9 minute read
DEFINING OT
Defining occupational therapy….and redefining client outcomes
Through its commitment to rehabilitation, with clients achieving things they thought no longer possible, Think Therapy 1st rehabilitation services are shining a new light on Occupational Therapy and its crucial role in ‘enabling’ clients, rather than ‘compensating’ for lost abilities.
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NR Times learns more about its mission to secure appreciation for the profession, while also redefining its capability, and how its focus on functional restoration is enabling it to deliver expectation-busting outcomes.
The term ‘Occupational Therapy’ is something that many people, even those working within neuro-rehab, frequently misunderstand. While ‘occupation’ is a word most commonly associated with a job or profession, in rehabilitation, ‘occupation’ essentially refers to every activity in a person’s day. In that context, an Occupational Therapist then guides people through those ‘occupations’, using the activities themselves as treatment, with focus always on meaningful goals and measurable outcomes. Yet despite such a wide-ranging and vital role at the heart of a person’s recovery, Occupational Therapy is still not properly understood or appreciated, believes Helen Merfield, chief executive of Think Therapy 1st. “People don’t really understand what Occupational Therapists (OTs) do, they don’t understand the breadth of what an OT does, and the word occupation doesn't help because everyone just thinks of work,” says Helen, who recently became TT1st chief executive from her previous role of managing director. “Everyone just thinks it's about getting you back to work, but they don't realise that it's actually about getting your life back together, and helping you live your best life.” A recent session TT1st held with a group of legal and insurance professionals helped to showcase that exact point - asked at the beginning of the session to write down words they’d associate with occupational therapy (OT), their use of vocabulary had changed entirely by the end, having learned the value of the support and empowerment delivered by an OT. “Essentially, we cover everything from tying your shoelaces and brushing your teeth, to doing your job, raising your child and even running a marathon,” says Penny Wosahlo, newly-appointed managing director of TT1st and a qualified Occupational Therapist, previously director of finance and operations. “But people are not one dimensional. You cannot fix a leg without using your brain to plan the physical movements, and you cannot ask your brain to do that without having the motivation and confidence to make change. “Your psychological and emotional needs, your cognitive and physical needs must all be aligned and co-ordinated. “But then you need to understand that people live in their own unique worlds, in societies and cultures which are all complexly interlinked to their needs.
“It’s the interactions between the environment, the persons components and the demands of the activity that an OT truly understands, breaking them down and coordinating them to make a purposeful therapy session. “An OT looks at all of this and figures out what the underlying issues are. Are they physical? Is it psychological? “Usually, it’s a mixture of these things, so we identify the key pinch points that are causing the person to stop doing the things they need and want to do. “We don’t address skills in isolation, we don’t just fix the leg, we fix all the components impacting on the life, some of which the leg provides” And while TT1st is keen to shout from the rooftops about the value of OT, its own approach to OT takes the traditional focus of the profession to the next level. In supporting a person with a life-changing injury, traditionally, expectations are often managed in their recovery to the extent they OTs are about so much more than equipment and adaptations. “We can empower people to be their own experts in their recovery. We can make rehab enjoyable. “One of our clients had therapy by learning to fly a kite on a beach, aware she was working on her physical recovery but oblivious to the gains she was making psychologically and cognitively as the OT tweaked and graded the activity to draw on these components too.” “Our OTs are amazing, they’re very much like OTs I worked with in the military. We focus on functional restoration, which is very similar to how they used to work at Headley Court, the Tri-services rehabilitation unit that is now sadly closed,” continues Helen, a former military nurse. “Absolutely everything we do is about rehabilitation, every activity is made into rehabilitation, nothing is wasted. Our progress and outcomes are measured by standardised assessments, and what we achieve is often beyond the expectations of the lawyer, insurer and the persons treating medical team. “They often don’t know how the magic happens, but they see that it does, so they let us get on with it, and come back to us time and time again. “Often, they will give us a chance on one case, and they are like ‘Blimey, that worked’. They get reports every month which show how much their client is improving, and they’ll send us another case based on our success. “We know what we’re doing, and we’re always willing to fight our clients’ corner - quite recently one of our OTs went with their client to see the consultant, and he said based on the injury that the client wouldn’t be able to return to the desk job he wanted. We had a training programme in place and were progressing well towards achieving exactly that. So, our OT, always an
are told they may never do something again. But for TT1st, they rarely treat anything as impossible, with their focus on delivering the seemingly impossible through evidencebased functional rehabilitation - rather than compensation - enabling clients to make progress beyond expectations. Through its array of programmes - including Specialist Rehabilitation Occupational Therapy (SROT), a specialist Children and Young Adult Service (CAYAS), Holistic Education for Living with Pain (HELP), Holistic Education for Anxiety Liberation (HEAL) and Fatigue Education and Exploration for Living (FEEL) - TT1st has a significant breadth of expertise available to clients whatever their injuries or condition, with a maximum of 12-months of functional restoration, such is their confidence they can deliver outcomes within that time frame. Natasha Bruce-Jones, clinical director, explains: “The scope of OT is so vast but often people only see what the NHS and local authority can offer and believe that’s all we have to give. Everyone thinks OT is about getting you back to work, but they don't realise that it's actually about getting your life back together, and helping you live your best life
advocate for independence said: ‘You’ve done a great job helping him under the knife, but everything else is now up to him and me. Please don’t pigeonhole him into a ‘diagnosis’, he can and will do this.” Penny continues: “Everything we do is therapy, from taking the dog for a walk, to taking the client bowling, to ironing or cake making. We know what works. We will choose activities depending on the client’s injuries and their interests and hobbies. “Often, they don’t even realise they’re doing therapy. People get better quicker when they’re motivated and engaged in something, they don’t notice. “For example, we had a client with upper limb issues in a wreath making class. At the end of one session, she proudly held her wreath up - and then realised she could raise her arm! She was absolutely delighted at how she’d progressed, but didn’t even realise there was a therapy side to it, she was enjoying it so much.” Using the entire breadth of skills of an OT, coupled with its commitment to rehabilitation, TT1st is keen to take a lead in the multidisciplinary team. “Someone once said to me that if you take a nurse, a psychologist and a physiotherapist and smoosh them together, you get an OT,” says Helen. “Their training covers physiology, anatomy, psychology and psychiatry as well as unique OT skills making them a Jack of all trades but a master of Occupational Therapy. “They know their limitations and bring other expertise in at the right time - that’s why they’re such a good person to head up the MDT, they understand the role of everybody. “The OT is supremely set up to do that because they're in for the long haul. Other therapists will come in for a shorter time, but the OT takes the case from the beginning to the end, from the really acute to back to work.” “But one thing that really sets us apart I think, is that we don’t do anything for the client that they can do for themselves,” says Penny. “So although we're coordinating the MDT, we're role modelling to the client how to coordinate their life and using this as therapy too. After all, they will need to know who to go to and how to get help to manage their long-term health and wellbeing, long after settlement. “Our plan is to put the scaffolding in place so they can carry on the life they want to live, independent of us. ‘I don’t need you anymore’ is the best news we will ever hear.” Helen adds: “We always help plan for the future with therapy contingency plans. If they have a life-changing event, like a baby, moving house, starting a new job, that type of thing, they will know who to call for advice and support. “If it’s us, great, they know they can contact us for the rest of their life if they need to but hopefully they won’t have to as we have set them up to be their own therapist ” Going forward, with Penny now overseeing the day-to-day running and supporting the longerterm growth of TT1st, Helen is free to press on with her desire to promote both OT and TT1st’s unique take on it. “I get so excited about our approach to OT and what these guys can do. But as well as showing people just why TT1st is different, why our OTs are so amazing, I want to help people understand what OT is and what we do - my big plan is to try and educate the market,” says Helen. Natasha says: “My entire career I’ve been looking for a way to make the world aware of OTs so we can help as many people as possible and now it feels like we are on the cusp of some enormous change and have the potential to bring independence and meaning to the lives of so many more.” Penny adds: “It’s very exciting for the whole team. As OTs, we are quite humble, and we don’t take the credit for our clients’ outcomes, we’ll put it back onto the client and the work they’ve done. “We couldn't shine that light on ourselves, we would feel uncomfortable - so to have Helen illuminating the way for us, and shining the light on OT, is brilliant.”
