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    • Bringing Mindfulness to Occupational Therapy

      Mindfulness is a much talked about practice these days, but it has been around for thousands of years. Mindfulness can be a formal or informal practice, which is weaved into our day. It does not need to involve a quiet sitting meditation, but that can be a good way to get some practice. Mindfulness certainly does not require us to push away thoughts or negative feelings, in fact, it is about being aware of what is happening in the moment and bringing awareness to our feelings, thoughts, sensations and environments. For me, mindfulness has been the most powerful tool that I have as an occupational therapist. Over the last 18 years, it has helped me manage my own work stress, be more present with my clients and been a tool I now teach to my clients and other occupational therapists. The simplest way for me to understand it, is that mindfulness has three parts: Intention: Set an intention for what you want to put your attention on (for example, your breathing, the sounds of nature as you walk, or the feeling of warm water on your hands as you wash them). Attention: Notice where your attention is. If it is not on your intention, can you gently bring it back to your intention? Attitude: How are you handling it when your attention wonders? How do you speak to yourself? Can you let go of judgements? The practice of mindfulness can be a formal or informal practice. If we are doing our daily occupations with a mindfulness attitude, that would be an informal practice. When we plan time in our day to do a mindfulness meditation, that would be a formal practice. What does formal mindfulness look like? To do a mindfulness meditation, we can be in any position. Typically, we are either sitting, standing, lying or walking. We then chose a focus (intention) such as the breath, sounds in the room or sensations in the body. We notice where our attention is and bring it back to our intention as often as needed. In fact, the bringing of our attention back is the practice, and sometimes we have hundreds of opportunities in a short meditation. This is best done for a fixed amount of time. Mindfulness is about increasing our awareness of what is present now. That means that it is not necessarily relaxing. However, over time, the practice can help us manage stressful or painful situations with more skill. What does informal mindfulness look like? 'Mindful doing' is the practice of paying attention to the present moment, while doing daily activities. This means connecting to an activity and curiously noticing what is happening around and within you with your senses while doing it, without judgement. It can be a way to practice slowing yourself down, to experience the world around you in more detail. Some examples: How does an orange feel under your thumb as you start to peel it? What is the smell of the food that you are eating – what is the texture like in your mouth? What do the bubbles look like as you start to wiggle your fingers together when washing your hands? What are the sounds like as you pull a tap on to start a shower? What is something you notice about your experience in the present moment while sitting at a red light or in a waiting room – what is there to notice? What are the benefits of practicing? There is significant research evidence available which has shown benefits to mindfulness practice for people dealing with stress, pain, sleep difficulties, mood disorders and focus issues. For us as OTs, it can help us manage stress, avoid burnout, develop compassion and be more present with our clients. How do I start? For most people, it is helpful to establish a formal mindfulness practice. This can help us build our “mindfulness muscles” and make it easier to bring a mindful attitude to other parts of our day. Perhaps you could set aside a few minutes each day to start investigating your breathing. Can you notice when the inhale changes to an exhale? Where do you feel your breathing? As a starting informal practice, you may want to try choosing one short activity in your day and bringing your full attention to it. The opportunities for mindfulness practice are truly endless! It is important to realize that, while mindfulness is simple, it is not easy. Putting it into practice can make us realize that we have more fatigue, pain or difficult emotions than we realized. It can be hard to find the time and space and know what practices to try. The research which outlines the positive benefits is based on people who have participated in an 8-week course with a trained teacher (2 hours a week, plus home practice). While you can begin the practice right now, you may benefit from a more in-depth course which allows you to ask questions and bring up challenges. If you are interested in learning more about mindfulness, I have developed an interactive course especially for occupational therapists (and student OTs and OTAs). The 8-week course involves a mix of pre-recorded teachings and weekly group meetings. This course focuses first of supporting you to develop a personal connection to mindfulness and then use it as a tool to support your work. You can learn more at Sarah Good is an occupational therapist and mindfulness teacher, offering services throughout Ontario, Canada. She also supports occupational therapists who want to weave mindfulness into their practices.

    • Coaching and Occupational Therapy (OT): Where is it at now?

      This year marks 15 years since I completed my first coach training and started to coach occupational therapists (OTs). It has been a fascinating journey. It is worth reflecting on what coaching is, what it offers OT, how OTs are using coaching in different settings, how coaching helps OTs themselves and how coaching could support OT in the future. Back in 2005, whilst I was still breastfeeding, I fell in love with coaching. It felt so natural to work this way; much less stressful than my OT work had been and more empowering for both parties. I immediately wanted to coach OTs who seemed stressed, burnt out, bullied, or wanted a change of direction. However, most of the OTs who got in touch wanted to learn to coach, rather than be coached themselves! Part of me was frustrated, but my coaching skills for OTs workshop went down so well that I let go of it and just went with the flow. Fifteen years later, that one day workshop has been taken by hundreds of UK OTs and hundreds more worldwide, online. I don’t mind admitting that I fell out of love with OT for a couple of years. I was entranced by the coaching world, its positivity and can-do attitude and was a bit fed up with 'problem lists' and deficit thinking, which seemed to abound in OT practice (well, in the settings I had worked in). I also felt less responsible for the outcomes as a coach, rather than as an OT – it wasn’t all up to me whether something was effective, or there was a good outcome. As time went on, I started to see how coaching could really enhance OT practice, not merely be an additional tool in our already adequate toolbox. I started to see how putting coaching philosophy at the heart of my OT practice changed me as an OT. In this way, coaching was much more than just asking questions and setting goals. To date, I have used coaching in various ways: as an occupational coach in a return-to-work service; as a private coach, mostly with OTs but also corporate clients; I have set up the coaching element for a cancer vocational rehab programme; I have specialised in coaching creativity and published the first book of its kind; set up a coaching party programme with full training; taught coaching to undergraduate OTs; and many other things too! I am in the privileged position of seeing how other OTs use coaching too. Along with the leading work by Fi Graham and others in New Zealand, many OTs who work with children and families now use occupational performance coaching (OPC) in their work. Many OTs are setting up their own wellbeing businesses, combining OT and coaching; the Lifestyle Redesign Programme at USC is at the forefront of using coaching and OT; coaching is now often used within vocational rehabilitation, helping people to overcome internal and external barriers to work. In mental health OTs and many other professionals see the value of coaching in recovery but also in prevention; a coaching approach is used in many other ways, including fatigue management and conditional management programmes. I could go on, but I think you are starting to get the picture. Coaching within OT has really come a long way. To me, there are many reasons why coaching has become so popular and why so many OTs are looking to how coaching can strengthen their practice: The notion of client choice/person-centred practice is very difficult in services which are so tightly controlled. To me, coaching is a way of ensuring at least some of what we do has the person and their world, at the core. Coaching helps shift the power away from the OT, into the hands of the client/patient. Not only does this grow responsibility and self-efficacy, but it should also help the OT too. In services where OT contact is limited, coaching can sow seeds, which grow long after the OT intervention has ended. Coaching helps people see how interconnected their world is, shifting away from 'I' to 'We'. An OT who coaches effectively helps people make conscious occupational choices and supports positive change. So why is all this important right now? There has been a drive, in recent years, to empower people and make them less dependent on healthcare services. Certainly, this has been seen in the UK and the Covid situation has expedited this change; access to GP services has changed and reliance on online support has increased. Covid, lockdown and the subsequent societal changes, have also shed light on how OT is such an important profession for the future. People are having their occupational lives turned upside down: staying at home more, working from home, less social contact or physical contact, with many hobbies and recreational activities stopped. Now is the time for OT to be seen in broader society and to shine. Coaching can support OTs to work in this way. Climate change, preventing further climate damage - and managing the impact that is now inevitable - all depend on changing our occupational lives. How we live, work, feed ourselves, socialise, travel etc.; all our occupations must change. Our daily 'doing' has caused climate change, so we need to change our daily doing – our occupations. Coaching helps raise awareness of the broader impact of our actions and behaviours and highlights our personal responsibilities. I am also hoping that those OTs who are interested in working in this arena will support themselves, through coaching. I know this may sound like coaching as a panacea for all the worlds ills, but if you understand what coaching can do, you will start to see its power and potential. We all need to be listened to, to have our deepest concerns and desires heard. We all need to understand our impact on our immediate and broader environment. We all need to have hope. That is why I love coaching 😊. Jen Gash Occupational Therapist Start coaching now by clicking on this link, and use the code: 20csot for a 20% discount (for users of the Hub!) at the checkout.

    • Of Swords, Paradiddles and Solitaire

      Thirty-four years ago, I was a new therapist, struggling through my first fieldwork experience. I used Connect-4* with a stroke survivor, for much longer than I should have. Why? Because I had watched my supervisor use it with this patient and I had no clue what else I might do. Over the following weeks I began to better understand how the activity supported his improvement in motor control, sequencing, planning and problem solving. Years later, as an associate professor teaching occupational therapy coursework, my students would frequently ask “What should I do for someone who has a diagnosis of X?” My reply became “The diagnosis is not all that important. Ask yourself what your patient cannot do and why. Then, to get started, pick an activity - ANY activity - that promotes the return of those missing components, be they cognitive or motor.” Occupational therapists working in rehabilitation settings are challenged to assist clients in maximizing the return of motor control in the affected limb. We encourage our practitioners to use activities which are purposeful as well as meaningful to our patients. The importance of purposeful vs non-purposeful activities are supported by the AOTA (AOTA, 2020). However, I frequently find it challenging to come up with novel activities, which both serve my goal of improving upper extremity movement, as well as being appealing to my clients. Be honest with me here, how long can you continue to practice buttoning a shirt? My Interest in Kendo/Iaido Some fifty odd years ago, while on R&R in Vietnam, I encountered a Japanese martial art, Kendo (the 'way of the sword'), which I have maintained an interest in pursuing. Early Japanese swordsman developed it as a safer way to train students or maintain their own skills. Kendo practitioners use split bamboo swords, along with helmets and body armour to reduce the risk of injury (The All Japan Kendo Foundation). In January 2020, I was recovering from my own surgery and decided to enrol at a local Dojo that offered Kendo instruction as part of my recovery. I quickly came to understand why Japanese children commonly start to participate in Kendo around the age of 7. I might be a healthy 72 year old, but I am still 72 years old and it soon became apparent that I no longer had the stamina or respiratory reserves to compete! As luck would have it, my Sensei ('teacher') also includes a martial art form, Iaido, in our Kendo instruction. Whereas Kendo requires quick movements and great stamina, Iaido stresses slower, precise motion. Kendo also involves sparring against a partner, while Iaido is generally practiced solo. I found the movement sequences of Iaido challenging but somehow calming. Literature suggests as many as 700,000 Americans will experience a cerebrovascular accident (CVA) in a given year, with nearly 500,000 survivors experiencing some level of remaining disability. (Kwon et al, 2004). For many of these survivors, a loss of upper extremity control will persist (Kyung et al, 2014). This loss leads to reduced participation and/or independence in activities of daily living (ADLs and IADLs), with a concurrent reduction in quality of life and loss of self-esteem (Misook et al, 2016; Hillis, 2014). Iaido as a Therapeutic Technique Iaido is a martial art that emphasizes the ability to smoothly draw a sword from its scabbard ('Saya'). Students of this martial art use a non-sharpened metal or wooden sword ('bokken'). As I practiced my lessons and observed other students, I began to realize that Iaido required many of the motion patterns that were difficult for my patients. My Dojo kindly provided me with a lightweight bokken, to use in our occupational therapy clinic. To-date we have used this with three patients. The initial individual had good standing balance, as well as the ability to perform many upper extremity motions, both in isolation as well as in mass. She was near the end of her treatment cycle and agreed to try this activity in an effort to 'fine tune' her abilities to perform bilateral activities. With a therapist guarding her balance, she followed movements I demonstrated for her. A second patient demonstrated good isolated motion, but had much difficulty with mass patterns. He initially was unable to perform reciprocal pronation/supination while holding the bokken. He stated he enjoyed the activity and would practice this sequence at home using a dowel or ruler prior to his next treatment session. On his follow-up session he was able to perform full pronation, with approximately 80° supination multiple times. He no longer had to grasp and release the sword with his affected hand as he supinated. He has continued to use the bokken during therapy sessions and is now working on increasing shoulder flexion while in supine. He was, with assistance, successfully able to use his affected arm to 'draw' the sheath from the sword during his last session. A third patient is working on increasing grip strength. He works with exercise putty at home, but had some knowledge of this martial art and was enthusiastic about increasing the amount of time he can hold the sword. His ultimate goal is to develop grip strength to decrease the incidence of 'drops' at home. One additional benefit of using Iaido is that the motion sequences can easily be done in sitting; neither the 2nd or 3rd patients are able to safely stand without contact guard at this time. We do not teach Iaido I should make it clear at this point that I am NOT attempting to teach my patients how to become Iaido practitioners. I am but a student myself, still struggling greatly with the required motions, balance and coordination. In introducing the activity, I mention the term Iaido briefly, but I do not attempt to teach full sequences, nor do I teach the purpose of any of the sequences (attack, defend, etc). No treatment session is devoted completely to Iaido and it is used only when an ADL/IADL deficit can be addressed by one or more of the motions required by Iaido practice. A variety of activities I firmly believe that we need to use a wide range of activities when working with clients... Often, the more novel and interesting the activity, the better chance that patients will be compliant and increase the time spent in self practice. I might work with a patient whose grip is weak, but who wants to work towards being able to hold a cup in their affected hand. We might start with an empty plastic cup, moving towards a styrofoam cup (carrying without crushing), to cups with increasing dry weight, to cups with increasing amounts of liquid - and finally a walk to the cafeteria and return to the clinic with that cup full of liquid (which they can then drink). I can increase the challenge level, by asking a client to talk to me as we walk, as this multi-tasking will engage other parts of the brain. Patients working on fine motor control are sometimes challenged to keep time to music they enjoy. We start with unilateral and bilateral wrist motions. If they are able, we progress to individual digits. If they do well with this and are interested, I might move on to teach them rudiments, drawn from my days as a drummer in a dance band. For fun, I often attempt to teach them some of the names of the patterns, such as flamadiddle, paradiddle** and ratamaque. The terms can be as challenging to pronounce as the motions are to perform; we frequently end up having a good laugh together! Other patients learn how to play Solitaire, without a computer. This is a common activity for those needing to address deficits in lateral pinch, upper extremity motions (particularly of the forearm), as well as the ability to plan, problem solve and recognize errors. Each activity is introduced by 'attaching' it to an important ADL or IADL task, that the patient finds challenging or impossible. After treatment sessions using these novel activities, we engage in discussions about whether a client feels the novel activity is helping them achieve greater independence in the targeted ADL task. Patients will, on occasion, ask that we return to task-specific behaviors and that wish will always be granted. I want my patients, however, to understand that 'living' provides an infinite number of ways they can enhance their own recovery, if they will challenge themselves to use the affected limb at home, as well as in the clinic. Unique terms ** Paradiddles are one of 26 sequences of drumbeats (called rudiments) drummers are often required to learn. The paradiddle is made up of alternating beats R L RR or L R LL. * Connect 4 is a strategy game, played by two players, with each attempting to get 4 of their tokens in a row: vertically, horizontally or diagonally. With appreciation to Karate International of Raleigh, North Carolina for the use of their logo. Sources cited American Occupational Therapy Association (in press). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74 (Supplement 2). Advance online publication. Hillis, A and Tippett, D (2014, November 11). Stroke Recovery: Surprising Influences and Residual Consequences. Retrieved September 30 2020 from: Kyung et al (2014). Correlation between the activities of daily living of stroke patients in a community setting and their quality of life. Retrieved September 30 2020 from: Misook et al (2016). Effects of Self-Esteem, Optimism and Perceived Control on Depressive Symptoms in Stroke Survivor-Spouse Dyads. Retrieved September 30 2020 from: Kwon et al (2004). Disability Measures in Stroke: Relationship Among the Barthel Index, the Functional Independence Measure, and the Modified Rankin Scale. Retrieved September 30 2020 from: The All Japan Kendo Foundation (n.d.). Retrieved from:

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    • Home | The Occupational Therapy Hub

      Events Research Webinars NEW IN 2 21 Articles Podcasts Downloads Welcome to your global occupational therapy community What's new? What is Plus+? Passionately empowering clinicians, students, patients and clients. ​ Created by occupational therapists. ​ Shaped by 176 countries. 11,900+ Members, in "You are doing a fantastic work here... I had to stop placement and continue to work remotely, for clients in an acute inpatient mental health ward affected by the pandemic. The site has been helpful in practical ways, helping me to gain experience from senior colleagues." ​ Olu (email, 2020) Hub News 10/01/21 Plus+ Disability and dating: People think I'm my boyfriend's carer "Disabled people spend too much time trying to get society to understand the 'social model of disability.'" "There's definitely a taboo around disability and sex, in that people think you cannot have both." Upgrade to to read this and all stories and updates. Membership Plus+ OT Updates (Plus+) 20/12/20 Free Events: Exploring Occupations in Occupational Therapy Presenting our first ever ! We will highlight, explore and amplify voices, visions, passions and varied occupational therapy practice areas and settings, around the world. New episodes air live online and are . Past episodes can then be watched anytime within , which Plus+ Members have unlimited access to. event series open to everyone OT Webinars Events 08/11/20 Plus+ Case Studies become a Membership Plus+ exclusive A library of in-depth accounts, detailing interventions with anonymised patients and service users. Case studies provide valuable insights into specialisms and settings you may not have experienced. This section is now exclusive to Plus+ Members. Therapy Articles Case Studies (Plus+) Therapy Articles latest Our Time is Now: The Role of Occupational Therapy During a Pandemic Bringing Mindfulness to Occupational Therapy Coaching and Occupational Therapy (OT): Where is it at now? Therapy Forum latest jennib276 Jan 8 Community learning disability occupational therapists and overnight on call rota Michelle Mcivor Dec 15, 2020 Urgent Care / Falls Response & Ambulance Service Ellie Dixon Sep 5, 2020 September - October 2020: Walking as a meaningful occupation OT Circles latest Groups are loading

    • Policies | The Occupational Therapy Hub

      Membership Terms of Use Privacy and Cookies ​ Our Policies Latest update: 16th January 2021 Communication PromOTe Partnerships Copyright Important notice from The Occupational Therapy Hub ​ Information and recommendations provided on The Occupational Therapy Hub have been shared by our global community. Whilst we review all web pages, we cannot guarantee quality or accuracy of all information. Therefore, platform content should not constitute medical advice. We cannot take responsibility for consequences arising from the actions of professionals or the public using the Hub's platform. Hub Membership Terms of Use The Occupational Therapy Hub is an information platform and global community, shaped by its Membership. To access the platform, anyone can join as a Free Hub Member . Membership Plus+ is an optional upgrade. 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Membership sign up here . ​ The Occupational Therapy Hub is owned and managed by The OT Hub Ltd, registered in England and Wales. Company number: 11084421.

    • What is OT? | The Occupational Therapy Hub

      What is occupational therapy? Information and public awareness Quotes, questions, videos and graphics about the healthcare discipline and profession of occupational therapy (OT). "Occupational therapy - where , and collide" science creativity compassion Jessica Kensky (2016 AOTA Welcome Ceremony) "Occupational therapy training provides the occupational therapist with the skills to plan and deliver . Occupational therapists believe that doing things that you enjoy has a positive impact on your health and well-being. Our occupations, or activities, provided us with a , and . They , fill our time and prevent us from boredom" purposeful, meaningful activity role routine structure define who we are Alice McGarvie - Occupational Therapist, From the Harp "We see humans as having an – to do things. We can break down these actions (or occupations) into what we , what we and the to be able to do them. While there will always be some overlap, an example might be that I want to play the guitar and I need to be able to go to the toilet. There are also a range of (physical, cognitive, emotional) skills that I need, to be able to manage both of these occupations. A big factor that impacts on my ability to do these things is the around me. If my social environment doesn’t like the sound of bad guitar players, my progress will be hampered. The environment will hinder my functioning. If my toilet is upstairs and I can’t use my legs then again, the environment is not helping me to do what I need. OTs help people to the things they want and need to do in their lives, identify areas where skills development is needed and how the environment helps or hinders people in achieving their ." inherent need to act want to do need to do skills we need environment identify assess goals Keir Harding - Occupational Therapist, mental health and BPD "Occupational therapy. Arguably the most empowering , creative , holistic and meaning-enhancing healthcare profession. We are proud to put on that uniform, follow models of practice, client-centred outcome measures and prioritise active engagement in self-care, productivity and leisure. We are occupational therapists. Adding life to days." Jamie Grant - Occupational Therapist; Director, The Occupational Therapy Hub Please reload What is occupational therapy? Play Video Facebook Twitter Pinterest Tumblr Copy Link Link Copied

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    Forum Posts (965)
    • Occupational Therapy and Coronavirus

      A Community Forum for sharing practice experiences, advice and support, in a time of change and occupational adjustment... As the global community reacts to the COVID-19 pandemic, clinicians, service users and the public are having to adjust to new ways of living and working. In an uncertain climate, occupational balance, engagement and participation will be inevitably affected. Whilst fundamental to slowing the spread of the virus, social distancing and isolation are also likely to impact on physical and mental health and well-being... Occupational Therapy Response to the COVID-19 Pandemic - WFOT Public Statement: 'The COVID-19 pandemic is having a profound impact on the lives, health and wellbeing of individuals, families and communities worldwide... As a profession, we recognise the consequences and changes that are occurring in how people access and undertake their occupations as a result of the COVID-19 pandemic. These include, but are not limited to: accessing resources, activities of daily living, communication, mobility, social isolation, displacement, mental health and wellbeing. Occupational therapists understand the vital need to access and use infection control measures, combined with the need to sustain good psychological, mental health and stamina in order to stay safe and healthy. Occupational therapists will be working with people to develop strategies to facilitate continued access to their occupations. These will include, but will not be limited to: individual, family, community, social and environmental adaptation, mental health, assistive technology and telehealth.' > Read more from the World Federation of Occupational Therapists In the spirit of care and collaboration, The Occupational Therapy Hub offers you this dedicated space for open dialogue, on themes such as (but not limited to): Adapting occupational therapy practice Adapting occupational therapy education and studies Supporting specific client groups Coping strategies, to offer fellow colleagues or those you support We invite you to engage below, in discussions that have the potential to support you and others, worldwide. All the best, The Occupational Therapy Hub Team

    • OT clinician yoga practice

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

    • Sleeping in Riser Recliner chairs

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

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