order I think about them)

Thriving in School this blog is from Hosmer Road School in the US. Funny thing is until I went back in to write this I had always thought Hosmer Road School was in the UK!! – So sorry Beth. This blog is full of practical hands on tips and ideas for therapists working with children. I think part of my love of this blog is that it takes me back to my days of being a Paediatric Occupational Therapist. But with over 17,000 visits to this blog since January 2007 it must be one of the busiest Occupational Therapy Blogs IN THE WORLD.

17th June No. 3

OT Students (B)E(LO)N(G) You have to give it to Karen she wins hands down for being the most prolific occupational therapy blogger. She’s a student in her SECOND YEAR of training. It is a blog with an interesting mix of: how my day has been from the exciting to the dreary (did I really need to know she has just done the laundry!), glimpses into what being an OT student in the US is like, thinking associated with her ongoing learning, insights into working with clients and how applying her training goes. But overall what comes through is a huge motivation and commitment to becoming the best therapists she can. I find myself just having to go see what she is up to.

June 25th – No. 4

Advance OT This next blog is an outside somewhat surprising entry in my best blogs (even to me) as it is a trade publication. What I like about this blog is that it reports on what is happening in the American Association of Occupational Therapy. I think blogs like this are a great way of ensuring the everyday happenings and events of professional bodies are visible to all and able to be discussed. I’d love to see the New Zealand Association of Occupational Therapists with a blog and blogger. It’s a great way of getting up to date information to members and to enable non members to see the benefits of the Association. So how about it NZAOT?

Freerice

Tonight I decided that it has been a while since I visited some of the Occupational Therapy Blogs that are out there. One of the first I found when I was first starting to blog was Hosmer School it always has an interesting range of postings. They don’t get a lot of comments but they certainly get a lot of visits. Tonight when I went on they had a link to Freerice. A site where you test your vocabulary and for every word you can define (through multichoice questions) you are donating 20 grains of rice to the United Nations world food programme to help end hunger. They state:

“FreeRice has two goals:

1. Provide English vocabulary to everyone for free.
2. Help end world hunger by providing rice to hungry people for free.

This is made possible by the sponsors who advertise on this site”.

They point out and again I quote from the site that:

“Learning new vocabulary has tremendous benefits. It can help you:

• Formulate your ideas better
• Write better papers, emails and business letters
• Speak more precisely and persuasively
• Comprehend more of what you read
• Read faster because you comprehend better
• Get better grades in high school, college and graduate school
• Score higher on tests like the SAT, GRE, LSAT and GMAT
• Perform better at job interviews and conferences
• Sell yourself, your services, and your products better
• Be more effective and successful at your job

After you have done FreeRice for a couple of days, you may notice an odd phenomenon. Words that you have never consciously used before will begin to pop into your head while you are speaking or writing. You will feel yourself using and knowing more words”

To find out more and to put your vocabularly to the test
visit Freerice

It certainly enhanced my vocab more than Gordon Ramsey was doing on the TV.

Trust yourself, explore, experience

Part of some homework I have for the permaculture course is to work out the microclimates on my plot of land, by moving around the land observing changes of temperature, wind, soil etc. I found myself thinking that it would be helpful to have a probe to tell me about my soil, a temperature and wind gauge etc. It made me realise just how technology and instrument driven we have become and yet our observation (what we feel and see) can tell us such a lot if we tune into it and trust what it tells us. It seems to me that it is easy to forget just how good our senses are and thus we could be in danger of not utilising these skills, not just when we are gardening but in everyday life. Perhaps this is one of the challenges for us as occupational therapists, the utilisation of a range of skills and abilities when we work with clients, taking care to focus in on what we observe. Perhaps we don’t need a test or assessment for everything? We already know evidence needs to be considered along side the clients context before we act. So my tip for today is build up and trust our skills in observation … however knowledge needs to grow alongside observations e.g if I knew the story the weeds in my garden were telling me my observations would be more meaningful e.g clover growing tells me there is nitrogen ? in the soil, but what do buttercups, thistles etc tell me.

There are holidays, there are distractions and there are … clinical workshops!

I can’t believe how long it is since my last entry. It’s been a pretty busy couple of months. I am a bit amazed that I even have to confess that I didn’t check my blog statistics for three weeks ( I was becoming a little addicted). I see Merrolee (Occupational Therapy Education) has a bit about checking the blog statistics and I have to agree they do give you a prompt to keep on posting – so all those lurkers who read but don’t post have something to think about (mind I would love it if they posted). I am interested that people are still visiting despite the weeks of silence.

Last week I attended the New Zealand Association of Occupational Therapy Clinical Workshops in Cromwell Central Otago ( so right here in our backyard) held in the off year to their conference. It was great to catch up with other occupational therapists and interesting to see what issues are occupying people’s mind about the profession.

There was quite a lot of conversation about how to position occupational therapy so that therapists are able to offer more in the primary health area, topics on strengthening communities – how to facilitate communities in their support and encouragement of each other, changes to ACC (New Zealand’s Accident Compensation Corporation) the International Classification of function (ICF). There was an interesting challenge about whether some people who clearly have significant challenges in going about their everyday occupations get the opportunity to receive occupational therapy. The example given was people who live with psoriasis (most often only seen by the doctor and treated through medication) . Perhaps maybe we need to open our and others eyes to think more about who could benefit from occupational therapy rather than staying with the traditional client base. Plus lots more.

I was fascinated to hear about how the building we were meeting in was built. A real story of a community knowing how to make something happen. I am not sure I have all the facts sorted but it goes something like this. The area needed a new church they decided that they would build a building that whilst a church could also be used as a conference centre and become a community asset . They had the plans drawn but were facing real issues in raising sufficient funds to build it. The community rallied and over a weekend the shell of the church come conference centre was built . Over 300 people donated their time and skills they saved themselves 1.5 million and were able then to get the funding to finish the building. It is a building that is now clearly used by the whole community and which has the potential to fund itself, by having people like us having their conferences and meetings there. A great story – one that makes you realise the power a community working together can have.

Well I hope this ends the blogging holiday – guess we will see.

Facilitating elearning communities

I have enrolled in a course on facilitating elearning communities. As part of that course I have to keep a reflective diary of my experiences. This is therefore the start of that journal.

The most exciting thing for me so far has been a link posted on the course to The Art of Building Virtual Communities http://www.techlearning.com/blog/2007/08/the_art_of_building_virtual_… it is well worth a look with a great discussion and links. I have heard a lot about the lurkers in elearning communities – the people that visit your site/community but who don’t post and who we all try to image and give form to. However it made me think about the other people that make up the community the linkers, the learners and the leaders. One of the links on the site talked about the leaders ‘building the fire’ which encourages participation and learning. I have been linking/lurking/learning at other occupational therapy websites recently and it has been really interesting to see what topics have ‘gone on fire’ e.g. got lots of comments. The observation I would make is that so often it is what the second and third person who comment that ensure that there is a ‘fire’. For me more learning happens when I can see different perspectives.

Linkers, lurkers, learners and leaders are all welcome to contribute.

Blogging duldrums

I seem to have the Blogging duldrums. I have a few things that I could blog about but it seems like a bit of effort at the moment. And so a post that doesn’t require too much thought is in order….

I was doing a little procrastination at the end of the day yesterday when a survey on using technology for professional development popped up in my emails – and so it got my attention. It made me realise just how dependent I am now on the web and yet 10 years ago it was not a feature of my work life at all, I started to wonder how I coped without the instant information I now have at my finger tips.

Did it mean I relied more on my own analysis and interpretation?…. was it easier to be confident in my own abilities and reasoning i.e. no checking it out on the net …. does the web mean we individually now know less or more? …. does it help us articulate ideas more easily or less? …. what do we do better as a result of the web and what do we do less well?

I think this post is turning out to require more thinking power than is available tonight as I multitask watching TV (as I was going to have an evening blobbing out) blogging, and trying to fit the cat and the lap top on my lap at once. So if anyone else has any thoughts they would be appreciated.

Supervision as professional development

     It’s still rather cold here in the far south.

I have been interested in supervision for some time and was involved in doing a small qualitative study that looked at supervision of occupational therapists in New Zealand. There were two parts to the study firstly participants in the study were asked what supervision is.

In defining supervision participants spoke of the activities of supervision, the nature of the supervisory relationship and identified three key concepts that described the purpose of supervision. The activities of supervision were raising issues and talking through problems: generating solutions. Raising issues gave a starting point from which supervision could begin. The issues raised were seen as emerging from a wide variety of contexts; those that relate to one’s professional and personal self, those that highlight one’s interactions and interventions with clients, and lastly those that relate to the wider context in which the person worked, for example the team or the organisation. Supervisees were clear that the activity of talking through problems: generating solutions was not about being given answers but rather enabling supervisees to work through their own solutions with guidance and support from a supervisor.

The quality and nature of the supervisory relationship was seen as critical to the effectiveness of these activities. In defining supervision participants described the nature of the supervisory relationship as one of mentoring which suggests as important the notion of nurturing within the relationship. All of the participants saw that the supervisory relationship must be supportive and trusting. These concepts provided a picture of a relationship that should be non-judgemental, respectful, encouraging, and that felt caring. It excluded the elements of oversight, checking and evaluation indicated in much of the literature. Interestingly mentoring was a term that was less frequently used as the interviews progressed and the characteristics of a supervisor became clearer.

For participants the purpose of supervision related to three key concepts; keeping safe, the opportunity for reflecting on practice and the provision of knowledge by the supervisor. Participants were concerned that their role and practice as an occupational therapist put them at risk. They felt at risk firstly by, being in situations where they might find their competence questioned. Secondly, due to the nature of working with people who were under stress or thirdly where they themselves felt physically or psychologically unsafe. Having a means to explore ways of keeping safe was therefore essential. Supporting this by looking at what they were doing in practice and how they were doing it, through reflection on practice and the feedback they received when involved in reflection were important purposes of supervision. Not all therapists have sufficient experience or resources for the variety of challenges that arise within their work place, particularly those new to occupational therapy or those settling into a new role. For these people the provision of knowledge is important. More skilled therapists likewise acknowledged that the knowledge supervisors impart as a part of offering different perspectives or suggesting resources is beneficial.

What really struck me about how the participants defined supervision is that they were showing that they saw that this was a process that could work for them. They clearly wanted to be able to lead in the supervision by having a system that enabled them to work through their own challenges, and at the end to feel that they had come to their own solutions. I think the other thing that strikes you is the committment the therapists were wanting to make to ensure that they were continuing to grow as therapists. In looking at the ability technology now gives us we clearly need to ask if there is a role for web 2 and the internet in this process.

Blogging for professional development – does it work?

 I set this blog up about 8 weeks ago and as my tag line says it was to explore blogging as a means of professional development in occupational therapy. Given professional development is all about learning – I thought it was time that I decided whether blogging was having any effect or not … so what have I experienced ? and has blogging had an effect on my professional development?

Well so far I have noted:

• increased confidence with web 2
• by looking at other bloggers sites a greater awareness of the things occupational therapists are doing, and on many of the sites the postings have made me think about an issue they have raised
• and on still other blogs an awareness that occupational therapy students are stressed by assignments, hate boring classes and time wasting – and some gems about what works in education for students but would like to know more about what they enjoy and what works for them what lights them up about occupational therapy – see the value of the positive in my earlier problem solving/appreciative inquiry posting
• I am just starting to to find that I am now thinking about some of the reading that I am doing and thinking – how might I express/summarise what I am thinking about or learning from this, such that others might be interested as well – the act of having to express it firms up my thinking.
• It is also pushing me to get into a regular pattern of articulating my ongoing learning – I am therefore more often asking myself what am I learning from this experience (reading, meeting, inservice, happening) – and this reflection firms the learning.

So I think I can say yes blogging is having a positive effect on my on going professional development. However I am not yet sure it is a habit – will I keep getting enough from this to keep it going – watch this space.