Saturday, 2 July 2011

Forensic Forum - Keynote Address

“Forensic Recovery and Rehabilitation”

Dr Tor Pettit and Dr Patricia Abbott – Pennine Care.

There were three main learning objectives or questions which were covered throughout this address:
1.       What is recovery?
2.       Is recovery different in a forensic setting?
Why OT?

Some brief notes on the definition of recovery:
·         Living a satisfying, hopeful and contributing life alongside an illness.
·         It’s not necessarily a cure.
·         Living well with an illness.
·         Growing as a person.
·         Never underestimate potential quality of life.
·         Analogous to the disabilities rights movement.

Recovery presents challenges for clients:
·         Developing a positive identity.
·         Framing the ‘mental illness’. – Personal experiences. We need to be client centred and see it from their eyes.
·         Self managing mental illness/antisocial- negative behaviours and attitudes.
·         Developing valued social roles.

Recovery also present challenges for staff:
·         Working collaboratively – patients as experts of their lives, OTs as experts in their profession, MDT working.
·         Maintaining hope. Believing in someone who may not have been believe din before. Future orientated.
·         Helping the person to:
o   Understand their own story.
o   Take control/ accept responsibility.
o   Develop plans for getting better/ staying well.
Recovery within forensic settings is crucial is the basic answer. Although it can be hard to justify and carry out when taking into consideration the priority of risk management. Perhaps OTs within forensic services should consider pushing for a shift from:
Managing risk to promoting safety!
Recovery must of course accommodate risk. Risk being the main reason why people are admitted to forensic services. It is important however to understand and monitor how risk labels can negatively affect individuals. Risk accentuates problems with recovery including, its affect on identity, environment, social impact, labelling and personality theories, enduring mental illnesses and also crime and its effects.
Recovery within forensic settings can be achieved in many ways, here are four ways explored:
·         Work collaboratively –Prioritising relationships. Looking for a hook (motivation). Which life choices can we support?
·         Maintaining hope – finding common goals. Future Goals, future you!
·         Helping the person to: Understand their own story, develop future plans/ getting better and staying well.
·         Interventions for cognitive impairment – collaborative working, environmental management, Antecedal control, compensatory aids, structured programs of enjoyable activity, long term goals, and increased tolerance. 
·         Personalised approach – client centred.
·         Enhancing life and quality of life.
·         Moving towards independence.
·         Promoting positive identity and self confidence etc.

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