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By Sadie Charlton. Written as a 2nd year OT student (2015)
So it’s the start of a new academic year for us all here at SHOUT (Sheffield Hallam Occupational Therapy Undergraduate Team). What better way to start than to be attending a two-day workshop hosted by Sue Parkinson based on her recent book release - Recovery through Activity. After a busy (and long!) summer entertaining my toddler (and not doing much reading... oops) this was exactly the opportunity I needed to jump back in to year 2 of the course. I was thrilled to be given this opportunity but also felt a bit nervous due to my lack of experience in Mental Health and also my knowledge on MOHO. So I thought the best thing to do to prepare would be to buy the book and see what it's all about.
Sue Parkinson, lead author of the Model of Human Occupation Screening Tool (MOHOST), is recognised as an influential and passionate occupational therapist who has made a huge impact within the evidence-based realm of mental health. The book which the workshop was based on, titled 'Recovery Through Activity' (2014) is a flexible, easy to digest, tool aimed towards facilitating groups and exploring the value of activities.
The first thing that jumped out at me about the book was the clear layout and straightforward text. As a second year student who, at times, has struggled with the extensive amount of reading and the effort that comes with reading and re-reading whole pages just to make sense…this text was a breath of fresh air. The book is sectioned into 12 areas of activity (eg; leisure, self-care), each with background information including evidence base. There is then suggestions to facilitate discussions about these activity areas, group exercises, ice breakers, hand-outs to photocopy and ideas to follow-up the session. The book is heavily underpinned by MOHO theory, which is great in allowing you to link in with MOHO assessments and recognising that familiar language (which as a student really helps me apply the language into something tangible). I wont say any more about the book itself as I have absolutely no experience in book reviewing (as you can probably tell) so I'm afraid that I wouldn’t do it justice. Just trust me when I say it is definitely worth owning a copy.
Back to the workshop! It was based in Sleaford, so very early start commuting from Sheffield but worth it. In total there were 4 students and the rest that were OT's from a variety of mental health areas. It was interesting to spend time with these professionals and exciting to hear them speak so passionately about their careers (& picking their brains during the tea breaks!).
The theme of the workshop started with a discussion about facilitating groups, and why we do this. I was surprised to find out that not many of the OT’s in attendance were currently facilitating groups, though the majority had experience in doing so. Group facilitation is not something I have experience in, but an area I am certain I will explore. Sue spoke about the basics of running groups and areas to think about when doing so such as; is the group open or closed, how often sessions are held, the target group, session topics etc. Sue also went on to explain why facilitating groups is worthwhile, as it brings it back to the OT basics – during group activity the emphasis is on the doing. Sue also used Yalom’s ‘11 curative factors of group therapy’ to explain the dynamics of engaging this way. It was certainly an eye-opening discussion for me as I hadn’t really thought about how powerful groups can be.
I particularly liked the way Sue explained so effectively where ‘Recovery through activity’ groups could fit in to the OT process and the role that they can play in exploring an individual’s interests resulting in goal collaboration. As a future Occupational Therapist I have a clear view to where I could use the recovery through activity groups in my future practice. Clients which need support in addressing areas of their volition could benefit from the exploratory opportunities of the group. This includes promoting confidence, social skills and validation of shared interests. Then, through 1:1 work this can be built upon by negotiating goals and focusing on skill development alongside roles and routines.
Day 1 of the workshop ended with a discussion and activity on negotiating treatment goals. This involved coming up with examples of goals which were measurable, achievable and person-centred. As a student I have sometimes struggled with writing the ‘SMART’ goals that we are taught at university, many times have I written a goal only to get the feedback ‘Make it smarter!’. The way MOHO uses levels of change and support strategies within the goal setting, I believe makes it a lot more focused and effortlessly smart. I feel confident now with my goal negotiating and I am looking forward to using it in practice. (At the end of the blog post you will find some additional reading references on goal negotiating that I hope you find useful).
Day 2 and getting up at 5am was even easier as I was raring to go with what I would learn at the workshop. The day was a lot more practical with emphasis on building a potential recovery through activity program. Before we did this though, Sue spoke about the Do-Live-Well Framework which is a Canadian framework for promoting occupation, health and well-being. See the YouTube clip here:
I think that the easy to understand video is a great tool for explaining the areas of occupation to service users and members of the MDT. Looking at the 8 areas, described within the framework as ‘dimensions of experience’, Sue explained where the activities within the Recovery through activity programme could fit. For example; under ‘Personal Care’ could be both self-care and faith activities. This allowed for a clear view to which activity areas would be useful to include in your programme depending on which of the 8 dimensions of experience you choose to focus on.
In the afternoon of day 2 we separated into groups, based on service areas, to have a go at outlining a recovery through activity programme which could be used within practice. The students were asked to separate and join in with the clinicians to bring ‘fresh ideas’. My group was made up with clinicians who were working in secure forensic settings. We brain stormed some ideas and decided on using the ‘Community’ area of activity, using resources from the recovery through activity book to support us. We decided using discussion exercises could prompt shared ideas on what community means to the individual and to reflect on their roles within their community setting. The session would end with brainstorming an activity to follow up, we suggested creating a wall mosaic that represents the community within the secure setting. This would link nicely to the next group topic which could be ‘Creative Activities’. This was just one idea of many shared that day by the group, all which centred on our main ethos of ‘doing’. This is what I loved about the workshops and the book itself, the focus is on what we trained (or are training) to do – the use of activities to recover, sustain and thrive.
Overall I had a brilliant two days and feel like I have really benefited from the experience. My knowledge of facilitating groups has grown, along with the concepts of MOHO. It was such a privilege to attend and meet Sue Parkinson, who is not only a MOHO legend but a really lovely and inspiring lady. Perhaps Sue may come to Sheffield Hallam and speak at a SHOUT event in the future?... Watch this space!
References
Kielhofner, G. (2008) Therapeutic Reasoning: Planning, Implementing, and Evaluating the Outcomes of Therapy. In: Model of Human Occupation. 4th ed. Baltimore: Lippincott Wiliams & Wilkins.
Parkinson, S. (2014) Recovery Through Activity. London: Speechmark Publishing.
Parkinson, S. et al. (2011) Enhancing professional reasoning through the use of evidence-based assessments, robust case formulations and measurable goals. British Journal of Occupational Therapy[online]. 74, pp.148-152.
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