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This piece is dedicated to a remarkable individual I had the privilege of treating for approximately two weeks. 'S' - a young man in his early twenties, from a small village in Assam, India - arrived at our department in a wheelchair, due to the sequelae of a non-traumatic spinal cord injury (SCI). Despite his physical challenges, S displayed an exceptional level of positivity and resilience... S was an aspiring fashion designer, who moved to Delhi to follow his passion. The lack of funds for his higher education forced him to look for a part-time occupation, which led him to take a keen interest in the make-up and beauty industry. Soon, S realised that he had a talent for using knowledge of colour theory in applying make-up and started gathering a small clientele for himself. Tragedy struck with the advent of COVID-19 and, along with many others, S was also a victim of its atrocities. Within time, he was rendered paraplegic, requiring full use of a wheelchair and with 'no possibility of going back to work again'. Clinically, S presented with impairments in: trunk control upper limb strength functional skills wheelchair mobility Recognising his aspirations and potential for rehabilitation, I immediately initiated a comprehensive treatment plan, tailored to address these areas of concern. Our first target was to establish good trunk control and dynamic sitting balance, by engaging him in activities that challenged him in these areas. For example, overhead ball throwing and graded stooping in a high-seated position. Once that was established, we worked on improving upper limb strength and endurance, as it was essential for wheelchair mobility and transfers. Push-ups were a great option and his performance was evaluated based on clearance, endurance and level of assistance provided. Perfecting a static push-up was essential for relieving pressure during long sitting hours, to prevent pressure ulcers. Dynamic push-ups were necessary for independent transfers, from bed to wheelchair and vice-versa. During our therapy sessions, one of the main issues to address was how his current functional status affected his work, to a point of resigning as a make-up artist (MUA). He educated me on all the postural and technical difficulties a male MUA faced, while doing his job in a wheelchair. His biggest challenge was the lack of trunk stability. The other issue he faced was positioning the client to accommodate his wheelchair. He wasn’t comfortable with the idea of leaning over the client’s face with the risk of falling over them while he worked. Another problem he faced was engaging in bilateral activities like hair washing and setting, since it involved him moving all around the client while working. He wouldn’t be able to manoeuvre the wheelchair if his hands were coated in any hair-care products... In order to better understand these hurdles, we conducted a simulation with some modifications, to better suit his functional status. Two of my colleagues assisted as volunteers; we gathered all the basic tools and equipment needed for him to apply basic make-up over a client. We were immediately able to identify some factors that affected his activity performance: The quality of wheelchair used significantly affected his performance. The size, material, state of repair, presence of chest strap, quality of brakes and removable armrests were important aspects to take into account. Environmental factors, like accessibility and open space, were necessary to take into account. Using more handheld tools and gloves helped with prevention of cross-contamination. Having the client, in this case, the volunteer, seated at an inclination instead of lying supine also made a positive difference. A detachable lapboard to place all his tools on was also a better option than the trolley that was usually used by them. Throughout our sessions, S's determination and creativity shone brightly. Despite facing financial constraints and the devastating impact of COVID-19, he remained unwavering in his pursuit of regaining independence and pursuing his passions. With the support of his mother and close friends, S embarked on a journey of self-discovery and adaptation. Incorporating occupational therapy, vocational rehabilitation and physical therapy, our sessions focused on enhancing S's functional abilities, while exploring opportunities for him to re-engage in his interests. Despite initial scepticism, S embraced the idea of utilising his talents in the makeup and beauty industry - leveraging his knowledge of colour theory and artistic skills. Our therapy sessions evolved into a collaborative exploration, of adaptive techniques and strategies tailored to S's unique needs. From mastering wheelchair positioning for optimal makeup application, to implementing pressure relieving techniques during prolonged sessions, each session served as a learning opportunity for both S and myself. As our time together drew to a close, S's remarkable progress and unwavering optimism left a lasting impression on me. His resilience in the face of adversity serves as a testament to the human spirit's capacity for adaptation and growth. S's journey continues, as he undergoes long-term rehabilitation at another branch of our institute. While I may no longer be directly involved in his care, I remain inspired by his tenacity and consistent determination to overcome challenges and pursue his dreams. In conclusion... S's story exemplifies the transformative impact of rehabilitation and the strength of the human spirit. As healthcare professionals, it is both our privilege and responsibility to empower individuals like S, to reclaim their independence and pursue their passions - irrespective of the challenges they may face. Further reading and learning World Health Organization (WHO) (2013) Spinal cord injury (online). Available from: https://www.who.int/news-room/fact-sheets/detail/spinal-cord-injury. Accessed 13 April 2024. OT CPD Courses: Fundamentals of Posture, Pressure and Ergonomics (2022, The Occupational Therapy Hub). Plus+ Member access to participate and receive a certificate.

Every now and then, the ambience in our office is disturbed by a member of the public roaring with laughter in the corridor, whilst reading the 'Sleep Office' sign on our door. We prick our ears with a sense of familiarity, anticipating what is coming next. "Sleep Office. Ha ha! What do you think they do in there then, sleep?" While the idea of sleeping on the job sounds amusing to some, to our patients, sleep at any time has often become a living nightmare. Night after night, for years or decades - stuck in a seemingly inescapable cycle of desperately wanting to sleep, yet spending much of the night exhausted and awake. We call this insomnia, which is one of the many sleep disorders we deal with at our sleep clinic. To those who have never struggled with sleep, it is hard to understand the profound impact that sleep disorders have on a person’s life. While they may be seen as a nighttime problem, they have a significant impact - across the full 24-hour spectrum - on: health emotions cognition productivity quality of life You might call me biased, but I think that sleep is the ultimate occupation! Every other occupation is affected by how well we sleep, and similarly, sleep is affected by all our occupations. At the Royal Surrey County Hospital (in the UK), we are a team of three Occupational Therapists, working within an outpatient National Health Service (NHS) sleep clinic to provide assessment and behavioural treatment for sleep disorders. While our respiratory nurse and physiotherapy colleagues provide the sleep disordered breathing service, our primary focus is on delivering treatment for insomnia. We also support patients with circadian rhythm disorders, concurrent insomnia and sleep apnoea (COMISA), nightmare disorder and parasomnias. Our patients range in age from 16-90 years and, unsurprisingly, many have complex medical or mental health issues in addition to their sleep disorder. A day in the life... Today, my day started with a remote clinic. Due to there only being a few NHS Insomnia services in the UK, many of our patients are not local and prefer remote treatment, to avoid long journeys. My first patient was a 45-year-old lady who, for the last 10 years, has taken several hours to fall asleep and then woken for another hour or two overnight. At first assessment, she estimated sleeping around 5 hours on a good night and was feeling desperate. Despite describing herself as a naturally positive person, her life had become a battle. She felt exhausted all the time, had been pulled up for mistakes at work and her relationship with her husband was deteriorating - not helped by their recent 'sleep divorce' (separate bedrooms). We initiated cognitive behavioural therapy (CBT) for Insomnia, which is misleadingly named, as it is nothing like regular CBT. After only a few weeks, her sleep is improving. CBT for Insomnia (CBT-I) is the recommended first line treatment for people with chronic insomnia - although sadly few services exist, which means that most sufferers are fobbed off with no help, or ineffective sleep hygiene. CBT-I has a robust evidence base, demonstrating efficacy in primary and co-morbid insomnia (references 1,2). It is a multi-component intervention, addressing cognitive and behavioural factors that perpetuate sleep disturbance. We deliver our programme in an innovative way, through a combination of treatment videos (which I created, after we were forced to close our service during covid-19) and one-to-one support (to tailor, troubleshoot and top-up video content). While the principles of CBT-I are quite simple, in reality they can be challenging, both to deliver as a healthcare professional and to implement as a patient. For example, techniques such as sleep scheduling can be very daunting. This requires an already-sleep-deprived individual to sacrifice catch-up sleep, get up at a consistent time and temporarily reduce their overall time in bed, in order to increase sleep efficiency. Not surprisingly, occupational therapy coaching skills are extensively employed, including: evaluating motivation explaining rationale instilling hope compassionately acknowledging concerns adapting guidance to overcome barriers or resistance In spite of patients’ initial scepticism, CBT-I literally changes lives within a matter of weeks. That was the case for my first patient. Only four weeks after first seeing me, she was surprised to find that she was falling asleep within 30 minutes - and getting back to sleep quickly during the night. Her average sleep duration had already increased to 6.5-7 hours a night. I explained the next steps and congratulated her on the positive spiral she was creating - where increased sleep consistency produces greater confidence, which in-turn promotes calm at bedtime and consequently promotes more sleep! My next patient was a 62-year-old man, whom I was speaking to for the first time. He explained that his sleep had been poor for years; as is the case for many of our patients, his physical and mental health was suffering. After initially describing symptoms suggestive of insomnia, he flippantly disclosed violent dreams associated with thrashing around and dream-related movement. Further questioning revealed a history consistent with REM Behaviour Disorder (RBD). Sadly, around 70% of those with RBD develop Parkinson’s Disease within 12 years (reference 3). RBD is not something that can be treated behaviourally and a formal diagnosis requires a laboratory sleep study, which we do not have available at our hospital. So I inform the gentleman on good sleep practices, recommend safety measures to avoid injury overnight, advise the GP to remain vigilant to other prodromal Parkinson’s symptoms and refer him to a London clinic, for a formal diagnosis. Other activities during the day include setting up a respiratory sleep study for a lady with insomnia - but whom I suspect has sleep apnoea too. Plus talking to a young woman with a severely delayed sleep rhythm (4am - 1pm) about light therapy. That and wading through an endless stream of admin, triaging referrals, attending a multidisciplinary (MDT) meeting and cursing the new electronic records system that isn’t cooperating... As my day draws to an end, I am left utterly convinced that when we help our patients sleep, we help them live. If this article has inspired you to think more deeply about sleep, I would encourage you to start building your knowledge of sleep, through reading or training. From there, your most powerful tool is to ask your patients about their sleep. In the words of Jane, a former patient and former insomniac: "Life feels so much brighter, better and happier when you’ve slept well!" Struggling to sleep? Listen up! This free 30-minute one-off podcast will provide insights and evidence-based techniques, to help you and your clients sleep better tonight! If you are struggling to fall asleep or stay asleep, please listen in below. Created by article author Louise Berger, the talk will cover: How you are not alone and there is hope What to do when you are having a few bad nights The difference between a few bad nights and full-blown insomnia How insomnia develops The vicious cycle of trying too hard to sleep The two systems that determine how well you sleep - sleep drive and hyper-arousal The difference between being sleepy and tired Practical ways to increase sleep drive, so you can fall (and stay) asleep more easily Ways to reduce alertness and anxiety at bedtime and overnight Why you don’t have to sleep 7-8 hours every night Why your insomnia isn’t going to take you to an early grave References Trauer, J.M., Qian, M.Y., Doyle, J.S., Rajaratnam, S.M.W. and Cunnington, D. (2015) Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Annals of Internal Medicine. 163 (3): 191-204. doi: 10.7326/M14-2841. Edinger, J.D., Arnedt, J.T., Bertisch, S.M. et al. (2021) Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. Journal of Clinical Sleep Medicine. 17 (2): 263-298. Roguski, A., Rayment, D., Whone, A.L., Jones, M.W. and Rolinski, M. (2020) A neurologist's guide to REM sleep behavior disorder. Frontiers in Neurology. Jul 8; 11:610. Berger, L. (2024) Say Goodnight to Insomnia Podcast. Royal Surrey NHS Foundation Trust: Occupational Therapy > Insomnia Clinic. Available online: https://www.royalsurrey.nhs.uk/saygoodnight. Accessed 15 February 2024.

How often have we heard: "Sign up for an activity!" "You should get out more." "Don't you think you spend a lot of time doing nothing? Go for a walk" "You need to start a new routine." or "I'm worried about you." These are expressions commonly used to attempt to 'motivate' someone to do something. However, a number of questions come to my mind: What am I signing up for? When? Where? How? With whom? And why?... What we do is part of who we are I am writing this as an occupational therapist (OT). I wonder why people know so much about the properties of aspirin, for example, but not about the make-up and importance of occupation, sleep, habits, roles and routines; certainly not about the properties of everyday life activities. Four years ago, I started a journey through a 'strange' world. I am an occupational therapist, specialising in mental health. My PhD in Psychology focused on researching the daily lives of people diagnosed with a rare disease: Variant Transthyretin Amyloidosis. I started by studying the condition, although after some time I became immersed in others, such as other Amyloidoses, Tuberous Sclerosis, Familial Spastic Paraparesis and Epidermolysis Bullosa (known as 'Butterfly Skin'). How lucky I was! Daily life Variant Transthyretin Amyloidosis is a rare genetic disease, complex to understand and with a variable prognosis. It was first described in 1952 by the Portuguese neurologist Corino Andrade as a peculiar form of peripheral neuropathy. In Europe, the incidence of Variant Transthyretin Amyloidosis varies widely. In Portugal, Sweden, Majorca and Cyprus, Variant Transthyretin Amyloidosis with Polyneuropathy is endemic and one particular mutation predominates - Val30Met. Low prevalence, little research and therefore little understanding. That is the reality. First symptoms of the disease usually appear in the third decade of life. Patients usually experience severe physical limitations due to the genetic mutation - but psychological, social and occupational effects have also been described (Luigetti et al., 2020). Existing research suggests that being diagnosed affects activities of daily living (Buades-Reinés et al., 2016). However, in addition to the clinical approach, no type of intervention has been described that focuses on the maintenance, improvement and adaptation of the daily life of patients and their carers after the diagnosis - a competence that sits within the discipline of occupational therapy. Specifically, my PhD project aims to analyse the effectiveness of an occupational intervention in patients with Variant Transthyretin Amyloidosis. The objectives were to have concrete understanding of: what the benefits of this intervention would be in which parameters of the daily life of patients these benefits would be realised what the magnitude of their impact would be I wanted to illustrate the impact of this disease on the occupational dimension and on daily life - to open up avenues for future research, to stimulate reflection on possible lines of intervention and to highlight the importance of a differentiated multidisciplinary team - complemented by professionals in the psychosocial field, such as occupational therapists. It is the journey that is important, not the destination During these four years I have worked with people in group and individual sessions, to work on daily living and understand how the body works as a whole. Studying, adapting, changing or starting new occupations have been my goals during my time specialising in rare diseases. I discovered that the occupational therapist is the key to motivation, planning and understanding the basic and not-so-basic aspects of daily life. And that it is not about people doing things; it is about having a meaningful life, without being conditioned by a diagnosis. I understood that occupation is not a luxury for a few; it is a right for all. Asociación Balear de la enfermedad de Andrade (ABEA) To make contact regarding this research: Aina Gayá Barroso ainabarroso@gmail.com Instagram: gaya_terapiaocupacional References Ando, Y., Coelho, T., Berk, J.L., Cruz, M.W., Ericzon, B-G., Ikeda, S-I., Lewis, W.D., Obici, L., Planté-Bordeneuve, V., Rapezzi, C. et al. Guideline of transthyretin-related hereditary amyloidosis for clinicians. Orphanet Journal of Rare Diseases. 2013, 8, 31-38. [Google Scholar] [CrossRef] [PubMed] Asociación Balear de la enfermedad de Andrade (ABEA). Available online: https://andradebalear.es/ Connors, L.H., Lim, A., Prokaeva, T., Roskens, V.A. and Costello, C.E. Tabulation of human transthyretin (TTR) variants. Amyloid. 2003, 10, 160-184. [Google Scholar] [CrossRef] Damy, T., Adams, D., Bridoux, F., Grateau, G., Planté-Bordeneuve, V., Ghiron, Y., Farrugia, A., Pelcot, F., Taieb, C., Labeyrie, C. et al. Amyloidosis from the patient perspective: The French daily impact of amyloidosis study. Amyloid. 2022, 29, 165-174. [Google Scholar] [CrossRef] [PubMed] Estébanez, C.T., Soriano, C.S., Escrich, A.G. and Segura, S.R. Late-onset familial amyloid polyneuropathy in the Safor (Valencia) area: Four case reports. Rev. Clín. Esp. 2007, 207, 75-76. [Google Scholar] [CrossRef] Gayà-Barroso, A., González-Moreno, J., Rodríguez, A., Ripoll-Vera, T., Losada-López, I., Gili, M. and Cisneros-Barroso, E. Accessibility to Occupational Therapy Services for Hereditary Transthyretin Amyloidosis. Int. J. Environ. Res. Public Health. 2022, 19, 4464. 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Clinical and analytical variability in cases of familial amyloidotic 331 polyneuropathy (PAF-TTR): Comparison between healthy carriers and symptomatic 332 patients. Med. Balear. 2015, 30, 31-36. [Google Scholar] Matyjasik-Liggett, M. and Wittman, P. The Utilization of Occupational Therapy Services for Persons with Charcot-Marie-Tooth Disease. Occup. Ther. Health Care. 2013, 27, 228-237. [Google Scholar] [CrossRef] Munar-Qués, M., Saraiva, M.J., Viader-Farré, C., Zabay-Becerril, J.M. and Mulet-Ferrer, J. Genetic epidemiology of familial amyloid polyneuropathy in the Balearic Islands (Spain). Amyloid. 2005, 12, 54-56. [Google Scholar] [CrossRef] [PubMed] Raya-Cruz, M., Buades-Reines, J. and Gállego-Lezaun, C. Variabilidad clínica y analítica en casos de polineuropatía amiloidótica familiar (PAF-TTR): Comparación entre portadores sanos y pacientes sintomáticos. Med. Balear. 2015, 30-33, 31-36. [Google Scholar] [CrossRef] Reinés, J.B., Vera, T.R., Martín, M.U., Serra, H.A., Campins, M.M.C., Millán, J.M.D., Lezaun, C.G. and Cruz, M.R. Epidemiology of transthyretin-associated familial amyloid polyneuropathy in the Majorcan area: Son Llàtzer Hospital descriptive study. Orphanet Journal of Rare Diseases. 2014, 9, 29. [Google Scholar] [CrossRef] Said, G. Diagnostic pitfalls in sporadic transthyretin familial amyloid 346 polyneuropathy (TTR- FAP). Neurology. 2007, 69, 693-698. [Google Scholar] [CrossRef] Sakellariou, D. and Pollard, N. Occupational Therapies without Borders: Integrating Justice with Practice. 2nd ed., Elsevier: Amsterdam, The Netherlands, 2017, pp. 102-108. [Google Scholar] Van Deusen, J. and Harlowe, D. The efficacy of the ROM Dance Program for adults with rheumatoid arthritis. Am. J. Occup. Ther. 1987, 41, 90-95. [Google Scholar] [CrossRef] [PubMed] Voortman, M., Fritz, D., Vogels, O.J.M., Eftimov, F., van de Beek, D., Brouwer, M.C. and Drent, M. 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As Occupational Therapists, we are always trying to identify activities that a client might connect with. Gardening is an accessible, adaptable pastime, that many clients have experienced and which an intervention can be built around. However, barriers exist with many mental health conditions, such as volition and fatigue, that need to be overcome in order to engage. Take this short course to explore these themes further. Questions and self-reflection will follow content, to help test your knowledge and provide evidence of learning.

Introduction As Occupational Therapists, we are always trying to identify activities that a patient or client might connect with. Gardening is an accessible, adaptable pastime, that many clients have experienced and which an intervention can be built around. However, for many mental health conditions, there are barriers such as volition and fatigue, that need to be overcome in order to engage. These can be minimised by using techniques to encourage engagement, predominantly appropriate for Occupational Therapists, but also Social and Therapeutic Horticulturists. A brief overview of depression Depression (also known as major depression, major depressive disorder, or clinical depression) is a debilitating mood disorder and mental health condition. It can affect people of all ages, races, ethnicities and genders, often presenting itself with low mood and cognitive distortion (Gonzalez et al, 2009). Characteristics often impact the ability to engage with others and in daily life activities, such as sleeping, eating, or working. Although men, women and people of all genders can feel depressed, how they express symptoms - and the behaviours used to cope with them - may differ. An individual with depression is likely to experience some (but not all) of the following signs and symptoms, most of the day, nearly every day: Persistent sad, anxious, or 'empty' mood Feelings of guilt, worthlessness or helplessness Feelings of irritability, frustration or restlessness Decreased energy, fatigue or feeling slowed down Difficulty concentrating, remembering, or making decisions Difficulty sleeping, waking early in the morning, or oversleeping Becoming withdrawn and detached; isolating from family and friends Loss of interest or pleasure in hobbies and activities Problems with sexual desire and performance Changes in appetite or unplanned weight changes Physical aches or pains, headaches, cramps, or digestive problems (no clear physical cause) Thoughts of death or suicide, or suicide attempts [National Institute of Mental Health, 2023] Depression interferes with day-to-day functioning and causes significant distress for the person experiencing it. Statistically, 4-10% of people in England (for example) will have depression at some time (NICE, 2011), with 7.8% being diagnosed alongside anxiety (HSCIC, 2009). The World Health Organisation (WHO, 2008) predicted that depressive conditions would be the second major cause of disability in the world by 2020. As symptom severity is highly variable, any effective intervention should be appropriate to the degree of depression. Evidence that gardening is beneficial for depression Soga, Gaston and Yamaura (2016) carried out a statistical quantitative research review of the health benefits of gardening and concluded it can provide a reduction in depression. This supports many of the qualitative experiences of the benefits of gardening with depression. "Gardening is a constant boost to my consciously nurtured optimism, as I am surrounded by the natural world, which pursues life with eager enthusiasm." (Mind, 2017) Gonzalez et al (2009) evaluated the impact of therapeutic horticulture on clinical depression, by measuring changes in the severity of the depression and the participants' perceived capacity for attention. They found a correlation between the extent to which attention was captured and the reduction in depression. They deduce that this was a result of the disruption to the participant’s rumination and the effortless attention involved in engaging in gardening. Berg and Custers (2011) demonstrated that gardening increased positive mood, reducing cortisol levels and enabled participants to handle acute stress better (Kings Fund, 2016). Rostami et al (2014) noted that visitors of gardens felt that the experience reduced their depression by 94%. Providing access to a garden environment - even visiting public areas - can have positive effects on well-being, evoking a sense of identity, meaning and reducing stress. The MIND charity and University of Essex (UK) have developed an eco-therapy project - including gardening and food growing - to support mental health conditions, including depression. They found 69% of people experienced significant increases in wellbeing by the time they left the Ecominds project. Their survey of GPs stated that the eco-therapy was a valid and suitable treatment for anxiety (52%) and depression (51%) (University of Essex, 2013). Thrive (2017) suggest that gardening is an activity that enables a person to often connect with their past, while developing personally through their growing horticultural knowledge. It provides essential physical exercise, social connectedness and environmental connectedness (Sempik et al, 2005).

Membership Poll 2024 Shaped by Members, The Occupational Therapy Hub is your global community of practice. So, to focus efforts in developing resources and content most useful to you , please submit opinions and feedback. We will upgrade a random participant's account for free, regardless of answers. The poll will close on Sunday 30th June 2024. Thank you in advance for your time! The Occupational Therapy Hub Team Contact the Hub The Occupational Therapy Hub Online platform and mobile app (iOS/Android) This poll takes a few minutes to complete. Questions with an asterisk (*) require a response. As a reference, to help you select answers, please click here to open a duplicate Hub webpage. Which of the following best describes you? Please choose an option How did you hear about/first come across the Hub? Please choose an option How long have you been using the Hub for? Never/Just started About a month 2-12 months Over a year Over 5 years How often do you access the Hub (platform/app)? Every day Most days Weekly Monthly Rarely Which subject material(s) are you most interested in? Acute and primary care Community or inpatient rehabilitation Equipment and manual handling Geriatrics / Older people Hand therapy Housing and adaptations Leadership and development Learning disability and neurodiversity Mental health and wellbeing Neurology Paediatrics / Young people Public health Research / Academia Theories / Models of practice Trauma and orthopaedics Vocational rehabilitation Other subject(s) [type into a text box below] Which free resource(s) do you most use? Therapy Articles Therapy Videos Podcast Portal Resources + Services Portal Therapy Forum / Student Spaces / The OT Journal Club What is Occupational Therapy? A Career in Occupational Therapy Access Occupational Therapists Member Directory OT Events OT Books: Buy & Sell Hub Store (free-to-access; individual purchases) Which word(s) do you feel best describe The OT Hub app? Convenient Easy-to-use Useful learning tool Helpful community support Difficult to use Too slow Lacking certain content Other [type into a text box below] N/A - I have not yet used the app [Plus+ Members]: Which Plus+ resource(s) do you most use? OT CPD Courses Research Portal 3.0 OT Updates OT Downloads OT Webinars OT Interventions Case Studies [Non-upgraded Members]: What might draw you to Plus+? A lower monthly/annual price Additional plan or payment options A greater volume of exclusive resources Something else [type into a text box below] [Plus+ Members]: How do you feel about the upgrade cost? Too cheap (could be higher) Good value for money Not good value for money Too expensive Please rate your overall satisfaction with the Hub's resources, support and experience Very dissatisfied A bit dissatisfied Pretty satisfied Satisfied Very satisfied How could we improve your experience? / What would you like to see more (or less) of? Any feedback not covered above? (e.g. navigation, technical aspects, design/visuals) Final thoughts? First name Your email address * Last name (optional) Submit Thank you very much for taking part! We always seek to improve and will review every submission. You can expect changes in the months ahead. The Membership Poll 2024 is now closed for submissions. Thank you for your interest. To share further feedback or suggestions, please contact us . Interested in being a more active part of the global occupational therapy community? Get involved!

The Occupational Therapy Hub - We believe in the power of occupation for health and wellbeing The Occupational Therapy Hub - We believe in the power of occupation for health and wellbeing The Occupational Therapy Hub - We believe in the power of occupation for health and wellbeing The Occupational Therapy Hub - We believe in the power of occupation for health and wellbeing 1/15 We believe in the power of occupation for health & well-being Your global occupational therapy community The platform and app run by Occupational Therapists. Shaped by 20,000+ Members , in 195 countries. News + Latest Free Membership Membership Plus+ Passionately empowering clinicians, students and those they support The Mission To show the world the value of our health and social care profession . ​ To share knowledge and resources, across an international community. To provide a community of practice, reducing geographical and professional isolation. On upgrading to Membership Plus+ : "I'm really looking forward to getting stuck in to the resources, as they look fantastic. Thank you for your hard work on The Occupational Therapy Hub." ​ ​ Carina (email, 2024) Testimonials Community dashboard Gill Court Jan 19, 2022 OT practitioners working in Domestic Abuse - making connections? ek.dawson Apr 15, 2022 OT and early intervention in psychosis (EIP) - UK help please!? Jens190301 Apr 02 Average day as a MH OT Jens190301 Mar 26 Counselling ba degree to OT MSc 2 year course. Verity Jones Mar 21 Research with Paediatric Occupational Therapists Maria Lönn Feb 28, 2023 Childrens experiences of weighted blankets as a sleep intervention – what can we learn from children with ADHD? Shanta Chellappoo Mar 09 SELLING Clinical Reasoning in the Health Professions Hannah Young Oct 06, 2020 OT Pen Pals Julia Peckham Feb 27 For sale: various OT books (2nd hand) Latest OT CPD Courses (Plus+) Sleep: An Occupational Therapy Domain 2 Plans Available Join ADHD and Occupational Therapy 2 Plans Available Join Therapy Article Highlights Reflective Journals Reflections on the Rebirth of an Artist A Day in the Life 'Drawing back the covers' on the OT role in sleep: An article and podcast Reflective Journals People doing things: Reflections of an OT in the field of rare diseases Hub News Hub News Plus+ Updates: Working With Your Hands Is Good for Your Brain 'Activities like writing, gardening and knitting can improve your cognition and mood. Tapping, typing and scrolling? Less so... Studies haven’t determined that hand involvement, specifically, deserves the credit. Researchers who looked at colouring, for example, speculated that it might promote mindfulness, which could be beneficial for mental health. Those who have studied knitting said something similar...' 29/03/2024 OT Updates (Plus+) Free How-to video: Resting Hand Orthosis Are you an occupational therapist looking to fabricate a thermoplastic resting hand splint for a patient or client? This is indicated when there is a need to maintain or increase range of movement in the distal upper limb. Watch this (and other) 'handy' step-by-step videos right here - or on-the-go, via The OT Hub app . [Video credit: Orfit - a useful resource; no affiliation to the Hub]. 26/03/2024 Therapy Videos Plus+ New to OT CPD Courses - 'Sleep: An Occupational Therapy Domain' An insightful, new short course, with sections exploring the benefits of (and ways to promote) good sleep, to support physical and mental health and well-being. It covers core assessments and latest research guidance. Quiz and self-reflective questions test your knowledge and provide evidence of learning. Then receive a CPD certificate. Full access included within Membership Plus+ . Log in or upgrade, to start this course today! 23/03/2024 OT CPD Courses (Plus+) Free 'Connecting People, Connecting Support: Occupation Matters' "Resources and activities have been tried, tested and recommended by people with dementia. The website was created by occupational therapists and design researchers, who are passionate about the role of occupation and meaningful activity, in enabling individuals to live well." Explore this excellent, external online tool, via the Dementia section of our Resources + Services Portal! 14/03/2024 Resources + Services Store / Plus+ New infographic document: 'Un derstanding Sleep' An infographic series by our very own Indonesian occupational therapist Tia Aja. Commonly de-prioritised, the impacts of good and bad sleep on our waking hours are significant. The downloadable PDF covers themes from circadian rhythm and sleep cycles, to quality vs quantity, difficulties encountered and strategies for positive practice. It builds understanding for both clinicians and those they support." Anyone can purchase this now via the Hub Store ; Plus+ Members have unlimited access at no extra cost, via OT Downloads . 12/03/2024 Hub Store Plus+ Primary research: Educational Mobility, Pace of Aging and Lifespan... (2024) People who complete more education live longer lives with better health. New evidence suggests these benefits operate through a slowed pace of biological aging. Findings from the Framingham Heart Study support the hypothesis. Upgraded to Plus+ ? Read this Primary Research paper now, within the Development and Ageing theme. 06/03/2024 Research Portal (Plus+)

Membership Terms of Use Privacy and Cookies Our Policies Platform updated: 17th April 2024 Communication Hub Store PromOTe Partnerships Copyright Important notice from The Occupational Therapy Hub ​ Information and recommendations provided on The Occupational Therapy Hub's website (the 'platform ') and The OT Hub App (the 'app ', available on Android and iOS devices) have been shared by our global community. Whilst we review all pages, we cannot guarantee quality or accuracy of all information. Therefore, 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 or app. Hub Membership Terms of Use Hub Membership Terms (Our Policies) The Occupational Therapy Hub is a global community, shaped by its Membership. To access the Hub, anyone can join as a Free Hub Member . Membership Plus+ is an optional upgrade. In joining, you must adhere to the Terms of Use ('Terms') below, as well as agree to our Privacy, Cookies and Communication Policies . ​ ​ Your Account and responsibilities As an online membership platform and app, we actively encourage participation in ​the sharing of information and content , for the benefit of the global community. At the same time, we ask that you acknowledge the following: ​ Please remember that you control what personal information you provide while using the platform and/or app You are fully responsible for all activities that occur under your Account and other actions you take on the platform and/or app You must not create content that is inappropriate, misleading or unlawful; Hub Management may change or remove any such content You are responsible for maintaining the security of your Account information and its content ; you must notify Hub Management of any unauthorised uses of your Account or any other breaches of security We are not responsible for (and cannot control) the use by other Hub Members of information which you provide to them. You should exercise caution in selecting the information you share. Similarly, we cannot assume responsibility for the content of information which you receive from Members through the platform and/or app. You release us from any and all liability in connection with the contents of any information which you may receive using the platform and/or app. ​ ​ Creating content By creating content, you represent and warrant that:- ​ The Occupational Therapy Hub has the right to use (host, index and format) and display your content on the platform and/or app Hub Management reserves the right to refuse or remove any content or terminate or deny access to use of the platform and/or app Your Account is not named in a manner that misleads readers into thinking that you are anyone other than yourself If your employer has rights to intellectual property you create, you have permission from your employer to make this available The content does not contain or install any viruses or other harmful or destructive content Downloading, copying and use of the content will not infringe the copyright, patent, trademark or trade secret rights of a third party The content is not obscene, libellous or defamatory, hateful or racially or ethnically objectionable; it does not violate the privacy or publicity rights of any third party ​ ​ Membership Plus+ ​ Standard Hub Membership accounts provide access to a breadth of free resources Upgrading to Membership Plus+ provides unlimited access to a wider range of resources, with priority response from the Hub Team ​ On purchase of a Plus+ plan, future recurring payments will be taken annually or monthly (as selected), from your chosen account. Please ensure your payment details remain up-to-date, for continued auto-renewal and access to your Membership Plus+ services. ​ At any point, The Occupational Therapy Hub may choose to transition Free Membership resources to Membership Plus+ resources (or vice versa). In its sole discretion, Management may also add, remove or change the services and resources offered, or the fees charged, at any time. Management will notify Hub Members of such changes , prior to any new or altered fees taking effect . ​ ​ Changes to Terms ​ The Occupational Therapy Hub reserves the right, at its sole discretion, to modify or replace any part of the Terms. Whilst we notify Members of key changes related to platform and app Policies/Terms, it is your responsibility to check the Terms periodically for changes. Your continued use of the platform and/or app, following the posting of any changes to the Terms, constitutes acceptance of those changes. The Occupational Therapy Hub may, in future, offer new services and/or features through the platform and/or app (including the release of new tools and resources). Such new features and/or services shall be subject to the Terms. ​ ​ Account termination ​ In the event that a Member breaches The Occupational Therapy Hub's Terms of Use, Hub Management may terminate access to all or any part of the platform and/or app at any time, with or without notice, effective immediately. Privacy, Cookies, Communication (Our Policies) Privacy, Cookies, Communication The Occupational Therapy Hub takes the privacy of its Members and visitors' information very seriously. We adhere to the EU General Data Protection Regulation (GDPR) (2016/679) and the UK Data Protection Act (2018). Hub Management continually reviews its policies. ​ KEY POINTS ​ Personal information We only collect, process and securely store personally identifiable information that you actively submit Such information is used solely for us to provide you with our services, or respond to a communication Once signed up as a Member, you can edit your 'My Profile' page; if you opt in, this can be publicly visible As part of Membership, we send Member Newsletters, to the email address provided No personally identifiable information is passed on to external organisations You have the right to access and edit your information on the Hub, at any time; on email request and subject to proof of identity, you may access personal information that we hold, used or communicated and ask that any necessary corrections be made ​ Demographic data Cookies allow Hub Management to understand anonymous visitor demographics and trends. In turn, this shapes and improves the service we provide you with. Cookies also allow any adverts shown to be more relevant A Facebook pixel within The Occupational Therapy Hub's platform is used to gauge the efficacy of any social media adverts we run ​ Protecting your information Information processed within The Occupational Therapy Hub is encrypted via secure HTTPS networks Data is backed up securely in a cloud-based drive managed by our platform host By using the platform or app and/or joining as a Hub Member, you consent to our Policies (signposted on the Sign up screen). HUB MEMBERSHIPS ( Fre e and Plus+ ) ​ Signing up as a Hub Member ​ ​ When you register as a Hub Member, you will be asked to provide a name, email address and a private password, which will become part of your Account information ​ The Hub securely stores Membership details provided (further details below) Any information requested will be used to activate your account, provide the platform/app's services to you and communicate with you about the status of your A ccount Part of Membership, you receive periodic Member Newsletters * by email; these include CPD recommendations and service changes Settings and notifications can be adjusted at any time; click 'Settings' in the Member Bar , which sits at the top of every page The 'Sign up' screen includes a link to this Policies page, to review all policies prior to joining as a Member ​ Your Profile Page Each Hub Member is given their own My Profile page; this can be accessed through the Member Ba r, or via the Member Directory * A public 'My Profile' page is optional; click 'Make Profile Public' via the '⋮' icon on your profile card ( in Member Directory) It includes the name used to sign up, alongside an optional profile picture and profile text - for the Member to promote their work in, or linked to, the occupational therapy profession Other than storing it for you, we do not do anything with information here; it is there for networking purposes only However, if information is posted that is deemed by Hub Management to be inappropriate or offensive, the Member will be notified and the information will be removed * Member Directory requires logging in to access. Membership sign up here . ​ ​ ​ ​ Personal information: what is collected, processed and stored? The only personally identifiable information we collect, process and/or store is that which you actively submit. This may be your name, email address or other contact details that you provide us with. We do not transfer this information to other organisations, unless: ​ You provide us with explicit written authorisation, by email or post It is necessary to comply with the law, or to protect the rights, property or safety of our Management, Team or Members ​ We collect information when you: ​ Sign up as a Hub Member (see below) ​Register for OT Webinars * or an OT Event Register and/or participate in OT CPD Courses * Submit research for inclusion in the Research Portal * Apply for a platform/app competition or promotion Submit a podcast episode or series to the Podcast Portal * Engage in communication, via an email or our Connect with the Hub form Engage in Hub CPD , the collaborative professional development programme Purchase a product , such as a PromOTe Partnership or item within the Hub Store Submit an entry to Access Occupational Therapists or the Resources + Services Portal Upload a file to The Occupational Therapy Hub's cloud storage, such as when contributing to Therapy Videos * Upload content to Therapy Articles * ; this is a moderated p ortal , with Member-generated content Upload a post to the Therapy Forum * , Student Spaces * or The OT Journal Club * - Member-generated content ( moderated ) ​ * Portals marked with asterisks require Member log in to use in full. Membership sign up here . ​ ​ ​ Demographics: what non-identifiable information tools do we use - and why? Cookies : When surfing The Occupational Therapy Hub, cookies (non-identifiable data) may be placed locally on your computer. These can be used by Google Analytics , to allow Hub Management to establish general visitor demographics and trends. This allows us to better shape and refine our service. Such information may also be provided to Google Adsense, so that advertisements on the platform are relevant to you. Cookies do not disclose personally identifiable information about any visitors or Members Facebook pixel : This is embedded within the platform and collects anonymised visitor data. This is used solely to allow Hub Management to gauge the efficacy of any advertisements run on social media How do we protect your information? We implement a variety of safety measures to maintain the security of your personal information: The personal information you provide within this platform is secured within HTTPS networks . HTTPS is the protocol over which data is sent between your browser and The Occupational Therapy Hub site. The ‘S’ at the end of HTTPS stands for ‘Secure’. These communications are encrypted. Data is backed up securely in a cloud-based drive . Member information is not stored in physical form. Statements from our website host: 'If you are a visitor, user or customer of any of our Users [The Occupational Therapy Hub], please read the following: [website host] has no direct relationship with the individual Users-of-Users whose Personal Information it processes. If you are a visitor, user or customer of [The Occupational Therapy Hub] and would like to make any requests or queries regarding your Personal Information, please contact [Hub Management] directly. For example, if you wish to access, correct, amend, or delete inaccurate information processed by [website host] on behalf of [The Occupational Therapy Hub], please direct your query to [Hub Management] (who is the “Controller” of such data). If requested to remove any Users-of-Users’ Personal Information, we will respond to such request within thirty days.' 'The transmission of sensitive payment information (such as a credit card number) through our designated purchase forms is protected by an industry standard SSL/TLS encrypted connection; and we regularly maintain a PCI DSS (Payment Card Industry Data Security Standards) certification.' Other than a Member’s 'My Profile' page - optionally viewable by the public - personal information can only be accessed by Hub Management; all management staff keep this strictly confidential ​ ​ Rights to my information You have the right to access and edit your information, at any time, through the web interface provided as part of the platform and app. On written request (by email) and subject to proof of identity, you may access the personal information that we hold, used or communicated and ask that any necessary corrections be made, where applicable, as authorised or required by law. However, to make sure that the personal information we maintain about you is accurate and up-to-date, please inform us of any change in your personal information by email. ​ ​ How can I edit or turn on/off communications? Email alerts : Click 'Settings' in the Member Bar , which sits top- right of every web page [ The Member Bar also allows you to review account details, Plus+ Membership and to log in/out of the Hub] Therapy Forum alerts : To adjust email or platform alerts for a specific forum, click the 'Follow'/'Following' button Member Newsletters : We send educative and CPD-related content periodically. These communications also keep Members updated about key service changes. If you no longer want to receive these, click the ‘unsubscribe’ link at the bottom of any newsletter ​ Third party links To provide a breadth of website content, we list third party links to useful, external resources and websites. These are mainly found in: Access Occupational Therapists , Therapy Articles * Therapy Forum * , OT CPD Courses * , OT Updates * , Podcast Portal * , Therapy Videos * and Resources + Services Portal . These external links (websites, videos, PDF documents, podcast platforms) have separat e and independent privacy policies. We therefore have no responsibility or liability for the content and activities of these links. Nonetheless, we seek to protect the integrity of our platform and app and welcome any feedback about these linked sites, including if a specific link does not work. * Portals marked with asterisks require Member log in to use in full. Membership sign up here . ​ Changes to our policies If our policies change, amendments will be posted here. Policy changes apply only to information collected after the date of the change. ​ Your consent By using The Occupational Therapy Hub platform/app and/or joining as a Hub Member, you consent to our Policies. Links to this Policies page are located within sign up sections. Questions or feedback? ​ If you have any questions or comments - about our policies or your personal information, to make an access or correction request, to exercise any applicable rights, or to make a complaint - our Data Protection Officer can be reached by email: hubteam@theOThub.com . Alternative methods of communication are listed on the Contact us page. ​ ​ ​ Registration with the UK Information Commissioner’s Office (ICO ) ​ ​ Nature of work Occupational therapy information service and networking website and application. ​ Description of processing The following is a broad description of the way The Occupational Therapy Hub processes personal information. To understand how your own personal information is processed you may need to refer to any personal communications you have received, check any privacy notices the organisation has provided or contact the organisation to ask about your personal circumstances. Reasons/purposes for processing information We process personal information to enable us to provide a current, sustainable information service and networking service for our Hub Members and site visitors; to maintain our own accounts and records; to support and manage our staff team. Type of information processed We process information relevant to the above reasons and purposes. This can include: ​ Hub Membership details, within the Member Directory * Therapy Articles * and Therapy Videos content Financial details, for Plus+ Members , PromOTe Partnerships and Hub Store customers External resources in Access Occupational Therapists , Therapy Articles * Therapy Forum * , OT CPD Courses * , OT Updates * , Podcast Portal * , Therapy Videos * and Resources + Services Portal . * Portals marked with asterisks require logging in to use in full. Membership sign up here . Who the information is processed about To operate our service to you, we need to process information about: ​ Hub Members (Free and Plus+) Members who participate in courses Customers who purchase a product Visitors who inquire about or submit files to the platform or app External podcasts External resources and services External research External occupational therapy practices External occupational therapists Who the information may be shared with In very rare circumstances, in the interest of the public, the company or its Members' safety or security, other governing organisations may need to be contacted. Where this is necessary we are required to comply with all aspects of the EU's General Data Protection Regulation (GDPR) ( 2016/679 ) and the UK's Data Protection Act (2018). In this instance, only when required of us, we would share information with: employer associations examining bodies central government suppliers and service providers persons making an inquiry or complaint Hub Store Terms of Use Hub Store (Our Policies) For attention of anyone using the Hub Store Please read these Terms of Use ('Terms') before purchasing items in the Store. ​ ​ Charges The Occupational Therapy Hub cannot issue refunds for digital products that are downloaded, as these cannot be returned If you make a purchase, you agree that our third party payment gateways will securely store your payment information If the payment method you provide has expired and/or valid payment information is not provided, the transaction will not occur At any point, The Occupational Therapy Hub may choose to transition products from paid to free access (or vice versa). In its sole discretion, Management may also add, remove, update or modify a product, or the fees charged , at any time. Management will notify Hub Members of such changes , prior to implementation of any new or altered costs. ​ ​ ​ Limitation of liability You agree that, under no legal theory, will The Occupational Therapy Hub or its management or team be liable to you or any third party acting on your behalf for any indirect, incidental, consequential, punitive, or exemplary damages or losses, arising from or relating to the use of (or inability to correctly use) a product it provides. ​ ​ ​ General representation and warranty ​ Your use of the platform and/or app will be in strict accordance with these Terms, the Privacy, Cookies and Communication Policies , the Hub Membership Terms of Use and all applicable laws and regulations. These include, without limitation, any local laws or regulations in your country, regarding online conduct and acceptable content. These include all applicable laws regarding the transmission of technical data exported from the United Kingdom, or the country in which you reside Your use of the platform and/or app will not infringe or misappropriate the intellectual property rights of any third party ​ ​ ​ Miscellaneous If there is any dispute between you and The Occupational Therapy Hub, about or involving the Terms or a product, you hereby agree that the dispute will be governed by and construed in accordance with the laws of the United Kingdom, without regard to its conflict of law provisions. PromOTe Partnerships (Our Policies) PromOTe Partnerships Terms of Service For attention of commercial partners and clients. ​ Please read these Terms of Service ('Terms') carefully before purchasing a PromOTe Partnerships plan. If you don’t agree to these Terms, as well as The Occupational Therapy Hub’s Privacy, Cookies and Communication Policies , you should not use our services. If you are entering into the Terms on behalf of a company or other legal entity, you represent that you have the authority to bind such entity to the Terms. ​ ​ ​ Fees and renewals The Occupational Therapy Hub cannot issue refunds for partial months of PromOTe Partnerships marketing If you purchase one of our services, you agree that our third party payment gateways will securely store your payment card or other payment information ​ You expressly agree that we are authorised to charge you: ​ A fee for any applicable service which you have purchased, billed on a basis of the outlined and agreed plan period Any charges for use of our service in excess of the usage or other limits placed on your use of our service (and you hereby consent to such charges) If the payment card you provide expires and you do not provide new payment information or cancel your Account, you authorise us to continue billing you and you agree to remain responsible for any uncollected fees. ​ ​ ​ Limitation of liability You agree that, under no legal theory, will The Occupational Therapy Hub or its owners, directors or team be liable to you or any third party acting on your behalf for any indirect, incidental, consequential, punitive, or exemplary damages or loss of profits (even if The Occupational Therapy Hub has been advised of the possibility of such damages), arising from or relating to the Terms or your use of or your inability to use the platform and/or app. ​ You agree that The Occupational Therapy Hub will not be responsible or liable for any loss or damage of any kind incurred as the result of any interactions or dealings with partners or advertisers, or as the result of the presence of such advertisers on the platform. ​ ​ ​ General representation and warranty You represent and warrant that: ​ Your use of the platform and/or app will be in strict accordance with these Terms, the Privacy, Cookies and Communication Policies , the Hub Membership Terms of Use and all applicable laws and regulations. These include, without limitation, any local laws or regulations in your country, regarding online conduct and acceptable content. These include all applicable laws regarding the transmission of technical data exported from the United Kingdom or the country in which you reside Your use of the platform and/or app will not infringe or misappropriate the intellectual property rights of any third party ​ ​ ​ Miscellaneous If there is any dispute between you and The Occupational Therapy Hub about or involving the Terms or the service, you hereby agree that the dispute will be governed by and construed in accordance with the laws of the United Kingdom, without regard to its conflict of law provisions. Copyright (Our Policies) Copyright The OT Hub Ltd is the legal copyright holder of the Portals, functions, designs, logos and names ('The Occupational Therapy Hub' and 'The OT Hub'), belonging to The Occupational Therapy Hub platform and app. Our content may not be reprinted, reproduced or modified without written consent. A link to The Occupational Therapy Hub's website (www.theOThub.com ) must appear in all authorised copies of any content owned by The OT Hub Ltd. Content uploaded by Hub Members, via their accounts, is copyright of its respective owners. ​ OT CPD Courses * Courses and contents are owned by their respective hosts. E xternal resources cited are owned by their respective external organisations. ​ Therapy Forum * , Student Spaces * and The OT Journal Club * Documents, uplo ads and external links are owned by their creators/authors, not by The OT Hub Ltd. Therapy Videos * Video footage showcased within the 'Community Videos' channel is owned by external organisations, not by The OT Hub Ltd. ​ Podcast Portal * Logos, audio content and embedded links to series and platforms are owned by their creators/authors, not by The OT Hub Ltd. ​ Research Portal * Content uploaded is owned and copyrighted by the research author(s), not The OT Hub Ltd. ​ Hub Store Assessments, documents, presentations and clinical and reflective tools are owned by The OT Hub Ltd, or their creators/authors . ​ Access Occupational Therapists / Resources + Services Portal Logos, information and links to external resources and services listed here are owned by external organisations, not by The OT Hub Ltd. * Portals marked with asterisks require logging in to use in full. 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.