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Occupational Therapy and enablement


Able to enable College of Occupational Therapists 1990 * * The underpinning concepts of occupational therapy are centred on meaningful occupation related to a ... – PowerPoint PPT presentation

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Title: Occupational Therapy and enablement

Occupational Therapyand enablement
  • Able to enable
  • College of Occupational Therapists
  • 1990

Occupational Therapy and enablement
  • The underpinning concepts of occupational therapy
    are centred on meaningful occupation related to a
    need for enablement, whether in a health or
    social context

Underpinning concepts of Occupation
  • Occupations fill and structure time
  • Occupation is centred on self-care, leisure and
    productivity (work)
  • Occupation has a socio/cultural context and
    incorporates social participation and engagement
  • Occupation contributes to a sense of identity
  • Occupation enhances self-esteem and supports
    mental and physical wellbeing

Where do we work?
  • Social Work/NHS liaison working (POA and ESD)
  • Orthopaedic rehabilitation
  • Neuro/acquired brain injury rehabilitation
  • Child development/habilitation/Bobarth
  • All areas of mental health/treatment and
  • Learning disabilities/habilitation and
  • Private practice
  • Work/industry rehabilitation
  • Counselling/CBT
  • Care Home liaison/education
  • Stroke rehabilitation
  • Community outreach
  • The Wheelchair service/orthotics/splinting
  • Consultancy
  • Volunteer/charitable agencies
  • NHS and Social Work general management

Occupational Therapy Training
  • All courses in Scotland are now 4 year Honours
  • All students have to fulfil placements in
    physical and mental health settings and also in a
    Community setting
  • Training encompasses psychology, psychiatry,
    biometric sciences, sociology, biomechanics,
    ethics, ergonomics, mental and physical illhealth
    and condition specific rehabilitation

Charity versus enablement
  • In the 18th and 19th centuries there was already
    philanthropic practice where charity was the sole
    outcome, with no expectation that the recipients
    would regard it as a route to achievement or
    self-determination. It was later advocated that
    rewarding productive activity would be more
    enabling, as outcomes would raise self-esteem and
    induce self-reliance

A common origin
  • Occupational Therapy and Social Work share common
    antecedents and there were significant
    individuals who were in the same sphere of social
    reform and with a common belief in social
    equality and occupation
  • For both Occupational Therapy and Social Work the
    formalisation of theory and practice has origins
    in America
  • and as they developed their eventual professional
    titles reflected their developed focus
  • Both chose routes to enablement

A link to Social Work
Octavia Hill (1838 - 1912) was an early and
significant social reformer who was instrumental
in formulating the concepts of Social Work and
who inspired others in her belief of the need
for social change and enablement Elizabeth
Casson (1881 1954), worked for Octavia Hill.
She later became a doctor and subsequently an
eminent psychiatrist. She set up the first
British school of Occupational Therapy in 1930.
Each year the College of Occupational Therapists
awards the Elizabeth Casson Prize for exceptional
practice In 1925 the first person in Great
Britain appointed to work as an Occupational
Therapist was Margaret (Peg) Fulton (1900
1989). She was later awarded an MBE in
recognition of years of advocating and practicing
meaningful occupation in rehabilitation. Peg
trained in Philadelphia but worked in Aberdeen
and contributed to the development of the British
and World Federation of Occupational Therapists
Facts and Figures
  • Occupational Therapy staff make up one percent of
    Scottish Social Work staff but account for 35
    percent of referrals for adult social work
    services. They can be individually responsible
    for assessment and equipment provision/adaptations
    that will allow greater independence and/or
    facilitate or support the carer role.
  • In 2008 there were 516 occupational therapists
    working in Scottish social work services. This is
    lower than in 2006!
  • This has happened when the fastest rising
    demographic group is the over 85s, with a
    commensurate rise in dementia and debilitating
    frailty. Similarly, previously life-limiting
    conditions are prolonged with more successful
    treatments, with a consequent need for extended
    and additional support services and interventions
    in the community

Changing Lives, Changing Practice
  • In response to this initiative, the College of
    Occupational Therapists has produced a report
    that analysed the role of community occupational
    therapy in the enablement process and set within
    their historic role of habilitation and
  • The COT report encompasses many Scottish Office
  • Changing Lives (2006)
  • Co-ordinated, integrated and fit or purpose a
    delivery framework for adult rehabilitation in
    Scotland (2007)
  • Framework for adult rehabilitation in Scotland
  • The better health, better care, action plan
  • These, amongst many others place occupational
    therapy alongside social work in the development
    and delivery of enablement initiatives

Current and future practice
  • The current enablement agenda is an opportunity
    to reinforce the historic relationship between
    Occupational Therapy and Social Work

Enablement in Angus Why change?
  • Due to demographics, we will be unable to meet
    future demands for service unless better use is
    made of our resources
  • Services must be at the time of need and be more
  • Care models of service provision can lead to
    disabling rather than enabling Service Users
  • Enablement will result in better outcomes for
    Service Users
  • To comply with initiatives and agendas such as
    Changing Lives, Shifting the Balance of Care and
    Angus Councils Best Value Review of Older
    Peoples Services

Enablement in Angus A Personal Care pilot scheme
  • In 2007 a Personal Care Pilot Scheme ran in Angus
    and focused on Service Users whose requirements
    included personal care
  • The scheme sought to determine the potential for
    enabling the person rather than an a tacit
    acceptance of a Long Term need
  • The scheme involved 29 SUs with a total of 137
    hours requested
  • At the end of the scheme only 21 hours of ongoing
    service required
  • 6 Service Users achieved total independence
  • The majority of the remainder only needed
    assistance with bathing

Enablement in AngusA Community Meals pilot scheme
  • The scheme ran between August 08 and April 09 and
    investigated requests for Older People in
    Brechin/Montrose for new meals provision or
    increases to existing provision
  • Prior to pilot scheme there was an average 15
    referrals monthly
  • Each referral was more fully assessed by a Home
    Care Assessor, Care Manager and an Occupational
  • There was a focus of the potential for short-term
    support with enablement/independence as the
    preferred outcome
  • In the last 12 months there has been a maximum of
    4-5 referrals monthly and 50 of theses has been
    for short term meals provision

Enablement in AngusWhat the schemes sought to
  • Better long and sort term outcomes for Service
    Users with regard to enablement and independence
  • For services to be delivered at the right time to
    the right people with the ability to adjust as
    needs change and to prevent waiting lists for
  • To provide flexible support and service delivery
    and give greater job satisfaction
  • To maximise resources in order to meet current
    and future demands
  • To comply with government and local initiatives
    and agendas

CLCP and Occupational Therapy
  • The COT report concludes
  • The full, effective and timely involvement of
    occupational therapy in social work services now
    and in the future will reduce the need for
    complex and costly packages of care
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