Using Occupational Therapy Theory in Practice

200 Pages·2012·1.7 MB·English

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Using Occupational
Therapy Theory
in Practice
Edited by
Gail Boniface PhD, MSc, DipCOT
CardiffUniversity
Alison Seymour MSc, BSc, DipCOT
CardiffUniversity
Foreword by M. Clare Taylor
A John Wiley & Sons, Ltd., Publication
i
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Thiseditionfirstpublished2012,©2012byBlackwellPublishingLtd
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Usingoccupationaltherapytheoryinpractice/editedbyGailBoniface,AlisonSeymour.
p. ; cm.
Includesbibliographicalreferencesandindex.
ISBN978-1-4443-3317-6(pbk.:alk.paper)
I. Boniface,Gail. II. Seymour,Alison.
[DNLM: 1. OccupationalTherapy. 2. Models,Theoretical.WB555]
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2011034240
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Contents
Contributorbiographies v
Foreword xi
1 Introduction 1
GailBonifaceandAlisonSeymour
Section1: Theory
2 Reconfiguringprofessionalthinkingandconduct:achallengefor
occupationaltherapistsinpractice 9
DellaFishandGailBoniface
3 Definingoccupationaltherapytheory 21
GailBoniface
4 FromStrandstoTheInvisibles:fromatechnicaltoamoralmodeof
reflectivepractice 38
DellaFish
5 Theuseofselfinoccupationaltherapy 49
AlisonSeymour
Section2: TheUseofTheoryinPractice:SomePractitionerNarratives
6 DevelopingtheuseoftheModelofHumanOccupationina
mentalhealthservice 63
LindaKeelanandLisaJohn
7 UsingReedandSanderson’sModelofAdaptationthrough
Occupation:ajourney 76
KarenLewisandSharonJames
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iv Contents
8 UsingtheCanadianModelofOccupationalPerformanceto
reconfigureanintegratedoccupationaltherapyservice 91
SiaˆnWaygood,MargotMason,HeatherHurst,TamsinFeddenand
CarolinePhelps
9 Dealingwiththebarrierstochangewhilstimplementingthe
CanadianModelofOccupationalPerformance 106
JaneWalkerandGillianThistlewood
10 DevelopingoccupationaltherapytheoryinPoland 120
AniaPietrzakandMagdalenaLoska
11 UsingoccupationaltherapytheoryinCroatia 128
AndrejaBartolac
12 PersonalreflectionsonunderstandingandusingtheModelof
HumanOccupationinpractice 141
SarahCook
Section3: ContemporaryDiscussionsontheUseofTheoryin
OccupationalTherapyPractice
13 Usingoccupationaltherapytheorywithinevidence-basedpractice 155
CarlyReagon
14 Occupationalscienceandoccupationaltherapy:acontemporary
relationship 165
JillRiley
15 Mythsaroundusingtheoryinoccupationaltherapypractice 180
AlisonSeymour,GailBonifaceandLouiseIngham
Index 189
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Contributor biographies
Editors
GailBoniface
PhD,MScinMedicalEducation,DipCOT,CertEd,CertificateinSupervisory
Management
Gailhasworkedinoccupationaltherapyeducationfor23yearsandiscurrently
workingintheSchoolofHealthCareStudiesCardiffUniversityasanoccupational
therapyprogrammelead.Shehasalong-standinginterestintheuseofoccupational
therapytheoryinpracticeandhasbeenverymuchinvolvedinprovidingcourseson
theuseofmodelsofoccupationaltherapyandsupportingpractitionersintheiruse.
AlisonSeymour
MSc,PostgraduateCertificateinUniversityTeachingandLearning,FHEA,BSc,
DipCOT
Alisonhasworkedinoccupationaltherapyeducationfor7yearsandiscurrently
workingintheSchoolofHealthCareStudiesatCardiffUniversity.Previoustothis,
sheworkedfor19yearsinavarietyofmentalhealthservicesincludingforensic,child
andadolescentmentalhealth,communitymentalhealthandeatingdisorderservices.
Shehasusedarangeofoccupationaltherapymodelsofpracticewithinthesesettings.
Contributors
AndrejaBartolacqualifiedinphysiotherapy,occupationaltherapyandpsychology.
AndrejahasbeenworkingasateacherattheOccupationalTherapyDepartmentof
UniversityofAppliedHealthStudiesinZagreb,Croatia,since2001.Herprofessional
interestsareinthefieldofoccupationaltherapyassessment,ergonomicsand
occupationalscience.Formorethan10years,shehasactivelyparticipatedinall
majoreventsassociatedwithdevelopmentoftheoccupationaltherapyprofessionin
Croatia,throughtheworkinthemainboardofnationalassociationofoccupational
therapists,establishmentofCroatianChamberofHealthProfessionalsandcurriculum
development.
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vi Contributorbiographies
SarahCook(BScinoccupationaltherapy)isaClinicalSpecialistHeadof
OccupationaltherapyintheAcuteandCrisisServicesatSouthLondonandMaudsley
NHSTrust.ShehasworkedinavarietyofNHStrustsacrossSouthWalesandLondon
aftercompletingherqualificationin1999.MostofherexperiencehasbeeninAcute
in-patientandCrisisServices,ForensicsettingsandAssertiveOutreachTeams.Sheis
passionateabouttheuseofMOHOinpracticeandregularlyprovidesworkshopson
variousaspectsofthemodel.SheisavisitinglectureratSouthBankUniversity.
TamsinFedden(DipCOT,PGCertHE,MSc)hasworkedasanoccupationaltherapist
for28years.ShehasworkedinMentalHealth,LearningDisability,PhysicalHealth
andSocialCaresettingswithadultsandchildrenandhasbeenemployedasasenior
lecturerattheUniversityoftheWestofEngland.Tamsinisparticularlyinterestedin
thelinksbetweentheoryandpracticeandinpractitioners’continuingdevelopment.
SheisamemberoftheGloucestershireCMOP(CanadianModelofOccupational
Performance)steeringgroup.
DellaFish(MA,MEd,PhD,DipEd,FAcadMed)taughtinschoolsandthenin
universityteachereducationfor24yearsbeforebecominganeducationalconsultant
inhealthcareeducation.Herinterestsareincurriculumdesignanddevelopmentand
inteachingandlearningintheclinicalsetting.ShehasworkedforTheCollegeof
OccupationalTherapyasanadviserandastheirrepresentativeinvariousvalidation
processes,fortheAcupunctureAccreditationBoard,transitioningprivatecolleges
intouniversitiesandforTheRoyalCollegeofSurgeons,helpingthemtodesigntheir
firstformalcurriculumforsurgery.SheholdschairsinSwanseaUniversity,Chester
UniversityandCharlesSturtUniversityinSydney.
HeatherHurst(DipCOT,MScinoccupationaltherapy)hasworkedinavarietyof
healthandsocialcaresettingsoverthepast20years.Currently,sheisHead
OccupationalTherapisttoateamwhoprovideoccupationaltherapyservicesfortwo
communityhospitalsandisstudyingforaProfessionalDoctorate.Sheisverymuch
interestedindevelopinglinksbetweentheuseofoccupationaltherapytheoryand
clinicalpractice.Shecontinuestoplayanactiveroleinimplementingatheoretical
modelwithinherorganisationandchairstheGloucestershireCMOP(Canadian
ModelofOccupationalPerformance)steeringgroup.
LouiseInghamqualifiedasanoccupationaltherapistin1985.Shespecialisedin
adultmentalhealthandwasoneofthefirstgroupofoccupationaltherapiststo
becomeestablishedincommunitymentalhealthteams.Inhercurrentclinicalroleas
anadvancedpractitioner,shesupportsoccupationaltherapistsinNorthWestWalesto
retainanddeveloptheirprofessionaloccupationalfocuswhilstbeingcoreMDT
members.ShealsoworksasalecturerpractitionerinBangorUniversity.
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Contributorbiographies vii
SharonJames(MPhil,DipCOT,CertificateinSupervisoryManagement)iscurrently
thedeputyheadofoccupationaltherapyservicesforAbertaweBroMorgannwg
UniversityHealthBoardatMorristonHospitalSwansea.Shecompletedaprojecton
outcomemeasures,whichledtothecreationofanoccupationaltherapyprofessional
model-ledoutcomemeasure:theMOTOM.
LisaJohn(MSc,BSc(Hons))iscurrentlyHeadOccupationalTherapistforAdult
MentalHealthServiceinSwansea(ABMU).Shepreviouslyworkedin,andmanaged
avarietyof,mentalhealthsettingsinEnglandandWalesincluding,forensic,
substancemisuseandgeneralmentalhealth.Sheiscurrentlyinvolvedindeveloping
anoccupationaltherapyservicetotheProlificandPersistentOffendersProgramme
withSouthWalesProbationService.
LindaKeelan(DipCOT)isanoccupationaltherapistwhohasworkedwithpeople
accessingmentalhealthservicesfor27years.Herclinicalrolehasbeenmainlywithin
communitymentalhealthsettings,andalsoincludesin-patientworkwithadults,older
people’smentalhealthandmentalhealthrehabilitation.Hercurrentroleisasleadfor
occupationaltherapyandothertherapiesformentalhealthservicesinAbertaweBro
MorgannwgUniversityHealthBoard,whichoffersextensivelocalandregional
mentalhealthservices.Lindahasmaintainedoccupationatthecoreofherpractice
andincorporatestheoccupationaltherapyphilosophywithinpeopleandservice
development.
KarenLewis(MSc,DipCOT)iscurrentlytheOccupationalTherapyManagerfor
MorristonHospital,Swansea,whichispartofAbertaweBroMorgannwgUniversity
HealthBoard.Shehasworkedinadiverserangeofsettingsthroughouthercareer
includinglocalauthority,mentalhealthandlatterlyspecialisinginphysicalsettings.
Herareasofpracticehavemorerecentlyincludedpalliativecareandneurosciences,
duringwhichshewasinstrumentalinsettingupaParkinson’sdiseaseAssessmentand
TreatmentCentreinSwansea.
MagdalenaLoska(PhD,MA,BA)currentlyworksasaseniorlectureratTheMaria
GrzegorzewskaAcademyofSpecialEducationandistheheadoftheOccupational
TherapyDepartmentthere.Sheisalsoaspecialeducationteacher,specialisingin
workingwithpeoplewithphysicaldisabilitiesandhasanumberofadditional
neuro-developmentalandsensoryintegrationqualifications.Shehascontributedtoa
numberofbooksandwrittenarticlesonthesubjectofenablingchildrenwith
disabilitiestobecomemoreautonomous.Sheisalsoengagedineducatingteacherson
thistopic.Hercurrentinterestsareinassessinglevelsofautonomyforchildrenwith
cerebralpalsyandidentifyingbarrierstothatautonomy.
MargotMason(BSc,PostgraduateDiplomainOccupationalTherapy)hasworkedin
AdultSocialCareoccupationaltherapyfor16yearsandiscurrentlyworkingasa
CommunityOccupationalTherapyManagerforNHSGloucestershireCareServices.
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viii Contributorbiographies
Shetakesanactiveinterestinservicedevelopmentandtheuseofevidence-based
practiceandisamemberoftheGloucestershireCMOPsteeringgroup.
CarolinePhelpsqualifiedin2002withaBSc(Hons)inoccupationaltherapyfromthe
schoolofhealthprofessionsandrehabilitationsciencesinSouthampton.Carolinehas
workedatGloucestershireRoyalHospitalsince2004.Carolinebecameinvolvedat
theverybeginningofGloucestershire’sjourneyinimplementingtheCanadianModel
ofOccupationalTherapyandwasoneofthemembersoftheoriginalsteeringgroup.
AniaPietrzak(MAinPedagogicalEducation,DipSocialWork,CertEd,DipOT)is
currentlystudyingforherPhD.Aniahasworkedinareformatoryschoolasan
occupationaltherapist.Currently,sheworksintheAcademyofSpecialEducationin
Warsaw(Poland)asalecturerandoccupationaltherapycurriculumco-author.Her
fieldofinterestistodevelopandadaptPolishoccupationaltherapytomeetthe
requiredworldstandards.Sheisinthecourseofcreatinganewassessmenttoolfor
measuringadaptiveskillsforpeoplewithlearningdisabilities.
CarlyReagon(PhD,BScinoccupationaltherapy)isalecturerandresearcherinthe
SchoolofHealthCareStudies,CardiffUniversity,Wales.In2006,shecompleteda
PhDexploringperceptionsofevidence-basedpracticeamongstagroupof
occupationaltherapistsinEngland.
JillRiley(PhD,MScinoccupationaltherapy,PGDip(socialscienceresearch
methods),DipCOT)hasbeenalecturerinoccupationaltherapysince1998andis
currentlyaresearchcoordinatorandprogrammeleadfortheMScinoccupational
therapyintheSchoolofHealthCareStudies,CardiffUniversity.Jillhasaspecial
interestinOccupationalScienceandespeciallycreativeoccupationsandtheir
relationshiptohealthandwell-being.
GillianThistlewood(MSc,DipCOT)currentlyleadsandmanagesanoccupational
therapyserviceovertwoacutehospitals.Afterqualifyingin1987asanoccupational
therapist,GillianwentontogainaMaster’sinHealthSciences(Universityof
London)in1994.Shebringsexperience,over23years,inoccupationaltherapy
practice,inarangeofclinicalandmanagerialsettings.Shehasworkedacrossteams
andinter-professionalboundariesandchallengeswitharangeofhealthcareworkers.
Gillianhasaninterestinclinicalethicsandperformancemanagementandisa
memberoftheGloucestershireCMOPsteeringgroup.
JaneWalker(MSc,DipCOT)leadsandmanagesanoccupationaltherapyservice
overarangeofhealthandsocialcaresettings,includingcommunityhospitals,
intermediatecare,socialcareandwheelchairservices.Shequalifiedasan
occupationaltherapistin1984andgainedaMaster’sinAdvancedOccupational
Therapy(PlymouthUniversity)in2008.Herparticularinterestliesinsocialcareand
developingtheroleofoccupationaltherapistswithinthispracticesetting.Sheisa
memberoftheGloucestershireCMOPsteeringgroup.
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Contributorbiographies ix
SiaˆnWaygood(MAinManagementandLeadershipinHealthandSocialCare,
DipCOT)iscurrentlytheProfessionalHeadofOccupationalTherapyServicesin
Gloucestershire.DuringhertimeinGloucestershire,Siaˆnhasworkedwithcolleagues
andkeystakeholdersfromarangeofstatutoryandvoluntaryorganisationsin
GloucestershireonanumberofprojectstoenhanceservicesforGloucestershire
residentsincludingIntegrationoftheOccupationalTherapyandCommunity
EquipmentServices,introducingTelecareServicesandDevelopmentof
Client-CentredPracticemodels.SiaˆniscurrentlyakeymemberoftheGloucestershire
CMOPsteeringgroup.
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Foreword
The notion of the theory/practice divide and the challenge of applying theory into
practice is not new and is something that academics, practitioners and students all
strugglewith.Therearetextsabouttheorybutwhathavebeenmissingarethestories
ofhowtoputtheoryintopractice.Whilstthereflectorsandtheoreticiansamongstus
mightbeabletousethestrengthsoftheirlearningstylestoworkouthowtoputtheory
intotheirpractice,thoseofuswhoarepragmatistsneedtoseeexamplestohelpusput
ideas into practice. Gail Boniface and Alison Seymour and their team of practitioner
colleagues have given us the tools and the stories to help cross the theory/practice
divideandhavecombinedthe‘ivorytower’oftheacademicworldwiththe‘reallife’
ofpractice.
Asoccupationaltherapistsweseeourselvesaspractical,pragmatic,hands-onpeople
whogetthejobdone.Howmanyofuswhenwebuyflat-packfurnitureskimthrough
theinstructionsbutthenjustgetstuckintryingtobuildthething?Practicecanseemto
belikethat,butwithoutthetheoryandtheevidencewecannotarticulateourclinical
reasoning, as Sarah Cook says in Chapter 12; we might get ‘found out’, but more
importantlywemightnotbeabletogiveaclearrationaleforourroleandsowewill
ceasetoexist.Weneedthetheoriesandweneedtobeabletodoasthepractitioners
inthisbookhavedone–weneedtobeabletotellthestoryofhowtheoryandmodels
underpinourpracticeandouractions.
In Chapter 3, Gail Boniface reminds us of the theory of occupational therapy and
definestherelevantterms(e.g.model,approach,paradigm)andusesthemetaphorofan
umbrellatoillustratehowtheory,modelsandtheprofessionalselfmustbeintegrated
withinpractice.Occupationaltherapistsareoftenaccusedofbeing‘jackofalltrades’
(Drummond 2010) and eclectic. However, the metaphor of the umbrella might help
practitioners who feel drawn to an eclectic approach to articulate and justify why
eclecticismisappropriateandusefulwithintheirpracticeconcept.
One of the key tools for linking theory and practice is evidence-based practice.
However,thenotionof‘evidence’iscontested,asCarlyReagondiscussesinChapter
13. Whilst the use and application of quantitative research evidence, such as RCT
and systematic review evidence, is well documented (e.g. Taylor 2007), the inte-
gration of the practitioner’s experiential knowledge is much more complex and less
wellarticulated.DellaFish,inChapter4,exploresreflectivewritingandpresentsthe
idea of ‘Clinical Reflective Writing’ and particularly the idea of the ‘rainbow draft’