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Clinician working with brain injuries and/or neurology? A forum to learn from and share recommendations! Dear all, I have largely worked within brain injury and neurorehabilitation since 2020 and find this specialism fascinating. Neurology is a complex, challenging - but highly interesting and rewarding - area of practice. There is constantly something new to learn; I know OT practitioners around the world have valuable insights to share. So I am keen for them to contribute to this knowledge bank. Do you work supporting any of the following?... • Stroke • Brain tumour • Traumatic brain injury (TBI) • Anoxic brain injury • Spinal cord injury (SCI) • Infection (e.g. encephalitis) • Congenital or progressive neurological conditions All ideas and suggestions are welcome, including: • Motor, sensory, visual or cognitive assessments • Structured interventions, including upper limb programmes • Tried-and-tested outcome measurement • Relevant research, or general reading recommendations With a person-centred approach, clearly no one method fits all. But what has worked well in your practice experience? N.B. Please be mindful of patient confidentiality

I have a question with regards to older people (65+) sleeping in their riser recliners (RR). I have a service user who sleeps in his RR out of choice. He has a perfectly good bed which he can get in and out of very well. But choses to sleep in his chair, he says he sleeps well and is happy with it. What are the most common issues/concerns about sleeping in a RR? I was thinking pressures needs & postural concerns.....What can you share with me?

I'm new to studying an MSc OT in the UK. My background is in crisis work around domestic and sexual violence and abuse. I'm particularly interested in how OT can be used for recovery and support with survivors of DVA. I would love to connect with other students or practitioners working in, or interested in, this area and join (or develop) a professional network. I am aware of a one local charity in Northampton (UK) that launched an OT led service for women survivors of DVA in a refuge setting, however I haven't been able to find any other services specifically offering OT for DVA survivors. Perhaps much of this is being done within LMHTs? Update March 2024: I'm now qualified and working in mental health. I'm still keen to develop a professional network. Please see latest posts.

Hi Everyone! I don't know if this is the place to post this, but I am a yoga instructor as well as an occupational therapist. I have been teaching online yoga during quarantine and I am thinking of trying to create a pay what you can zoom yoga class for practitioners. Would anyone be interested in that as a way to disconnect and engage in self care?

Myself and another student OT brought the Five Ways to Wellbeing to pupils at a deaf school, via a variety of weekly classes. For a fuller account of this intervention, check out my article 'School OT: Using the Kawa Model and Five Ways to Wellbeing' in OT Interventions [Plus+ Member access] The Kawa Model We decided to use the Kawa Model of occupational therapy practice, to engage students in a creative activity. We wanted each person to consider the personal challenges they currently face and the skills and supportive structures to help overcome them. We designed a basic river template (left) and laminated a copy for each child - to write on with wipeable ink. We felt that the visual element could be supportive to learning. Objects to place in the river and write on were then cut out and laminated. This formed a blank canvas for each pupil to map out their life flow! This would be a changing picture... KEY Rocks = circumstances that block life flow and cause dysfunction or disability Driftwood = skills and resources that support and enhance daily living Fish = personal qualities that help to overcome challenges faced River bed = the social, physical, cultural and institutional environment (a hinderance or help) Each student could experiment by placing objects in different places within their river, to assess how one could support or hinder another aspect of their life. Check out my example river at the top of this post. Why not utilise the Kawa Model in your work with clients/patients? It's a tool that works across ages and cultures. Jamie Grant Occupational Therapist Director, The Occupational Therapy Hub

Hosted by Abigail Matthews - Occupational Therapist, UK Aims and issues addressed This article seeks to explore the evidence behind Sensory Integration Intervention for Children with Autism, in order to ensure quality of practice. Intervention takes place within a context of play, involving a collaborative relationship between therapist and child - and focusing on participation-oriented outcomes, that are collected at regular intervals throughout the duration of the intervention. The focus is on developing sensory motor skills, due to evidence that some people with autism have difficulty processing everyday sensory information and can experience a lack of, or sensory overload. Too much information can cause stress, anxiety and possibly physical pain. Abstract Sensory integration is one of the most highly utilised interventions in autism; however, a lack of consensus exists regarding its evidence base. An increasing number of studies are investigating the effectiveness of this approach. This study used the Council for Exceptional Children (CEC) Standards for Evidence-based Practices in Special Education, to evaluate the effectiveness of research, from 2006 to 2017, on Ayres Sensory Integration (ASI) intervention for children with autism. What is already known how can it help solve important problems for practice? ASI is an individualized intervention designed to address the specific underlying sensory-motor issues that may be affecting children’s performance during daily routines and activities, including participation within the classroom and in other contexts of the school. Consequently, occupational therapists play a key role in developing sensory motor skills in schools, due to their role in enhancing daily living skills, through meaningful occupation. However, the evidence behind such practice has been criticised, which is problematic when implementing evidence based practice. This systematic review is critical of past systematic reviews and meta-analyses of studies, claiming to evaluate sensory integration intervention. Concerns are based around inconsistence use of ASI principles (Case-Smith et al., 2015) and lack of participant engagement and outcomes in the interventions (Lang et al., 2012 and Barton et al., 2015). Outcome measures in existing studies also vary widely, meaning that it is difficult to synthesise the findings of these systematic reviews to identify a useful outcome measure (Case-Smith & Arbesman, 2008; Case-Smith et al., 2015; May-Benson & Koomar, 2010; Watling & Hauer, 2015). Research Design To answer this question, we conducted a systematic review of available research studies: The first stage involved a series of electronic database searches, to locate potentially relevant studies. The second stage involved selection of studies using specific inclusion criteria related to methodology and description of the intervention. The third stage involved evaluation of the quality of each included study, to explore the reliability of findings and remain evidence based. The diagram below shows the search strategy. Data was analysed using the CEC Criteria, to ensure that interventions were based on similar outcomes. Three of the six reviewed papers were excluded from further analysis, because the intervention description was inconsistent or insufficient to be confidently considered ASI intervention, or because of significant methodological issues. Main findings ASI has strong evidence for positive outcomes on individual goals, moderate evidence supporting improvements in autistic behaviors and caregiver assistance for self-care activities - and emerging but insufficient evidence for outcomes related to play, sensory-motor skills, language, and social skills. Reliability and validity The diagram above shows the PRISM diagram used to show the search strategy, detailing the search process can improve the reliability of the study, as it can be replicated at a later date to consider any new research. This study also demonstrates that it has sought knowledge from a number of different electronic databases, in order to give a valid representation of ASI from the literature. Limitations The lack of relevant studies identified of a good quality mean that conclusions were formed based on three articles; findings may have lost quality as well as reliability. It could be argued that, while this article has achieved rigour, validity and reliability due to its focus on reducing bias, the paper lacks exploration around the role of occupational therapy using a sensory integration approach. It would be necessary to explore the literature to understand the core principles and focus under study. Facilitator’s comments Across my career, I have worked in learning disabilities and mental health, as a mental health practitioner. I found a passion for supporting this client group, focusing on skill development and increasing independent living. I valued the challenge of weaving my OT skills into my generic role, to promote the value of OT across healthcare roles. I choose this article because I wanted to understand more about autism, due to the differences between learning disabilities and those on the autistic spectrum. I was inspired to choose this article after reading the last Journal Club article on autism. I learnt a lot from this and wanted to explore the evidence behind the use of sensory integration as a well-known approach, when working with clients with autism. Given the level of scrutiny the authors undertook, the recommendations around future practice appear valid and reliable. It provides a good base for development of further research, in line with principles of AI, ASI and CEC standards of practice as an outcome measure. Open-access link to the journal article: www.researchgate.net/publication/329613236_A_Systematic_Review_of_Ayres_Sensory_Integration_Intervention_for_Children_with_Autism/fulltext/5c1251c5299bf139c755a8d6/329613236_A_Systematic_Review_of_Ayres_Sensory_Integration_Intervention_for_Children_with_Autism.pdf?origin=publication_detail A note from the Hub Team Thank you to @Abi Matthews for an excellent contribution to The Journal Club! What are your thoughts on this article? Do you have comments or feedback on host Abigail's critique? Members: Get involved in the conversation - and print off your input for your CPD/CEU files!

We wanted to celebrate how diverse and holistic the Occupational Therapy skill set is. We wondered what ‘non-traditional’ OT roles have you come across, and if you have had any experience in a non traditional role? Please share..

Hi Everyone, As a recent graduate and having the opportunity to work in a few different settings so far I've had to continuously work on my wellbeing and selfcare as a clinician including finding new strategies and ways to integrate selfcare into my daily routine. For us all to avoid compassion fatigue, vicarious trauma and general burnout it's imperative we all keep on top of this even as students on placement. What sorts of tasks/strategies do you do to support your wellbeing as clinicians? Mine include: Transition tasks from work to home incl. music, calling family/friend Aiming for daily exercise e.g. 30min walk after walk and walking at lunchtime with colleagues Reaching out during supervision for tools and supports Coming home and not thinking about work (as much as possible) and engaging in enjoyable/meaningful occupations such as practising an instrument, cooking, watching a series, reading. I'm keen to hear from everyone- Students to experience Clinicians.

Hello everyone! I'm a fellow OT Student from Vienna. While browsing the forums I came across a couple concepts that I couldn't quite figure out. Can somebody please explain what a degree apprenticeship is? What's the difference to a regular degree program ? And also what does an OT Assistant do? In Austria we don't have this role as far as I'm aware. Looking forward to any insights :) Thanks a lot, Julia

Facilitator for the Month | Charmi Shah, Mumbai, India (Community Forum Lead) The following article is an open access article, published in BMC- Psychiatry Journal in 2017. Link to the complete article at the end of the post. The Article is level Ib of the level of evidence AIM and Issues addressed by the article- What is the research question/ aim and objective of the article? The study aim was to evaluate the effectiveness of the 16-week Balancing Everyday Life (BEL) program, compared to care as usual (CAU), for people with mental illness in specialized and community-based psychiatric services. Why does it matter? How it fits to what already is know? Interventions that address everyday life in general, and that are aimed at assisting people with mental illness in shaping a satisfying and balanced lifestyle, are less well developed. Such interventions have shown to be effective for other target groups, however, such as the Lifestyle Redesign™ to prevent ill-health among independently living older people and the Redesigning Daily Occupations (ReDO)™ for people with stress related disorders. The Balancing Everyday Life (BEL) program, which was based on the same principles, was developed for people using specialized and community-based psychiatric services. The BEL program has a strong focus on accomplishing activity balance for the participants, defined as having a satisfying amount of and variation between activities Design of the study- It is RCT study based on cluster randomization Study methods- All settings in both specialized psychiatry (outpatient units within general psychiatry and psychosis care) and community-based psychiatry (activity-based day centers) in three regions in southern and western Sweden were invited to enter the project Inclusion of settings admitting patients with a broad spectrum of disorders, such as psychoses, mood disorders and neuropsychiatric disorders. In settings that agreed to participate, a gatekeeper (an occupational therapist employed at the unit) identified clients according to the following criteria: a) self-reported imbalance between everyday activities (assessed in an interview with the gatekeeper), b) age of 18–65 years, c) substance abuse not the main diagnosis (according to team conference), d) no comorbidity of dementia or developmental disorder (according to team conference) and e) sufficient command of Swedish to participate in the data collection (assessed in an interview with the gatekeeper). A total of 226 participants entered the study; 133 from BEL settings and 93 from comparison settings. Intervention - 1. BEL is a group-based program (5–8 participants) consisting of 12 sessions, one session a week, and 2 booster sessions with two-week intervals. The themes for the group sessions are, e.g., activity balance, meaning and motivation, healthy living, work-related activities, leisure and relaxation, and social activities. Each session contains a brief educational section, a main group activity and a home assignment to be completed between sessions. The main group activity starts with analyzing the past and (foremost) the present situation and proceeds with identifying desired activity goals and finding strategies for how to reach them. This mapping and planning step is followed by a home assignment that means performing the desired activity in a real-life context. The home assignment is aimed at testing one of the proposed strategies. During the next group meeting, the real-life experience is evaluated and group members discuss and give each other feedback. 2. The CAU occupational therapy sometimes included some form of group intervention, addressing for example daily living skills, social skills or creative activities, while some occupational therapists offered individual therapy only. Primary outcomes- The Swedish self-rating version of the Profiles of Occupational Engagement among people with Severe mental illness (POES), the Swedish version of Satisfaction with Daily Occupations and Occupational Balance (SDO-OB), Occupational Value with predefined items (OValpd), Swedish version Secondary outcomes- Manchester Short Assessment of Quality of Life (MANSA), Rosenberg self-esteem scale, first item of the MOS SF-36 , Global Assessment of Functioning (GAF) scale The participants responded to the questionnaires at the start of the BEL intervention, and after 16 weeks of intervention (including the booster sessions) the measurements were repeated. A follow-up was then made after another six months. The same data collection (instruments and procedures) was made at corresponding time points with the participants who received CAU Main findings Results- The BEL group improved more than the CAU group from baseline to 16 weeks on primary outcomes in terms of activity engagement (p < 0.001), activity level (p = 0.036) and activity balance (p < 0.042). The BEL group also improved more on the secondary outcomes of symptom severity (p < 0.018) and level of functioning (p < 0.046) from baseline to 16 weeks, but not on well-being. The group differences on activity engagement (p = 0.001) and activity level (p = 0.007) remained at the follow-up. The BEL group also improved their well-being (quality of life) more than the CAU group from baseline to the follow-up (p = 0.049). Implications- 1.The impact of care context, together with other potentially influential factors such as psychotropic medication, diagnosis, sex and socio-demographic factors, were to be investigated in their forthcoming study to see if these factors play a role for the possibility for benefitting from the BEL intervention. 2.The care context might influence the outcome of the BEL intervention, which could be another possible implication. Limitations - 1. The exact participation rate couldn’t be calculated, however, due to use of gatekeepers and dissatisfactory administrative routines with respect to registration of non-participants. This is a limitation of this study and weakens its external validity. 2. The design did also not allow for blinding. Conclusion- The BEL program was effective compared to CAU in terms of activity engagement. The BEL appeared to be important in shortening the time required for participants to develop their engagement in activity and in attaining improved quality of life in a follow-up perspective. Generalizability- Not mentioned in the article Facilitator’s Comments – The BEL program although was developed for community based psychiatric services. It still holds implications on other areas of occupational therapy where group interventions are given for developing activity engagements or quality of life and also where holistic approach to treatment is used such as in palliative Care centers or residential homes for seniors. However, the details about the intervention has been superficially mentioned in the article. Hence it becomes less likely to use it for clinical or future research purpose. The article is now open for discussion. Don’t forget to share your thoughts and views on it in the comment section below. Link for full article - https://doi.org/10.1186/s12888-017-1524-7 Reminder- The discussion will be open for 3 weeks and summary would be posted at the end of the month. If you wish to facilitate for any particular month get in touch with The OT Hub Team or simply place a comment below.

Hi. I'm at that moment in my life that I finally found courage to follow my dream and passion. I'm not even sure if I'm in the right place to ask, but I'm reaching out. I'm 44 years old, done loads of different jobs through my entire life but just recently my path led me to a role as a carer. And I've found myself for the first time in my life. I've been caring for a gentleman with MND and had an opportunity to take him to his hospital appointment with wheelchair services. What I saw there, how his new wheelchair is being tailored and built from scratch to suit his needs, that was absolutely amazing . All that problem solving and thinking outside the box. And of course being able to help another human being. Problem is I'm from Poland. I have absolutely no knowledge about education in UK and don't have any idea where and how to start. If anyone would be able to share some knowledge or their experience I would be forever grateful. Kind regards Bartek

The following article is published in Occupational therapy international: Sleeping difficulties are common in children with attention deficit hyperactivity disorder (ADHD). Meeting children with difficulties with emotional regulation and/or families experiencing struggles in their night-time routines and maladaptive activities connected to sleep is common in pediatric occupational therapy practice. A sleep intervention with weighted blankets was designed to increase current understanding of using weighted blankets to target children’s individual needs in connection with sleep and daytime functioning. We have recently published an article that is available on the subject in Occupational Therapy International. An explorative qualitative design in which 26 children with ADHD and sleeping difficulties were included, 6-15 years old, were interviewed about participating in a sleep intervention with weighted blankets. Children’s experiences revealed that the use of weighted blankets: 1) requires a commitment 2) improves emotional regulation 3) changes sleeping patterns 4) promotes everyday participation Using weighted blankets promoted children’s management of daily life with ADHD and sleeping difficulties. We can thus improve the assessment and delivery of weighted blankets tailored to individual needs based on increased knowledge from the children themselves. This article is part of a larger project, and is the first article in my Phd project about weighted blankets effect on children with ADHD. The article can be found: https://downloads.hindawi.com/journals/oti/2023/1945290.pdf Please feel free to contact me if you want to connect on the subject of sleep and weighted blankets. Or share your views and thoughts below =) /Maria Lönn, Occupational Therapist with an interest in mental health and sleep

Facilitator for the Month: Bill Knight, Bristol, UK (Resources & Services Lead) The following article is an open access article published in The Open Journal of Occupational Therapy. The link is provided for the same at the end of the post. Aims and Issues addressed by the article This article aims to identify elements in gardening that can be effectively harnessed in Occupational practice and what features support or impede participation. Social and Therapeutic Horticulture is the process of using plants and gardens to improve physical and mental health, as well as communication and thinking skills (Thrive, 2020). The study examines how and why occupational therapy practitioners across practice areas use gardening as an intervention. The respondents’ interpretation of the best and least desirable aspects of their facility’s garden and whether they contributed to its design was also examined. It was chosen for the Journal Club as it provides an evaluation of key issues for Occupational Therapists to consider when planning Social and Therapeutic Horticulture interventions. Why does it matter? How it fits to what already is known? Social and Therapeutic Horticulture is a becoming increasingly recognised as an effective intervention as part of the Occupational Therapist’s toolkit. While few disagree with the potential wellbeing benefits of nature-based activities, due to the variable settings and influence of individual biosocial factors, it has been challenging to scientifically measure the general applicable benefits. As a result, much research has focused on qualitative, experiential data from participants. In these times of Covid-19 social isolation, with the limited access to shared natural spaces, but an increasing focus on home gardens, gardening has become more relevant as an occupational tool. Design of study Questionnaire Survey (incl. open-ended) Study methods 91 OTs or OTAs were contacted. A description and link to a 15-question online survey about gardening as an occupational therapy intervention was emailed to Western Michigan University Occupational Therapy alumni and posted on four OT Connections groups and the AOTA LinkedIn site. The authors designed a short 15-question survey looking at the use of gardening as an occupational therapy intervention. The study was purposely kept short to encourage a higher participation rate. Fourteen of the survey questions were forced choice and one was open ended. The questions were designed to examine whether and how occupational therapy practitioners use gardening as a therapy intervention and what, if any, features in the garden support or impede participation. The survey also sought to examine whether (if present), the facility garden where occupational therapy practitioners work (or, if doing home care, their client’s garden) met the needs of both clients and practitioners. The open-ended question invited respondents to share their favourite story involving the use of gardening with a client. The survey was posted on Survey Monkey. Descriptive statistics and a contingency analysis using Pearson’s chi-square with significance at .05 were used to interpret the data for the closed-ended question by means of SPSS Version 21. A content analysis was completed on the open-ended question. It was then sorted into categories based on occupational therapy practitioners’ responses. Results Of the initial pool of 91 respondents who answered the question about general demographic information, 92.86% (n = 65) identified as being occupational therapists and 7.14% (n = 5) identified as being occupational therapy assistants. For the 60 who responded affirmatively to using gardening with clients, the following findings were generated. Of the 60 practitioners who responded to the question about why they use gardening as an occupational therapy intervention, overwhelmingly the responses supported a client-centered approach to treatment. Gardening was selected because it was determined to be meaningful, purposeful, fun, and beneficial for a client. A summary of the findings can be found in Table 4. When asked if the respondents worked in a garden with their client and whether the practitioner helped to design the garden, 42 participants responded to the question. Of this group, 21.42% (n = 9) indicated that they did help to design the garden and 78.57% (n = 33) indicated they did not help design the garden. The association between whether an occupational therapy practitioner helped to design the garden and the frequency of using gardening as a therapeutic intervention was significant (x= 17.80, p = 007). Practitioners who helped to design the garden used it more frequently than those practitioners who did not. When asked to share a favourite story about using gardening as an intervention, the predominant themes that emerged from a content analysis of the stories were as follows: Gardening as an occupational therapy intervention was (a) client centered, (b) provided for a sense of accomplishment, (c) functioned as an antidote for depression, (d) offered connection to the earth and with the practitioner, (e) was therapeutic, and (f) was meaningful and purposeful. Of the 54 shared, four are particularly noteworthy in acknowledging the meaning and purpose of gardening. Environments that support active engagement and meaning are motivating and fun. Universally designed environmental contexts, including gardens, can support occupational engagement, and subsequently, flow, the just right challenge, and mindfulness. The importance of a just right environment is paramount to enhance the effectiveness of this time-honored activity. While it is evident from this study that occupational therapy practitioners use gardening as an intervention in highly evidence-based climates, such as health care and education (Müllersdorf & Ivarsson, 2012), there is a paucity of evidence from the profession validating its effectiveness. Further, there is a disconnection within the profession in translating this intervention into measurable outcomes. Frequency of gardening as a therapeutic intervention and practitioner involvement in designing the garden was significant (p = .007), suggesting that for respondents, environmental context supports engagement and heightens the meaningfulness and purposefulness of gardening. Implications Results of this study support this contention by Fieldhouse that practitioners “cannot bestow meaning on occupations used in therapy” (2003, p. 287). Rather, meaning must derive from client-centered therapy. Occupational therapy practitioners were nearly twice as likely to use gardening as an occupational therapy intervention because it is a meaningful, purposeful, and motivating activity for their clients, rather than because the practitioner likes to garden. There is a need to acquire an evidence base of the clinical effectiveness, meaning, and purpose of gardening as an occupational therapy intervention based on the positive health benefits that have been identified with engagement in it. The results of the pilot survey along with AOTA’s priority for translational, intervention, and health services research (2011) suggests that further rigorous randomized controlled trial research to evaluate the effectiveness and efficacy of gardening as a client centered, meaningful and purposeful activity for occupational therapy and our engagement in the design of the garden is warranted. Equally as important, phenomenological research endeavours will help to elucidate the meaning and value that gardening as a therapeutic intervention provides to the clients with whom we work. Conclusion This study highlights the practical considerations to improve the effectiveness of Nature interventions. Based on results of this study, a suggested next step is evidence-based translational and intervention research to validate the efficacy of gardening as an occupational therapy intervention and occupational therapy practitioners’ professional value as implementers of such intervention. Assessing the effectiveness of the role of occupational therapy practitioners in facility garden design is also important to consider. Facilitators Comments- I liked the recognition that meaning can only be derived from the client’s individual participation in the activity and their interest e.g. there is a need for client centredness to identify the appropriateness of the horticultural intervention. By involving clients in garden design, the responsibility and control may improve their motivation. The open-ended question enabled richer, more qualitative data to be captured which may have been lost in the quantitative figures. Ultimately however this is a snapshot of the occupational Therapists’ subjective evaluation of effectiveness rather than being driven from the client’s perspective (although with a client-centred approach, these should be similar). The study provides some useful guidelines for future horticultural interventions. The article is now open for discussion. Don’t forget to share your thoughts and views on it in the comment section below: The link for the full article can be found at: https://scholarworks.wmich.edu/cgi/viewcontent.cgi?article=1128&context=ojot Open for discussion

Continuing Professional Development (CPD) courses are coming to the Hub! Please vote in the poll below, to help us produce programs most useful to you: Do you want the Hub to feature a course on a subject not listed above? Comment with your suggestion below! Do you have knowledge and/or experience of the subjects listed - or others related to occupational therapy? Interested in sharing it with clinicians worldwide? C(https://www.theOThub.com/contact)ontact us (https://www.theOThub.com/contact) if you would like to create/design or contribute to a course.

Topic for September – October 2020: Walking as a meaningful occupation. Hosted by: Eleanor Dixon, MSc OT student at Sheffield Hallam University, UK. This article is titled “Walking as a meaningful leisure occupation: the implications for occupational therapy” (Wensley & Slade, 2012), published in the British Journal of Occupational Therapy. This level of evidence falls into category VI as seen in the following table, which is based on the effectiveness rating scheme by Ackley, Swan, Ladwig & Tucker (2008). Why was this article selected? Despite this article being dated 2012, this research article was chosen for Journal Club due to the relevance of walking as an occupation throughout the COVID-19 pandemic, as many occupations were disrupted. It also focuses on individual meanings and experiences of individuals who participate in walking as an occupation, highlighting both the importance of meaning and value for occupation, and the benefits of walking, which are influenced by the individual, activity, environmental and social contexts in which they take place. Aims and issues presented This article aims to identify the occupational benefits of walking, to both gain a deeper understanding of individual meanings and experiences of engaging with this occupation, and to evidence the use of walking in therapeutic practice. The authors suggest that even though literature focusing on leisure occupations is extensive, perhaps due to the promotion of community wellbeing and health promotion, there is a limited amount of literature focusing on walking as an occupation, despite its benefits for both physical and mental health, as well as social functioning, which have been further promoted by public health campaigns. Design Qualitative study design, using semi-structured interviews. Methodology The researchers gained ethical approval from their host institution ethics process prior to conducting this research. Primarily, 6 participants with no physical or mental health conditions (2 Male, 4 Female, all Caucasian, mean ages 21-34.5) were recruited using convenience sampling. All participants were current members of a University Walking club. Each participant gave informed consent, in full knowledge of their right to withdraw and right to confidentiality and anonymity before engaging in a 30-60 minute semi-structured interview. The interview sought to examine their experiences of walking, how long and how often they had been walking for, what interested them about walking and why is was important to each person. Secondly, the researchers familiarised themselves with the data, transcribing, and re-reading, before coding and developing themes to represent the data. To promote credibility, the researcher sent a summary of the results and themes to the participants, to ensure that the results were representative of their individual experiences. Findings The authors highlight that participants had individual and different experiences, engaging in walking occupations to establish and maintain social connectedness, improve fitness and problem solving, and to promote feelings of relaxation, escape, mastery and being within the natural environment. The themes identified are presented in the table below. A summary for each theme and sub-theme will now be presented. Social connectedness Building new social relationships and a medium for social interactions The results suggest that the participants main motivation for joining a walking group was to meet new people and make new friends, established due to a similar interest, and often maintained outside of the group environment. Further to this, one participant mentions that being part of a group environment enabled an increase in social interaction skills, built around scenarios specific to the common interest. Group membership Participants report that being part of the group enabled a developed social identity and a sense of belonging, as well as a sense of purpose, as well as an increase in motivation due to the support given from the group members. However, some participants highlight negative experiences, including “stopping walking due to feeling that the group was too fast”, diminishing enjoyment. Walking and talking Communication by “walking and talking” had been highlighted as both an important way to share experiences, as well as a more natural way to discuss, share and understand each other’s experiences rather than in a more formal setting. Wellbeing Emotional wellbeing Many participants expressed that walking increased positive feelings and happiness, facilitating relaxation and distraction from other life events. One participant described the positive feeling gained from walking as “transformative”. Physical wellbeing Some participants highlighted that the physical aspect of walking was a reason to engage, whereas others did not enjoy the physical aspect of walking. Some participants described “a sense of achievement” from the physical exertion, whilst others highlighted the “unconscious nature” of fitness and physical exercise provided by walking. Escape Participants identified that walking is “a nice way of getting away from everything, switching off and relaxing”, and some participants used words such as feeling “free” to describe their experiences. De-stressing Participants described “escaping physically and mentally separating” from everyday scenarios through engaging in walking. However, the authors suggest that the de-stressing effect of walking relates to the meaning that each individual holds, as well as the environment. Connection to nature Each participant spoke about the connection to nature when discussing their feelings of pleasure whilst walking, which also added to their sense of achievement. The results report that the connection to nature facilitated feelings of peacefulness, tranquillity, and excitement, exploring new places. The authors report that these findings echo Roe & Aspinall (2011), who highlight the “restorative effect of nature and rural walking”. Achievement from a challenge Self-actualisation Participants reported a sense of achievement, giving a sense of purpose, satisfaction and pride. The researchers suggest a link to self-actualisation through goal achievement, promoting self-worth and self-esteem, as evidenced by one participant who mentioned that “proving yourself to yourself, or achieving something that is just so great and it feels really good to do that”. Conclusion and practice implications This research study highlights the value of both walking as a meaningful occupation, and the use of walking in Occupational Therapy intervention. Furthermore, it draws attention to not only the physical, mental health and emotional benefits of walking, but also the potential negatives associated with engagement in activities that are too challenging or activities that do not match an individual’s ability or needs. Therefore, this study promotes highlights the importance of remaining client-centred, focusing on meaning that occupations hold for each individual, emphasising the benefits for the general population. The researchers suggest that Occupational Therapists are placed in an ideal situation for health promotion, health prevention and wellness campaigns, including advocating for accessible walking routes, appropriate to different levels of challenge. Furthermore, a sound evidence base could facilitate the promotion of activity, as seen in current practice. Further research related to this study, as identified by the researchers, could include research into if the benefits and meaning identified within this study are seen in individuals with either physical or mental health conditions, barriers and motivations to walking to inform public health initiatives, or specific benefits such as stress-reduction for the general population. Comments I like that this research study highlights the importance of individual meaning when engaging in occupations, highlighting the importance of considering social and environmental contexts. The results emphasise both the physical, mental health and emotional benefits, as well as the possible negatives from engagement in an activity that may not offer an appropriate challenge in relation to the persons individual ability and needs. This is of concern whilst using this occupation within clinical practice, which is often used within mental health practices. Furthermore, it highlights the need for individuality, utilising occupations which hold meaningful and value to the individual. Although the researchers were able to use some techniques within their methodology to improve credibility and trustworthiness, such as participant checking, the sample may be not representative of the general population, as the participants were all members of a university walking group. Furthermore, future research with a more diverse participant base would be useful to improve the evidence base for using this occupation within OT practice. However, the results draw attention to the benefits of walking for public health, especially considering the physical and mental health impacts of COVID-19. About me I am currently studying an Occupational Therapy MSc at Sheffield Hallam University. I am interested in a variety of areas, and I am hoping to work as a rotational Band 5 to gain more experience after graduation in December 2020. This article is now open for discussion. Please share your thoughts and views on the comments section below. The article can be accessed by the links below: Wensley, R. & Slade, A. (2012). Walking as a meaningful leisure occupation: the implications for occupational therapy. British Journal of Occupational Therapy, 75(2), 85-92. DOI: 10.4276/030802212X13286281651117.Retrieved from: https://journals.sagepub.com/doi/pdf/10.4276/030802212X13286281651117 This article can also be accessed from the following link (open link) : https://pearl.plymouth.ac.uk/handle/10026.1/1242 Further references: Ackley, B. J., Swan, B. A., Ladwig, G., & Tucker, S. (2008). Evidence-based nursing care guidelines: Medical-surgical interventions. (p. 7). St. Louis, MO: Mosby Elsevier. Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370-96. Image retrieved from: VeryWellMind, 2020.

Hello, I’m a new 1st year Occupational Therapy student, from Kent in the UK. I’m looking to connect with Occupational Therapy students from other countries to explore the similarities and differences in what we are studying and our experiences as we start our training. I’ll of course be happy to share my own experiences with you too. I look forward to hearing from you! Best wishes, Rachel

Facilitator of the month: Dr. Abhinav Mishra, India ( Neuro-Occupational Therapist) The following article is an open access article published in the JIMR publications. The link to the article is provided at the end of the post. Aims and Issues addressed by the article: This article aims to identify the potential and latest trends in the area of exoskeleton- or robotic-aided therapy in combination with VR, AR, or gamification for the improvement of motor function for post-stroke patients. The review specifically aims to determine -(1) If such a coupled approach i.e. VR, AR or gamification combined with exoskeleton is helpful in improving the outcomes for the patients. (2)trends and popular configurations across both types of exoskeletons and software mediums; and (3) future challenges in the field of exoskeleton-based human-computer interaction (HCI) therapy. The article has been chosen for the Journal Club as it gives an overview of the best technologies available and its implication into practices of Occupational Therapy for a better client outcome. What is the need of this type of intervention? How it affects the society? Along with conventional treatment, Robotic Rehabilitation is trending in various parts of the world. There have been several studies to support the various forms of the robot aided therapy for both Upper Limb and Lower Limb in various conditions including Stroke. So this is increasingly being recognized as an effective intervention as a part in Occupational Therapist’s toolkit. But with this we as a therapist need to know various types of devices available and their differences to provide the best to our client. Study design: Review based study, combining both published and unpublished articles and summarizing the findings. Methodology A systematic search of the literature on exoskeleton robotics applied with any of the three technologies of interest (VR, AR, or gamification) was performed in the following databases: MEDLINE, EMBASE, Science Direct & The Cochrane Library. Exoskeleton-based studies that did not include any VR, AR or gamification elements were excluded, but publications from the years 2010 to 2017 were included. Results in the form of improvements in the patients’ condition were also recorded and taken into consideration in determining the effectiveness of any of the therapies on the patients. Studies which fulfilled the inclusion and exclusion were selected. So the process which was followed by the authors was Identification ,Screening, Eligibility and Inclusion. What where the results obtained? There were 30 studies which the author identified based on the inclusion criteria. This included the Randomized control trials and exploratory research papers. The result based on analysis of these articles which included as many as 385 patients shows that there were general improvements in the motor function of patients using the novel interfacing techniques with exoskeletons. Also this could fill the gap between hospital to home transition of the patient. The results also categories the various types of therapies devices that were used by various clinical settings, degree of freedom offered by the devices, number of participants included in the literature. Conclusion and what does it mean for us? Systematic Review showed that various technologies used in the field of rehabilitation helped the client in a better recovery. One of the study mentions that clients found multiplayer gaming to be appealing as it helped them in socializing and interacting with peers. This could in turn help in a better outcome. But most of the rehabilitation was carried out in a clinical setup and home-based rehabilitation is rarely attempted using the current technologies available. Also as an occupational therapist we should see to it that the technology and the therapy sessions are designed in a way such that patients feel motivated and confident during home-based rehabilitation sessions as well. The review also shows that these exoskeleton devices are rarely available for trials at home, thereby showing a gap in transition of the rehabilitation services from clinical to home based setup. This leaves an open door for future studies to be a successful application of these technologies in home based Rehabilitation. What is my perspective of this Systematic Review: The study has covered on multiple dimensions of treatments such as Robotic training, VR, AR and gamification for rehabilitation. The study has a focused research question specified with the aim to assess the effectiveness of exoskeleton robotics in conjunction with any of the three technologies (VR, AR, or gamification) in improving activity and participation in post-stroke survivors. Authors of the study have followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following databases were searched for relevant studies: MEDLINE, EMBASE, Science Direct and The Cochrane Library. Although the study has been done taking into consideration the researches from the year 2010 to 2017, with a good reproducible literature search, but the included studies were not sufficient for the question asked as authors did not find any relevant study which combined Exoskeleton robotics and AR technology. Authors have not clearly stated their basis for inclusion or exclusion of the primary RCTs. Also authors have not specified the type of VR been used by the primary RCTs i.e. immersive, non-immersive or totally immersive. The SR has taken into account the methodological quality of few studies, though not all. The methodology of few studies has also been mentioned in the discussion section in brief. This helps in better understanding of the various studies included in the review. The SR combine primary studies appropriately, taking into consideration the studies which had Exoskeleton robotics, VR gaming and AR gaming in the primary studies. Also the SR clearly stated the number of Upper-limb and Lower-limb cases, type of devices used etc.Also SR has highlighted few studies summarizing their methodology and results. SR states that there were different types of assessment scale and quality of collected data, which made it difficult to compare the outcomes and results accurately or quantitatively against each other. In addition, some articles could have been missed in the review due to very specific search criteria. In the conclusion SR highlights that very little work is done to make use of these technologies for rehabilitation of lower limbs when compared to upper limbs, and that there are a wide variety of exoskeleton-based devices currently in use. Authors have taken great efforts to identify the future implications of their study. There were researches that were done for Upper Extremities and did not have much evidence on lower limb comparatively, except the two studies. A study using the Rehabilitation robotics in home setup is needed, as almost all of the studies were carried out in clinical setup. I would like to thank the authors of the study to give us the access to the review. The article is open for your views and discussions. Do let us know your views on it in the comment section. The link for the full article can be found at: https://rehab.jmir.org/2019/2/e12010/ Dr. Abhinav Mishra, MOTH (Neurosciences), is a Mumbai based Occupational therapist who is currently working with Adult clients with Neurological disorders in an advanced rehab setup, which includes Robotic devices, sensor based gaming devices as well as water based rehabilitation. He can be contacted on drmishra.abhinav@gmail.com

Hey everyone. So I want to try working in England as a COTA and I am wondering if my license and NBCOT certification will carry over. If not, what is the process of being able to work as an OTA in England? WIll highly appreciate the help and advice!

Relevant for all occupational therapist roles, worldwide. With UK 'Band 5' positions in mind. Top tips Organise and update your CPD file Review HCPC guidelines (or other bodies) for structure Research conditions in the area of OT you are applying for Take a copy of your CV/application form and CPD file Relate each question to occupational therapy Try and use clinical examples Research the Trust or organisation you will be working for; find out what the its values and goals are Research changes in the NHS - or if it is a private organisation, research the company Review the job specification/description and compare it to you; refer to this in the interview - what skills enable you to be a desired candidate? Keep a copy of you DBS documents, such as passport, driving licence and a bill from the last 3 months Dress formally to the interview. No harm in keeping it simple - shirt and formal trousers. If heels are worn, be aware they may want to give you a walk around tour. Possible questions 1. Tell me something about yourself? Discuss personal qualities and skills to have obtained in relation to occupational therapy. The answer will be a mix of qualities and traits which you display that are required to be a good occupational therapist. Example answer: I am a caring individual and I enjoy supporting others to fulfil their potential I have spent X amount of years in a hospital setting… Why? Because you have a caring mentality? What did the role involve and what did you like about it? Are you inspired by other professionals? Do you enjoy seeing others progress with rehab? I communicate well within an MDT and work well individually with my duties I am eager to build my skills and develop myself, so that I can treat my patients to the best of my abilities I am good at time management and prioritise my case load effectively Think about past experiences as an OT or student - was there a time where you were flexible and helped other teams? I am a great listener; I enjoy taking a holistic approach and create goals which are specific to my patients/clients I am hard working and motivated by positive patient feedback Qualities of an occupational therapist: Empathetic Highly motivated Great listener Good work ethic Dependable Flexible Honesty Confident Hard working Passionate Kind Supportive Team player Verbal and written communication Keep answers related to OT if possible. Use examples from placements. 2. Where do you see yourself in 5 years? Review professional growth Discuss opportunities the role may open up Reflect on your own personal goals Goals connected with the position in relation to OT How will the position enable them to reach these goals? The interviewer may want to know if you will be staying in the location/in the same trust 3. How would you describe the role of OT within this setting to a student nurse? Passionate about occupational therapy during the conversation Discussing the OT role - what interventions can an OT complete? Seeing this as positive and discussing outcomes, e.g. how MDT members refer more appropriately, future practitioners understand the role and encourage patients to maintain independence with their ADLs 4. Describe a difficult situation that you have had with a patient and explain how you handled it Reflecting - maybe refer to a reflection in your CPD folder Keep it as simple as possible; the key details, but describe how you built a rapport Ensure your example demonstrates supporting patient to the best of your abilities and an outcome that worked well for the patient How did you help them achieve their goals? Use of active listening, to calm a situation down? Demonstrate clinical reasoning 5. How would you manage when you have lots of patients handed over, to be seen in the morning handover? Prioritise - ensure you see medically fit patients first Make a list? If this is something that helps you, check you have completed all tasks in relation to each patient. For example, on a busy day you may be between a few patients; a check list enables you to clarify what was completed. Ask for support from your senior if required - working as a team works both ways Use an example Discuss it as a learning curve but remain positive Remain calm and efficient with caseload 6. Condition-related questions / scenario questions If you have applied for a role, you should research relevant conditions If you have not come across the condition, break it down via the occupational therapy process, gather information, research the condition and discuss with a senior prior to an intervention 7. ...And do you have any questions for us? What opportunities for professional development are available? What is your supervision schedule like? What are the working hours? Does uniform have to be worn? Is there an in-service programme or peer support? 

Best of luck with your interview! Jessie, Student Engagement Lead

Hello I am currently on placement with a refugee charity in UK. Is there anyone that have worked in similar sector that can share your experience? Such as what are the challenges? How do you do you apply the core skills of occupational therapists with working with this group of service user? Many thanks, Matt

Hi everyone, Are there any UK trained OTs who have ever gone through the OTED process to work in the States/ know of anyone who has completed this process? I am hoping to move there, however, looking at the education requirements (below) I am unclear as to whether my BSc (Hons) is enough to be accepted?: "You need to have a minimum of an entry-level master's degree in occupational therapy, or a bachelor's degree in occupational therapy with a post-professional master's or doctoral degree in occupational therapy, or a bachelor’s degree in occupational therapy with a master’s degree in a related field to apply for the Occupational Therapist Eligibility Determination (OTED®) process. Internationally educated therapists must go through the OTED process to obtain eligibility to take the NBCOT OTR® Certification Examination." Apologies for the long question but if anyone has gone through this process, I would be very keen to pick your brains! Many thanks, Christine

Hello! I'm doing some research for a current project and wondered if anyone would be happy to share their role as an OT who can work remotely? This meaning you're able to be in any country and any time zone whilst still carrying out your role as an OT whether clinical or non-clinical. You don't have to call yourself an OT but be using your skills and training in your day to day work. Look forward to reading any replies and connecting further! Hannah x

I created this channel to help spread the word about the amazing world of OT! I hope to help those during the application process and to give tips and advice while in OT school! Help spread the word please! This is the link to my channel: https://www.youtube.com/channel/UCSjhB6hM8MRIFgq3ej3aVCw This is my most recent video! This video is all about the application process and the do’s and don’ts! Share with those you know who are interested in OT and who are thinking about applying! Thank you! https://youtu.be/Abboffqwo9Y

Facilitator of the Month| Pooja Jethani, Missouri, U.S.A. The following article is an open access article published in Canadian Journal of Occupational Therapy in 2015. The link is provided for the same at the end of the post. Aims and issues addressed by this article: The above article emphasizes the introduction of “sustainable practices” into the environmental aspect of occupational therapy employment. The article hopes to instill a sense of awareness amongst current Occupational Therapists to develop a “sustainability lens” in everyday practices. Occupational Therapists and Occupational Therapy organizations (WFOT, SAOT, COT) address the need for global outreach to understand the gravity of global health issues and collaborate to overcome them. This vision is the need of the hour as it is a major influence on health, both individually and as a community. Search Strategy: Recommended by a professor in a class on contemporary issues in OT, searched via Google Scholar Issues addressed by the article, Why does it matter? How it fits to what already is known? How can it help solve important problems for practice? The issue addressed in the article is that human beings are responsible for the environmental degradation, considering this aspect; it is our responsibility to take measures to improve environmental health by introducing sustainability. Unknowingly, we, as OT’s may harm the environment while providing treatment interventions by using materials or measures that are not conducive to environment. Sustainability blends into OT practices and can help improve the global environment. Addressing and taking charge of changing the global environmental conditions by creating awareness and modifying the way we practice is one of the substantial ways OT's can help solve the problem. Design of the study Descriptive; ecological Main findings Canada’s Federal Sustainable Development Act (2008) defines sustainability as ‘‘development that meets the needs of the present without compromising the ability of future generations to meet their own needs’’. The article introduces the concept of sustainability in environmental practices in OT and talks about the relevance of including this concept as a part of the basic models of OT. If our literature includes notions of sustainable OT practices, the concept will be more effective. Further, the article helps us adapt a sustainability lens and look at everything around us from a sustainable aspect. The authors believe that a change at the micro level by millions of people could bring about transformations at macro level. The article successfully describes ways to implement sustainability in everyday application of OT through examples and clinical reasoning strategies for everyone. It stresses on how Occupational Therapists are most suitable for this role to bring a change within the environment. Generalizability The article hopes to develop better living conditions for our future generations by implementing modifications in the present. The examples mentioned in this article can easily be put into practice if considered each time we treat and generalized for OT in all settings and sub fields. Implications Adapting sustainability is easy; all we need to do is have a sustainable outlook for every time we practice. Some of the interesting methods mentioned in the article include recycling adaptive equipments, use of technology and tele-medicine to make paper less treatment sessions possible, use of local products, arranging public transport to enable access and improving environmental living conditions by planting plants. Use of these methods may not necessarily be time consuming; instead some of them may give us occupations and activities for our clients to incorporate in our therapy sessions. Occupational Therapists have a major role to play in environmental upliftment and helping create better conditions for the future. Limitations 1- The author talks about how sustainability could be a part of our models as an aspect in environment but further information is required as to how and where is its place in our literature. 2- The article mentions various examples on implementing sustainable practices but a structured resource will be necessary in near future in order to include sustainable practices in OT interventions. Conclusion Although the concept of sustainability is crucial, it is not yet implemented by most countries of the world. In order to successfully bring sustainability in practice, it needs to be introduced at the root level, which is possible if we include it in our educational resources and advocate it to current and future OT’s. The authors insist that we think globally and act locally for our OT interventions. The authors believe that occupational therapy practitioners have the power to initiate change in their personal actions, their workplaces, their communities, and their governments to promote a sustainable and resilient future. By studying and researching, discussing, presenting articles on this topic, spreading awareness to other health professionals, Occupational Therapist can positively incorporate sustainability. Facilitator’s comments The concept of sustainability is relatively new and needs to be introduced in the basic practice models of OT, like Model of Human Occupation, Person environment occupation, Person environment occupation performance, ecology of human performance. It definitely has a place in everyday OT. Certain sustainable occupations like gardening or farming, planting trees, helping recycle, healthy habits like walking or biking can be a part of the treatment process of clients. Sustainability can be adapted in each and every thing if you develop an outlook for it. Organizations around the world are trying to make Earth a better place for us and our future generations. Let's join hands and work towards it. Link for the article: https://journals.sagepub.com/doi/pdf/10.1177/0008417414566925?casa_token=Y6F5eWJ60nkAAAAA:WR-2WIiyiz7dFMWD3HlzvBo7M2xL73liFlwMMaCXATRAzZtN4aYgZ8-IV6N22c7r0GnOe_LFsXaH Open access link for the article: A call for sustainable practice in Occupational Therapy Link for WFOT's Guiding principles in sustainability in Occupational Therapy Practice, Education and Scholarship: https://www.wfot.org/resources/wfot-sustainability-guiding-principles A special Thanks to the author Carole Dennis for providing us access to her article. Hope you like the new perspective of Occupational Therapy in Environment!! Please share your comments and ideas below! About the facilitator - Pooja Jethani is a Master's in Occupational therapy( Neurosciences) from Mumbai and is currently a PPOTD candidate at Washington University in St. Louis.

Hi I am doing my literature review on the benefits of OT in UK prisons but so far I'm not really finding much research out there if any. Can anyone give some advice or direction I might find some or know anywhere I should be looking other than the usual databases. Many thanks.

Hello ☺️ My name is Jacqueline and I am currently in my first year of studying occupational therapy. Since I started studying and our field of work has often become a topic of conversation, I have noticed that there are many people who know someone who has done occupational therapy or even they themselves. I was very pleasantly surprised by this. Now I would be very interested to know what your experiences are in other countries? ☺️ Do you have the feeling that occupational therapy is becoming better known and what our goal is? In our country, occupational therapy is relatively expensive and often has to be financed privately, which is a shame as it is often not used even though it is needed. How is it handled in other countries, is occupational therapy also cost-intensive in your country and do clients have to bear the costs themselves? I look forward to your feedback! Kind regards From Vienna ☺️

Hi! I'm an Indian student studying occupational therapy. I'm in the 2nd year of my bachelor's degree. I was curious what it's like to study occupational therapy in other countries, including what you learn in the programme, what sort of activities you participate in, etc. Although the majority of people in this country are unaware of what occupational therapy is, we do have a lot of clients here and get to practise with OTs in the outpatient setting. There are very few well-known institutions that offer this course, and the resources we have access to are extremely constrained. I also wanted to know if joining AOTA is worthwhile. I've always been curious to learn more about and investigate this profession. I have always thought that occupational therapy is a fantastic career choice and I adore everything about it. I would love to interact with OTs, OTAs, or students. Feel free to get in touch with me at creativemc23@gmail.com. Thank You!

Topic of the month- Integration of NLP and Occupational Therapy Facilitator for the month- Nidhi Kuvadia Shah, Occupational Therapist, Certified NLP Practitioner, Mumbai, India. 📷 The following article is an open access article published in the researchgate.net. The link is provided for the same at the end of the post. 📷 Aims and issues addressed by this article: The given article draws attention towards a new approach for Occupational therapist in conjunction with Neuro Lingustic Programming as the holistic approach used in different domain of life of an individual. What is NLP? 📷A very little is known about ‘Neuro Lingustic Programming’ (NLP), its techniques and tools. To start with, NLP was developed in USA by John Grinder and Richard Bandler. NLP is a multi-dimensional process that involves the development of behavioural competence and flexibility, but also involves strategic thinking and an understanding of mental and cognitive process behind behaviour. Hence, the article tries to correlate NLP with OT that can help clients with psychological disorder to get back in their lives. Integration of NLP and OT might be used for understanding cognitive and psychosocial performance such as self- awareness, self –direction of roles, self-management including (personal, educational, Social) and internal adaptation (belief, values, interests) which is the basic aim of all the occupational therapist working with the clients. NLP describes the fundamental dynamic between mind and language and how their interplay affects body and behaviour. Objective of this study is “To compare the outcomes of MHR-OT (composed of OT, Neuro-linguistic programming (NLP), and integrative NLP & OT in Thai clients with mental health experiences or diagnosed chronic psychosis.” Design of Study and Methodology: Level of evidence –III, Non randomised, single group, pre and post intervention, descriptive study Ten clients with mental health experiences were recruited with a subset programming named ‘Mental Health Recovery of OT (MHR-OT)’ which was created by a set of three serial modules: 3-week of OT, 3-week of NLP and finally 3-week integrative NLP & OT. The OT module included OT assessments, psychoeducation of mental health recovery, cognitive skills training of individuals, group dynamics of social skills training, and self-management skills (time, fatigue, and leisure) training whereas NLP module included C.U.R.E. model which has shorted by conversational frames, understanding, rapport-connect, and empowerment (reconstruction of S.C.O.R.E. model – symptoms, causes, outcome, resource, effects) as well as reframing and anchoring Outcome assessed on cognitive levels and self-efficacy scores Main findings: The article provides a tabular format to understand the effects of OT, NLP and OT-NLP in the cases with 3 weeks intervention respectively in areas of cognition and self- efficacy. Though the scores in self -efficacy remained more over same in NLP intervention but there have been vast increase in the score when NLP and OT were used in coordination. The study gives a direct view on the use of NLP in OT and its effect on individual’s cognitive level. 📷 Implications: NLP incorporates and draws idea from ones cognitive, biological, social, behavioural psychology, sociology, anthropology, body- language, expressions, neuroscience etc.; all these factors are considered by an occupational therapist while interacting with client and their family members, thus understanding these factors on larger terms and working on these factors using tools and techniques of NLP not only of clients but of their care takers will have a greater impact on the goal settings. Limitations: · The study does tell about NLP but the models or tools used are not specified in length. · There is very limited information on the combine use of NLP and OT. · A certified NLP practitioner is required to carry out the NLP techniques. Conclusion: Thus as an Occupational Therapist our motto is to bring the best of the given situation and provide at most independence to our clients. The authors have sustained to this thumb rule and tried using a method to which very few studies have been done with a commendable success. Generalizability: The article gives an over view of adjunct therapy with a good success rate in the clients, which can help therapist to formulate models in different domains of ADL. Felicitator’s comments: I have been certified as a NLP practitioner and have been using NLP as an adjunct to my therapies since a year and have found success with it. The most important thing is to understand the Human Behaviour as to why it is been done by the specific person, the need of best option available to them at the given point and finally the meaning of your communication is the response that is elicited. So if these basic assumptions as said in NLP are understood one can easily understand the patterns seen in adults and individuals. LINK TO THE ARTICLE https://www.researchgate.net/profile/Supalak_Khemthong/publication/293821280_Integration_of_Occupational_Therapy_and_Neuro-Linguisting_Programming_for_Thais_with_Mental_Health_Experiences/links/56bc1ddf08ae2481ab6ae9dc/Integration-of-Occupational-Therapy-and-Neuro-Linguisting-Programming-for-Thais-with-Mental-Health-Experiences.pdf?origin=publication_detail

Hello! I'm Hannah and am currently in my 1st year my Occupational Therapy Apprenticeship at Coventry University in England. We have bee given a project to connect with OT's from around the globe and find a Pen Pal to find out more about OT within other countries and cultures and how they may differ. I would love to find out more about how your role as an Occupational Therapist where you live and if you are happy to chat, let me know! Thank You, Hannah

"Occupational therapy: Where science, creativity and compassion collide." - Jessica Kensky (2016 AOTA Welcome Ceremony) "Occupational therapy: Arguably the most empowering, creative, holistic and meaning-enhancing healthcare profession... Adding life to days." - Jamie Grant (Director, The Occupational Therapy Hub) As occupational therapists, OTAs and student OTs, we provide person-centred support to those whose health and/or well-being prevents them from doing the daily activities that matter to them. Our professional remit is vast, so the settings, client groups and tools we use can differ greatly. But, despite these differences, many experiences and elements of OT are universal! So - to mark 5 years since The Occupational Therapy Hub was born - we are asking you to share your thoughts and ideas with us! In this forum... please tell us the 5 things (you think) that all OTs can relate to. 🌎 We look forward to reading and sharing your views with the global community! 🎈#HappyBirthdayHub

Hi all, I have worked in the mental health services for a number of years now and am looking to go it alone. I have the ideas all in place and just looking for some advise with the advertising aspect of things? What advice would you give? I plan to do nature based therapy for mental health. Thanks 🙏🏼

Hello everyone , I am newly qualified and my first rotation is in an acute medical setting. I found myself pondering over my transitionary period and all the different conditions I am seeing. The positive and the negative and thought otherothers might be thinking the same and benefit from peer support through discussion.

Hi I’m Holleigh and I’m a newly qualified OT currently on my first rotation which is cardiac. I was wondering if anyone wanted to start a supervision group of other OTs working in this area? I really want to learn as much as i can and get as much as I can out of this rotation, so I think a supervision group would be super useful. Thank you

Good day everyone! I am a practicing OT, working in mental health & addictions, and am currently completing a Doctor of Science degree in rehabilitation and health leadership. Through conversation with colleagues, friends, and clients, I started to become concerned about the rates of alcohol use in women - and how frequently problem drinking in women goes unnoticed. My dissertation work is primarily focused on this area, but what I'm wondering is what your thoughts - as OTs - are around this issue? Do you currently screen all clients for substance use disorders? Do you feel it falls within your scope? Have you considered the impact of substance use within general practice? You don't have to answer all of those questions... but I'd love to get a dialogue going! I am very interested in your perspectives...

Hello! I'm an OT who has worked for many companies and different populations. And I feel I'm ready to start things on my own and pick up some private patients. However I'm terrified and have no clue to where to start! My biggest fear is doing something improperly and not having the proper policies/procedures in place to protect me. As I'm aware some families can be unhappy no matter how hard you try. Looking for ANY advice or even a mentor who is willing to meet with me ( which I would be eternally grateful for). I'm very confident working with geriatric patients in manual handling, Neuro/stroke, positioning and adaptations. Hand and splinting. Major trauma and spinal. And also have just started working with children with ASD/ADHD. SO I'm hoping to help a wide range of patients. Yet again, happy with any advice on where to start. Thank you all 😊

I’m a student just starting out on my training to become an Occupational Therapist. I also have a disability myself and am finding it really interesting to explore the different ways of adjusting practice. I’ve come across some innovative approaches by other Occupational Therapists to work with their disability and how this can influence and change the nature of some client interactions (eg. adjustments to techniques for physical or sensory impairments, distance consultations & social media engagement). I wondered if anyone else had any resources, experiences or thoughts to share about this?

I was wondering if there is anyone currently intergrating CAM into their OT practice or has some experience in this area. Thank you

Introduction With increased access to information, women across the globe are becoming more actively involved in their care, especially during the Perinatal period. Occupational Therapists are holistic practitioners working with individuals through the lifespan, and Women's Health is an emerging frontier for OT practice. With increased OT practitioner and consumer interest in this stage of life, there needs to be more evidence to support OT's role in the medical care team during the perinatal period. Further discussion in this post is based on the open source article “Effect of pelvic floor muscle training on postpartum sexual function and quality of life: A systematic review and meta-analysis of clinical trials” by Talasz et al (2019). The article can be found at : https://www.sciencedirect.com/science/article/pii/S1028455919302086?fbclid=IwAR15Y-JU9rR-KFaZHdCPmy78EfI0t0-aAGwqiziHGa_p8Ld2DBlmQ2sgbmE#bib24 The article reviewed in this post was not authored by Occupational Therapists, but reviews an intervention - Pelvic Floor Muscle training - that is frequently employed by OTs practicing in Women's Health. Specifically, the study of Sexual Health during the perinatal period is interesting as it is an aspect that is often ignored. As the woman’s body recovers physically and emotionally from birthing, it is easy to overlook the ADL of Sex amongst the larger changes in the woman’s life which usually include an identity shift to being a mother, loss of previous occupations (work role outside home, active social life, prior physical activities & leisure pursuits), new occupations (infant caregiving, breastfeeding, viewing partner in new role of parent) and changes in social support systems. The article discussed helps to fill the gap in knowledge of postpartum sexual function by using a Systematic Review design to analyze the available research in English and Persian to determine the effect of Pelvic Floor Muscle (PFM) training on postpartum sexual function and quality of life. By demonstrating the positive effects of PFM training on postpartum recovery, it helps strengthen the role of Occupational Therapists in the postpartum care team. Below is a superior of the Pelvic Floor Musculature that is targeted in PFM training interventions. Performing internal PFM assessment & intervention is beyond the scope of practice of entry-level Occupational and Physical Therapy practitioners. Please refer a client in need of PFM training to a qualified professional. Study Design The researchers used a keyword search to find English & Persian studies in the following databases - PubMed, CINAHL, Medline, Scopus, Google scholar citations, SID and Iran Medex. The PICOT method was used to select studies as listed below: P (Population): women with pelvic organ prolapse, I (Intervention): pelvic floor exercise, C (Comparison group): watchful or other types of therapies, O (Outcome): Sexual function, T (Time or duration): Pregnancy or postpartum. Only studies using a quasi-experimental and randomized controlled trial (RCT) design were used for meta-analysis. Studies that tested interventions on women birthing via cesarean section were excluded from analysis. The search resulted in 347 titles and abstracts, which were narrowed down to 12 potentially eligible articles. The 3 major outcomes measured were: - Sexual Function – 5 studies - Appropriate function in any stage of the sexual process- desire (or libido), excitement, lubrication, orgasm, satisfaction, and pain - Sexual quality of life – 2 studies - Satisfaction with sexual outcomes with self, single or multiple partner(s) - Quality of life – 3 studies - A broad ranging concept that includes a person's physical health, psychological well-being, social relationships, and sexual satisfaction Two articles were excluded from meta-analysis, because they were pre-post clinical trial and did not have control groups. Findings & Generalizability A statistically significant increase in sexual function was found, when pelvic floor muscle exercises were used during the postpartum period. The American Occupational Therapy Association recognizes that Sex and Sexuality are important occupations (https://www.aota.org/About-Occupational-Therapy/Professionals/RDP/Sexuality.aspx) addressed by OTs across practice settings. The use of physical exercises, such as PFM training as a component of care falls within Occupational Therapists’ scope of practice, and should be used with individuals in the perinatal period. Limitations One limitation of the study was the significant heterogeneity introduced by different intervention methods used in the studies analysed. The article also had grammatical errors which can be attributed to the authors not being native English speakers. Practice Implications and Conclusion Pelvic floor muscles play an important role in sexual function (other functions are support of abdominal organs, sphincteric control of bowel & bladder and stabilization of pelvis). Given that pregnancy and childbirth are factors in weakening the pelvic floor muscles, PFM training is an important intervention in improving sexual function, which will subsequently improve the quality of sexual life and overall QoL. Based on the study reviewed and other existing evidence, health professionals should encourage women to perform postnatal exercise with a qualified provider. Referral to an Occupational Therapist with advanced training in Women’s Health will enable women to have access to PFM training and psychosocial approaches to ease the transition to motherhood, which can help improve postpartum health outcomes. Medical care providers should also encourage adherence to and continuation of postpartum recovery programs at postpartum care appointments, rather than only providing informational support in the form of pamphlets & other reading material. Women's Health is an emerging area of rehabilitation and Occupational Therapists should aim to actively participate in contributing to it clinically and academically. Sujata Martin, MS OTR/L is a Women's Health Occupational Therapist specializing in preventative and rehabilitative Pelvic Floor Therapy focusing on the Pregnant and Postpartum Woman. She is based in Buffalo, USA, and can be contacted at https://mothernurturewny.com/

Hi I’m wondering if fellow OTs would share any Apps (android or apple) they have found useful in practice. My areas of interest are, Stroke, Dementia, DCD, Dyslexia. Thanks in advance.

Hi folks, First time poster here :) I have just been offered a place on the MSc Occupational Therapy (pre registration) at the University of Brighton, UK. I'm thrilled, but also very much questioning if it's the right time for me to accept... Some background: I'm currently living in Australia but returning to live in the UK this August. The course starts on the 4th September. I haven't studied OT before, my first degree was a Bachelor of Arts 15 years ago, but I have been working as a music therapist in healthcare and community settings for the past 10 years, alongside OTs and other healthcare staff. I'm very rusty when it comes to study! But, I'm extremely passionate about OT and know it's the field I want to go into. I have two young children in school. I'm questioning if I should start the course this September, and just get on with it...or leave it until next year. Does anyone have any insight on studying a masters in OT and how challnging it is? I am fully expecting it to be hard work (the interviewer's words!) and very intense. I know it's a question only I can really answer, but thought I'd throw it out for any advice/similiar experiecnes! Thank you :) Amy

Hi, I am an NHS Community Occupational Therapist that is seeing an increased number of referrals for elderly clients, often with Dementia, and or in care homes with severe contractures of the hand. The referrals are made, generally, too late for palm protectors/ passive/ active ROM exercises/ Thera putty etc. I am looking for advice that I can pass onto the care homes a) to prompt earlier therapy intervention b) promote good hand hygiene/ tissue viability regimes (often when the clients are reluctant to engage with staff) and c) how to best manage the complex scenarios: such as poor hand hygiene/ severe pain and pressure sores to palm/ fingers/ thumb with dignity. Many thanks to OT Hub for sharing.

Definition: 'Mental capacity' means being able to make your own decisions (Mental Health Foundation, 2019). Mental Capacity Act (MCA) 2005: The principles The following principles apply for the purposes of this Act: A person must be assumed to have capacity, unless it is established that he/she lacks capacity A person is not to be treated as unable to make a decision unless all practicable steps to help him/her to do so have been taken without success - e.g. different methods of communication/language A person is not to be treated as unable to make a decision merely because he/she makes an unwise decision An act done or decision made under this Act, for or on behalf of a person who lacks capacity, must be done or made in his/her best interest Before the act is done or the decision is made, regard must be given as to whether the purpose for which it is needed can be as effectively achieved in a way that is least restrictive of the person's rights and freedom of action Capacity assessments: Who can undertake them? Any professional caring for or supporting a person who may lack capacity could be involved in assessing capacity (however check Trust guidelines) The MCA is designed to empower those in health and social care to do capacity assessments themselves, rather than rely on expert testing by psychiatrists or psychologists However, in cases involving complex or major decisions, you may need to get another professional opinion. This could be a general practitioner (GP) or a specialist, such as a consultant psychiatrist or psychologist (SCIE, 2019) Before completing a mental capacity assessment Gain an understanding of the 4 principles: Do they understand the decision? Are they able to communicate the decision (consider the assessment to be in their language or preferred method of communication)? Can they retain information in regards to the decision? Are they able to weigh up pros and cons of the decision made? Further considerations around mental capacity Remember: each assessment is decision specific. Capacity is decision specific, so ask questions surrounding this topic only; for example, in regards to discharge destination from hospital Know your patient; take a holistic approach Are you the best professional to discuss the 4 principles? Is another professional better suited to complete the capacity assessment? Could a joint capacity assessment be completed? Give the patient the best possible opportunity; e.g. involve a carer/family member/translator if required Write as much evidence as possible to support why a patient lacks capacity Medications management - e.g. due to limited finger dexterity, patient stated this has been a problem for them; 'power phrase' this back and state that you previously stated you were limited with your finger movements, so which activities does this limit you with? If individual lists activities, then ask how they would manage with those when not in hospital? Does the patient have insight into equipment being needed - are they aware they are on the ward? Ask how they will get to the bathroom at home, to see if they have insight to the fact that they need assistance. How will the patient transfer/mobilise to the toilet in between care calls? If the patient has 4 care calls, is the patient aware of how they would manage in-between those care calls? Consider how the patient would have drinks/snack/medication/pressure relief/ how they would call for help if needed? Can they use a phone or pendent alarm?

Hi There, My name is Kristina Marchiori, I am a new graduate OT in Toronto, Canada. I am currently not very busy with clients due to the nature of my pediatric practice in this time of COVID. However, I have chosen to start a conversation within our Canadian Association of Occupational Therapy via twitter about the lack of diversity in our profession and the education around our profession, in response to the protests and call to action that have been amplified in the past week. I am a white, queer identifying female, raised in a middle class family and recognize that this adds to my privilege as an individual who was able to be accepted and afford completing a Masters degree. I wanted to use my voice to help amplify the voice of the Black community and get a conversation going. I am sharing this link below written by Lauren, who is an OT reflecting on her experience as one of two Black people in her office. https://gottabeot.wordpress.com/2020/05/31/black-ots-matter-changing-your-ot-practice-to-combat-racism-address-racial-trauma-and-promote-healing/ Please read the article and feel free to reflect in the comments. In the meantime, also I am interested in a couple questions if you don't mind answering Where are you from (Country is fine, just curious about difference outside of Canadian profession) How many non white OTs do you work with How many Black OTs do you work with In your OT degree, how many students of colour (non white) were in your class In your OT degree, how many teachers or guest speakerss of colour (non white) did you encounter in your OT degree, how many Black teachers or guests speakers did you encounter In your OT degree, did you learn about the lived experience of different cultures and how you as an OT could adjust your practice to be accessible/supportive of all? (this DOES NOT include your own research, previous education or self started learning) I'm not too sure where I want to go with this information (I don't really have funding or anything to start a large project) but I would like to get the conversation going so we can work on becoming a more diverse and accepting professional body for all of our clients and colleagues

I have worked as a contact tracer for the last 9 months and I have had many conversations with Covid patients. My role as contact tracer may be coming to an end soon, but it has left me wondering whether there may be an emerging role for OTs with Long Covid patients? Does anybody know more?

I have another question about cognitive screens applicable to the acute care environment which is related to the previous MOCA question. I have developed a brief functional cognitive screen, essentially a collection of cognitive tasks with a scoring system that can be performed by a non-impaired person in 15 minutes. I am trying to set up a research design that compares it to the MOCA but need some third measure to compare them both to. I was thinking to have people perform a specific cognitively-demanding task which can be performed in bed but can't come up with anything. Does anyone have suggestions or recommendations for a useful way to set up a comparison for research purposes? I would very much appreciate any feedback. Thanks, Heather Sloman, Toronto, Canada

Hello, My name is Emily. An OT in the UK. I started in a wellbeing hub for NHS staff in the last few months. I am the only OT on my team, and really struggling with finding my identity as an OT in the team. We are here to support staff mental health and wellbeing. I was just wondering if any other OTS work in this area? Thanks Emily