Occupational Therapy in A Diverse Setting:

Vocational Rehabilitation

Sarah Mead Occupational Therapist Content

My journey into diverse settings:

• Newly qualified OT in diverse setting – Vocational Rehabilitation • 2nd post in a diverse setting – Vocational Rehabilitation

Setting up the service:

• Referral pathways • Caseload management • Vocational Pathway • Assessments • Action (treatment) plans • Outcome measures • My CPD Sarah Mead - Occupational Therapist My journey into diverse settings

• Previous experience as OT Technician in inpatient general medical, orthopaedic, and elderly rehab wards

• 2005 – 2007 – OT training at UoB

• 2007 onwards: 1st post in a diverse setting – Vocational Rehabilitation PT - Local government supported service PT - Social Care OT

2nd post in a diverse setting – Vocational Rehabilitation

Sarah Mead - Occupational Therapist 2nd post in a diverse setting – Vocational Rehabilitation

Sarah Mead - Occupational Therapist Scrutinising the job description to ensure I could stay registered as an OT in the post

Was it OT enough ?

• Job description….

Sarah Mead - Occupational Therapist Referral pathways

Referred in from the IAPT service only

• 1 Work & Learning Co-ordinator (me) 4 days per week • 20 – 30 referrals per month • Average lasting 3 – 6 months with some 1 or 2 sessions only • Monthly average caseload 60 +

• Because of high volume of referrals, promoting a self-advocacy approach with referrals out to other services and unions who could provide in work support

Sarah Mead - Occupational Therapist Caseload maangement

Using a caseload management tool to guide best practice:

Sarah Mead - Occupational Therapist Vocational pathway

Using a Vocational Pathway to guide practice and focus clients:

OT News, Dec 2012, “Enabling employment through tailored support” by Susan Bradford OT Sarah Mead - Occupational Therapist Vocational pathway

Evidence and CPD reflection sheet

OT News, Dec 2012, “Enabling employment through tailored support” by Susan Bradford OT

Sarah Mead - Occupational Therapist Assessments

Service managers wanted: • generic assessments only • not OT specific assessments • but were happy for me to use an OT perspective

• I selected MOHO as my model as this model has a lot of reference to work and assessments tailored to work that I could reference.

Sarah Mead - Occupational Therapist Assessments

IAPT Assessments • PHQ-9 • GAD-7 • WSAS (Work & Social Adjustment Scale)

Work & Learning Service Assessments: • MOHO based initial assessment (home grown) • Wellbeing Recovery Action plan for Work • TSA (Transferable Skills Analysis)

Sarah Mead - Occupational Therapist Outcome measures

IAPT / Work & Learning Service Outcome Measures

• PHQ-9 • GAD-7 • WSAS (Work & Social Adjustment Scale) • Key Performance indicator – number of job/education retentions

Sarah Mead - Occupational Therapist Evidenced-based practice

Using evidence through the process of service creation and delivery

Using Moore’s and Bannigan’s model to demonstrate evidence-based decision making

Sarah Mead - Occupational Therapist Evidenced-based practice

Reflection using Moore’s and Bannigan’s model

Sarah Mead - Occupational Therapist Questions ?

Sarah Mead - Occupational Therapist References Bradford, S, 2012, “Enabling employment through tailored support”, Dec 2012, OT News Farr, J, 1991, The very quick job search, JIST Works, Indianapolis Fortune, T, Ryan, S, 1996, Applying Clinical Reasoning: A Caseload Management System for Community Occupational Therapists Volume: 59 issue: 5, page(s): 207-211 Kielhofner, G. (2008). Model of Human Occupation: Theory and Application. Fourth Edition. Philadelphia, PA: Lippincott, Williams and Wilkins Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613 Liptak, J & Shatkin, L, Transferable Skills Scale 2nd Edition, Administrator’s Guide, 2001, JIST Publishing, Indianapolis Moores, A, & Bannigan, K, 2009, A model of professional thinking: integrating reflective practice and evidence based practice, CJOT , No.5, Volume 76 Mundt, JC, Marks, IM, Shear, K, Greist, JM, 2002, The Work and Social Adjustment Scale: a simple measure of impairment in functioning British journal of , 180:461-464 Perkins, R, Farmer, P, Litchfiled, P, 2009, “Realising Ambitions: Better employment support for people with a condition” Department of Work and pensions. Simon, SE, 2015, How to conduct comprehensive Transferable Skills Analysis (TSA) in Vocational Rehabilitation (VR): The Human Services Outcomes (HSO) Approach, {accessed on 1.9.17 at: http://www.hsoutcomes.com/tsaguide.htm] Spitzer, RL, Kroenke, K, Williams, J, Löwe, B, (2006) "A brief measure for assessing generalized anxiety disorder: The GAD-7". Archives of Internal Medicine. May 166 (10): 1092–7

Sarah Mead - Occupational Therapist