FEATURE RESEARCH AND DEVELOPMENT
our healthcare system , partly because therapists don ’ t have the basic knowledge and skills that they need .
‘ Collaborating on the consensus recommendations has been a cathartic process for me in this respect and I hope they will provide occupational therapists with the necessary foundation on which to build their confidence and expertise in working with people with this treatable condition .
‘ My professional experience working with adults with FND has enabled me to share my knowledge and insights to produce consensus recommendations that are a prerequisite to future research to into the efficacy of occupational therapy in the management of FND .
‘ When we work together , we don ’ t need to have all the answers individually , but we have a strong , collective voice that can educate others and promote the value of our profession .’
In his reflection , Ed Sum highlights the benefits to his continuing professional development : ‘ I developed an interest in neuroscience when I was a teenager and , after several years as an occupational therapist , gained a position in an outpatient neurology service ,’ he explains .
‘ It was there that I met patients with “ functional disorder ”, “ conversion disorder ”, “ functional overlay ” and other terms that were unfamiliar to me . It was interesting to me that , as a multidisciplinary team , we would talk a lot about how to conceptualise their clinical presentation and what we could do to help .
‘ At times we differed in our clinical reasoning . At times our patients achieved small goals . At times professionals held negative opinions towards people with FND .’
After moving through a variety of job roles , Ed returned to working in an outpatient neurology setting , this time based in Nottinghamshire .
‘ By this time ,’ he days , ‘ there was increasing interest in FND , however , there remained a lack of published evidence for occupational therapy practice . I began to undertake more CPD in this area , as I was not satisfied with my clinical knowledge .
‘ Over time , my clinical practice evolved and I changed the focus of my professional doctorate to FND . Through my links with the RCOT Specialist Section – Neurological Practice ( RCOTSS-NP ) Longterm Conditions Forum , I was in contact with Clare Nicholson and had recruited her into my pilot study .
‘ Although I later abandoned my studies , Clare invited me to join her work on developing the consensus recommendations .’
Ed adds : ‘ Through this project , I have been able to contribute and learn from experts in the field . I have developed new friendships and a network that
I can consult with . My professional confidence has increased and I have presented on the topic at inservice training sessions , RCOTSS-NP regional study events and the MS Trust conference .
‘ For me , contributing has resulted in more than I could ever have achieved by myself . I think for some occupational therapists , we value being invited to participate in projects where we can bring our individual experience , strengths and talents , as not all of us has the ability to lead and produce work of this magnitude .
‘ I have also learnt that there is a lot of expertise and evidence-base within the profession that is not published that needs to be shared .’
Through their reflections , Carrie , Ed and Kate highlight that although they share a strong clinical interest in working with people with FND , they each had their own motivations for taking part in the project and uniquely benefitted from their involvement .
Collaborations like this are a positive step forward in encouraging occupational therapists with clinical expertise but limited research experience , to begin to engage in research , as well as facilitating the sharing of knowledge for the benefit of other health professionals and service-users .
With the increasing availability and use of technology to enable occupational therapists to connect remotely with fellow practitioners , it has never been easier to collaborate .
References
Carson A , Stone J , Hibberd C et al ( 201 ) Disability , distress and unemployment in neurology outpatients with symptoms ’ unexplained by organic disease ’. J Neurol Neurosurg Psychiatry , 82 , pg 810 – 3 .
Espay AJ , Aybek S , Carson A et al ( 2018 ) Current concepts in diagnosis and treatment of functional neurological disorders . JAMA Neurol , 75 , pg 1132 – 41
Nicholson C , Edwards M , Carson A et al ( 2020 ) Occupational therapy consensus recommendations for functional neurological disorder . J Neurol Neurosurg Psychiatry , 0:1 – 9 . doi : 10.1136 / jnnp-2019-322281
Kate Hayward , Department of Therapy Services , University College London Hospitals NHS Foundation Trust , National Hospital for Neurology and Neurosurgery ; Carrie Lumsden , Lobe Neurotherapy and Consultancy , Scotland ; and Community Rehabilitation and Brain Injury Service , West Lothian Community Health and Care Partnership ; and Ed Sum , Integrated Community Neurology Team , East Coast Community Healthcare CIC
56 OTnews February 2021