Category Archives: Problem solving

New Years Greetings

I am having a new year tidy up before life gets busy again. I am not going to say I have a new years resolution to post more as that is most often the best way to ensure it doesn’t happen! So I am going to apply some occupational therapy wisdom (not sure occupational therapy can own it, but we do use it a lot with clients) ‘”start with small steps and you will be surprised at the opportunities and possibilities that unfold”.

Todays small step is to tell you that we are about to do some work upgrading the website everydaymadeeasier.blogspot.com  Please go and look at it and give us your thoughts on what is useful and what could be developed further, or things that you think should be there that aren’t etc. There is a feedback tab on the site.

Happy New Year, may 2013 through your actions be one to remember positively.

Advertisements

Occupational therapy is just commonsense isn’t it?

NO NO No!!!

I don’t know how many times I have heard an occupational therapist or an occupational therapy student say “its just commonsense” when someone comments on something that has been suggested or recommended by the occupational therapist. After all doesn’t everyone know how to set goals, how to use a problem solving process or know that being well occupied contributes to self worth and self identity?

No !! If it was that easy everyone would just do it. Yes some but not all people do know about theses things but many struggle with how to bring them about . In the case of goal setting knowing how to not only set an achievable goal but to break it down to achievable steps to, work out how to remain focused on the goal, to learn how to plan for and scale any barriers that may be in the way and to celebrate the successes especially when one is coping with change, injury, disbility, illness or changed circumstance is difficult.

It’s definitely not just commonsense rather skilled artistry on the behalf of the therapist in getting alongside the person and making the difficult seem achievable.  Just as being well occupied, engaging in a range of satisfying occupations can require careful consideration of the environment, the person and the occupation/task or activity  by the therapist in order to bring it about successfully enabling the  person to experience meaningful engagement and the feelings of wellbeing that go with it.

The good bit (and sometimes the hard bit) is if we are good at what we do many don’t notice the intervention it just worked -they did it and slowly the skill of goal setting, problem solving, and the ability to bring about being well occupied moves from being facilitated by the occupational therapist  to being within the clients arsonal of skill to use as and when needed and so it begins to becomes the every day, and as that happens the illusion of commonsense develops.

I am not saying others can’t bring these things about however an occupational therapists ability to manipulate context rather than the person is a pretty unique skill.

The dictionary says commonsense is: “good sense and sound judgement in practical matters” so perhaps occupational therapy is commonsense – but perhaps commonsense isn’t all that common? Perhaps occupational therapists amongst other things are builders of commonsense?

Here ends my first rant and first blog for ages…

So visitors to this blog – Is occupational therapy just commonsense?

Are we busier?

Today has been one of those days when you feel that there is not enough hours in the day to do all the things that need to get done. By the time one attends the meetings, and attends to the emails (in this instant world everyone expects an email reply pronto), there seems little other time left in the standard work day.

So what was today like:

The morning was full of meetings and email – when I look back now the meetings were actually very productive, and I did manage to get most of the emails responded to although the ‘a response needed file’ in the emails grew somewhat.

At lunch time we celebrated one of our staff members going off to the Masters World Games and I found myself saying to the staff member who had arranged the celebration – it’s great to be celebrating, but sadly sometimes in today’s busy world we need to ensure that we have plenty of people around who remind us to celebrate.

After lunch things went backwards I did manage to deal with one meeting on the phone rather than a face to face meeting freeing some time. But it was one of those afternoons where the technology and I were definitely not in sych, the computer was having a go slow day, I couldn’t get the library data bases to workfrom my computer – all I wanted was one article!, then I couldn’t figure out how to cut and paste some info into a table I was trying to complete (the usual methods didn’t work) etc etc.

But I think the biggest frustration of the day was that feeling that no matter how quickly I was working there were things I just wasn’t getting to, the lecture I have to write and give on Monday, the proposal due tomorrow, the timelines that need to be written and implemented for some key activities we have planned, a second proposal due next week, the monthly reporting etc.

So today’s questions are how do we work smarter?? and how do we look after ourselves to ensure work/life/ balance. As an occupational therapist I see that it is important to live it was well as talk it. So watch this space – I’m not sure of the answers but something is going to chance.

My impact on the World!

I’m on a conquering technology blitz. For those of you interested in your blog statistics check out my clustrMap on the right. This gives a visual representation of the visitors to my blog telling me where in the world they are based (so now whilst I don’t now who the lurkers are I can enjoy knowing where they are based!!). I have admired for a while Hosmer Schools cluster map and suddenly realised that I to could have one.

It continues to amaze me the things people have developed that are free to download and use. If you want a clustrMap when you click on mine it offers the opportunity for you to set up your own.

Doing occupational therapy differently – have we considered it?

Frost

I was watching TV last night and they were talking about the Accident & Emergency department crisis in New Zealand where people have to wait for hours and don’t always get the service they need. They showed an A&E department in Australia – who had taken some learning from the toyota motor cars assembly facility – the ‘lean’ method/technique (or some similar word) as a way to address the waiting issue and to avoid getting into traps that prioritising patients though a triage system often brings. They were focusing on seeing the person and getting the intervention right by the right people at the right time, seeing the whole and not just the parts, focusing on the best outcome.

 

I’m not in the heart of practice any more but can remember going to one job where it felt that the people in the job before me had spent most of their time assessing and putting people on the waiting list and not therefore having time to treat the clients. The TV programme and my experience made me wonder whether it was time for us to also think about how we prioritise our clients and whether prioritising is the most effective way to go. I also know that the pressure of waiting lists often gets to therapists. Seeing people who have beenwaiting for a time is also frustrating as it often means intervention has become harder and the client and the family are incredible frustrated about having had to wait.

Interesting on the same night there was a segment on a new stroke initiative to give rehab to stroke clients who have received little since they returned home. It’s a sad fact that rehabilitation seems to be a dying art – so great to see someone pushing for it’s return. I guess what it reiterated for me is that some services that were previously provided by hospital facilities are going to need to be championed by non-government organisations if they are to survive – and as occupational therapists we need to be advocating hard ensure clients have the possibility to receive services such as rehabilitation.

Food for thought

Supervision as professional development

Frozen Cabbage     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.

Problem Solved?

house-ida-valley.jpg Occupational therapists are often associated with problem solving. In reading about a change concept called appreciative inquiry. I was interested in the following description of problem solving

Traditional diagnostic model

  • Defining the problem
  • Fixing what is broken
  • Focusing on decay

What problems are you having?

And then an alternative model

Appreciative Inquiry

  • Searching for solutions that already work
  • Amplifying what works
  • Focus on life giving forces

What is working well around here?

Um…. It makes you think about the approach you use

So what is appreciative inquiry?

It was described in Cooperrider & Whitey as “Taking the best of the past and stretching it into the future”.

And in Hall and Hammond as having these features

  • Acknowledging that we all have rich positive experiences to call on
  • Works on the principle that whatever you want more of already exists in the organization (or I’m adding ‘an individual’) you just have to recognize it
  • People can have confidence in the future when they can carry though parts of the past
  • When you do more of what works the stuff that doesn’t work goes away

Much of the literature talks of using the Four D – model within appreciative inquiry In Magruder Watkins & Mohr they describe the four D model this way:

  • Discovery Appreciate the best of what is – by focusing on times of excellence(when are you or the organization most alive and effective)
  • Dream Involves challenging the status quo by envisaging a preferred future
  • Design Creating the social architecture – what will the structures and processes be
  • Deliver Deliver on the new images of the future a time of continuous learning, adjustment and improvisation

In summary

Appreciative inquiry is described as:

  • A search for the best in people
  • It identifies your positive core
  • It is about building on what works well
  • And most importantly it is about recognising the best in the people and world around us

Certainly makes you wonder what the world would be like if we all thought this way.

References:Cooperrider, D. & Whitney, D., A positive revolution in change: Appreciative inquiryGoogle Scholar http://appreciativeinquiry.case.edu/uploads/whatisai.pdf

Hall, J., & and Hammond, S. What is appreciative Inquiry Google scholar http://bands.butler.edu/~dluechau/articles/hallhamwhatisai.pdf

Magruder, J., & Mohr, B. J. (2001). Appreciative Inquiry: Change at the speed of imagination.
San Francisco:Jossey-Bass/Pfeiffer.