FEATURE STUDENT EDUCATION
Bridging the gap
Third year occupational therapy student Kim Jones reflects on her final year
placement opportunity in a role emerging setting within the third sector
With over a decade of experience
working in the field of domestic
abuse, I began my journey as an
occupational therapy student with a
clear goal of returning as a graduate therapist.
My final year placement opportunity was with a
local charity providing support to men, women and
children who have, or are experiencing, domestic
abuse.
In recent years, the crime survey for England and
Wales shows little change in the numbers of people
affected by domestic abuse.
It is estimated that, ending March 2018, two million
adults aged between 16 and 59 years experienced
domestic abuse within the last year (1.3 million women
and 695,000 men) (ONS 2020), costing the UK an
estimated £15.7 billion in 2008 alone (Walby 2009).
This cost includes:
• £3.9 billion for the criminal justice system, civil
legal services, healthcare, social services, housing
and refuges;
• £1.9 billion to the economy, based on time off
work because of injuries; and
• £9.9 billon in human and emotional costs, for
example, for treating and supporting someone
who is experiencing post-traumatic stress disorder
as a result of violence and abuse (NICE 2020).
Considering these figures, occupational therapists,
within their caseloads and in a range of different
settings, are likely working indirectly with individuals
who are, or have suffered, domestic abuse, without
directly addressing or even recognising the associated
issues.
The aim of the placement was to explore the
potential role of an occupational therapist within the
setting, specifically to:
• recognise how the occupational therapy process
could be implemented within a third sector
organisation, focusing on those people who have
experienced domestic abuse;
• explore rebuilding an individual’s occupational
identity incorporating ‘doing, being, becoming and
belonging’;
• improve quality of life by overcoming barriers of
occupation deprivation and injustice;
• empower individuals to believe in occupational
mastery; and
• enable individuals to create a balance of self-care,
productivity and leisure activities.
A partnership approach was acknowledged on the
placement, working in collaboration with the drop-in
centre, outreach support, refuge and a one stop shop.
I worked alongside the GP, hospital staff, social
services, police, health care providers, occupational
therapy colleagues, the mental health team, speech
and language team, independent domestic abuse
advisors (IDVA) and court, which truly incorporated the
principles of integrated care.
I worked on a one-to-one basis with clients, which
allowed the occupational therapy process to be
developed, considering functional abilities in daily life
activities, such as returning to work, education, home
management, parenting, and leisure, and working with
cognitive functioning, decision-making, judgement,
problem-solving, following direction, task initiation,
self-confidence, coping skills, stress management and
interpersonal relationships.
It was observed that experiencing domestic abuse
created difficulty with self-calming, sleeping, eating
activities, maladaptive behaviour, poor verbal and
social skills and somatic complaints.
In addition to this, I ran a four-week ‘My journey
without words’ art group. This was formulated
by the clients after a forum had taken place. The
Kawa Model’s river theme was used throughout the
group, which allowed the clients to visually look at
their environmental factors, life circumstances and
problems, personal assets and liabilities and life flow
and health.
The group was attended by the clients for a variety
of reasons, including as a social outlet, and to build
confidence in their own ability.
While working in the refuge, I was asked to
assess Mary, a 54-year-old women who lived alone.
Mary had recently moved into the refuge and was
displaying high levels of anxiety; she had been
married for 37 years, but for the last two years had
been living with another partner. Both partners had
shown sustained, long-term, abusive behaviour
towards her simultaneously.
54 OTnews August 2020