Connections - December 2019 by Occupational Therapy Australia

The magazine of Occupational Therapy Australia, the peak body representing occupational therapy in Australia DECEMBER 2019 | VOL 16 ISSUE 6

Print Post Approved PP340742/00147 ISSN 1832-7605

Connecting with the Next Generation of OTs Local Charm and National Support: Launching A Career in Rural Queensland OT Students as Therapy Assistants: Investing in Our Professionâ&#x20AC;&#x2122;s Future Record to Reflect: A Look at Video Interaction Guidance S E E H O W Y O U C E L E B R AT E D OT W E E K 2 0 1 9

CAIRNS

2021

Bringing OTAâ&#x20AC;&#x2122;s Premier Event to Far North Queensland

SAthVe E DATE

23-25 JUNE 2021

CAIRNS CONVENTION CENTRE

QUEENSLAND www.otaus2021.com.au #OTAUS2021

29TH NATIONAL CONFERENCE AND EXHIBITION

CONTENTS

NEWS

FEATURES

CEO’s Report

Advocacy and Lobbying: The Year That Was

Professional Practice: Looking Back, Looking Forward

Conference Review & Outlook

Reflecting on our CPD Program Reviewing Membership and Marketing

The Next Gen: In Their Own Words

Local Charm and National Support: Launching My Career in Rural Queensland

Connecting With Good Design

OT Students as Therapy Assistants: Investing in Our Profession’s Future

Graduates in Rural and Regional Areas: Why They Come, and Why They Stay

The Next Generation of Assistive Technology

How You Celebrated OT Week 2019

Looking Forward, With Experience

A New Vision for Connections in 2020

A Guide to Involving Animals in Your Practice 30 Record to Reflect: A Look at Video Interaction Guidance 34 Your OT Journal Connects Past, Present and Future Generations of OTs 36

WFOT Update 38

About Connections Connections is a publication of Occupational Therapy Australia (OTA), the peak body representing occupational therapy in Australia. Contact us Occupational Therapy Australia ARBN 007510 287 ABN 65 470 069 906 6/340 Gore Street, Fitzroy, Victoria 3065 Phone: +61 3 9415 2900 or 1300 682 878 Email: info@otaus.com.au Web: www.otaus.com.au Contributions and Advertising Would you like to contribute to Connections, or do you have a product that is attractive to occupational therapists and would like to advertise your product? For advertising enquiries, please email advertising@otaus.com.au 3 www.otaus.com.au

Editorial material including letters to the editor, upcoming events, research material, and important information for inclusion in Connections should be sent by email to digitalcomms@otaus.com.au. The editor reserves the right to edit material for space and clarity and to withhold material from publication. Deadlines for Submissions Autumn 2020 Edition: 10 January Winter 2020 Edition:

10 April

Spring 2020 Edition:

10 July

Summer 2020 Edition: 9 October Design Perry Watson Design

Disclaimer This newsletter is published as an information service and without assuming a duty of care. It contains general information only, and as such, it is recommended that detailed advice be sought before acting in any particular matter. The materials included in this newsletter by third parties are not attributable to Occupational Therapy Australia, and are not an expression of Occupational Therapy Australia’s views. Occupational Therapy Australia is not responsible for any printed expressions or views in any third parties’ inclusions. Any enquiries regarding inserts, advertisements or articles placed by these third parties should be directed to them. Cover image: ©gettyimages/RgStudio

CONNECTIONS DECEMBER 2019 3

CEO’S REPORT

here are few activities more energising than spending time with the generations that are coming up behind us. Their enthusiasm, passion, energy and ideas are always welcome in my home and in all aspects of my life. I am the mother of a Millennial. I volunteer on the board of a football club where the average age of players is 23. I often have a crowd of young adults in my living room or backyard. I find them fun, funny, challenging, engaging and interesting— often all within a single conversation. I have noticed that some members of more experienced generations often like to moan about the newer generations behind them. This has always been the case—I recall my parents complaining about the Gen X of their day. I have no complaints. I see the similarities of our generations more than I see the differences. And the differences that I do see are opportunities to look at situations from their perspective, hear their arguments, learn from their experiences and challenge my own thinking. Sometimes they open my eyes and change my mind. And it’s not just Millennials and Gen Z who are forming our next generation. Mature-aged students may have gained a mid-life appreciation for the power of OT, while parents and carers who put their career on hold may now be

re-invigorated to return to practise. The considered contributions and the varied life experiences they bring to the profession are invaluable to supporting the diverse needs of all Australians. Having an open heart and an open mind is necessary for continual personal growth. The same can be said for leading Occupational Therapy Australia. As a member-based organisation, we need to continue to evolve and grow to represent all of the needs of our members. We need to explore the new ideas, technologies and professional pathways for our staff to make our association a place where innovation and ideas are valued. The same applies for our association. We are an inclusive association representing the needs of all of our members. We have Baby Boomers, Gen X, Millennials and Gen Z all sharing ideas and learning from each other, respecting the skills and experiences that each of us brings to OTA. We learn, share and grow together. To continue to grow the capacity of our association, we strive to provide our members with greater leadership and development opportunities, especially fostering skills in the generations that are now beginning to graduate from our universities. These are the people to whom the profession will be entrusted to. The people who will shape and

HAVING AN OPEN HEART AND AN OPEN MIND IS NECESSARY FOR CONTINUAL PERSONAL GROWTH. THE SAME CAN BE SAID FOR LEADING OCCUPATIONAL THERAPY AUSTRALIA.

Samantha Hunter, CEO

forge OT in the dynamic technologydriven environment of the future. These digital natives will go on to have careers that have yet to be identified. Technology is embedded in their thinking and learning which makes now an exciting time to explore and develop bringing tech and OT closer together. The role for those of us who have some years of wisdom and experience behind us is clear. This is our time to share our knowledge, to mentor the next generation, and to listen and learn from them. If we are to remain relevant, engaged and interested as we age, it is important that we hear different (and sometimes dissenting) voices. It is important to learn about and hear where the profession is heading and how it is evolving. Our leadership should be shared and transferred, much as it was to us. In this digital age many people are not turning to magazines and printed articles. That’s why OTA is investing in new communication channels such video and an online blog to ensure we’re reaching and connecting with the next generation in the areas that best resonate with them. I would love to hear from our early career OTs with ideas about how the association can better serve you. Please email your ideas to: haveyoursay@otaus.com.au Sam Hunter

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P O L I C Y, L O B B Y I N G & A D V O C A C Y U P D A T E

ADVOCACY AND LOBBYING: THE YEAR THAT WAS Michael Barrett, OTA National Manager: Government and Stakeholder Relations

he theme of this issue of Connections is “Connecting with the Next Generation” and I am immediately reminded of two events I had the honour to attend in Canberra during OT Week 2019. At an informal breakfast on the Monday, three OT students—Kiza Graham, Lisa Tredinnick and Rachael Mitterfellner— received awards for outstanding scholarship. And, significantly, those OTs attending the breakfast were urged to consider participating in MentorLink, a mentoring program facilitated by OTA which brings together OTs with at least five years’ experience and newer graduates who might benefit from occasional advice and support. Information on the program is available on the OTA website. Later in the week, I addressed a Professional Development event attended by 150 people—a significant proportion of them students. At both events I was struck by the fact that the passion for OT does not dim with the passage of time, and that more “mature” OTs are genuinely excited to share their experience with the next generation. This bodes well for the profession and the people you help.

Reflecting on the Year

As 2019 draws to a close, your advocacy and lobbying team can look back on some notable wins. An increase in the hourly rate paid by the National Disability Insurance Agency (NDIA), from $179 to $193.99 per hour, was great news for those OTs who have experienced so much frustration during

the early years of the NDIS. And things could have been so much worse. Just 18 months ago, the Independent Pricing Review commissioned by the NDIA recommended significant cuts in the fees paid for most NDIS services. A tiered pricing structure, based around the highly problematic concept of the client’s “complexity”, would have seen some services attract payments of as little as $110 per hour. OTA played a leading role in vociferous and protracted efforts to overturn a proposal which was bad for providers and potentially disastrous for their clients. We warned the NDIA and the federal government that hundreds, and possibly thousands, of OTs would have been forced to walk away from NDIS work because their businesses would have been rendered unviable by the lower rates of pay. As a result of these efforts, the NDIA and the federal government saw sense, and a mass exodus of allied health professionals was averted. While we can celebrate this win, OTA is conscious of the fact that there are still huge problems confronting many NDIS participants and their service providers. We will be raising these issues with the new CEO of the NDIA, Martin Hoffman. The Federal Government’s review of Medicare Benefits Schedule (MBS) items was at once a challenge and an opportunity for OTA. It required us to marshal arguments and

evidence across the wide range of fields in which OTs perform work for which they are remunerated by the Commonwealth Government. There were, in fact, several dozen reviews undertaken as part of the review of MBS items, three of which are of direct relevance to occupational therapists: the review of allied health items, the review of mental health items, and the review of items pertaining to eating disorders. In the case of the Review of MBS Allied Health Items, OTA contributed to the submission being developed by Allied Health Professions Australia (AHPA). While we had input into all aspects of the AHPA submission, that is to say all item numbers under review, OTA was the lead association in the development of arguments around the issue of case conferencing. This is because OTs so frequently find themselves de facto case managers, convening and driving meetings aimed at the coordination of multi-disciplinary care. I am pleased to report that this recommendation was picked up and supported by the Specialist and Consultant Physicians in their review of MBS items and by the General Practice and Primary Care Clinical Committee’s review of items. So, while the matter is still under consideration by government, it is fair to say we have some powerful bodies supporting our claim that allied health providers should be remunerated for case conferencing. Continued next page CONNECTIONS DECEMBER 2019 5

P O L I C Y, L O B B Y I N G & A D V O C A C Y U P D A T E

Continued from previous page

In the case of the Review of MBS Eating Disorder Items, the results are in. From November 2019, people diagnosed with severe eating disorders will be able to access up to 40 subsidised psychological services and 20 dietetic services each year. OTA joins with other peak bodies in welcoming the introduction of a separate program for eating disorders. OTA sought and received confirmation that the new program includes occupational therapy services, and has been advised that the initiative will be consistent with Better Access. Having said that, not all OTs who do BAMH work will be able to access eating disorder items, and work around credentialing is ongoing. OTA is participating in this work. In the case of the Review of MBS Mental Health Items, informal feedback to date suggests that OTs will continue to be able to access MBS items, thereby enabling them to play an important and remunerated role in the multidisciplinary care of people experiencing mental illness.

S A V E T H E D AT E

I’d like to take this opportunity to thank all those OTA members who supported our efforts to achieve what promise to be—at this stage—highly satisfactory outcomes. It was you who helped develop comprehensive, persuasive and, most importantly, evidence-based submissions to government. Other highlights of 2019 include a substantial OTA submission to the Royal Commission into Aged Care Quality and Safety. Despite the horror stories emerging from this inquiry, OTA’s submission was deliberately positive, highlighting ways in which residential aged care facilities can be improved, not least by allowing OTs to exercise the full range of their skills. The existing system, in which OTs are effectively prevented by the Aged Care Funding Instrument from bringing their expertise to bear, is professionally frustrating for you and a tragedy for your clients. Our submission highlighted the importance of home care— increasingly the preferred way to age for millions of Australians. We reminded the Commissioners, as we constantly remind government and the private health funds, that every dollar invested in falls prevention returns multiple dollars to the health system in savings. But for an inexpensive grabrail in a shower recess, an elderly person would not be occupying a public hospital bed at a cost of thousands of dollars a day. As we said in our submission, falls prevention should rank alongside road safety and obesity in the national consciousness. Another highlight of the year was, of course, our National Conference and Exhibition in Sydney. I was honoured to address a plenary session of the conference and to make a presentation to the scientific program on OTA’s role in the review of MBS items. We also held three National Reference Group meetings on the sidelines of the conference.

Friday 13 November 2020 SMC Conference and Function Centre Sydney, New South Wales www.otausevents.com.au/ mentalhealthforum #OTMH2020

The year ahead will feature our ongoing campaign to secure an immediate and meaningful increase in the fees paid by the Department of Veterans’ Affairs to those OTs working with veterans and war widows. The Commonwealth Government has for too long exploited the good nature and loyalty of OTs, paying them fees that are less than half those paid by some other schemes and which render DVA work unsustainable. We will continue to monitor the review of MBS items, the results of which can be expected early in the new year. And we will engage constructively with the new leadership team at the NDIA. As always, we will offer support and advice to the states and territories on local issues, helping them to achieve favourable outcomes for members working in the compensable schemes, working with students in schools or undertaking driving assessments. The policy and advocacy team would like to wish members all the best for the holiday period and the year ahead.

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P R O F E SS I O N A L P R A CT I C E & STA N D A R D S U P D AT E

PROFESSIONAL PRACTICE: LOOKING BACK, LOOKING FORWARD Anita Volkert, OTA National Manager: Professional Practice and Development

his year we have seen some welcome growth in the Professional Practice team, with Carol Jewell joining the team as a Professional Practice Adviser earlier in 2019, and two new team members joining us by January 2020 to further support your practice enquiries! Carol’s current key projects are the development of a package of resources to support new graduate transition into practice, to be released in the coming months, and to work with some external agencies on the accreditation and credentialing of occupational therapy practice.

What Does the Professional Practice Team Do?

Together, Carol and I deal with in excess of 50 practice enquires per week, support our lobbying, events, and membership teams with specific clinical and occupational therapy knowledge, as well as working on projects and documents that support the practice of occupational therapists across Australia. We also manage a range of practice related programs, such as endorsement for the Medicare Better Access to Mental Health program and the World Federation of Occupational Therapists education accreditation program. The Mentorlink program, Continuing Professional Development and our NDIS support to practitioners also sit under the professional practice umbrella, and we are fortunate that occupational therapists Lissa Selga, Lindsay Vernon and Andrea Douglas have been heading these up respectively.

Practice Guidance in 2019

Occupational Therapy Australia’s Evidence Informed Position Paper was released at

the end of 2018, outlining Occupational Therapy Australia’s recommendations for all occupational therapists to follow the best available evidence for their practice using an approach that considers all available streams of evidence. Occupational Therapy Australia’s Supervision Framework was released in early 2019, setting out best practice in occupational therapy supervision. In a joint project with Central Queensland University, Occupational Therapy Australia also released the Competency Standards for Occupational Therapy Driver Assessors. During 2019, the practice team has worked closely with a range of committees, reference groups and special interest groups to prepare documents which will be ready for publication through 2020, including an Advanced Practice Framework for the profession, and Position Papers covering aged care, mental health, pain, medico-legal practice and environmental modifications. The volunteers who work on our committees, reference and interest groups are highly valued by the professional practice team, and we would like to extend our thanks to them as the year closes.

External Engagement in 2019

The National Conference was a highlight of the year, but the practice team were also well represented at a range of external events and committees, ensuring that the voice of occupational therapy was heard as widely as possible. These included work with the National Transport Commission on motorised mobility devices, the NDIS (particularly on workforce, planning, vehicle modifications and early childhood), various Departments of Health, and the National Aged Care Industry Reference Group, who are currently working on a knowledge,

skills and qualifications framework for care and assistant level staff in the industry. The practice team attended and spoke at high-profile events, including a range of mental health consultations, the Royal Australian College of General Practitioners National Conference, the National Conference for Aged Care Reform, and at parliamentary inquiries into the NDIS.

Where to in 2020?

A key focus for 2020 will be preparing the workforce for the future. There has rarely been a better time to be an occupational therapist. There is high demand and schemes such as the NDIS have their principles in the concept of participation as wellness—perfectly suiting the philosophy of our profession. However, there is a flipside. The speedy growth of the past few years means that there can be a lack of structure and support in newer positions, or for our newer graduates/ returners to practice. OTA will be working to bridge this gap over the coming year. Additionally, how we work as occupational therapists is likely to shift over the coming 5-10 years. The health landscape is altering quickly as our population ages and becomes more complex, with comorbidities, frailty, co-existing mental and physical health issues and social justice concerns. Information technology and artificial intelligence are increasingly present in our day to day working lives. These changes will mean that as occupational therapists we will need to increasingly work to the top of our scope rather than engage in routine or repetitive tasks that don’t require Continued next page CONNECTIONS DECEMBER 2019 7

PROFESSIONAL PRACTICE & STA N D A R D S U P D AT E

PROFESSIONAL PRACTICE: LOOKING BACK, LOOKING FORWARD

CONFERENCE REV

Continued from previous page

complex assessment and decision making (OTA’s Scope of Practice Framework can be found on our website). Additional documents and strategies to assist occupational therapists to identify advanced and extended scope work, and a framework in which to support the building of new skills, knowledge and competencies, may be ways OTA can support occupational therapists’ work to the top of scope.

Rebecca Meyer, OTA National Manager, Conference Events and Business Development National OT Aged Care Symposium 2019

A career in health and social care is many things—rewarding, interesting, challenging and never dull. But it can be emotionally demanding, and OTA would like to work to support all occupational therapists as they move through the various stages of their professional career. Stay tuned for support strategies as we move through 2020 and beyond. And finally, welcome to all our new graduates joining the profession this year. You have made a fantastic choice in becoming an OT, and OTA’s professional practice team is here to support you, and all our members. Happy holidays to all.

The National OT Aged Care Symposium 2019 was held in Brisbane from 22-23 February 2019 with 240 delegates attending from all states and territories. The Symposium theme of Respect Relate and Renew showcased the work of OTs supporting individuals, their families and communities, and the opportunities created by the rapidly changing aged care sector. Delegates also gained insights into the Commonwealth Government reforms that impact on clients, families and service providers.

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Delegate feedback applauded the keynote speakers and the range of topics covered, also commenting on the insightful trade exhibits and networking opportunities to interact with like-minded peers.

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From 10-12 July 2019 OTA held its 28th National Conference and Exhibition. Over 1,400 people descended on Sydney’s International Convention Centre across three big days to learn, discuss and network about all things occupational therapy. The conference proved incredibly enriching for all involved and was OTA’s largest yet in terms of delegates, exhibitors and tweets. Delegates praised the Keynote Speakers along with the variety of presentations in the scientific program and, in particular, enjoyed the introduction of the new presentation formats of Occupation Stations and ePoster Oral Spotlights.

E V E N TS U P D AT E

VIEW & OUTLOOK The exhibition area provided delegates with a wide range of industry information and the introduction of the 3 Minute Massage Angels in the lounge area offered delegates an opportunity to relax and refresh. Exhibitor Airtime Presentations were new to the exhibition program and offered exhibitors an opportunity to present educational pieces around their products and services. Thank you to the 132 industry organisations that supported the event—without their support OTA would not have been able to host such a high caliber event. Opportunities to network were abundant. The introduction of the Student and New Graduate Drinks and a revised format for the First Timers Briefing offered many first-time attendees the chance to meet peers and connect prior to the conference starting. The Gala Dinner held at the iconic Luna Park was a Conference highlight with guests arriving by ferry and enjoying a ride across the stunning Sydney Harbour.

Practice domains included in the OT Exchange 2020 will focus on the streams of Driving, Environmental Modifications, Working with Children, Rehabilitation and Knowledge Translation. The conference will bring together thought-leaders in each field, present the latest approaches to practice and invite leading exhibitors to share and discuss their innovative solutions. The Exchange is truly for all OTs of all levels of experience. While it focuses on certain streams of practice, it also welcomes those interested in those practice areas (not just those currently working in them). The approachable nature of the Exchange is a great first step into presenting for those who are eager to present at scientific conferences. For more information on this event and to register now at the early bird rate, visit www.otausevents.com.au/otexchange2020

OT Mental Health Forum 2020

We would like to offer our sincere gratitude to the many speakers, delegates, staff, volunteers, exhibitors and sponsors who, through their tireless energy and enthusiasm, made the 2019 National Conference an overwhelming success. The 2021 National Conference and Exhibition will be held in Cairns Queensland from 23-25 June 2021. For more information, visit www.otaus2021.com.au In the off-year to the National Scientific Conference, OTA’s 2020 Conferences will focus on particular areas of practice within occupational therapy.

OT Exchange 2020

Taking place 22-23 June 2020 in Melbourne, we are pleased to introduce Australia’s inaugural OT Exchange. The OT Exchange is a new and collaborative format conference, designed to be accessible and inclusive for all working within the broad spectrum that is occupational therapy.

On 13 November 2020, we are delighted to host the OT Mental Health Forum in Sydney. This Forum has a long and successful history, starting as a grass-roots local initiative and expanding to the national event it has now become. The day will reflect on the rich, diverse and ever-expanding areas of mental health practice that the OT profession is engaging in. The Forum will provide opportunity to make connections, explore possibilities in your work, and come away with a renewed spark of energy, enthusiasm and pride in the collective impact of mental health OTs working across Australia! For more information, visit: www.otausevents.com.au/mentalhealthforum We are looking forward to seeing you at our Conferences in 2020 as we come together from across Australia (and beyond!) to learn about the latest developments, discuss innovative approaches to practice, and work towards enriching our communities.

CONNECTIONS DECEMBER 2019 9

N AT I O N A L C P D U P D AT E

REFLECTING ON OUR CPD PROGRAM Lindsay Vernon, OTA Professional Adviser: Learning and Development

he Continuing Professional Development team had another busy year, supporting almost 100 workshops around the country this past year. We continue to have high demand for both environmental modification and paediatric professional development opportunities, and in response to this we ran over 10 workshops for environmental modifications alone! We also hosted some new workshops this year. Foundations of Mental Health practice was facilitated in three states with a focus on OT assessment and intervention, aligned to the Australian National Practice Standards for the mental health workforce. We worked with Indigenous Allied Health Australia (IAHA) to deliver cultural responsiveness training. Not only is this an important part of our work to support client centred practice, it is directly aligned to the OTBA competency standards for occupational therapists. The IAHA training is a highly interactive workshop centring around three driving principles: ‘Being, Knowing and Doing’ i.e. what do we need to know, be and do in order to be culturally responsive. Moving forward, we have drawn from the presentations at the National Conference in Sydney, and are providing a cultural responsiveness online learning opportunity recognising that Australia has a rich and diverse population from around the world. We are working with presenters from the conference and look forward to expanding our webinar program and library for you. We also worked with new presenters, expanding our program with constraint induced movement therapy, effective communication skills and the LiFE falls 10 www.otaus.com.au

program. We hope to maintain these relationships moving forward. We doubled our eLearning opportunities from the previous year. We worked with a range of presenters who have maximised the use of their learning management systems with OTA and also through presenters who have worked with OTA’s CPD team to develop their online literacy skills and hence expanded their capacity to offer CPD across more diverse learning modalities. This is an exciting growth area for OTA and something we plan to continue into 2020. We had over 6,000 registrations for our CPD events and hope that not only did we provide you with a first class learning opportunity, but that you were also able to meet new (and old) friends, learn from each other, explore new resources, hear about best practice and emerging areas of intervention, and develop networks that will grow throughout your career. We know that our learning is not linear and does not consist of a single workshop or webinar, but a diverse range of opportunities that we gain from being in a space with others with a similar interest and a different experience. With that in mind, it is important to take note of the change in OTBA’s CPD

registration standard as we move into the new registration year. As of December 1 2019, the CPD standard is: Complete at least 20 hours of CPD each year that: • seeks to improve patient/client outcomes and experiences • draws on the best available evidence, including well-established and accepted knowledge that is supported by research where possible, to inform good practice and decision-making • contributes directly to improving your competence (performance and behaviour) and keeping you up to date in your chosen scope and setting of practice • builds on your existing knowledge and • includes a minimum of five hrs of CPD in an interactive setting with other practitioners. This is required to be documented in a CPD portfolio. Learn more about the changes here: www.occupationaltherapyboard.gov. au/Registration-Standards/Continuingprofessional-development.aspx

OTA members can access their CPD Tracker by visiting www.otaus.com.au/mycpd

What You Had to Say About Our CPD Program ‘The workshop allowed for health discussion to take place in a safe space where participants could seek answers and develop their knowledge and understanding further’ ‘Highly experienced presenter, intelligent, excellent professional boundaries, knowledgeable, practical & engaging’ ‘The workshop detailed contemporary OT assessment and intervention for children’

‘It provided great detail, information re: standards as well as practical tips and advice. It was engaging and moved along quickly’ ‘It was a great balance of theory and prac and gave me confidence in how I can utilise this knowledge in our workplace. The presenter was really great and extremely knowledgeable’

M A R K E T I N G & M E M B E RS H I P U P D AT E

REVIEWING MEMBERSHIP AND MARKETING Lauren Jensen, OTA Head of Marketing, Communications and Membership

n March 2019, OTA brought the Marketing and Membership portfolios together to ensure a more cohesive and collaborative approach between servicing our members and communicating the activities and benefits of the association. We invested in a new Member Services Team to ensure quicker response times with a focus on being a member-led organisation—this means putting members at the heart of all our decisions. OTA currently represents over 10,000 occupational therapists and occupational therapy students. My role as Head of Marketing, Membership and Communications is to develop a strategy to ensure OTA has a sustainable membership model that delivers a suite of valuable benefits to our members. The first step in developing this strategy was to understand what we were doing well as a member association and where we could improve. In June 2019, we conducted the Membership Satisfaction Survey. The feedback from this survey, along with research into the changing health care landscape and the needs of the next generation of OTs, has informed the 2019-2021 strategy. To implement the benefits and services to our members, we launched the new OTA website. The website has been completely redesigned to make resources easier to find, introduced accessibility features and streamlined membership functions. At the time of launch, we also reviewed our member communications and launched OT Today, our new fortnightly

newsletter. We designed OT Today in response to the need for shorter, more timely and relevant communications. The marketing team worked closely with our Government Relations team to bring awareness to the remuneration conditions of those OTs working with Veterans. This campaign included the launch of the otsforveterans.com.au website and social media campaign. This site has received more than 2,800 visitors, and more than 320 letters have been sent to Ministers. OT Week 2019 saw us respond to the call from members to continue to raise the awareness and understanding of OT by developing the #ThisIsOT campaign. 2019 has arguably been our biggest OT Week to date. The feedback we’ve received in person and on social media has flooded in and been overwhelmingly positive. The ‘What is OT’ video, produced by OTA for OT Week 2019, has now been viewed 5,000 times, while posts with the #ThisIsOT hashtag have been shared by 200+ people, reaching over 300,000 people across social media. During OT Week OTA exhibited at the GP Conference, an opportunity to engage with and educate over 1,400 GPs and health professionals. OTA will use the insights gained at the conference to develop resources for GPs and Referrers. These resources will form part of the review of our consumer website aboutoccupationaltherapy.com.au. Launched in OT Week 2017 this site receives over 3,000 visits per month.

The focus for the year ahead is on meaningful engagement with our members, and we want to ensure that each member who has chosen to be part of the association receives value for their membership. We will be implementing a series of touchpoints with all members to invite you to experience the variety of member benefits we have on offer. In particular, we will be focusing on our incoming New Graduate members, and are excited to be working with the Professional Practice Team to launch a series of New Graduate Resources to support the next generation of OTs. Connections is undertaking a review and will move to a quarterly release cycle in 2020 (more on that on page 15). Reviewing the 2019 OTA Member Survey, several members sought more coverage of rural and remote issues. Beginning with our Autumn 2020 edition, we will establish a recurring column, through which rural and remote OTs can share the stories, learnings and issues affecting them. Profiling rural and remote members will also serve to better educate their metro peers about the unique issues faced by their more isolated peers. 2020 will be an exciting year, and I would like to extend my sincere thank you to all our members for choosing to be a member of the association and working with us to increase the profile and understanding of the profession.

CONNECTIONS DECEMBER 2019 11

F E AT U R E

HOW YOU CELEBRATED OT WEEK 2019

OT Week feature in the Bendigo Advertiser

During OT Week 2019 we reflected on and promoted the value of occupational therapy. Out in the community, we often receive the question “What is occupational therapy?” For 2019 we shined a spotlight on how OTs work to support people of all abilities to engage in activities they find meaningful. 2019 was arguably our biggest OT Week to date. Thank you to everyone who hosted or went to an event, engaged with their peers or shared resources with their networks. The positive feedback we received in person and on social media has been overwhelming.

with #ThisIsOT have been shared by 200+ people, reaching over 300,000 people. Here’s how you celebrated across the country!

Through the hashtag of #ThisIsOT, together we’ve created a visual dictionary of OT in action. People have shared stories from their OT journey, learnings to offer, team photos, information on their practice area, and why they love OT! In terms of the numbers, more than 25 OT Week events took place throughout Australia (with every State and Territory taking part), our ‘What is Occupational Therapy?’ video has been viewed almost 5,000 times, and social media posts tagged

Brisbane OT Week Breakfast Celebration 12 www.otaus.com.au

RAR Therapy in Ayr baked cookies to celebrate OT Week with their team and clients

Sydney OT Week Celebration Linda Elliott (left) Chair NSW Divisional Council, Lynette Mackenzie (middle) OTA Board

F E AT U R E

Eastern Health Occupational Therapy OT Week Celebration

Samantha Hunter, OTA CEO, presenting at the WA Annual Divisional Meeting

Sydney Kids Randwick

Echuca OTs playing mini golf Guide Dogs Victoria

Northern Tasmania OT Week Dinner at Alchemy Restaurant National OT on a Mental Health Walk at Albert Park CONNECTIONS DECEMBER 2019â&#x20AC;&#x201A; 13

F E AT U R E

HOW YOU CELEBRATED OT WEEK 2019 Continued from previous page

Afford’s Surfers Paradise Inclusive Flash Mob rilyn th McHugh SA DC Chair Ma SA OT Week 2019 Elizabe ndt OTA President Ber ela Ang and nt side Patterson WFOT Pre

Kathryn Denton receiving the FIVEaa and Community Living Australia Healthcare Hero Award for 2019 (Allied Health) Bendigo OT Week Breakfast

SHOTS OT Week Lunch 14 www.otaus.com.au

TAD Staff putting the FUN in functional at their Northmead bike track

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A NEW VISION FOR CONNECTIONS IN 2020 Mitch Green, OTA Content Marketer

ou may have noticed a gradual change in Connections. We’re sharing fewer news items and more articles. We’re sharing fewer timesensitive updates and more experiences, more insights and more learnings. Connections is a platform for our members, our staff and our partners to tell their stories. We want Connections to be a conversation with the association at large, and ultimately, a conversation with our broader communities. Starting in 2020, Connections will move to a quarterly release cycle with Autumn, Winter, Spring and Summer editions. This will enable us to produce a high quality, long-form publication—one considered more as a ‘coffee table’ magazine and not stored away in a filing cabinet. Producing an evergreen magazine will allow us as your association to further distribute it to other organisations/ professions. With time, the intent is for the magazine to be left in GP waiting

CONNECTIONS IS A PLATFORM FOR OUR MEMBERS, OUR STAFF AND OUR PARTNERS TO TELL THEIR STORIES.

rooms or put on display in offices/ reception areas, expanding the reach and impact of Connections beyond the membership. Additionally, we are also investing in producing a more interactive, ‘flippable’ digital magazine. A high-quality digital magazine will support the association’s environmental goals and offer more interactive features/links. This digital magazine will be available for members through otaus.com.au in early 2020.

Share Your Story

Connections magazine is seeking members interested in sharing their occupational therapy story, knowledge and learnings. Perhaps you might share some insightful research you collaborated on, a consumer success story, or reflections on your journey as an OT. If you have a story you’d like to submit for an upcoming edition, please contact digitalcomms@otaus.com.au with your idea—we’re happy to help you form and refine the article topic. We’re looking forward to receiving and sharing your stories! The way we consume and share media is changing. And so too is Connections. We’re working to ensure Connections remains a high-quality magazine, both in print and digitally. We’re working with our members and partners to tell stories that matter—stories that will leave you informed and inspired. We’re working to produce a publication that you will be proud to display and share. Here’s to 2020 and beyond!

CONNECTIONS THEMES FOR 2020 Autumn 2020 Edition

Theme: Occupation Celebration Submissions by: Friday 10 January Related concepts: • Exploring the diverse range of occupations • Promoting the benefits of participating • Lessons and tips to help support people to engage in occupations

Winter 2020 Edition

Theme: Collaborate and Connect Submissions by: Friday 10 April Related concepts: • Working in a multidisciplinary team • Exploring Consumer Directed Care • Collaborating with other professions (allied health and beyond)

Spring 2020 Edition

Theme: Innovate and Influence Submissions by: Friday 10 July Related concepts: • Emerging trends/fields in OT • Highlighting new products and services • Positioning and promoting OT for the future

Summer 2020 Edition

Theme: Regional, Rural and Remote Submissions by: Friday 9 October Related concepts: • Exploring the unique challenges and solutions isolated OTs face • Telehealth and how non-metro consumers find support • Sharing inspiring stories from regional, rural and remote communities • What can metro organisations and individuals do to support

CONNECTIONS DECEMBER 2019 15

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THE NEXT GEN: IN THEIR OWN WORDS What was your experience as a student navigating the world of occupational therapy for the first time? Why did you choose to study OT? Where did you want to go with your career?

e wanted to find out how the next generation of OTs are finding their entrance into the profession. Speaking to a number of our student and new graduate members (if you’d like to share your story, stay tuned for a callout next year!), we offered a platform to share their experiences and aspirations. Here’s what they had to say!

What drew you to study occupational therapy?

Seeing the major positive impact that occupational therapy had on both my grandparents after my granddad had his stroke, and how still to this day my grandmother is thankful for that occupational therapist’s input, made me want to be that person for someone else. — Tahlia Spano I had a friend growing up who had juvenile rheumatoid arthritis, and she lived independently in a unit with a custom-built kitchen for wheelchair users, as well as driving an adapted car. I was so impressed by her tenacity and the way in which the environment could be adapted to meet her specific needs. Six years ago I was talking to a friend and discovered she is an occupational therapist. My passion for the profession was reignited and I was able to graduate earlier this year at the age of 49! — Suzi Harris

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It was a good friend, Jennifer Lai, at university (Australian National University) who introduced me to the profession. As I was volunteering at the Mental Health Unit at the Calvary Public Hospital in Canberra during my Psychology Honours year, she (an OT student) suggested I consider the profession where I could support people with mental illness to reintegrate with their community. Even though we now work in different cities, she is my number one OT friend! — Vincci Lee I was wanting a career change that involved supporting people. I liked that OT looks at the entire person in a wholistic way and that it enables people to do things they want to do. — Lissa Strauss

What areas of occupational therapy interest you the most?

I enjoy working in the area of home modifications, as our home environment can influence how well we can perform our everyday activities such as having a shower, using the toilet, preparing a meal or entering/leaving your home. — Samantha Boulionis Aged Care. The elderly have lived a whole life, so why should it stop now that they’ve grown older? I was always, and still am, passionate about ensuring the elderly can still feel like they can do the things they want to do and have always dreamt of doing despite being older. — Tahlia Spano

I’m very interested in paediatrics. I love working with children and building relationships with families. I believe that family and child centred practice is so important. — Sarah Ingram I’m interested in rehabilitation as well as community. Five years ago I had a very bad knee injury and this sparked an interest in the rehab process and how individual this journey is for each person. — Lissa Strauss

Since entering the workforce, what aspects have you found the most rewarding?

I thrive on the ‘happy moments’ when clients realise they do have the capability to achieve their goals and their faces light up. I also appreciate being a member of an incredibly supportive team. — Suzi Harris The most rewarding thing within OT is to meet supportive experienced therapists. I am very lucky to meet quite a number of very experienced therapists, who are now OT academics/researchers, and offer me the opportunity to collaborate with them in different research projects where I can utilise my skills gained in both my Honours and OT degrees. — Vincci Lee Supporting people at various life stages and during those important transition periods in a person’s life. Supporting people to achieve highly personalised and meaningful outcomes. — Samantha Boulionis

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How has being a member of OTA supported you throughout your OT journey? Having access to the wide variety of professional development opportunities has rapidly enhanced my learning as a new graduate. In addition, being an active member of special interest groups has helped not only to expand my knowledge, but to meet other OTs working in my area to share thoughts and ideas. — Tahlia Spano

Thanks to Kim, Carol and Anita, they all have generously helped me to go through the challenges in my early OT career journey and made me feel supported and a sense of belonging to the OTA community. — Vincci Lee OTA provides opportunities for continuing professional development, professional support, evidence-based practice and resources, and fosters opportunities to contribute to and shape professional excellence. — Samantha Boulionis

What aspirations do you have for your career? I would love to be involved in advocating for occupational therapists to work in schools more. I would also love to travel to regional/ remote Australia to work with socioeconomically disadvantaged children. — Sarah Ingram

I would like to pursue a career where I can consolidate my clinical skills as an early career OT and continue build my critical appraisal skills in research. I believe they are the important qualities to evidence-based practice. — Vincci Lee

Social media channels, such as Facebook groups, have helped to connect occupational therapists to enable the sharing of ideas, resources, experience and opportunities to support each other as well as being a tool for advocating for the profession. — Sarah Ingram

I would like to work in an environment that recognises the unique value of OT, and one that supports professional growth and embraces new technology. My background is in teaching and technology—I’m very interested in applying technology (such as ‘the internet of things’, mobile devices and apps) to OT. — Lissa Strauss

What new/emerging areas and approaches have you excited for the future of occupational therapy?

How has technology helped to bring occupational therapy into the 21st Century?

I believe technology has helped to shift the focus away from “disabled” toward “enabled”. Technology in new equipment means we can find ways to increase someone’s independence and adapt their environment to make it safe, stimulating and functional. It has also created new treatment modalities for pain management, making each treatment personalised to the consumer. — Tahlia Spano We are able to have professional conferences/webinars ‘Zoomed’ and provide assistance to people living in rural areas via teleconferencing. Technologies such as Wii, PlayStation, laser printing, etc provide a wealth of opportunity for clients to increase mind/ body coordination, physical activity, communication and creativity goals. The opportunities for the use of technology within occupational therapy are endless! — Suzi Harris

The Aged Care Quality Standards that have recently been introduced has excited me, as it finally acknowledges the elderly person at the centre of care—something that meshes so well with the philosophy of occupational therapy! — Tahlia Spano Based on my own research results, I’m excited at the prospect of being able to try and reduce stigma toward those with mental health illness and particularly forensic mental health consumers. The training that we can provide around vocational disclosure and readiness for work is beginning to evolve and is so important. — Suzi Harris Perhaps public health/health promotion would be one of the emerging areas? I believe OTs are equipped with the skills and training to become active members in the upstream and mid-stream of health promotion (i.e. government policies and modifying health behaviours) and to empower the population to do what they want, need and expected to do! — Vincci Lee

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OT STUDENTS AS THERAPY ASSISTANTS: INVESTING IN OUR PROFESSION’S FUTURE Brad Dent, Managing Director WHR Allied Health

nitially, our ties with seeking occupational therapy students to join WHR Allied Health as casual therapy assistants came from an operational need to increase the face to face supports our NDIS clients were receiving. Whilst many NDIS plans had sufficient funding across other categories, the therapy supports were often underwhelming and not aligned with the client’s actual needs. This was easily related to both the youthfulness of the scheme and to NDIS participants’ limited understanding of how they could best advocate for the supports they required funding for. In providing supports, we were able to complete initial assessments and create intervention plans. However, our proposed interventions were often required to be implemented by support workers with oversight of the treating OTs due to insufficient funding/hours allocated to therapy. The need to educate support workers on an individual basis meant that it was an inefficient use of funding for clients and that outcomes were even more difficult to prioritise and achieve. There were also challenges in getting some support workers on board with intervention plans which required them to shift their focus from ‘doing for’ to ‘facilitating with.’ In 2013 we were fortunate to have some excellent NDIS planners in our Barwon trial site. There was an element of flexibility and understanding that would, unfortunately, 20 www.otaus.com.au

likely be foreign to many OTs working in the NDIS space now. There was a collaborative approach of listening to feedback and affecting change responsively. It was not uncommon to have attended an initial assessment with a new client and then to contact the planner immediately after, providing clinical justification that there was an urgent need for supports in the plan to be amended/increased as the home environment and informal supports were not quite as had been reported/ understood. This is better avoided now that the scheme moves to maturity and clients and their families become better advocates themselves, further supported by maturing service providers who gain an improved understanding of the intricacies of the scheme and other support types that can be funded. Reflecting back, it feels easy to come to the conclusion that therapy assistants were what we needed, but at the time we too were maturing as an organisation as we navigated the ‘new world’ of providing therapeutic supports under the scheme. We considered that the answer might be found in seeking out an OT student for a therapy assistant role with the intention of increasing face to face time with our clients—being confident that our intervention plans were understood and followed, and that we would now have access to reliable documentation/ reporting, demonstrating progression/ regression. This would enable us to

appropriately respond in real time and be more efficient using funding to support our clients to achieve their goals. In June 2015, WHR Allied Health employed its first therapy assistant who was concurrently studying occupational therapy at Deakin University in Geelong. Within weeks we had sufficient evidence to demonstrate that this had been a great decision for our existing team, our future plans and our clients. At the time, clients without therapy assistant involvement may have received 15 hours of OT supports annually which could now be utilised as 5 hours of OT supports along with 40 hours of therapy assistant supports (at the time the OT hourly rate was set at a maximum of $168.26 and the therapy assistant rate was $39.17). Within three months we had added to our therapy assistant team, made up exclusively of OT students via peer recruitment. We were seeing significant positive changes from the increased opportunities for regular supports that this was now providing. Externally, the news was good as well. Planners were rapidly on board as evidence of client progress was demonstrated and shared (between reviews). Therapy assistant supports were also more readily being included in client’s NDIS plans. As the WHR Allied Health team of occupational therapists continued to

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grow, so too did our recruitment of therapy assistants. From the moment our first therapy assistants started, we have continually encouraged them to provide upwards feedback. We actively encourage them to share details around emerging areas of practice or to share research completed by themselves or their peers. As an organisation, we want our team members to speak up if they think things can be approached differently or they have had an experience that might improve outcomes if utilised with our clients. WHR Allied Health has been incredibly well supported by the occupational therapy educators at Deakin University in Geelong and Charles Sturt University in Albury. As of October 2019, we have been fortunate to have almost 60 OT students fill our casual therapy assistant roles since 2015 and over this time have gone on to employ 10 of those into new graduate roles. For other OT service providers (whether private or public and large or small), we strongly encourage you to speak with local universities to explore the opportunities that might be available to you. Developing an informal relationship with universities has meant that they have been happy to facilitate us advertising our therapy assistant positions. As a result of the relationships, our staff attend 4th year student conferences, not only in support of their team members, but as an opportunity for professional development. Staff are invited to guest lecture as a great opportunity to share their experiences and be challenged on what they know. We have had employees return to the university as graduates to contribute to course accreditation interviews and to join panels on new graduate experiences. It is an excellent example of how universities

WE LOOK FORWARD TO EMPLOYING MORE OT STUDENTS AS THERAPY ASSISTANTS, AS WE CONTINUE TO SUPPORT AND INVEST IN THE FUTURE OF OUR PROFESSION.

and practitioners can extend their relationships beyond offering placements. Whilst we continue to take on students for their placements, WHR Allied Health believes that our greater professional contribution is in having these students engaged in employment that emulates or offers them a sustained glimpse into what their future may look like. There is a tremendous opportunity for OT students and professionals that exist in the NDIS space. There is an increasing void developing for placement opportunities and while employing OT students as therapy assistants is not a valid substitute for this issue, it does go some way in equipping those students with exposure to aspects of everyday OT practise. However, there are some scope issues to bear in mind. Even if they are OT students, therapy assistants must work strictly in that capacity—despite the developing knowledge and skill set they may have, they cannot provide assessment, intervention planning or evaluation. Their role is limited to completing the intervention programs set by a qualified therapist. Please refer to Occupational Therapy Australia’s Scope of Practice Framework for more information on delegation of scope. There have also been challenges of having OT students as therapy assistants. Endeavouring to provide consistent

therapy assistant supports is sometimes difficult where our employees are required to take extended periods of leave for placements. From a financial/sustainability perspective as of 1 July 2019, we are anticipating that our Therapy Assistant incomings will move to the positive side of the financial balance sheet as a result of long overdue pricing amendments. Having therapy assistants as part of our team has never been about opportunities for increasing income. It has and will continue to be about enabling our clients to be better supported in achieving their goals. The funding ratio of OT:TA supports has now reduced and is closer to a 1:2 type arrangement—some clients and families may not elect to engage therapy assistant supports as a result. To date, this is not something we have observed. There is now more opportunity to utilise this increased income from the amended rates to improving the training and support that we can provide therapy assistants. We look forward to employing more OT students as therapy assistants, as we continue to support and invest in the future of our profession. About the Author Brad Dent is the Managing Director of WHR Allied Health in Torquay and Albury. The team primarily provides NDIS funded supports to clients with Autism Spectrum Disorder and Intellectual Disability. CONNECTIONS DECEMBER 2019 21

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GRADUATES IN RURAL AND REGIONAL AREAS: WHY THEY COME, AND WHY THEY STAY Sian Chapman, Graduate Occupational Therapist

s the end of the year draws near, thousands of university students will be graduating and registering with AHPRA as occupational therapists. As they start to look for work, the question remains of how to attract and encourage graduates to remain in regional and rural areas. In terms of opportunities for occupational therapists, the 2019 report from the Department of Employment, Skills, Small and Family Business found1: • Victoria: regional shortages • Northern Territory: general shortages • New South Wales: general shortages • Australian Capital Territory: shortage of experienced occupational therapists • Tasmania: general shortages • Western Australia: no shortages • South Australia: no shortages • Queensland: no shortages, can be difficult to recruit for non-ongoing positions in regional areas In all states and territories, the number of job vacancies had significantly increased over the last three years, mostly attributed to population growth, the NDIS, and an ageing population1. For graduates, the initial prospect of rural and regional work has much to offer, but the turnover rate is still tremendously high, and retaining staff in rural areas is difficult. This is by no means an unusual thing—it happens in most allied health disciplines2. So, how do we retain graduates? I graduated in July 2019 with a Master of Occupational Therapy, and have now worked for three months in North East 22 www.otaus.com.au

Victoria. A number of my cohort also moved rurally or regionally for work. Some are already back in the city, while others still work in a rural or regional area. I’ve also met a large number of young professionals through social networks since moving to a regional area for work, and the majority of them have made the decision to stay. Why does this happen? How can graduates enjoy the move to rural and regional? What drives them to make that decision, what makes them stay? I can only speak for the graduates I know that have started working rural, but there is a common theme of three features that support the graduate experience.

Opportunity

connection. If graduates are missing experiences with their friends in the city, and if they are constantly going back on the weekend to maintain community and connection, they are less likely to stay.

Understanding the Graduate’s Reality Towards the end of my university degree I attended a talk by Goulburn Valley Health on keeping rural graduates. They talked about having midweek events and social gatherings, and not focusing on weekends, as a number of their graduates went back to the cities on weekends.

This approach is going to be different in somewhere like Mildura or Townsville, where the city of origin is not a two-hour commute home. Acknowledging what your graduate workforce is likely to do will allow you to provide recommendations that will connect them with the community, fitting in with how they live their lives.

Some positions are harder to break into. For graduates who wish to get experience in these more competitive areas of employment, they are more likely to go rural (where there is less competition) to get that experience. Positions outside of this also have an advantage in opportunity, in that rural and regional jobs tend to be more generalist. These positions provide the opportunity for a broad scope of experience and the chance to try out different facets of occupational therapy.

Opportunity is the reason many graduates decide to move. If that is all that is there for them, eventually, the siren call of friends and family will draw them back home, particularly once they have experience. Connection keeps them in a rural or regional area. And understanding their reality—that they may go home on weekends, or that they may be in the middle of proverbial nowhere— helps to foster that connection.

Connection

References

People will move pretty much anywhere if it will help them gain the experience they need, and the opportunity they want. But they will stay because of connection.

1. Department of Employment, Skills, Small and Family Business, 2019. Occupational Therapist, Occupational therapy reports. Accessed via: https://docs.employment.gov.au/collections/ occupational-therapist-occupational-reports.

Making friends outside of work, having family in the area, and the opportunity to participate in the local community are all important factors in fostering

2. Campbell, N., McAllister, L. and Eley, D., 2012. The influence of motivation in recruitment and retention of rural and remote allied health professionals: a literature review. Rural & Remote Health, 12(3).

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LOCAL CHARM AND NATIONAL SUPPORT: LAUNCHING MY CAREER IN RURAL QUEENSLAND Brooke Tunks, New Graduate Occupational Therapist

t was the end of my final semester, having completed my final viva exam when the examiner asked me what my plans were for 2019. The examiner was also a university lecturer who I admired over the duration of my degree, so when the response to my exciting report of working in rural Queensland was “You’ll do well. You will make sure you get the support you need” I was mortified. Had I been an obnoxious student? Did she think I needed lots of support? Ten months into my career as an occupational therapist in rural Queensland, I now understand. As a new graduate, what has been essential to my ability to provide quality services to this community is a commitment to assertively seeking out the support I need. My workplace is a little house with a big yard, working alongside a speech pathologist and an admin. We are part of a larger organisation with frequent

Brooke Tunks (third from right) graduating with her future colleagues

contact via teleconference, but I am the sole occupational therapist for our Chinchilla clinic. In fact, I am one of only a handful of occupational therapists in the town of approximately 6,000 people. Most occupational therapists are based at the local hospital and the one other works down the road in her private practice. Every morning, I travel for two minutes to work. No traffic and no traffic lights make the daily commute a dream and the sound of nature means I rarely start my day feeling anything but relaxed. I set up for the day and soon my first client arrives. The family of four children, all barefoot, roll into the waiting room and each child gives me an update. The siblings settle on the couch or begin their colouring and I start my first therapy session of the day. It’s mornings like these that I am thankful for the relaxed nature of rural work and how I can be family-centred in what I do. As a rural generalist, my caseload is varied and challenging. My speech pathologist colleague often laughs as she watches me go from playing soccer in the yard, making spaghetti bolognese in the kitchen to prescribing grab rails. On my lunch break, I return my book club book to the library and I also pop my head into the NDIS local area coordinator for a quick chat. I love my job as an occupational therapist, and despite the charms of rural life it has its challenges and I attribute my ability to

Brooke Tunks in front of her workplace

provide quality services to the support I have received. I hope that my experience will encourage occupational therapists that going rural doesn’t mean that you are professionally isolated, and say a big thank you to our profession for supporting new graduates so well. Here are the ways I have been able to get the support I have needed: 1. Regular supervision sessions: I receive weekly supervision sessions via teleconference with a senior OT based in Brisbane. Being the sole OT in my practice, I don’t have the luxury of being able to have a quick chat to ask another OT a quick question. To make the most of my supervision time I keep track of quick questions in a notebook ready for supervision. My experience has taught me that supervision is invaluable and worth advocating for and has helped me feel competent and confident, and to enhance outcomes for clients. CONNECTIONS DECEMBER 2019 23

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LOCAL CHARM AND NATIONAL SUPPORT: LAUNCHING MY CAREER IN RURAL QUEENSLAND Continued from previous page

2. Peer and group supervision: Most new graduates often experience feelings of doubt, but those who are isolated have fewer opportunities to see what other OTs are doing. Peer supervision helps me to calibrate my clinical decision making. It’s helpful sometimes to bring a ‘help me case’ to the group and the group feeding back that that case sounds hard and I am doing the best practice for that issue. I love the opportunity to be part of a team of occupational therapists and having the opportunity to contribute my learnings. 3. Being a mentee: When I had been in my role for 3 months, I signed up for the Occupational Therapy Australia MentorLink program and have been lucky to be matched with a wonderful mentor. My mentor and I speak once a month on the phone and our discussions tend to revolve around general OT theory, best practice, personal improvement at work, career and professional development advice and managing the challenges of living and working rurally. Each session of mentoring I leave feeling encouraged and am provided with new research or resources to take away. I am so grateful for the time she invests in me.

Exploring the local sites 24 www.otaus.com.au

4. Special interest groups: I recently joined the ‘Paediatric OT Special Interest Group (Brisbane & beyond)’ via teleconference which I really enjoyed engaging with another new group of occupational therapists. Online Facebook groups have also been great for feeling a part of my wider professional community. My favourite is the ‘Australian Paediatric Occupational Therapists’ group which has over 2,600 members where I get exposed to upcoming professional development opportunities, discussion of issues amongst the wider profession and case discussions. 5. Multi-disciplinary learning: Getting to work so closely with a speech pathologist has enriched my practice ten-fold. I have loved learning more and thinking more about how I communicate with my clients. As we have many shared clients, it’s great to share each profession’s perspective and strategies to improve the outcomes for our clients. 6. Work shadowing: I have found that sometimes it helps just being able to watch someone do something you haven’t done before, which sometimes is tricky being rural. My employer arranged for me to visit an experienced occupational therapist to increase my equipment prescription skills which supported me in improving my own services. 7. Professional development: One big perk of going rural is access to scholarships, bursaries and organisations designed to support rural clinicians. I have accessed ‘Health Workforce Queensland’ which has supported me to access professional development to upskill in areas

which the community needs. I have also been supported by my region’s Primary Health Network (PHN) to connect with other local clinicians. 8. Connecting with other new graduates: I have been fortunate to have been connected with the other new graduate occupational therapist in town who works at the hospital. It has been so encouraging be able to share skills and experiences. We cross paths during work about shared patients and we also get to just be friends who are sharing a lot of experiences. A group of colleagues I graduated university with have also provided support, helping me understand the diversity of the occupational therapy role. 9. Counselling: For a professional who considers the person, the environment and their occupation on a daily basis at work, it took me an embarrassingly long time to notice that my new role of being a rural clinician would impact my mental health. I have benefited from accessing a counselling service via telehealth to work though the loneliness of moving away from friends and family, the stress of being a new graduate and managing my wellbeing where the environment doesn’t necessarily support my engagement in my usual self-care techniques—there are no beaches or speciality coffee shops in Chinchilla! It has been really encouraging for me to see how more experienced occupational therapists have been so willing to help their junior peers. Thank you to all my fellow professionals who have provided the support I needed and thank you to all the other occupational therapists across the country who I know are doing the same thing for other new graduates.

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THE NEXT GENERATION OF ASSISTIVE TECHNOLOGY Technology for Ageing & Disability WA, Solve Disability Solutions Inclusive Design In the age of inclusion, we are seeing a wave of assistive technology (AT) innovation and development across Australia. Communities, universities and service providers are joining forces and building collaborative intersections between innovative design and allied health professionals; contributing to an idea-rich, innovative, open-source AT community. With the rising tide of sector collaboration, we are seeing greater demand for (client) inclusion, client-centricity and co-design—all with an ability focus and people with disability leading the charge.

The Age of the Virtual OT As the demand for OTs continues to climb, wait lists grow and access has become more challenging, especially for people in rural and remote areas. Thanks to the power of technology, clients have access to a range of options to see their therapist, remotely. Using day-to-day mobile technology (such as FaceTime, WhatsApp and Facebook Messenger), professional platforms like Zoom, or universal health channels such as HealthDirect/Telehealth technology, clients are now able to connect to

their provider networks from the convenience of their home or office. Community health centres are also a valuable link in the connective chain, with some centres providing clients with appointment spaces and access to computers, internet and cameras to attend virtual appointments.

Recycle, Repurpose, Repair!

As the world re-evaluates its carbon footprint, individuals and industry are brushing up on the art of recycling, repurposing and a throwback to a repair culture—fixing what you already have. In modern, local communities throughout Australia, volunteer initiatives like Repair Café and Men’s Shed are investing their social capital, with a ‘make it work’ philosophy, and promoting sustainability by reducing waste. Free fix-it initiatives are popping up left, right and centre, offering end-to-end value—from waste reduction to the agency of skilled volunteers, and of course, equitable solutions delivered to recipients.

TADWA: Supporting the Next Generation in WA In Western Australia, Technology for Ageing & Disability WA (TADWA) supports the education of future OTs in offering Edith

“WE ARE CONNECTING WITH PEOPLE WITH DISABILITY (NEED KNOWERS) TO CREATE THE PUBLIC DOMAIN ASSISTIVE TECHNOLOGY SOLUTIONS.” – TOM: MELBOURNE

Cowan University and Curtin University student placements, for first through fourth year OT students (up to eight weeks), as well as clinical supervision of OT Honours students. In 2019, TADWA facilitated eight projects involving students and supervisors at Curtin in the assistive technology and home modification space. TADWA also accepts students in a voluntary capacity to assist with a variety of aspects of their work. This then gives OT students hands-on experience in providing support to busy work environments to diverse and unique cohorts of individuals in Western Australia. TADWA offers OT graduates employment opportunities including a comprehensive two-week Induction. Following induction, further support is facilitated through weekly and then monthly supervision teamed up with a Therapy Service Manager. An informal mentoring program CONNECTIONS DECEMBER 2019 25

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THE NEXT GENERATION OF ASSISTIVE TECHNOLOGY Continued from previous page

is set up within the team, made available based on experience and capacity. Informal training is also taught by technical staff—for hands-on training within the specialisation of design and engineering, giving new grads first-hand experience within this specialised service sector. TADWA offers a variety of professional opportunities, including OT placements, joint projects with the community sector, and ongoing relationships with Universities. TADWA has created an active and reputable profile in the broader OT community, highlighting the specialised work of TADWA OTs and being well placed to confidently manage an increasing demand for specialised services and technologies. Suppliers and community stakeholders up and down the WA coast engage with TADWA to assist with problem-solving and facilitating AT-user independence, safety and participation.

Solve Disability Solutions: Supporting the Next Generation in Victoria In Victoria, TADWA’s sister-site, Solve Disability Solutions, echoes a similar therapeutic focused model with ample career and inclusive collaboration opportunities for OT student and practising OTs. Like their team in WA, Solve offers a state-wide outreach service with metropolitan and regional customers and OT networks. Through partnerships with the occupational therapy departments at both Swinburne University and Deakin University, Solve’s therapy team have actively positioned themselves within the core curriculum for OT students at undergrad and post grad level. This gives students at all levels the opportunity to engage with therapists ‘in the field’ and 26 www.otaus.com.au

explore the clinical benefits and outcomes of fit-for-purpose, and customised technologies for people with disability. This immersive experience also provides access to over 40 years of case studies, and custom training programs for individual and group capacity building. This also provides opportunities for Solve OTs to continually refresh their theoretical knowledge and calibrate their practice. Solve Senior Occupational Therapist Liz Doyle is a Clinical Associate at Swinburne, and selects two students per term for placements within the diverse Solve team. Working with experienced OTs and over 100 state-wide engineers and technical volunteers, students play an active role in the therapy process. The placement sees students putting client’s abilities at the centre of their practice, and working in co-design environment with a multidisciplinary team to create and improve innovative solutions for clients of all ages. Along with fulfilling course requirements, OT students with an interest in bestpractice service provision have opportunities to work with a multidisciplinary team in a collaborative working environment. As well as standard coursework, students are encouraged to take on special projects and quality improvement opportunities. With an inhouse Clinical Associate (through Swinburne), Solve offers post-grads an opportunity to conduct research to fulfil post-grad research requirements. One current example is a qualitative investigation into individual occupational meaning and individual changes across the lifespan. OTs with a particular interest in targeted health literacy have access to a broad

range of disciplines, working between clinical and marketing teams, focusing on client engagement, current health literacy standards and evidence-base practice. Solve’s interactive student placements emphasise the valuable role OTs have in developing current, relevant and useful clinical support resources, equipping clients and families with tools to increase their comprehension and enable informed choice. The multi-faceted role of OTs in the modern AT space encompasses a broad skillset, from client engagement, provision of custom AT and training, to interaction with stakeholders such as the NDIS, and continually exploring and promoting the benefits of AT. Solve OTs play a critical role in the assistive technology codesign process. From assessment and prescription, to design and development, through to therapeutic intervention and training. The role of OT is essential to facilitating occupational participation and performance outcomes. As a seasoned organisation with over 40 years’ AT experience, the fresh-face value of students and the emerging OT workforce provide valuable insights as Solve continues to pave cohesive pathways linking occupational therapy and the development and engineering of assistive technologies. About TAD Australia TAD Australia provides occupational therapy services and assistive technology solutions—that are safe, high quality and appropriate—to help people with disability and older Australians achieve their goals. To find out more about student placements, OT practice and career opportunities, visit www.tadaustralia.org. au and connect with your local provider.

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LOOKING FORWARD, WITH EXPERIENCE Nicola Sydes, Occupational Therapist

s an occupational therapist who has worked on the fringes of clinical practice, I’ve been blessed by a number of career opportunities beyond the wards. While working in a hands-on treatment role has its own rewards, the pace and challenges of occupational therapy practice and its commercial implications for our community funding schemes, was where I found my stride. Whilst carving out a career inside the compensable injury sector, I worked indirectly with a number of successful, self-employed occupational therapists who were creating careers on their own terms. Choosing to practice in roles directed more at assessment, rather than treatment, this small group of occupational therapists was highly regarded for its capacity to bring clarity to a client’s functional capacity outside the clinical setting. Through meeting clients—often long after formal treatment programs had ended—these occupational therapists were vital to identifying strategies to help clients regain their independence with everyday tasks at home and in the community. Fast forward several years, throw in a few career moves away from the health care setting, a sabbatical (or two) to focus on some travel and creative endeavours, and a freelance writing career, I found myself longing, but unable, to work as an occupational therapist in a world that now included professional registration.

Registration for the Generations

Having exited the profession prior to the 2012 introduction of registration, I found myself at the mercy of AHPRA’s mouse wheel of despair. I was faced

with the challenge of finding a way to register without current clinical experience, and no way to get clinical experience without registration. Notwithstanding the (massive) administrative burden involved in navigating AHPRA’s process, the hardest part of gaining registration was convincing an employer to work with me to achieve AHPRA’s required supervision hours. But keen to contribute to an area of practice I was passionate about, I looked to my unique skills. I knew the compensable injury sector and its legislative framework, I was capable of working autonomously, and having written in both my professional career, and later in a freelance capacity, I could write.

Unlimited Untapped Potential

Narrowing my focus, I contacted one of Victoria’s largest providers of specialist occupational therapy services to the compensable sector. UNLIMIT-ED’s unique, human centred approach looks to well-designed equipment, changes to the built environment and support services to help clients live unlimited lives. They are a group passionate about what they do, how they do it, and the innate potential of everyone to do more and be more. But what makes their practice so highly regarded is the professionalism they bring to documenting their assessments and recommendations. UNLIMIT-ED’s support enabled me to complete my supervision hours, receive direct support to meet my re-learning goals and re-engage with a profession I had long lost touch with. Now registered, my

career has come full circle in many ways. And the bonus? Just like the occupational therapists I worked with at the beginning of my career, I’m able to create a role on my own terms, choose my own work hours, and drive my own earning potential. But the benefits haven’t only been mine. UNLIMIT-ED have had the opportunity to see the profession through eyes that know the past but are keen for a future. In this second incarnation, my career motivation is very different to that held as a new graduate. Today, I’m more focused on where we’re going as a profession, how we gain the visibility we deserve, how we can promote innovation in practice, and how we can create opportunities for those returning to a profession that is well served by the maturity and experience of past generations.

5 Reasons to Support a Re-registering OT

1. There is much to be gained from the clinical, professional and life experience we bring to the workplace 2. The process is easy for employers if we manage the process 3. We are motivated by far more than “getting a job”, just ask us! 4. If we can survive AHPRA’s process, trust me, we can handle anything! 5. It’s the only way to achieve a workable and sustainable registration process that protects and preserves our professional history and assets, and that is something we should all care about About the Author Nicola Sydes graduated with a B.App. Sc. (OT) from the University of Sydney in 1998. After a brief clinical career, Nicola found herself working in the compensable injury space with a focus on alternative dispute resolution. Followed by a stint with one of Australia’s biggest corporates, Nicola took some time out, travelling and freelance writing from her bayside home. Looking to take her career full circle, Nicola registered as a practising occupational therapist in 2017 and now works for UNLIMIT-ED: www.unlimit-ed.com.au CONNECTIONS DECEMBER 2019 27

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CONNECTING WITH GOOD DESIGN Dr. Peter Sweatman, Industrial Design Specialist at Caroma

ustralia has one of the world’s highest life expectancies, which is a testament to our lifestyle and health system. But with Australians living healthier for longer1 and support/ services for older people undergoing major changes, there is more demand for, and pressure on, occupational therapists, carers and other professionals involved in caring for older Australians. The aged care industry can be challenging for older people and those caring for them, so it’s important we extend our thinking beyond the realms of bare necessities to consider how innovation can help improve quality of life and support professionals working in the industry. This includes rethinking effective design in aged care and in-home environments, and engaging both carers and older Australians in the process. The whole sensory experience of a building can have a strong effect on residents’ health and wellbeing. Designers are increasingly considering the multiple levels of effect that the environment in which people live and work has on them beyond meeting basic functional requirements. People are highly attuned to the sensory impacts of the place where they live. An enriching environment featuring natural light that changes through the day, outlooks onto nature, organic and interesting sight lines, fresh air, and a mix of quiet private spaces and lively social spaces all need to be top of mind. In the bathroom, a place crucial for wellbeing, design can elevate a user’s experience from the achievement of basic hygiene functions to one of relaxation and rejuvenation. However, as we experience the effects of ageing, our ability to adapt safely 28 www.otaus.com.au

to unsupportive design configurations is diminished. A prioritisation of good design guided by a growing body of evidence and creative problem solving can enable more supportive and enjoyable product and building outcomes for users and their carers. It’s hard to overstate the importance of aesthetic impression of a bathroom for people, particularly in private homes when aiming to provide more supportive features. A person’s home is a reflection of themselves. If they feel that grab rails or other assistive products don’t correspond to their perceived level of need, they are likely to trade off function for conventional appearance. The aesthetic design of supportive products (and stigmatic associations) is a barrier to their adoption at a time when they would be useful for improving comfort and safety, and a challenge exists for carers when encouraging their continued use in a care environment. More integrated, adaptable and attractive supportive design aligned to positive motivations is essential in the construction of bathrooms to enable long term liveability and reduce the need for carers to perform manual tasks and data collection, freeing them to focus on interpersonal interaction. Increasingly, users and their carers are turning towards a collaborative process involving builders to help ensure well considered decisions about configuration, choice of products and finishes. Where possible it’s important to customise outcomes to an individual residents’ size, needs and preferences. There is no one size fits all solution, so active engagement is

Dr. Peter Sweatman

an effective (and often efficient) approach to reaching integrated design solutions. Research from the Livable Bathrooms for Older People project* investigated older Australians living independently, and their experiences with the bathroom. It found they had difficulties accessing the shower, reduced taking baths, visited the toilet more frequently through the night, and were concerned about overall bathroom size, climate and floor slipperiness. A dedicated co-design group proposed innovative designs to maximise safety while being supportive, comfortable, easy to clean and aesthetically attractive. The group also prioritised inclusive design elements to make bathrooms usable for visitors, children and carers. Laboratory studies of specific bathroom tasks found that people may experience a higher level of difficulty than they

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DESIGNERS AND OTS SHOULD INCREASINGLY BE SPEAKING A COMMON LANGUAGE.

reported in questionnaires. For example, toilet transfer from standard height toilets was not reported as a significant concern in survey data, however when observed and measured biomechanically, participants exhibited strategies that indicated a high degree of effort while they reported no difficulty. As occupational therapists are already aware, this points to a reluctance to recognise difficulty in this area. While the research excluded people diagnosed with dementia for ethical reasons, literature supports approaches where bathrooms are designed to support task performance routines that people have had for their whole lives. Change can be upsetting and visual perception becomes reduced so clearly contrasting colours and shapes can make products like taps and toilet seats easier to use independently.

While designers, builders and occupational therapists all aim to provide optimal solutions for people on time and under budget, their conception of users’ needs varies significantly. With multiple disciplines it can be difficult to find a common language of user requirements that translates into the physical parameters of the built environment. It can be tempting to limit consideration of those who deal in the familiar terminology of a field. While a refined technical specification like an Australian Standard can be reassuringly simple, it doesn’t necessarily support the best solution for users.

Following research exploring the parallels between person centred design and whole person care occupational therapy approaches, we’ve learned collaboration between fields is increasingly important in ensuring optimal outcomes. Designers and OTs should increasingly be speaking a common language. Both have a lot to contribute to each other’s respective fields to improve the built environment for people as they age.

As we press on, an increasing number of products and renovation services will be targeted towards people actively choosing to age comfortably and independently in an environment that supports their lifestyle and aesthetic preferences.

1. Establishment of a Codesign project reference panel comprising 5-12 older people (twelve meetings) and with an additional (three) meetings for the support device extension.

The practice of design aims to synthesise multiple priorities into a unifying solution. The lines between “aged care” and general market designs will become less defined. Fixtures with high aesthetic values will incorporate supportive elements in subtle and adaptable ways.

3. 80 in-depth Interviews

A variety of products will be developed with carefully designed innovations that incorporate technology appropriately to address users’ desires and needs.

About the Author An Industrial design expert at Caroma, Dr Sweatman specialises in developing user-centred bathroom design for older Australians through collaborative workshop programs and laboratory research.

As person centred design becomes more prevalent as a means of ensuring the built environment supports all aspects of an individual’s daily experience, OTs with a grounding in a whole person approach to care are well placed to advocate for the implementation of better design solutions within the industry.

*The Livable Bathrooms for Older People project was an ARC funded linkage project between UNSW and Caroma. It comprised five overlapping phases of work:

2. National Survey (4469 responses) 4. Laboratory work around toilet activities with 31 older people aged 60 to 90 years of age 5. Laboratory work around use of support devices with 12 older people 64-91 years of age

Reference 1. https://theconversation.com/were-not-just-livingfor-longer-were-staying-healthier-for-longertoo-118588

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A GUIDE TO INVOLVING ANIMALS IN YOUR PRACTICE Melissa Y. Winkle, OTR/L, FAOTA (Dogwood Therapy Services, New Mexico, USA) Karen Ni, OTD, OTR/L (SunDog Therapy Services, California, USA) Claire Dickson, BA, MOccThy (Assistance Dogs Australia, Sydney)

he April 2019 edition of Connections featured an introductory article on animal assisted therapy. This article provides further information to therapists interested in involving animals in their practise. There are three types of animal assisted interventions (AAI), including animal assisted activity (AAA) involving volunteer visiting, animal assisted education (AAE) delivered by a teacher, and animal assisted therapy (AAT), provided by an allied health professional. Occupational therapists may incorporate animals into practise by contacting a

Figure 1 30â&#x20AC;&#x201A; www.otaus.com.au

volunteer visiting team from a reputable organisation, by training and having their own dog evaluated to be included in therapy sessions, or by procuring a dog from a reputable organisation that has been specifically prepared and trained for AAT. Winkle (2011) recommends allied health professionals take a tiered approach to education and skill development (Figure 1), including Resource Building, Preparatory Phase, Volunteer Visiting (AAA), and then AAT. This article will guide you through the first three tiers.

Resource Building involves obtaining information about state and national regulations relating to AAT. There is interdisciplinary agreement that AAT is an advanced scope of practice and requires additional skills and knowledge (Chandler, 2017; Winkle & Jackson, 2012; VanFleet, 2017) related to the communication, behavior, handling, training, and welfare of the animals involved (Chandler, 2018; Andreasen, Stella, Wilkinson, Szczech-Moser, Hoesel & Hendricks, 2017; Stewart, 2016).

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The Australian Occupational Therapy Competency Standards (OTA, 2018) provide requirements about the delivery of advanced scope of practice services. The standards include the Occupational Therapy Code of Ethics (OTA, 2014), which describe enforceable principles including beneficence, non-maleficence and veracity. These ensure therapists providing AAT “acknowledge the boundaries of their competence… provide services and use interventions for which they are qualified by training and experience” (OTA, 2014), and appropriately prepare, train and evaluate the animal involved. Resources for continuing education in the theoretical foundations of human-animal interactions, the humananimal bond, and AAIs include: • Animal Assisted Intervention International (AAII) • International Association for Human-Animal Interaction Organisations (IAHAIO) • International Society for Anthrozoology (ISAZ) In 2017, the American Occupational Therapy Association (AOTA) recognised AAT under Rehabilitation and Disability (AOTA, 2017). In order to provide an advanced scope of practice like AAT, therapists

Feeding Dottie

must seek mentoring, networking, and membership to organisations specialising in AAT (AAII, 2018; IAHAIO, 2018). Animal welfare, well-being and safety are critical aspects of AAT practise. Therapists must ensure they can accurately elicit, read, and respond to their animal’s cues (Winkle & Jackson, 2012). Our animal’s performance is largely based on their secure attachment to us, their ability to trust us to advocate for them, and mutual respect (VanFleet, 2017;

Stewart 2016). Many therapists have not considered obtaining consent from their animal, which may be as simple as giving them a choice to stay or leave the session (Winkle, 2012). While some may refute that this could negatively impact a client, others may argue that it is a teachable moment about perspective taking. In AAT programs it is essential to teach participants appropriate interactions to keep both animals and participants safe. Continued next page

ANIMAL WELFARE, WELL-BEING AND SAFETY ARE CRITICAL ASPECTS OF AAT PRACTISE. THERAPISTS MUST ENSURE THEY CAN ACCURATELY ELICIT, READ, AND RESPOND TO THEIR ANIMAL’S CUES. AAT Dog Books

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A GUIDE TO INVOLVING ANIMALS IN YOUR PRACTISE Continued from previous page

Without an understanding of how animals perceive human verbal and non-verbal communication, practitioners risk injuries to participants and negative outcomes for animals. Professionals must not allow participants to create discomfort for the animal, and must not prevent the animal from moving away. Animals, like humans, can reach sensory overload and each have different preferences for proxemics (Winkle & Jackson, 2012). An animal should enjoy, not just tolerate, any activity it is invited to participate in. Be mindful that participants also observe the therapist’s interactions with animals. Practitioners must promote healthy, humane interactions and avoid the use of painful equipment and physical force, not just because of the profound negative impact on the animal, but also in the interests of creating a safe environment conducive to learning prosocial interaction, morals and ethics. As an OT begins the Preparatory Phase, more complexity is added. This is the time to learn the theoretical foundations of AAT. Query into the Frames of Reference used in OT practise may be seen through a new lens as they guide the theory and practise to successfully blend OT and AAT. OTs should familiarise themselves with the literature on AAT. OTs often use several different theories, frames of reference, and practice models at one time to inform treatment. AAT can complement a multitude of theories used within OT practise. The animal can act as a motivator, a model to demonstrate the activity, a participant to encourage social interaction and turn taking, and a facilitator to promote skill development. Volunteer Visiting is a valuable opportunity for therapists to work with animals in a setting similar to the animal’s 32 www.otaus.com.au

Gertie playing games

future workplace. Volunteer visiting allows the handler to engage the animal, observe and create the animal’s professional profile and identify any additional training needs. In addition, it is an opportunity to self-evaluate as a handler. While volunteer visiting is not the final destination for allied health professional teams, it is a great stop along the way where teams receive formal education and support during the journey, so they may gain hands-on experience preceding the formal roles of AAT. Winkle (2011) recommends introducing animals to environment and staff prior to volunteer visiting, and observing the animals’ preferences and responses. Handlers advocate for their animal,

document the duration and quality of interactions, proxemics preferences, and other key information needed to prevent animal stress and fatigue. AAT program proposals identify risks, resources and training needs, and create processes, policies, and procedures. Several books describe AAT for executive staff members who may not be familiar (VanFleet, 2017; Chandler 2017; Winkle, 2018). AAT program proposals should also include professional liability insurance specifically for AAT; and each animal’s professional portfolio with requirements for health, welfare and well-being. A third article providing information about the implementation of AAT will be provided in 2020, guiding you through the fourth tier.

References American Occupational Therapy Association (2017). Incorporating animal assisted therapy and assistance dogs into practice. Retrieved from https://www.aota.org/ Practice/Rehabilitation-Disability/service-animal-assisted-therapy.aspx Animal Assisted Intervention International. (2018). Standards of practice. Retrieved from https://aai-int.org/aai/standards-of-practice/ Chandler, C.K. (2017). Animal assisted therapy in counseling. New York: Routledge. Chandler, C.K. (2018). Human-animal Relational Theory: A guide for animalassisted counseling. Journal of Creativity in Mental Health, 1-16. International Association of Human-Animal Interaction Organizations. (2018). IAHAIO white paper: The IAHAIO Definitions for Animal Assisted Intervention and Guidelines for Wellness of Animals Involved. Retrieved from http://iahaio.org/wp/ wp-content/uploads/2018/04/iahaio_wp_updated-2018-final.pdf Occupational Therapy Board of Australia. (2018). Australian Occupational Therapy Competency Standards. Retrieved from: https://www.occupationaltherapyboard. gov.au/codes-guidelines/competencies.aspx Occupational Therapy Board of Australia. (2014). Code of Conduct for Registered Health Practitioners. Retrieved from: https://www.occupationaltherapyboard.gov. au/codes-guidelines/code-of-conduct.aspx Stewart, L. A., Chang, C. Y., Parker, L. K., & Grubbs, N. (2016). Animal-assisted therapy in counseling competencies. Alexandria, VA: American Counseling Association, Animal-Assisted Therapy in Mental Health Interest Network. VanFleet, R., & Faa-Thompson, T. (2017). Animal assisted play therapy. Sarasota, FL: Professional Resource Press. Winkle, M. (2011). Tiered Approach for Education and Skill Development for Healthcare and Human Service Providers. Symposium conducted at the development meeting for Animal Assisted Intervention International. Groesbeek, Netherlands. Winkle, M. (2012). Dogs in practice: Therapeutic agents and assistive technology. Presented at Dogwood Therapy Services, Albuquerque, NM. Winkle, M. (2016, May). Animal assisted intervention: A conceptual framework. Presented at Dogwood Therapy Services, Albuquerque, NM.

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Winkle, M., & Jackson, L. (2012). Animal kindness: Best practices for the animal-assisted therapy practitioner. OT Practice, 17(6), 10-14.

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RECORD TO REFLECT: A LOOK AT VIDEO INTERACTION GUIDANCE Angela Tieman, Paediatric Occupational Therapist ‘The art of Occupational Therapy is the soul of its practice’ (Peloquin, 1988. p.219). I love this quote—it reminds me why occupational therapist’s shine. Over my career, I have come to understand that what contributes to my own ‘art’ is the way I use myself to develop a trusting relationship with clients, which in turn plays a significant role in helping them to identify meaningful occupations and achieve their goals. Punwar and Peloquin describe this as a therapist’s “planned use of his or her personality, insights, perceptions, and judgments as part of the therapeutic process” (2000. p. 285). In my clinical work with children with complex behaviours, emotional dysregulation, and a history of developmental trauma, I’m continuously reflecting on what makes an interaction more successful than another—either between myself and the child, parent and child, or myself and the parent. I started reviewing videos of my intervention sessions to seek clarity on behavioural triggers and to observe parent-child relationships more closely. Without this video feedback, it was hard to notice the impact of subtle signals displayed through body language, facial expressions, posture, and tone of voice. At times, it was uncomfortable seeing myself on video. Sometimes I missed early warning signs in the child because I was focused on completing an activity, or how a change in my tone of voice and body language contributed to a child’s anxiety when preparing to transition at the end of a session. In addition to identifying 34 www.otaus.com.au

areas for improvement, the video feedback enabled me to see what I was doing well to facilitate the child to feel safe, motivated and engaged, and ultimately, to have fun. Sensory Attachment Intervention (SAI) is an integrative approach to treating people who have suffered severe neglect, trauma or abuse, (www.sensoryattachmentintervention.com). The research supporting SAI theory and practice is emerging. SAI is a process of parent-child co-regulation whereby the therapist supports the parent to facilitate child-led, sensorimotor play with the child, as a tool in developing attachment. During sessions, the role of the therapist is to provide a sensory enriched environment to enable the process of co-regulation between the parent and the child. The sessions are filmed and video feedback is used to help the parent reflect on their own and the child’s responses to sensation and engagement. Childhood psychiatrist, Perry (2009), stated that the principle of ‘use dependence’ is at the heart of effective therapy, that is, “any efforts to change the brain or sensory systems requires provision of experiences that create patterned, repetitive activation in the neural systems that mediate function or dysfunction” (Perry, 2009, p. 244). When implementing effective therapy from this ‘use dependence’ and SAI theory, it is imperative that parents and school staff are supported to consistently embed strategies into activities of daily living and academic learning. These strategies must address both the sensory and attachment needs of the child within predictable and consistent caregiving and teaching relationships.

When I first began using SAI in my clinical practice, I encountered some challenges with being able to successfully support parents to think about their relationship with their child, and find their own solutions. Review of the video with my supervisor revealed a tendency at times to rush in and offer parents solutions, rather than allowing the space to first hear and receive the lived experiences, thoughts and feelings of the parent. I began to appreciate the therapeutic use of the self and my need for selfawareness, flexibility and adaptation— depending on who I was interacting with. I sought to develop this ‘art’ more consciously. At the time, I was working in collaboration with a highly skilled practitioner with expert knowledge of child and adult attachment who introduced me to Video Interaction Guidance. Video Interaction Guidance (VIG) is a relationship-based intervention (Kennedy, H., Landor, M., & Todd, 2011) that involves capturing what is going well on video to help build communication and interaction. The process starts with the guider (trained in the use of video and principles of attunement) meeting the client to identify the area they would like help with. For instance, Penny*, adoptive single mum of 6 year old Lily* who has a diagnosis of Foetal Alcohol Syndrome, stated one of her goals for VIG work was ‘To learn about what I am doing to facilitate fun during play.’ On a scale of 1-10 (0 = no fun and 10 = lots of fun), she placed herself on a 4, stating, “I often get confused as to what to do next, she is frequently controlling and it doesn’t feel fun.”

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The guider takes a 10-minute film of adult-child interactions in their natural environment and edits it, to produce 3-4 short films and/or still shots that address the client’s goals. It was important in this case to show Penny clips of herself looking confident during play and having fun with Lily. As Penny and I watched the edited clips together, I supported her to identify a) what she was doing well and b) what impact her behaviour was having on her relationship with Lily. We focused on the varying principles of attunement that Penny was displaying such as giving time and space, looking interested, showing emotional warmth through intonation, and receiving with body language. In VIG, the feelings and thoughts of both the parent and child are explored with the guider, (see Figure 1). It was powerful for Penny to reflect on her spontaneous and intuitive interaction with Lily. She began to notice more positive moments of interaction with Lily at other times throughout her week. By our second VIG session, Penny had learnt to trust herself more as a parent and her confidence had grown, (see Figure 2). Lily’s behaviour, particularly during morning transitions, had also improved.

The VIG approach takes the view that change can be achieved more effectively in the context of a ‘coaching’ relationship than a didactic ‘teaching’ relationship, because it is collaborative rather than prescriptive, empowering rather than de-skilling, (https://www. videointeractionguidance.net/aboutvig). A similar approach is adopted in supervision with trainee guiders being supported to appreciate their own strengths when reviewing their practice in the filmed shared review with the client. Supervisors are similarly supported by their supervisors or colleagues. While VIG is an intervention in its own right, the principles of attunement can be applied to any context and relationship. SAI and VIG have been instrumental in developing the art of my practice, particularly when working more closely with parents. Reviewing videos collaboratively as a tool for intervention or as part of clinical supervision brings exciting possibilities for change. What is it about your therapeutic use of self that shines? What innate skills do you bring to your interactions with clients? Maybe it’s time to review a video with an appreciative eye to affirm or discover something about yourself.

Exploring together in shared review

Ideas for change

*Author’s Note: Names have been changed for confidentiality. About the Author Angela Tieman is a Paediatric Occupational Therapist with extensive experience working in Early Childhood Intervention in both Australia and the United Kingdom. Angela supports children and their families with a range of conditions, including Sensory Processing Difficulties, Dyspraxia, Developmental Trauma, Attention Deficit Hyperactivity Disorder, Developmental Delay, Anxiety, Learning Disabilities, and Autism. Her core expertise encompasses both Ayres Sensory Integration (ASI) and Sensory Attachment Intervention (SAI) as well as Video Interaction Guidance (VIG). Angela’s work is grounded in hope and trust, with a strong focus on fun and the ultimate goal of improving the quality of life for the families she works with. Angela is also an experienced clinical supervisor. Angela can be contacted via www.linkedin. com/in/angela-tieman-8a5479165/ References Kennedy, H., Landor, M., & Todd, L. (Ed(s).) (2011). Video Interaction Guidance: A Relationship-based Intervention to Promote Attunement, Empathy and Wellbeing. London, England: Jessica Kingsley Publishers. Perry, B.D., (2009). Examining Child Maltreatment Through a Neurodevelopmental Lens: Clinical Application of the Neurosequential Model of Therapuetics. Journal Of Loss and Trauma 14, 240-255. Taylor & Francis Group. Peloquin, S.M., (1988). Sustaining the Art of Practice in Occupational Therapy. American Journal of Occupational Therapy. 1989; 43(4):219-226. doi: 10.5014/ajot.43.4.219.

New meanings

Punwar, J. & Peloquin, M. (2000). Occupational Therapy: Principles and Practice. Lippincott, PA.

Emerging new feelings and thoughts

Eadaoin Bhreathnach. (n.d). Home - What is SAI? Retrieved from https://www. sensoryattachmentintervention.com

Feelings, thoughts about self, child and relationship on video What we both see in the video clips

Association for Video Interaction Guidance UK. (n.d). How is VIG delivered. Retrieved from https://www. videointeractionguidance.net/aboutvig

Deepening achieved by guider using film, naming, wondering and building on client’s initiatives and responses

Figure 1

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YOUR OT JOURNAL CONNECTS PAST, PRESENT AND FUTURE GENERATIONS OF OTs Anne Cusick, PhD, Retiring Editor in Chief, Australian Occupational Therapy Journal The theme for this Connections issue is ‘Connecting With the Next Generation of OTs’. It’s a theme to motivate and inspire all of us to think of what we have done and can do for those occupational therapists who follow. After 40 years as an occupational therapist—and five of those as Editor in Chief of the Australian Occupational Therapy Journal—it’s a good time to reflect on the past, present and future as I exit this role. My last year ‘at college’ was 1979. We were the second cohort to graduate with a degree in New South Wales and it was from a College of Advanced Education, not a university. Before that, occupational therapists in my state were diploma qualified. Most of our teachers, supervisors and colleagues held diplomas; many were studying to ‘upgrade’ their diplomas to degrees. We had compulsory research training, delivered by academics with backgrounds in biological and social sciences. At that time, ‘evidence-based practice’ had not been “invented”, and qualitative research was just emerging as a potential methodology in health; so we learnt about traditional experimental and survey research applying our statistical skills in exercises that generated reams of binary-code print-outs. While the vast majority of occupational therapists in the late 1970s and early 1980s were enthusiastic about the shift

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to bachelor-entry, some bemoaned the fate of ‘hands-on’ OT, worried that person-centered practice and the focus on everyday life may be lost. Further, there was a concern that research training of undergraduates and research expectations of practitioners could have unintended consequences. Specifically, the worry was that demands for evidence of intervention impact would strip occupational therapy of everything that could not be measured—at the time, quantitative research reigned supreme and qualitative approaches were barely known. Resistance to research-informed occupational therapy was not uncommon in the 1980s. Consequently, the case to use, produce and promote research was thus a common theme in occupational therapy association activities of the 1980s and 1990s. You can see it in the pages of articles in the Journal at that time. The Australian Occupational Therapy Journal provided continuity between the past and the present. The journal was a solid reminder of the professionalisation journey that occupational therapy in Australia was on. The journal was an artefact that we physically held with our hands—it was not online. The shelf-copies of the journal physically placed occupational therapy in the great swathe of knowledge about science, humanity and health.

The journal volumes were lined up on library bookshelves at Dewey 615.8 between “Phamacokinetics 615.7” and “Toxicology 615.9”. We had to go into the library and get issues off the shelves to see the articles. If an issue or article was missing (torn out by some desperate or lazy student), there was no alternative but to ask the librarian to purchase a back-copy from the publisher or ask for an inter-library loan to send a copy by postal service. We thus had a physical sense of where occupational therapy knowledge ‘fitted’ in the great Dewey classification of scholarship. Occupational therapy was within the “Pharmacology and Therapeutics” 615 domain of classified knowledge, alongside other allied health. That Dewey number and the shelf-space occupied by 615.8 showed us that other codes and topics had a lot more knowledge published than we did. The journal was thus a visual and physical cue that reinforced our teacher’s stories of the evolution of occupational therapy knowledge from OT Club days in Sydney to their calls to investigate more, use more research and write more about occupational therapy as the first research-ready bachelor graduates in our state. Our generation was connected to the past as we needed to expand that shelf-space through producing more occupational therapy knowledge!

A O TJ R E P O R T

In the 1980s and 1990s the push to increase research-capable and research productive occupational therapists was happening all over Australia. This was pushed along by Commonwealth government changes to post-secondary education that saw all occupational therapy programs move into universities with minimal practice entry being bachelor degree. The University of Queensland was a precedent, having been the first to offer bachelor level education many years earlier. As this shift in education happened, the number of Australian Occupational Therapy Journal issues increased and the number of research articles within those issues grew as well. During the 1980s and 1990s, more occupational therapists were doing research as practitioners and increasing numbers were engaged in postgraduate study to upgrade to masters degrees or even doctoral level awards. This diversified topics and methodologies being used in research published in the journal. We also shifted from being a self-published journal through the Australian Association of Occupational Therapists in the 1980s to being produced through an international scientific publishing company. This changed not only the format but also the way in which manuscripts were received, reviewed, processed and disseminated. Peer review was introduced, and editorial practices were aligned to occupational therapy and other professional journals around the world. It also changed the journal from being a ‘member service’ sent out to members and institutions who subscribed, to a ‘publishing product’ owned by the association but one of hundreds of professional society journals produced by a global publishing company. In the 2000s the first nationwide wave of doctorally qualified occupational

THERE IS AN UNBROKEN LINE OF AUSTRALIAN OCCUPATIONAL THERAPY SCHOLARSHIP FROM THE FIRST HAND-TYPED CARBON COPIED OT BULLETINS THROUGH TO THE LATEST ONLINE-ONLY ISSUES OF THE AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL.

therapists emerged. Many obtained their PhDs in other disciplines or they went overseas for doctoral studies in OT. Queensland had led the way for some time, with the first PhD qualified OTs in Australia, but across the country the capacity for occupational therapists to supervise other occupational therapists in higher research degrees exploded. This expanded the type and amount of research being produced by occupational therapists in Australia at the same time as it expanded the scope and scale of that research. Dissemination of research into publications well beyond the Australian Occupational Therapy Journal was commonplace as international impact became more important for staff and students in academic settings. While the journal for the most part captured and represented occupational therapy research going on in Australia in the 1970s-1990s, after 2000 the amount of research by Australian occupational therapists and the diversity of their publication avenues meant that continuous consolidated record of research was dispersed. As we enter the third decade of the 21st century, the Australian Occupational Therapy Journal is now one of many ways to connect past generations of occupational therapists with those of the future. But there is and always will be something special about our journal.

There is an unbroken line of Australian occupational therapy scholarship from the first hand-typed carbon copied OT Bulletins through to the latest online-only issues of the Australian Occupational Therapy Journal. Almost every issue is now available to members online—if you have one of the missing issues please alert OTA! There is the collective pro-bono effort by generations of occupational therapists to support dissemination of high-quality research—often through reviewers providing instructive feedback to authors or editorial board members sharing their skill and knowledge through continuing professional development. There is the unique focus on Australian occupational therapy practice, profession and education issues. This continuity is maintained because it was and is the official publication of the peak professional society for occupational therapists in Australia. As the unbroken public record of occupational therapy in Australia, it is important that present members, who own the journal through OTA, maintain connection with the past by reading, citing and reflecting on articles, and provide a strong foundation for the future by sustaining its viability and relevance through membership subscriptions, writing, reviewing and reading. This is how we will connect, through its pages, with generations into the future. CONNECTIONS DECEMBER 2019 37

WFOT REPORT

WFOT UPDATE Adam Lo, WFOT 1st Alternative Delegate World Occupational Therapy Day

World Occupational Therapy Day was on the 27 October 2019, on the last day of our Occupational Therapy Week in Australia. The theme for 2019, “Improving world health and wellbeing”, was promoted across the world by occupational therapists everywhere. It was an opportunity to enhance the public awareness of our profession, as well as enhance the understanding of what we do and the potential career pathways for our current and future students. Here are a couple of pictures from World Occupational Therapy Day.

New WFOT Resources

WFOT has recently released four new Position Statements. They are useful documents to enhance our awareness of where the profession stands in relation to specific issues and areas of practice, where we are likely to head in the future, as well as what (and how) occupational therapists can contribute on the global stage. 1. Occupational Therapy and Mental Health 2. Occupational Therapy in Driving and Community Mobility 3. Occupational Therapy in Obesity in Childhood and Adolescence 4. Occupational Therapy and Human Rights (Revised) These are available to download for free at: www.wfot.org/resources

Call for Applications for the WFOT Congress 2022 Scientific Programme Committee OTs from Indonesia

OTs at the Council of Occupational Therapists for the European Countries (COTEC) Congress in Brussels

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global community. This is an exciting opportunity to assist in the delivery of a relevant and innovative programme that showcases the best in occupational therapy research, education and practice. The majority of the work will be conducted online however funding will be provided to attend the Congress. Please refer to the terms of reference available from this link http://wfot.link/ cspctor. All applicants must complete the application form online via http://wfot. link/cspcapplication by 3 February 2020.

Merry Christmas and See You in 2020! Associate Professor Lynette MacKenzie, Occupational Therapy Australia’s WFOT Delegate and I, the First Alternate Delegate, as well as Dr Leanne Zakrzewski, Second Alternate Delegate, would like to wish everyone a very Merry Christmas and a very happy New Year.

WFOT is calling for applications from occupational therapists to form a Congress Scientific Programme Committee (CPSC) that will be responsible for the planning, development, management of the scientific programme for the WFOT Congress in 2022. Up to 10 suitably qualified occupational therapists will be appointed. They must be Individual Members who are willing to provide their time on a voluntary basis. The appointment of Members will be made to reflect the diverse geographical, professional, research, clinical and academic expertise that are a part of our

Adam Lo and Lynette MacKenzie

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