Occupational Therapy News OTnews May 2020 | Page 23

COVID-19 FEATURE
Adapting to crisis
The reality for most individuals living with brain injury is
that social isolation also means physically distancing
themselves from their professional support team. Routine
rehabilitation needs may not be an immediate priority
in the face of a global pandemic; however, the risks
associated with a sudden reduction in rehabilitation are
very real.
A sudden change to the physical and social
environment can potentially, for some, cause a
deterioration in function and/or psychological wellbeing
and behaviour. There may be associated complications,
including carer distress and family breakdown, or the
worry of accessing acute and emergency services while
COVID-19 infection risks prevail.
Our role as specialist occupational therapists is to
support individuals during times of crisis and periods of
transition. But how could we, as individuals, continue
to offer an effective service if we too were experiencing
trauma and struggling with the transition, both from a
personal and professional perspective?
In a world where remote conferencing tools had
suddenly become the new norm, could our occupational
therapists adapt?
Remote possibilities
Our only option for meeting the ongoing needs of our
clients during COVID-19 was to move all intervention,
almost overnight, to remote delivery. But how could we
ensure that remote intervention was safe and retained a
focus on occupation? Could we connect therapeutically
in the virtual world with our clients and deliver an effective
service?
The solution for the team was to approach the actual
and perceived challenges, for ourselves as professionals
and our clients, in a practical way. We had to put in place,
for all concerned, a plinth of stability amongst the shifting
sands of coronavirus.
We started by devising a client-centred remote
working framework that would act as our guide. It would
provide much needed structure to meet the challenges
of delivering intervention to clients with such varied and
complex needs.
In this new and evolving area of practice, it was
essential that we remained focused on the core of our
profession – occupation.
As such, advice was offered to the occupational
therapy team to guide the structure of their remote
sessions, focusing on:
The Krysalis team has compiled a list
of over 200 activities for brain injury
survivors and their families during
COVID-19, which is available at:
www.krysalisconsultancy.co.uk/
resources/item/over-200-home-
activities-for-brain-injury-survivors
a very real challenge for Krysalis Consultancy as an
organisation and the clients we support across the
country.
• key frames of reference, such as transition theory,
which is useful in times of crisis;
• key models of practice, such as the Model of Human
Occupation (MOHO), which helps to inform our clinical
reasoning and intervention; and
• therapeutic resources to enhance online intervention,
such as coaching techniques.
The first step for our occupational therapists was to
undertake an analysis of each of their client’s ability to
access technology and remote meeting tools – and it
quickly became clear that this was a significant barrier.
Indeed, if any good is to come out of this crisis, it will
be in defining the role of the occupational therapist in
enabling individuals to access virtual worlds and ensure
they are not left behind.
The team was also encouraged to:
• facilitate a client’s performance and participation with a
communication device of choice;
• reflect on the impact of belief systems in engaging
with technology and recognise that, for some, just the
thought of a computer presents a significant internal
barrier;
• review environmental challenges and consider
solutions;
• utilise all possible social support, including family
members and support workers, to assist with online
access; and
• remain mindful of the experience of the client
themselves.
While the world was ‘going remote’, it was also vital that
the focus of occupational therapy involvement remained,
first and foremost, on maintaining a therapeutic
relationship.
Practical points
Using technology to deliver therapeutic intervention
was new to many of us. However, further investigation
highlighted that tele-medicine as an approach is utilised
successfully in other countries.
Practical considerations needed to be addressed,
including, fundamentally, did team members feel confident
in using the technology themselves? If not, individual
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