Occupational therapy evidence in paratice for mental health

Occupational Therapy Evidence in Practice for Mental Health Occupational Therapy Evidence in Practice for Mental Health Second Edition Edited by Cathy Long Former senior lecturer York St John University UK Jane Cronin‐Davis York St John University UK Diane Cotterill York St John University UK This edition first published 2017 © 2017 by John Wiley & Sons Ltd First edition published 2006 by John Wiley & Sons Ltd Registered Office John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial Offices 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030‐5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley‐blackwell The right of Cathy Long, Jane Cronin-Davis and Diane Cotterill to be identified as the 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should consult with a specialist where appropriate The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read No warranty may be created or extended by any promotional statements for this work Neither the publisher nor the authors shall be liable for any damages arising herefrom Library of Congress Cataloging‐in‐Publication Data Names: Long, C (Cathy), editor | Cronin-Davis, J (Jane), editor | Cotterill, Diane, editor Title: Occupational therapy evidence in practice for mental health / [edited by] Cathy Long, Jane Cronin-Davis, Diane Cotterill Description: Second edition | Chichester, West Sussex ; Hoboken, NJ : John Wiley & Sons, Inc., 2017 | Includes bibliographical references and index Identifiers: LCCN 2016055401 (print) | LCCN 2016056140 (ebook) | ISBN 9781118990469 (pbk.) | ISBN 9781118990551 (pdf ) | ISBN 9781118990544 (epub) Subjects: | MESH: Mental Disorders–therapy | Occupational Therapy–methods | Evidence-Based Medicine Classification: LCC RC439.5 (print) | LCC RC439.5 (ebook) | NLM WM 450.5.O2 | DDC 616.89/165–dc23 LC record available at https://lccn.loc.gov/2016055401 A catalogue record for this book is available from the British Library Wiley also publishes its books in a variety of electronic formats Some content that appears in print may not be available in electronic books Cover image: iwanara-MC/Gettyimages Cover design: Wiley Set in 10/12pt Warnock by SPi Global, Pondicherry, India 1 2017 This book is dedicated to Lindsay Rigby who gave so much to occupational therapy in mental health vii Contents List of Contributors  ix Preface  xv An Introduction: Tracking Developments in Mental Health Practice  Cheryl McMorris Service User and Carer Involvement: Co‐production  17 Nashiru Momori and Gabrielle Richards Creativity as a Transformative Process  35 Diane Cotterill and Lucy Coleman Group Work in Occupational Therapy: Generic Versus Specialist Practice  59 Catherine Benyon‐Pindar Working with Alice Smith: Services for Older People  87 Caroline Wolverson and Alison Williams Occupational Therapy Interventions for Someone Experiencing Severe and Enduring Mental Illness  109 Lindsay Rigby and Ian Wilson Forensic Mental Health: Creating Occupational Opportunities  139 Jane Cronin‐Davis viii Contents Promoting Self‐Efficacy in Managing Major Depression  165 Gill Richmond Veterans: Understanding Military Culture and the Possible Effects on Engagement  191 Nick Wood, Diane Cotterill and Jane Cronin-Davis Index  223 ix List of Contributors Catherine Benyon‐Pindar,  BSc(Hons), BHSc (Hons) After years of medical school and a BSc in Psychology with relation to Medicine, Catherine decided medicine was not for her However, she discovered a passion for occupational therapy and qualified in 2005 She specialised in mental health immediately, initially working in forensic mental health She moved to a specialist post at The Retreat in York in 2007 and has worked for years on the Acorn Programme, an intensive group work programme and an accredited therapeutic community for women who predominantly meet the criteria for Borderline Personality Disorder, Complex Post Traumatic Stress Disorder and/or Dissociative Identity Disorder She has facilitated a wide range of groups including psychoeducational, occupation‐based and psychotherapeutic She regularly presents at national conferences and in 2014 completed the Institute of Group Analysis’ National Foundation Course in Group Analysis She is passionate about student education, group work, trauma and mindfulness Lucy Coleman BA(Hons), BHSc(Hons), PGCE Lucy first became involved with Converge Communitas choir in 2010 when she was an occupational therapy student at York St John University Before starting her occupational therapy programme, she taught music and sang professionally Lucy qualified in 2013, and was offered the post of Support and Progression Worker with Converge at the university One of her main roles at Converge is to co‐ordinate support for anyone enrolled on courses who may need this by liaising with course tutors, York St John student buddies and peer mentors Lucy also works with people to help them achieve their creative goals in different ways This could mean x List of Contributors offering them people to progress in our courses, with application for university places and finding employment opportunities Diane Cotterill,  Dip COT, Bsc(Hons), MSc, PGAP, PGCHR, FHEA Diane is an occupational therapist who graduated in 1990 Following this Diane worked in a range of psychosocial settings, both inpatient and community, predominantly with working age adults but she also has experience of working alongside older people with complex needs Diane now teaches on the undergraduate occupational therapy programme and contributes to teaching at postgraduate level at York St John University Diane maintains a keen interest in mental health services, the care provided for older people in care homes and also from a professional perspective, ethical practice and professionalism Jane Cronin‐Davis, PhD, MSc (Crim Psych), BHSc (Hons), BA (Hons), BA, PGCAP, FHEA Jane graduated as an occupational therapist in 1994 from what was then the College of Ripon and York St John (now York St John University) Much of her clinical experience is in mental health, specialising in forensic mental health She has worked in high and medium secure hospitals Her last post before moving to work in a university was Head of Occupational Therapy at Broadmoor Hospital in the UK Her specialist interest is in occupational therapy occupation‐focused assessment and treatment interventions; risk assessment and management; and working with people diagnosed with personality disorder in forensic settings She currently offers supervision and practice development to practitioners working in secure services Jane focuses on research related to forensic practice She was a lead for the College of Occupational Therapists (2012) practice guidelines ‘Occupational Therapists use of occupation‐focused practice in secure settings’ She has worked for National Institute of Clinical Excellence and other national organisations representing occupational therapy Jane was previously the Chair of the College of Occupational Therapists Specialist Section for Mental and the Forensic Forum Cathy Long,  SROT, DipCOT, MSc (Applied Psychology), CertHE Until recently Cathy taught at York St John University She qualified as an occupational therapist in 1982 and has worked in Birmingham and Manchester as a mental health occupational therapist She has worked in adult community mental health teams, resource centres, List of Contributors acute inpatient services and a unit for group and individual psychotherapy Immediately prior to teaching she worked within an NHS funded arts and activities centre for people experiencing mental health illnesses Cheryl McMorris, BSc(Hons) Cheryl qualified as an occupational therapist in 1997 from the University of Derby Cheryl’s first post was working in adult mental health in patient services in Gloucestershire, before moving to Scotland where she worked for a year in a Social Work Department for Glasgow City Council Since then Cheryl has specialised in working in mental health primarily forensic services She has worked across high, medium and low secure services In 2004, she took up post as a Clinical Specialist Occupational Therapist for discharge liaison at The State Hospital, Carstairs before taking on her current role as Forensic Care Group OT Lead for the Directorate of Forensic Mental Health & Learning Disabilities in NHS Greater Glasgow & Clyde in 2007 Cheryl has a special interest in vocational rehabilitation and employability in mental health specifically for forensic service users She has an enthusiasm for the development of others particularly leadership skill developments for occupational therapists and support staff Cheryl chaired the Scottish subgroup of College of Occupational Therapists Specialist Section Mental Health (COTSSMH) for years before becoming Vice Chair in 2014 and the Chair of COTSSMH in 2015 Nashiru Momori  Nashiru is Founder and Director of Real INSIGHT – an organisation aiming to transform services through user involvement He has extensive experience of inpatient and community services, drug dependency and the criminal justice system His experience of his recovery journey has enabled him to recognise the importance of a holistic approach to recovery and the need for meaningful involvement Since 2011, Nash has been an Expert User Consultant for West London Mental Health Trust providing insight to Senior Management Teams working directly with frontline staff and peers in a recovery oriented practices, and enhancing relationships From 2013 to 2015, Nash worked with Resolving Chaos to help create and implement the Fulfilling Lives programme in Lambeth, Southwark & Lewisham He was the National Expert Citizen Group Coordinator for the programme funded by the Big Lottery Fund from 2014 to 2015 He was founder and Chair of the Expert Service User Reference Group, which xi xii List of Contributors enables individuals currently using support services, or at the periphery, to participate in the development, management, delivery, monitoring and evaluation of their projects Nash is a Governor of South London and Maudsley NHS Trust, and part of the development team for its Recovery College, vice chair of their Social Inclusion and Recovery Board, and a regional Ambassador for the Equalities National Council Currently, Nash is a Trustee for the Blackfriars Settlement and West London Collaborative Gabrielle Richards,  BAS (OT), MSc, FCOT Gabrielle has worked in mental health all of her career She is passionate about co‐production and promotes a collaborative and recovery based approach to all her work from practice, organisational and strategic levels working alongside people with lived experience Gabrielle chairs the Board for the Social Inclusion and Recovery Strategy work of the Trust and leads on several Trust wide projects and initiatives including volunteering and the Recovery College Gabrielle has been involved in working parties and Boards of the College of Occupational Therapists focusing on mental health She was the chair of the Colleges Specialist Section for Mental Health During this time the profile of mental health was raised significantly most notably with the development of the Colleges Strategy for Mental health ‘Recovering Ordinary Lives’ She has contributed to publications and presented at national and international conferences She is currently Chair of the London Mental Health Occupational Therapy managers group and Professional Head of Occupational Therapy and Lead for Social Inclusion and Recovery at South London & Maudsley NHS Foundation Trust, King’s Health Partners In 2008 she was awarded the British College of Occupational Therapists Fellowship in recognition of her outstanding contribution to the work of the Specialist Section in mental health and to the profession of occupational therapy Gill Richmond DipCot, Grad Dip Counselling, PGDip Cognitive Therapy, BACP accredited CBT practitioner, Gill trained and qualified as an occupational therapist in 1991 at the University College of York St John She has worked in a range of mental health settings and has primarily worked with adults with complex mental health needs in an NHS setting using CBT for individuals and groups Gill is BABCP accredited, a CBT practitioner, Supervisor and Trainer 214 Occupational Therapy Evidence in Practice for Mental Health understanding of military life 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occupational skills training, 78 Addenbrooke’s Cognitive Examination (ACE III), 90 Allied Health Profession (AHP) Officers, Alzheimer dementia see dementia Alzheimer’s Scotland, 92 Alzheimer’s Society, 92, 100, 101 Antecedent and Coping Interview (ACI), 115, 117 antidepressant medication, 172 antipsychotic medications, 109–110 anxiety, 64–66, 68, 75, 78, 82, 96, 99, 101, 117, 119, 204, 205 Armed Forces Community Covenant, 208 Armed Forces Covenant, 199, 207–208, 210, 213 Arts, Creativity and Mental Health Initiative, 42 Assessment of Motor Process Skills (AMPS), 93, 94 attention disruption, narrowing, 116 behavioural activation (BA) activity scheduling, 177–180 background, 166, 172 case formulation development, 175–176 goal setting, 174–175 levels of, 176–177 mood monitoring, 177–180 principles, 173 problem‐solving, 181 relapse prevention, 181–182 rumination behaviors, 169, 175, 176, 178, 181 between session assignments, 180–181 Socratic questioning, 178–179 style of therapy, 173–174 suitability screening, 170–171 therapy outcomes, 182–183 Belief About Voices Questionnaire (BAVQ), 114–115 belief modification, 116 Occupational Therapy Evidence in Practice for Mental Health, Second Edition Edited by Cathy Long, Jane Cronin-Davis and Diane Cotterill © 2017 John Wiley & Sons Ltd Published 2017 by John Wiley & Sons Ltd 224 Index c Canadian Model of Occupational Performance and Engagement (CMOP‐E), 112, 113 Canadian Model of Occupational Performance Measure (COPM), 113 Care Programme Approach (CPA), 113, 142–143 carers see service user involvement clinical reasoning 67, 69, 146, 183 cognitive‐behavioural therapy (CBT), 70, 165–166, 171–172, 175, 181, 183–185 Communitas, 43, 49 community arts projects, 40, 42, 43 compensatory model implementing adaptive occupation, 77 Converge background, 35–36 belonging, sense of, 46–49 challenges to, 50–51 community arts projects, 42 community of learners, 43 creativity, 50 environments, supportive, 36–37, 44 labels, language, 44, 47–48 Model of Creative Ability, 40–42, 45 narrative, value of, 42–43 positive identity development, 37, 49 principles, converge of, 43 recovery, 38–39, 41, 46–48, 50–51 Student Buddy Scheme, 44–45 ‘us and them’ divide, 48–49 coping strategy enhancement (CSE), 118–122, 120–121, 155 co‐production, 21–25 creative activities, 39–40 creativity, use of, 39–40, 50 d dementia assessment process, 91–96 capacity, consent, 95 carer support, 100–101 care, support for, 87–88, 103 discharge, 102–103 evaluation, 101–102 friend, 99 intervention planning, 96–101, 103 long‐term goal, 96–97 medication management, 97–98 memory aids, 96–98 person‐centred practice, 22, 92–95 referral information, 90–91 resources, 92, 97, 100–101 service context, 88–89 service integration, 91 social isolation, loneliness, 98–100 Dementia Action Alliances, 90, 92 Dementia Engagement and Empowerment Project (DEEP), 92 Dementia Services Development Centre, 92 depression behavioural activation (BA) (see behavioural activation (BA)) clinical reasoning, evidence base, 183–184 Index cognitive‐behavioural therapy (CBT), 165–166, 171–172, 175, 181, 183–185 feedback loops, 176 initial assessment, 169–170 nature, impacts of, 167–168 risk assessment, 170 rumination behaviors, 169, 175, 176, 178, 181 suitability screening, 170–171, 185 therapy, accessing, 166–167 therapy outcomes, 182–183 Disablement Service Centres, 201 diversity of clinical practice, e educative model implementing occupation‐focused educational programmes, 78 evidence‐based practice, 1–3, 5, 6–13, 23, 37, 60, 70, 83, 97–99, 101, 103, 109–112, 143, 154–156, 165, 171, 183, 197, 202 f Family Questionnaire (FQ), 124 FIMT Transition Mapping Study, 203–205 Forces in Mind Trust (FIMT), 202, 210–211 forensic services admission, referral to, 145 background, 139–140 Care Programme Approach (CPA), 142–143 definitions, 140 environmental conditions identification, 152–153 intervention model, 146–158 legislative framework, 140–142 multi‐disciplinary team, 142–143 My Shared Pathway (MSP), 143, 155–156 negotiated targets, action plans, 154 occupational risk factors, 149, 149–152 outcome evaluation, 157–158 performance components identification, 152–153 plan implementation, 154–157, 155–156 resources, strengths identification, 153–154 risk assessment, management, 147 service user evaluation, 147–148 service user involvement, 142 theoretical approach selection, 148–152, 149 4Pi National Involvement Standards, 22 g General Health Questionnaire (GHQ), 124, 130 group work animal‐assisted interventions, 68 belonging, 61, 64–65 cause definition/clarification/ interpretation, 75 challenge, change, 65, 77, 79–81 client‐centred goals, 74–75 client‐centred performance context, 71 community meetings, 66–68 225 226 Index group work (cont’d ) focus, shift of, 62, 77, 79–81 identification/prioritisation, 71–72 intervention selection/ implementation, 76, 76–81, 80 learning, reflections on, 81–82 Model of Human Occupation (MOHO), 69–70 mutuality, 65, 79 occupational therapy process, 71–81, 73, 76, 80 occupation‐centred practice, 68–70 performance observation, analyses, 72–74, 73 Phoenix Programme, 60–61, 65, 69, 70 policy, 61–62 pre‐affiliation stage, 64 re‐evaluation, 81, 82 relational base establishment, 64–65 Relational Model of Group Work, 64–66, 78 self‐harm risk, 71–72 self, styles/modes of, 67–68, 81–82 sensory processing patterns, 75 service users, 62–63 Shop and Cook group, 70, 76, 76–81, 80 story telling, 66–67 termination, 65–66 h Helping Occupational Performance through Engagement (HOPE), 101 Homo Occupacio, 149, 150 home treatment, 112–113 Hull Dementia Action Alliance, 97 i implementing recovery through organisational change (IMROC), 30 Insight Service User Involvement Framework, 24 International Classification of Functioning, 36 j Jobcentre Plus, K Knowledge about Schizophrenia Interview (KASI), 124, 130 l Living Well With Dementia, 88 m major depression see depression memory aids, 96–98 Mental Health Strategy 2012– 2015, 20 mental illness see psychosocial interventions (PSI) Model of Creative Ability, 40–42, 45 Model of Human Occupation (MOHO), 69–70, 152, 172 Model of Human Occupation Screen Tool (MOHOST), 79 My Shared Pathway (MSP), 143, 155–156 n National Dementia Strategy, 88–89 neuroleptics, 109–110 Index NHS Constitution Handbook, 199, 208–209 NICE guidance, 6, 19, 22, 60, 65, 88, 91, 94, 110, 111, 142, 156, 165, 171 ‘No Health without Mental Health’ strategy, 19–20 o occupation‐based, 78 Occupational Performance Process Model, 146–158 environmental conditions identification, 152–153 negotiated targets, action plans, 154 occupational alienation, 149, 150–151 occupational deprivation, 149, 150 occupational disruption, 149, 150 occupational enrichment, 149, 151 occupational imbalance, 149, 151 occupational performance deficits, 149, 150 outcome evaluation, 157–158 performance components identification, 152–153 plan implementation, 154–157, 155–156 resources, strengths identification, 153–154 occupational therapy concepts, definitions of, 22–23 evidence‐based practice, 1–2, 5–6, 8–9 evidence‐based practice, barriers to, 9–10 future of, 11–13 leadership, value of, 10–11 legislation, policy, 2–6, 3–5 principles, 18–19 roles, clinical practice diversity, 6–8 values‐based practice, 10 Occupational Therapy and Dementia, 88 Occupational Therapy: Helping People to Live With Dementia, 88 Occupational Therapy: Improving Lives, Saving Money, 102 Occupational Therapy Intervention Process Model (OTIPM), 70 Older People with Social Care Needs and Multiple Long Term Conditions, 91 Out of Character, 43 p person‐centred care guidelines, 22, 92–95 Phoenix Programme, 60–61, 65, 69, 70 see also group work physiological arousal, 117, 121 Pool Activity Level (PAL), 94–95 post‐traumatic stress disorder (PTSD), 68, 193 The Prime Minister’s Challenge on Dementia, 88, 90 prosthetics, 200–202, 209 psychosis see psychosocial interventions (PSI) physiological arousal, 117, 121 psychosocial interventions (PSI) antipsychotic medications, 109–110 227 228 Index psychosocial interventions (PSI) (cont’d ) auditory hallucinations, 113–115, 115, 117–120 case study, 112–115, 115 client‐centred model, 112 cognitive‐behavioural family interventions, 119, 122–126, 124–125 contract, 114 coping strategies, 115–122, 116, 120–121 coping strategy enhancement (CSE), 118–122, 120–121 diary, journaling, 120, 120–121 distraction techniques, 118 education package, 126 engagement, assessment, 113–115, 115 evidence base for, 110–111 family assessments summary, 124 family case formulation, 125 goal setting, 127–129, 128 high levels of expressed emotion (HEE), 122–123 interactional model, 126 interventions, evaluation of, 129–130 referral, 113 relapse reduction, 122–123 self‐care, 114, 122, 127 stress management, 126–127 stress/symptom relationships, 121–123 sub‐vocalisation, 118 training in, 111–112 Psychotic Symptoms Rating Scale (PSYRATS), 114–115 r recovery, 11, 18, 20, 22–23, 30–31, 35–39, 41, 46–47, 50–51, 65, 69–70, 111, 117, 139–143, 148, 151–153, 155 Recovery Colleges, 30–32, 38, 47 Relational Model of Group Work, 64–66, 78 Relative Assessment Interview (RAI), 124 reservists, 209–210 restorative model implementing restorative occupation, 78 s schizophrenia see also forensic services; psychosocial interventions (PSI) forensic services, 140, 142, 145–146 psychosocial interventions, 110, 118–123 Scotland’s National Dementia Strategy, secure environments see forensic services self‐affirmation, 116 self‐defeating behaviours see group work service families, 210–211 service user involvement collaboration case study, 30–32 co‐production, 21–25 direction, meaning, 28–29 empowerment, 28 framework components, 25–29, 25–30 guidances on, 22 labels, language, 44, 47–48 Index learning, discovery, 27 levels of, 24–25 mutual acceptance, 26 overview, 17–19, 32 ownership, 28 policy context, 19–20 principles of, 24 self‐belief, hopefulness, 26–27 trust and relationship, 25 smoke detectors, 97 Social Care Institute for Excellence, 92, 100 social engagement/disengagement, 116 Social Inclusion and Recovery Strategy, 30 social isolation, loneliness, 98–100 Socratic questioning, 178–179 sprinkler systems, 97 structured activity, 116 suicide, 147, 167 t telecare, 97 Time Banks, 21 Together for Mental Health: A Cross‐Government Strategy for Mental Health and Well‐ being in Wales, 20 v values‐based practice, 1, 3, 10, 92, 103 veterans alcohol, drug use, 197–198 armed forces, motives for joining, 194 asking the question, 206–207 criminal justice system, 211–213 definition of veteran, 205–206 emotional pathway, 204, 204–205 employment, 202, 203 mental health programmes, 198–200 mental health stigmatisation, 192–193, 196, 199–200, 204 military culture as family, 194–196 military to civilian transition, 191–193, 202–205, 204, 211–213 mutual obligation covenants, 207–208 NHS Constitution Handbook, 199, 208–209 post‐traumatic stress disorder (PTSD), 193 prosthetics for, 200–202, 209 reservists, 209–210 service families, 210–211 shell shock, 192 Veterans and Reserves Mental Health Programme, 198 Veterans in Custody Support (VICS) model, 212 vocational rehabilitation, Vona du Toit Model of Creative Ability, 40–42, 45 w Well Elderly Study, 60 229 ... medicine was not for her However, she discovered a passion for occupational therapy and qualified in 2005 She specialised in mental health immediately, initially working in forensic mental health. .. guidelines for occupational therapists in mental health, setting standards for best practice and demonstrating the role of occupational therapy within different clinical areas for other healthcare... occupations, occupational and mental health in forensic and prison services, occupation and older people’s mental health and participation and mental health Mental health legislation Mental Health