Explaining occupational therapy

Over the past week I have been teaching brand new occupational therapy students as they start their BSc degree programme at the University of East Anglia. I have been asking them to reflect on their journey to this point in their lives and encouraging them to be confident when they are asked the inevitable question, “What is occupational therapy?”

Here are some of their thoughts, shared with permission. They give me huge hope for the future of the profession.

Lewis thought that the definition would be easy, until he heard what other students had to say;

“It came as a surprise to me that the hardest part of the week wasn’t entering a new place or meeting new people but the critical question, ‘What is occupational therapy’? At first, I felt confident in my definition of occupational therapy but quickly realised that individuals have their own definitions which have meaning to them. While occupational therapists have shared professional values and goals, it only seems appropriate that a profession that enables people to live life in a way that is meaningful to them has a definition that is meaningful to each and every individual who encounters the profession in some way. For me I see occupational therapy as giving individuals the tools they need to live life in a way that is meaningful to them.”

I shared a picture of World War One veterans making baskets alongside a picture of veterans from the war in Afghanistan off-road racing to illustrate how, from proud roots, the profession has evolved.

Francine responded to this slide;

“This reflection starts with a reaction to an image in your class. I had quite a visceral response to the image of ex-soldier’s off-roading, my excitement was tangible. At this point I wasn’t aware of why but as the day unfolded and I spent more time in reflection it became more and more apparent… On Facebook I watch an American series called Returning the Favour, with Mike Rowe. This is a series that helps deserving people in all sorts of ways. Today’s episode coincidentally featured an ex-soldier who had lost all four limbs in an accident and had found purpose in Colorado mountain biking. The bike struck me as, and here’s the connection, similar to the sit-ski another friend used that I used to ‘buddy’. I was so struck with the realisation of how tightly linked recovery can be to finding and participating in meaningful activity.”

Rebekah reflected on why she chose the profession and looked forward;

“Occupational therapy was the natural choice for me because it really encompasses all that I am. My enjoyment for a practical and creative approach, my heart of empathy and my desire to develop everyone into the wonderful person they were created to be are all qualities found in, and relevant to, an occupational therapist.

And so it is with a smile that I set out on this journey of learning and growing so that I can help others to learn and grow, too.”

This week we will explore human occupations, leading on to an introduction to occupational science, when the power of occupational therapy to change the world will be revealed!


The start of a huge adventure

Forty years ago a letter arrived offering me a place on an occupational therapy diploma course at St Andrews School of Occupational Therapy, Northampton. It was an unconditional place so it didn’t matter that my A-level grades would turn out to be rubbish. I wrote a proper, handwritten letter to accept the place. No emails back then!

I was nearly 19 and I had no idea what I was letting myself in for. I was creative and wanted ‘to help people’, so my form tutor suggested a career in occupational therapy. I’d never heard of it. My parents wanted me to study something that led to a ‘proper job’ so in September 1977 off I went to Northampton. My Snoopy mug was to accompany me in what became a very well-travelled, cardboard box of possessions. My father, ever the pessimist, predicted that the mug would be broken by the end of the year. It was his way of expressing his anxiety about me leaving home. Today the mug is a little battered, but still in one piece. Sadly Dad passed away in 1985; I hope he would be proud that both me and the mug survived. The Snoopy motto is still a good one.

It really was a different age. We wore uniforms in school for the first year with fetching, pale blue capes. We actually loved our capes and went everywhere in them. We learnt lots of craft activities, including basket weaving with Mrs Mason, woodwork, weaving, sewing, and macramé. We had end of year exams in anatomy, physiology and psychology, but there was no research or critical appraisal. There was no theory of occupational therapy or occupational science. My placements took me into huge general hospitals like The London at Whitechapel which I loved and hated in equal measure. I also spent a lot of time in large Victorian asylums.

The waste paper bin that I made has travelled everywhere with me and is currently in my office in the Queen’s Building at the University of East Anglia. It was, and remains, wonky.

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During my career I have seen the asylums close and become transformed into luxury housing. Or in the case of St Lawrence’s Hospital in Bodmin it has been completely demolished. I have seen constant change and reorganisation in health services and I remain constantly inspired by the resilience of NHS staff and the service users they work with.

Along the way I acquired a psychology degree and a Masters in Health Sciences. I spent 20 years in the NHS and, to date, I’ve been working in higher education for 17 years. I have worked in Florida, Cambridge, Cornwall and now in Norwich. I have been privileged to work with some incredible people and I’ve never stopped being challenged and learning new things. As each year goes by and life on this fragile planet becomes more challenging, my understanding of the potential of occupational therapy to make a difference to people’s lives grows. It has been a huge privilege and every day I learn something new.

The Elizabeth Casson rose celebrates the life of a pioneer of our profession. As I look forward to retiring from full time work I’m planning to reconnect with creative occupations, like gardening. I’ll probably be able to resist the urge to weave another wonky basket though!

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Why I care about research

This week by the #whywedoresearch campaign on Twitter is celebrating its second birthday. From humble beginnings it has grown into a global phenomenon linking health researchers who are passionate about making a difference. Where I work in the School of Health Sciences at the University of East Anglia we have formed an ambassador hub to share the campaign even further and to tell the world about our own ground-breaking discoveries.

The blog below shares my individual thoughts which have been published along with my colleagues here: http://whywedoresearch.weebly.com/guest-blog-new

“I am a qualitative researcher, mainly because I’m nosey and like to find out what people really think and feel. In health research the lived experience of service users is vital knowledge in making people’s lives better. As an occupational therapist my passion is to help people to get the most out of life and to have every opportunity to participate fully.

“I teach qualitative research to students who are studying on our pre-registration programmes in occupational therapy, physiotherapy and speech and language therapy at both undergraduate and Masters level. I enjoy facilitating their curiosity about what helps people and what doesn’t. I like to push them to be really critical about what they read in research papers. I also supervise student dissertations in my main areas of interest, mental health, combat injury and occupational science. I often remind students that although we might observe that certain interventions have benefit, what we don’t know is whether people would have improved anyway over time, or whether something else would have worked more effectively. We can’t spend vital public funding on interventions just because we think they help.

In 2015 I received a UEA Community Engagement Award for my voluntary work with military charities providing free consultancy on digital media and occupational therapy. I currently work with The Baton; supporting the military family – http://www.thebaton.co.uk and Surf Action; providing evidence-based interventions for people who have served in the Armed Forces and their families – http://www.surfaction.co.uk. We need much more research to help us to understand what really works to support people who have served in the Armed Forces, particularly people living with Post Traumatic Stress Disorder. There’s a lot of charities and organisations that mean well and they are providing opportunities for people to participate in wonderful activities, but we don’t really know, especially in the long term, if this funding is being spent wisely.

Why I teach research; to inspire the next generation of healthcare professions to be the very best evidence-based practitioners.

Why I do research; to ensure that people who have served their country get the very best help and support to have a good life free from the trauma of combat.”



A week with The Baton in Norfolk

Today is Memorial Day in the United States; a day to pause and remember the fallen and honour their memory. It is an occasion when the pain of the battlefield can bubble to the surface.

A week ago I took The Baton to the drop-in morning at the Britannia Centre in Norwich which is now a hub for Veterans’ Services in Norfolk. The Baton is made from the handle of a stretcher used for medical evacuations on the battlefield in Afghanistan. We continue to carry it, with care and concern, to honour the fallen and the wounded. At first the veterans at the drop-in looked nonplussed at the strange object in my hand, then I started talking about The Baton and the penny dropped. One person when I handed it to them could not hold back their tears.

The Britannia Centre at Norwich Prison brings together The Walnut Tree Trust, The Matthew Project’s Outside the Wire service and Walking with the Wounded’s Project Nova. Between them they are supporting veterans and their families with mental health support, drug and alcohol advice and counselling as well as support for those in the criminal justice system. They are working closely with many other charities. While I was there I met someone from the Warrior Programme which runs an effective education and training course. A prison officer with responsibility for mentally disordered offenders called in for coffee and a catch-up; the local community Police officer also called in to see whether there was anything that he could do to help. It was so encouraging to see genuine interagency working with the veterans’ needs paramount.

I went on from there to visit David Miller who is planning an expedition to the Arctic to raise awareness and funds for the RAF Benevolent Fund. They provided vital support for his brother who has a back injury with severe pain and PTSD. He told me about the long and frightening journey his brother has had to survive and the terrible misunderstandings that led to Police brutality when he went off the rails. It was a clear illustration of the very real need for the services of the Britannia Centre in every town and city. It was good to let David hold The Baton; as the family member of a wounded veteran he really understood what it represents.

Then on Wednesday I took The Baton to the University of East Anglia Community Engagement Event. It gave me an opportunity to talk about the good work happening in Norfolk for veterans and to share The Baton message with academics and students. I reflected at the time that it was a bit daunting to stand beside very clever scientists and professors, but The Baton gave me courage. One academic colleague from the Law School told me about her close friend whose son has severe PTSD. He’s just 21 she said, with tears in her eyes.

We must never stop reminding people that they have the freedom to research, to study, to express an opinion because of the sacrifices of our forces. Many have paid, and will continue to pay, a heavy price for those freedoms.











Reflections on a busy week; we can make a difference

Sunday afternoon is usually the time when Monday morning starts looming in my mind, wondering what the week will bring. To ring the changes, I’m going to look back over the past week and see what I can learn from it. Last Sunday I was anxious about starting a new Enquiry-Based Learning case for our MSc occupational therapy students and there was the social media workshop on Wednesday, a total unknown.

Actually, it was a brilliant week, one of those that remind me why I do what I do. The students returned from Easter leave having read the novel ‘Elizabeth is Missing’ by Emma Healy and ready to discuss the impact of dementia on the occupations of an 81 year old lady. On Tuesday evening an Inaugural Lecture by Professor Hornberger was live streamed from the University of East Anglia and I watched it at my desk at home. We had the opportunity to learn more about the latest research and the devastating effects of dementia that go way beyond memory loss.

Then Wednesday. What an amazing day that was. Working with my colleague Tony Jermy @ODPGuru we started the social media day with a wide range of colleagues, health practitioners and academics. A few had no Twitter account and were terrified. We had speakers travelling from afar who we had met on Twitter, but never face-to-face. It sounded like a recipe for disaster, but our enthusiasm along with the generosity and passion of our speakers meant that the day was a huge success. Everyone got engaged on Twitter and by 9.00 in the evening our Tweet Chat had involved a few more. Our hashtag #UEA4Health had over 3 million impressions!

My favourite tweet with 1,731 impressions was, ‘#UEA4Health @thebestjoan broke out of his isolation and #SoMe put the world in his hands; he connected & became himself #inspiration’. The favourite story of the day was from @JennytheM who wrote on the wall in theatres to get her #skintoskin message across. At the end of the day my ‘take home’ message was that people with courage and passion can make a difference, they can improve care. Social media connects and supports those who believe in making the world a better place.

By Friday I was tired but still buzzing. I described myself feeling like a toddler who has eaten too many Haribos. Then, as I caught up with a growing number of emails I discovered that the Canadian Occupational Therapy Association had published a blog about my work with veterans. That gave me the chance to give some great charities and brilliant people a shout out on social media. Seeing the past four years work summed up in one place gave me another pause to reflect on how privileged I am to have these opportunities.

So… what will tomorrow bring? I will stay positive, keep connecting and stay open to all possibilities.

Dear diary…the joys of keeping a journal

Two years ago, on the advice of good friend and colleague Dr Mick Collins, I started writing a journal every day. My thoughts often feel like a tangled ball of wool and the knots just get tighter when I try to mentally reason my way forward. A few minutes spent each day writing those thoughts down can help the wool to unravel to a point where knitting something beautiful might be possible.

My journal isn’t a work of literature though, most of the time it is totally boring drivel. As a teenager I kept a diary which mostly consisted of… ‘School was so boring today.’ The interest level hasn’t gone up much, but as I write down how stressed, tired and unhappy I am, the positives also start to emerge. If I feel that I have achieved nothing, writing down what I have done throughout the day can reframe that sense of failure completely. Then there’s the goal setting. If I write down both short and long term goals in the journal then that will help me to stay focused. The writing helps me to realise dreams that I would never have thought possible.

I write out the words of songs that I love or inspirational quotes, maybe something nice someone has said. I have done a few little drawings, but not many, it’s mainly words. Sometimes I just write words of comfort and reassurance to myself. Writing it all down makes the positives more real and can be returned to in moments of doubt. It’s a form of therapy, or maybe just giving myself a good talking to! Occasionally I need that little reminder, ‘It’ll be fine.’

Keeping a journal is a ‘thing’ these days. I followed advice in a ‘How to keep a journal’ guide in the Guardian (where else?) and bought a beautiful unlined book with thick paper and glorious coloured covers. I have filled seven of these now and it has become an addiction. I also followed advice just to write unselfconsciously and not to worry about the quality. I am writing for me, nobody else. Now looking back through the pages I can see how far I have come in 24 months. The goals I set back in 2014 are being realised, some have evolved, but I can see where I am going and I am open to new possibilities.

Here’s the guide from The Guardian; http://www.theguardian.com/lifeandstyle/2014/mar/22/how-to-start-journal-writing-drawing

More detailed advice here: http://www.creative-writing-now.com/writing-journal.html



A New Year’s Resolution isn’t just for Christmas…

On January 8th I blogged about my good intentions to adopt a healthier lifestyle, saying that I had no health problems and just wanted to feel fitter. Then I had a warning about my cholesterol level from my GP, at the top end of the average range it was placing me at over 10% risk of having a heart attack or stroke. I declined to take statins after talking it through with him, basing that decision on my new lifestyle changes. At that stage I was successfully being alcohol free, eating healthily and attending my twice weekly exercise class. I was feeling smug.

Things haven’t quite gone to plan. The twice weekly exercise class remained a challenge, but I kept going and achieved a little more each week. The pain and discomfort after each class however did not improve. Longstanding problems with my joints, and my back in particular, were being aggravated. After another chat with my GP, I took his advice to stop going. The exercises were too high impact, even with my adjustments. It felt like a failure to stop attending because it had been such a big deal for me to do something like that.

During this time I was teaching 1st year occupational therapy students at the University of East Anglia about the connection between well-being and occupation. Their energy and creativity was shared in my last blog. One of the lectures was about how we all need to become more physically active generally in our lives and it doesn’t need an expensive gym membership to get fit. By small changes to every day routines we can get exercise. So I had to apply those principles to my own life. I love to walk and it doesn’t cause me pain, so more walking it had to be. I enjoy my long walks with the dog at the weekend, but this needed to be more regular.

Every day I now park my car a 15 minute walk away from where I work. It avoids a 10 minute queue in traffic so also helps to reduce my carbon emissions. On cold, wet mornings I almost give in to the temptation to drive all the way to the university campus, the car is warm and Kiss on the radio is highly entertaining. Then I remember that I need the exercise; so many people face far greater challenges than me and manage to keep fit. One of my inspirations is Mark Ormrod. He was in the Royal Marines and got blown up in Afghanistan. Three of his limbs were amputated and this does not stop him from working on his fitness every day. He is such a motivator for me when my inclination is to be lazy. I’m also walking a little faster and the last stage of the journey is up a small hill (this is Norfolk we’re talking about) so I try not to slow down to a plod.

I’ve been fighting a sense of disappointment that I couldn’t do everything that I set out to do, but I have to remind myself what I have achieved. The healthy eating is going fairly well, with loads more salad, vegetables and fruit included every day. I take a salad to work instead of a doorstep cheese sandwich. I couldn’t keep off the alcohol completely, I do love a glass of red wine, but I’ve halved how much I drink. The challenge now is to keep going, but really I have no choice. There’s still so much that I want to do with my life; I need to be fit and well, not just for New Year but for always.

To find out more about the health benefits of walking follow Sarah Hanson on Twitter – @walkingresearch. Sarah is a PhD student at Norwich Medical School, UEA, researching walking groups within the natural environment to improve health.

Mark Ormrod’s Facebook page: https://www.facebook.com/markormrodmotivationalspeaker/?fref=ts