Occupational Therapy News OTnews May 2020 | Page 24

FEATURE COVID-19
Staples and stability
One element of our intervention for clients with brain
injury is to look at the value of meaningful activity
specifically around leisure.
The MOHO interest checklist is useful here in
stimulating ideas and highlighting potential interest
areas, or to adapt existing goals to enable access to
meaningful leisure activities during a lockdown.
In a world of shiny new technology, it is important not
to forget simpler things, such as board and card games,
which can be tailored to specific needs, including Uno,
Dobble, Othello, Chess and Risk, or jigsaw puzzles and
construction kits (see Resources box).
Our ‘virtual’ occupational therapists have been
conducting functional assessments while taking part in
games and activities with clients located many miles away.
One client, notably, could not see how board games
would be appropriate for him. However, by tapping into his
long-held values relating to the importance of helping others,
he was encouraged instead to evaluate the games for use
by others with brain injury. This promoted engagement,
offered a sense of purpose and served as a therapeutic
process for him personally.
Other clients have explored the value of gardening as a
meaningful activity. For one client, a portable greenhouse
was sourced and delivered, with the help of his support
worker, after he identified the equipment that he needed
during remote occupational therapy sessions. He now
has the daily responsibility of tending the seeds growing
in it.
Adapt and pivot
For many of our clients, the lockdown has meant a shift
of neurological occupational therapy provision to virtual
delivery. Our team has physically engaged our clients in
therapeutic sessions, helping them to adjust to the crisis,
develop personal resilience and continue with activities and
rehabilitation goals that are important to them.
24 OTnews May 2020
Setoguchi et al (2020) conducted a study to
examine the potential utility of existing mobile
applications (apps) to facilitate/augment
coaching in occupational therapy. Systematic
searches of iTunes and Google Play stores were
used to identify apps, which were screened
and evaluated against pre-determined criteria.
Thirty six apps met the established criteria and
were categorised according to primary purpose
(‘chronic conditions’, ‘goals’, ‘habits and
routines’, ‘mental health’ and ‘sleep’). Fourteen
of these were chosen for in-depth discussion,
based on clinical utility and overall features. The
authors identify that a number of apps may be
useful to augment specific areas of coaching in
occupational therapy, and the paper provides a
strategy that occupational therapists can use to
identify and evaluate apps for clinical use.
clinicians were encouraged to seek help from an IT
expert.
Remote session pre-checks ensured successful
delivery and maximum client engagement, including
device set-up to minimise technical glitches, connectivity
and sound quality issues.
Environments were modified to ensure they were
conducive to a successful session and, to help meet
communication needs, sessions were structured to
incorporate:
• a beginning, including a summary of previous
session and plan;
• a middle, to deliver the therapeutic intervention; and
• an end, for review purposes.
Reference
Setoguchi M, Motruk S, Frank V, Kessler D
(2020) A review of mobile applications to
enhance coaching in occupational therapy.
British Journal of Occupational Therapy, Mar 05.
[Epub ahead of print].
As a team, in the face of personal and national crisis,
we have shown that we can overcome our fears of the
unknown by:
• integrating our core skills into a careful, measured and
informed process;
• mastering the use of digital aids, such as white
board drawing, remote coaching, screen sharing and
questionnaires;
• drawing stability from our models of practice and
applying them to a useful framework; and
• engaging our clients in traditional activities more suited to
a slower pace of life.
In times of crisis, it is the familiar that offers stability
and certainty, and it is our specialist knowledge base
that guides our way forward. We must be open to
opportunities for growth and innovation, demonstrating
what we, and all occupational therapists, are capable of.
Above all, however, we must ensure we continue to
deliver occupation focused, goal-led, remote therapy
services to the most vulnerable in our society throughout the
COVID-19 pandemic.
Jo Throp, clinical director, and Nichola Shellum, clinical
manager, Krysalis Consultancy Ltd. Linked In: Krysalis
Neuro OT; Twitter: KrysalisNeuroOT; Facebook: Krysalis
Neuro OT; YouTube: Krysalis Consultancy Ltd