Practice Feature
J
ust over a year ago , Sue Parkinson and I published the book A guide to the formulation of plans and goals in occupational therapy . This article reflects on a year of its implementation and draws on discussion with a number of occupational therapists from around the world who are applying , developing and researching occupational formulation .
As a concept and practice , it continues to evolve as occupational therapists enact formulation with the people they work with . The voice of these people is an important and integral part of its advancement and I acknowledge their absence in this article due to ethical reasons ; they are involved in ongoing research and the occupational therapists in this article report on some of their experiences .
What is occupational formulation ?
As an introduction to occupational formulation , for those who are new to the idea and as a recap to those who have already explored and started to implement the process , occupational formulation is a structured process of making sense of someone ’ s circumstances that is informed by a person ’ s narrative and theories of occupation ( Parkinson and Brooks 2021 ).
Occupational formulation is a complementary perspective to psychological formulation and medical diagnosis that asserts our unique professional reasoning .
Sue and I recommend a three-part structure to capture :
• A person ’ s subjective viewpoint of their past and roles , relationships and interests impacted by their life turning points .
• An objective overview of their current routines , skills and performance , in relation to their environment .
• The occupational focus that will shape the future direction of therapy .
In this way , an occupational formulation forms a summary of your assessment that is written in
… occupational formulation is a structured process of making sense of someone ’ s circumstances that is informed by a person ’ s narrative and theories of occupation .” a narrative form , is informed by your knowledge of occupation and leads to measurable goals that focus on occupation ( Brooks and Parkinson 2018 ).
How is it being developed ?
Through Sue ’ s training , the book , conference presentations and engagement on social media , the strategies for occupational formulation and measurable goals have reached around the globe – across the UK and Ireland , to Australia , Finland and South America .
An occupational therapist in Peru commented , following a keynote address by Sue in February 2022 : ‘ I see a great dynamism that allows us to integrate all aspects of [ a person ] in the course of therapy ’ and ‘ it allows me to realise that writing is not putting more , but putting what is necessary and important ’.
More occupational therapists talked to me about their experiences during informal conversations to discuss the book , training , practice , challenges , impact on colleagues and the people they work with .
Noona is an occupational therapist at the Helsinki University Hospital , Finland ; Richard is an occupational therapist in Yorkshire and Humber , UK ; Natalie is an occupational therapist in Melbourne , Australia ; Cassie is an occupational therapist and a researcher in Queensland , Australia ; Lorrae is an occupational therapist and researcher in Melbourne , Australia .
The occupational therapists came across occupational formulation in different ways ; some found the book online , others attended training or heard about it through colleagues . Whatever their route to finding formulation they all felt that having time to understand the concept and time to practise was important .
Noona and Natalie found it helpful to read the book , talk with colleagues and to get some practical hands-on practise . Richard read it cover to cover and felt that this was enough to feel some confidence and competence to do formulations .
Having opportunity to do formal training was valuable , although not necessary , and opportunity to learn from or with colleagues was key .
Natalie found that when she was developing a new role was an ideal time to integrate formulation into a new way of working . Several people mentioned how the case examples really consolidated and brought to life what they had read and that they could refer to these to help guide their writing further .
All the occupational therapists commented on how formulation had changed the way they think and practice . Noona and Richard suggested it created a clearer theory to practice link and
February 2023 OTnews 33