Ward based OT vs. Therapy Team based OT.

Hello everyone,

Recently I’ve been pondering some of the difference between my old job (Ward based lone OT in a Medium Secure Unit) and my new job (One of two OTs in a therapy team based in a private Autism and challenging behaviours school). The most major difference I think is the fact that I am now based in a therapy team as opposed to being a lone OT ward based.

I thought it would be useful to note some of the strengths and benefits to each different way of working.

Ward based – strengths:

·         Easier to build a therapeutic relationship with your clients and get to know them and their personalities, strengths and weaknesses quickly. Build a stronger relationship from being round them more often.

·         Easier to build relationships with staff as you are working directly with them on a day to day basis. Easier to communicate, swap ideas, become part of the overall team dynamics.

·         Logistically you have everything you need around you. It’s easier to instantly speak to clients or to round them up for groups etc.

·         You are directly linked to the ward programme and so you know when and where people are doing certain things – this makes it easier to plan groups, sessions etc.

Ward based – weaknesses:

·         Hard to plan groups and sessions because you are hotdesking and sharing a limited work station with others.

·         You are constantly being asked questions or being distracted by both staff and clients.

·         You don’t have a chance to leave the ward for a break which can make the days long and draining.

·         You don’t get to directly work with the MDT as in my last post only the OT and nurses were Ward based. Therefore the Psychology team and social workers were not present on the ward other than for occasional sessions with clients.

·         Working as a lone OT (only one OT per ward) meant that you were lone working and this proved hard from a CPD/sharing knowledge and advice perspective as well as being tiring maintaining the OT role and having a large caseload and list of responsibilities for one person – especially if you are a newly grad. Or new to the area of practice.

School based strengths:

·         You get to work as part of a therapy team – I work along side another OT, Speech and Language Therapists, a Nurse and Psychology team. This is great for sharing ideas, knowledge, resources etc. I’m learning so much from spending my days surrounded by these people.

·         You have a desk and places to store resources, a quite place to do work uninterrupted. You don’t have to worry about hot-desking or where to put the resources for your next group etc. If you need to concentrate and right a report you can without being distracted.

·         The other staff in the school has more of an idea who you are in relation to your job role as you are instantly known as being in the Therapy team.

·         You are able to plan groups and make resources, look at research etc. more when you have the office space and the time to do so.

·         You have a place to reflect and debrief after any stressful situations of incidents. Being able to come back to your team and talk things through or vent about certain situations helps you to deal with them then and there, rather than carrying them around with you and needing to hide it when ward based and surrounded by clients all the time.

School Based - weaknesses:

·         You don’t build a report with the clients you work with as quickly as you would when you are ward based and around them throughout the whole day.

·         It is easy to get into the trap of spending more time at your office rather than on the ‘shop floor’ as you get caught up planning, writing reports etc.

I think I can definitely say that I am enjoying working as a School based therapy Team OT in comparison to lone working as Ward based. It would be really interesting to hear if anyone else has experienced this change and what they feel/prefer?

Happy OTuesday everyone,
Kate :)

The wonder of TED.

Hello,

Very short post this week as I am snowed under with work - plus the sun is shining and the sandy shores of Sandbanks are at the bottom of my garden and are calling out to me! 

Have you come across the wonder of TED yet? I'm probably way behind the times but after a friend sent me a video link from it I've been hooked ever since. 

So what is TED? .....

TED is: "a non profit website devoted to Ideas worth spreading. It started out as a conference bringing people together from three worlds: Technology, Entertainment and Design. Since then its scope has become even broader." 

TED is now a global website where people from all over the world have their talks and ideas published via global conferences. 

It is a brilliant place to broaden your ideas, learn something new and see and hear about the world from a different perspective. 

I have been watching videos about a wide range of topics from the criminal justice system, to the anti-trafficking movement (which I wholeheartedly support, to areas of Occupational Therapy. 

One talk which I found particularly interesting and moving is linked below. It is by a lady called 

Faith Jegede and is titled: What I’ve learned from my autistic brothers. I hope you can find the time to watch it.

http://www.ted.com/talks/faith_jegede_what_i_ve_learned_from_my_autistic_brothers.html

Happy TED exploring people, and happy OTuesday!

Kate 

Helping the Homeless.

This week I'm going to be writing about a topic which is close to my heart. I have a real passion and desire to work with the socially excluded groups of people in society. Whether that means offenders, drug and substance addicts, sex workers or the homeless. I feel that part of Gods purpose for my life is to work with these kinds of people.

I have been really encouraged over the past couple of months to see more articles and discussion about Occupational Therapy and the Homeless featured in both the BJOT and OTnews. Today I want to explore a bit more the situation in the UK with regards to Homelessness and how OT can make an impact on individuals who could really benefit from help and encouragement.

Although there are no official statistics due to the nature of homelessness some facts and data are as follows:

• Rough sleeping is the most visible and extreme manifestation of homelessness, but it’s only the tip of the iceberg. Government street counts and estimates give a snapshot of the situation in England. In 2012 they estimated around 2,309 people slept rough on any one night which is a rise of 31 per cent since 2010. 

• Statistics from Crisis UK (UK homeless charity) state that around 5,678 people slept rough at some point in London during 2011/12, an increase of 43 per cent on the previous year's total of 3,975. 

• Of rough sleepers in London: 88 per cent are male, 71 per cent are white. 58 per cent are aged 26-45 years and 11 per cent are under 25. 11 per cent of rough sleepers in London have been in care, 10 per cent have been in the armed forces and 34 per cent have been in prison.

• On average homeless people die at just 47 years old. 

• Homeless people are 13 times more likely to be a victim of violent crime. 

• 97% of homeless people want to work but only 2% work full time. 

Homelessness is about more than not having a roof over your head. A home is not just a physical space, it also has a legal and social dimension. A home provides roots, identity, a sense of belonging and a place of emotional wellbeing. Homelessness is about the loss of all of these. It is an isolating and destructive experience and homeless people are some of the most vulnerable and socially excluded in our society.

After years of declining trends, 2010 marked the turning point when all forms of homelessness began to rise in the UK. However, it is reported that homelessness has significantly increased further as an effect of the economic downturn, cuts to housing benefit and other reforms all start to have an profound impact on individuals and families.

What can OT do to help??

An Occupational Therapist enables people to achieve maximum levels of independence through developing personal & domestic skills, community integration, social & communication skills, leisure & recreational skills, work skills and practical coping skills. Therefore they are perfectly trained to work with the homeless population.

From reading some of the publications in the BJOT and OTnews (references can be found below) I have put together some key bullet points on example areas of intervention for OTs working with the homeless. 

• Teaching individuals skills for independent living - including budgeting, activities of daily living, cooking skills, healthy eating etc.
• Developing social skills and helping individuals integrate back into society in a pro-social way. 
• Restructuring their occupational balance, developing their use of time and the occupations which they engage in.
• Promoting integration back into the working world. 
• Developing motivation, establishing and promoting self esteem and a sense of purpose and self efficacy. 
• Utilising grading and adapting techniques to help work with individuals at a pace which works for them.
• Relaxation skills. 
• Helping individuals to engage in hobbies, activities and meaningful occupations to them.

These are just a few ideas and I am sure there are many more fantastic ways which OTs are working with this group of society. 

If you have any more information about this area of OT - whether you work with the homeless of know of people/organisations who incorporate OT in their work then I would love to hear about it.

Whether you are an OT or not, there are many ways how you can help the homeless community. I'm certainly going to look into what I can do in my local area and I encourage you all to do the same. 

Happy OTuesday. 

Kate :).

References:

http://www.crisis.org.uk/ - The national charity for single homeless people. 

Hocken Y (2012) "Developing an outreach approach" OTnews 20(12)pp. 35

Parmenter V, Fieldhouse J and Barham R. (2013) "An Occupational Therapy Intervention Service to hostels for homeless people: an overview." BJOT 76(5) pp. 242-245.

Redman G, (2012) "Filling a gap in service provision" OTnews 20(8) pp. 42.

The importance of CPD in a Multidisciplinary Team.

We've all heard the saying: "Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime." - and I couldn't agree more.

The focus for this blog post is on the importance of CPD and training within in the workplace. The school where I work is really focused on both of these and I'm reaping the benefits from it.
Last week, when the therapy team were at work but our students were on their Easter holidays, the team decided to use some of the time we would have spend in sessions to work on developing our CPD folders and improving our practice. The therapy team where I work consists of the following: 2 OTs, 2 SALTs, 1 Nurse, 1 Clinical Psychologist and 2 Assistant Psychologists.

Each member of the team presented a specific aspect of the work there are involved in or on the area which they specialise in. Over a week presentations were given on subjects such as Attachment theories, to the Tactile system and sensory defensiveness, to pictorial communication aids all the way to an introduction to Forensic OT (which if you can't already guess from previous posts was mine!)

It was so interesting to learn together about the different areas which were taught. The consensus from each of the team members was that it was a roaring success. Being able to sit down together as a team and learn about different ways of working with the students we have was a real inspiration and helped us to think of how we could incorporate other disciplines methods of working into our own to make our interventions better.

Another benefit to it was to see how we could work as a team better by incorporating all of our skills more effectively. The importance of working together for a shared goal and integrating our methods of working and expertise to best work with our students.

I think it would be fair to say that each member of the team spent the week buzzing from the excitement of learning new information and skills which we could put into practice the following week when the students returned. It has really expanded my knowledge and I feel has helped us as a team to understand each others occupations better and to pull on each others knowledge a bit more. Being in a central office together means that we can clinically discuss our students progress and brainstorm ideas with each other in a really effective way.

We already have plans for the school holiday where we are going to use the time to start a journal club where each individual brings a profession specific article or piece of research relating to our area of work.

I would really encourage you all to perhaps do something similar, to start a journal club or similar - it really does make a difference to your practice!

Do you already do something similar or have a different approach to CPD? I'd love to know so please leave a comment below :).

Happy OTuesday,
Kate

Social Stories and Autism.

I am now two weeks into my new job as a Paediatric OT and I am absolutely loving it. I am blessed to be working with a really knowledgeable and friendly therapy team who have made me so welcome.

It’s been really interesting getting to know some of the children I will be working with as well as attending some really fascinating training sessions. I’m really excited about how I am going to be able to develop as an OT in this field.

One of the most interesting areas I have started learning more about is Sensory integration. Sensory integration which, in simple terms, is how a person’s brain is able to register the information provided by their senses within the body and from the external environment. It’s an absolutely captivating area of work which I am keen to get started working in. I’m hoping to dedicate some blog posts to some of the different areas of SI so keep your eyes pealed!

For today however I have decided to talk a little bit about Social Stories. I had never encountered these before and have soon come to realise how fundamental and effective they are when working with people with Autism and ASD.

In 1991 Social stories were created by an ASD teacher named Carol Gray to help teach social skills to people with Autism. Social Stories are short descriptions of a particular situation, event or activity, which include specific information about what the individual can expect in that situation and why.

The stories are often written simplistically with either symbols or photographs above each word in the sentence. They allow individuals to learn about the different levels of communication within a conversation or situation. Individuals with Autism find social situation difficult and struggle with developing and appropriate social skills, this includes understanding others feelings, reasons why certain things happen – abstract ideas etc.

The different levels of communication which Social Stories help explain include the following:

·         The things which were actually said in a situation.

·         How others in the situation felt.

·         What will happen in a certain situation and why.

·         What people’s intentions may be.

At work we use Social Stories for a variety of reasons, some of which I have listed below:

·         To help a student cope with changes to their routine whether this is an absence of a teacher, a change to an activity or moving to a different living group.

·         To help a student to understand how others might behave or respond in a particular situation, and therefore how they might be expected to behave

·         As a behavioural strategy, for example what to do when angry or upset.

·         To help the student develop with self-care skills (eg. Importance of washing their hands, getting dressed etc.) 

Why are Social Stories effective for people with Autism?

·         Many people with autism are good at visual learning, and like social stories because they're written down. Social stories are also often created using symbols and photographs as well as simple words so they are accessible for individuals whether they are verbal or non-verbal.

·         Social stories present information in a literal, 'concrete' way, which may improve a person's understanding of a previously difficult or ambiguous situation or activity.

·         Social stories can help with sequencing (what comes next in a series of activities) and 'executive functioning' (planning and organising) - difficulties experienced by many people with autism.

·         By providing information about what might happen in a particular situation and some guidelines for behaviour, you can increase structure in a person's life and thereby reduce anxiety.

There are some really good examples of Social Stories on the website link below:

http://www.slatersoftware.com/autism.html

It would be interesting to know if anyone uses or has any experience of using social stories. Please comment in the box below this post if you do!

Thank you for taking the time to read my latest post,

Kate :)

New beginnings.

It's been a few months since my last blog post back in December and a LOT has changed.

Today was the start of a new chapter in my OT career. After leaving my job in a Medium Secure unit I started a new job as a Paediatric OT!
Leaving the world of Forensics for a completely different area of practice was a decision which took a lot of consideration, and although I still have a great interest and passion for Forensics, the chance of developing my skills and gaining experience in my new job is an incredibly exciting prospect.

My new post is set in a mixed-gender residential school for students aged 7-19. The pupils have a diagnosis of complex needs, learning difficulties associated with autism and challenging behaviour.

I'm looking forward to learning about a completely new area of practice and seeing how I can adapt and develop new ways of working as an OT.

Stay tuned for updates on how my journey develops.

Happy OTuesday,
Kate