Connections - Winter 2020 by Occupational Therapy Australia

Supporting all people to engage in activities they find meaningful

WINTER 2020 | VOL 17 ISSUE 2

Print Post Approved PP340742/00147 ISSN 1832-7605

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Connect and Collaborate Collaborating to Build Educator Capacity Creating a Healthier Relationship with Your Mind A Clinic for the Community, in the Community

SHARING OUR KNOWLEDGE AND SKILLS TO MAKE A DIFFERENCE

OT MENTAL HEALTH FORUM Crown Promenade, Melbourne, Victoria MONDAY 16 NOVEMBER 2020 #OTMH2020 www.otausevents.com.au/mentalhealthforum Occupational Therapy Australia is pleased to invite you to participate in the 2020 OT Mental Health Forum on Monday 16 November in Melbourne. The forum is an invaluable event for occupational therapists working across every area of mental health practice in Australia. The forum provides the opportunity for us to come together and exchange ideas, to share practices and challenges, to network and meet new colleagues and to learn from an exciting array of current OT mental health practice and research activity.

KEY DATES Call for abstracts close 28 May 2020 Notification to authors of abstract acceptance 16 July 2020 Registration open July 2020 Program released 13 August 2020 Early bird registration closes 17 September 2020

KEYNOTE SPEAKERS

SPONSORSHIP AND EXHIBITION OPPORTUNITIES To discuss how you can be involved, please contact Rebecca Meyer, Head of National Conferences, CPD Events and Business Development via events@otaus.com.au or phone 0451 807 647.

FURTHER INFORMATION P: 1300 682 878 E: mentalhealthforum@otaus.com.au

Maggie Toko CEO, VMIAC

Carolynne White Participation and Engagement Advisor, MIND AUSTRALIA

CONTENTS

ABOUT CONNECTIONS

Connections is a publication of Occupational Therapy Australia (OTA), the peak body representing occupational therapy in Australia. CONTACT US

Occupational Therapy Australia ARBN 007 510 287 ABN 27 025 075 008 5/340 Gore St, Fitzroy, VIC, 3065 T: 1300 682 878 E: info@otaus.com.au W: www.otaus.com.au

The Benefits of Collaboration in Rural Practice

CONTRIBUTIONS AND ADVERTISING

Would you like to contribute to Connections, or do you have a product that is attractive to occupational therapists and would like to advertise your product? For advertising enquiries, please email advertising@otaus.com.au Editorial material including letters to the editor, upcoming events, research material, and important information for inclusion in Connections should be sent by email to digitalcomms@otaus.com.au. The editor reserves the right to edit material for space and clarity and to withhold material from publication.

UPDATES

FEATURES

President’s Report

CEO’s Report

Policy, Lobbying & Advocacy Update

Professional Practice & Standards Update

CPD Update

WFOT Update

Perry Watson Design

AOTJ Report

DISCLAIMER

Vale Rachel Norris

CPD Calendar

DEADLINES FOR SUBMISSIONS

Spring 2020 Issue: 10 July Summer 2020 Issue: 9 October DESIGN

This newsletter is published as an information service and without assuming a duty of care. It contains general information only, and as such, it is recommended that detailed advice be sought before acting in any particular matter. The materials included in this newsletter by third parties are not attributable to Occupational Therapy Australia, and are not an expression of Occupational Therapy Australia’s views. Occupational Therapy Australia is not responsible for any printed expressions or views in any third parties’ inclusions. Any enquiries regarding inserts, advertisements or articles placed by these third parties should be directed to them.

OT Life in Darwin: Thinking Outside the Box

The Call-Up: Sharing Our Knowledge and Skills to Make a Difference

OTA’s Tea pOT Talks

Peers Empowering Peers to Get Up and About

ECU Paediatric Occupational Therapy Clinic: A Clinic for the Community, in the Community

A Conversation with OTs in Central Australia

Working From Home Tips

Collaboration in Rural Practice

OT Life in Darwin: Thinking Outside the Box

Innovative OTs in Education: Collaborating to Build Educator Capacity in South Australia

Creating a Healthier Relationship with Your Mind

Implementing Animal Assisted Therapy to Reach Goals and Promote Wellbeing

Connecting, Collaborating and Adapting OT Practice in a COVID-19 World

CONNECTIONS WINTER 2020 3

PRESIDENT’S REPORT

President’s Report Associate Professor Carol McKinstry | OTA President

ollaboration and connectedness are more important than ever during these difficult times. As occupational therapy associations across the world grapple with the challenge of providing members with the latest accurate information to guide practice, we have seen some wonderful examples of collaboration and connection. Fortnightly I am meeting with the US, UK and Canadian association presidents as well as the WFOT President, while our CEO Sam Hunter is meeting with the CEOs of these associations on a fortnightly basis as well. We have committed to collaborate and share resources to not only assist members, but also others including the general public. We are also collaborating with other health professional associations to utilise their resources and adapt these for occupational therapists. Many of you have read or would be aware of the excellent ebook Normal life has been disrupted: Managing the disruption caused by COVID-19 by Lorrae Mynard. I have sent this far and wide to students, colleagues (occupational therapists and others), friends and family. The success of this ebook, being translated into other languages to be used internationally, typifies our unique contribution to assisting those impacted by the COVID-19 crisis. I know we are all using our occupational therapy skills

in many ways to help not just ourselves to cope, but also others around us. I am immensely proud of the ‘can do’ attitude of occupational therapists and students, and of course the OTA staff. Collaborating with clients and carers to deliver services in a new and different way to ensure we are doing all we can to minimise risks for particularly vulnerable people is very evident. We do not need to reinvent the wheel to problemsolve every challenge that presents. Through collaboration, we take practices for one client population and adapt them for others. Telehealth is a great example. Occupational therapists’ digital literacy and technology skills have quickly increased, and I would also like to thank those therapists who have so willingly provided assistance based on their knowledge and experiences in telehealth. We have also benefited from those who have expertise in ways to overcome occupational deprivation. Yet it is also disturbing to see an increase in participation in occupations that often bring harm, such as online gambling and those associated with alcohol sales. This will put very vulnerable people at risk due to disruptions in routine and occupational participation. In hard times, however, it seems that the best in occupational therapists always shines through.

Using technology to stay connected has become the new norm, and we will never take for granted the importance of social connectedness again.

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I am conscious that many have been impacted by COVID-19 in ways other than your occupational therapy practice. This crisis will particularly impact women, who not only make up the majority of our occupational therapy workforce, but also more broadly our front-line health workforce. Women are also more likely to be impacted due to their informal carer roles, particularly with changes to our schools, health services and agedcare services. The other community group immensely impacted is our First Nations People. Given their possible poor health status often due to co-morbidities and chronic disease, their occupational participation will be more disrupted than others. Occupational therapy students have also been impacted. Not only have most students lost income from their part-time employment, but also their studies have been disrupted. Australian students are studying online with practical classes postponed until faceto-face classes can resume. Professional education or placements have also been impacted, with many students concerned about progression through their courses and graduation. Please know that OTA is also supporting student members and is in regular contact with universities, the OT Council and the OT Board. Students will still need to meet graduate competencies and 1,000 hours of professional education before being registered, but how that will be achieved may be different from usual ways. Our OTA staff have done an amazing job in keeping us connected, particularly through social media and our website. Using technology to stay connected has become the new norm, and we will never take for granted the importance of social connectedness again. On behalf of the Board, please stay safe, collaborate and connect for everyone’s sake.

CEO’S REPORT

CEO’s Report Samantha Hunter | OTA CEO

as there been a more important time in our lives to communicate, to collaborate, to connect—even when we can’t congregate? I don’t remember a time when there has been so much stillness, yet so much frantic activity simultaneously. Pockets of calm and pockets of chaos. The remoteness of our lives calls for all of us to more intensely and more purposefully collaborate and connect. It is also a time when we need to nurture and protect ourselves, to practise patience, gratitude and understanding. This is a time when we are so physically alone but so connected to the whole of humanity. It is a time when people are being extraordinarily brave, resourceful, innovative and caring. It is a time when we start to realise that we’re all #inthistogether. In these strange times, talking to my counterparts in the United Kingdom, Canada and the United States brings great solace as well as great ideas. Forging bonds is fast-tracked, and while I despair at their members’ situation, I appreciate how lucky we have been so far here in Australia. Above all, I hope we all continue to stay safe, stay supportive and stay well. Likewise, collaboration has flourished with my partners in the association sector. Associations date back to the 16th century, functioning as a way that a group of people working in the same industry or profession can band together. The collaboration and connection fostered through associations bring about ideas, innovation and, importantly through strength in numbers, leverage and protection.

The collaboration and connection fostered through associations bring about ideas, innovation and, importantly through strength in numbers, leverage and protection.

Our relationships with other allied health associations including the Allied Health Professions Association demonstrate our importance as an individual association advocating both specifically for our members, as well as collectively raising the voice and concerns for 130,000 allied health professionals across Australia. One is not a replacement for the other. We are mutually beneficial, and at times when there are so many competing voices, one collective voice can achieve more than a cacophony. Whilst formal and industry-specific collaborations are important, so are the more informal connections. Forging and fostering relationships and linking together allows us to draw on a multitude of bright minds—and brings different perspectives to the fore. I unashamedly draw on the knowledge of a solid group of association CEOs from across all sectors, and I have another group of senior leaders who connect to talk about the challenges of leadership and share learning. I trust all of these people to challenge and change my thinking.

Critically important to the future of Occupational Therapy Australia is the incredible collaboration of our team. Having disbanded from our offices and de-camped to our homes, all of the team has juggled the influx of member enquiries and demands of lobbying government and synthesising policy, developing guidelines, re-scheduling learning and development, re-imagining our major events, re-casting budgets as well as continually communicating with members— all whilst continuing our business as usual and juggling the demands of home. Whilst our team is working tirelessly on keeping the organisation running and the members informed, the Board—the collective of members representing you—turns its talents to the longer term of the organisation. It is a truly humbling experience to be surrounded by so many talented people to draw on, and so many of our members stepping up and contributing to the important and urgent work that this crisis has prompted. It makes me both grateful for the support and the connections throughout our community—and hopeful for the future.

CONNECTIONS WINTER 2020 5

P O L I C Y, L O B B Y I N G & A D V O C A C Y U P D A T E

Collaborating Across Allied Health Professions Michael Barrett, OTA National Manager: Government and Stakeholder Relations

The value of OTA’s collaboration with other allied health professions was never more evident than in the first weeks of the COVID-19 lockdown when the lives of clients—and the livelihoods of the clinicians who care for them—were on the line.

hile the Federal Government moved swiftly to ensure the work of general practitioners could be delivered by means of telehealth, we had to remind the authorities that some of Australia’s most vulnerable people faced deteriorating health outcomes unless they continued to receive the support and care of allied health professionals. Given governments’ understandable preoccupation with the immediate needs of the acute-care sector, it became apparent that the allied health professions would need to speak with one voice if we were to be heard. Moreover, there was room for only one representative of the allied health sector at the councils convened by the Commonwealth to chart the course of Australia’s response to the pandemic. So we had to collaborate, and we had to do it quickly. Allied Health Professions Australia (AHPA) convened meetings of its member associations almost daily. Here we assessed the latest developments in the crisis and identified the 6 otaus.com.au

most pressing needs of our members and the clients they were increasingly unable to support face-to-face. We told AHPA what was needed most urgently, and in turn we were briefed on the Federal Government’s response to earlier representations. First and foremost, it was essential that as much allied healthcare as possible be delivered by telehealth and that this care attract the same rebate that face-to-face care previously had. This was true across the gamut of departments and agencies in which occupational therapists work: the Department of Health (and the Medicare Benefits Schedule (MBS) it administers), the Department of Veterans’ Affairs, and the National Disability Insurance Scheme (NDIS). It is important to note that occupational therapists’ clients are almost uniquely vulnerable to this pandemic. By virtue of their particular disability, their chronic disease or their age, many clients fall into cohorts requiring immediate isolation. But in doing so, they lose access to the

very care they need to maintain maximum possible function, avoid deteriorating health outcomes and, crucially, stay out of hospital. It was therefore in everybody’s interest that as much allied healthcare as possible be delivered by telehealth. The National Disability Insurance Agency confirmed early on that it was amenable to as many services as possible being delivered by telehealth. This was good news for providers and great news for participants. On 11 March, the Prime Minister announced an initial package of measures to address the pandemic. This included telehealth consultation services provided by doctors (both GPs and specialists) nurses and mental-health allied health workers to be available under Medicare for people aged over 70, people with chronic diseases, Aboriginal and Torres Strait Islander people aged over 50, people who are immunocompromised, pregnant people and new parents with babies.

P O L I C Y, L O B B Y I N G & A D V O C A C Y U P D A T E

While this was good news for OTA members providing services as part of the Better Access scheme, it still left many occupational therapists wondering if they would be able to deliver services via telehealth as part of the MBS. OTA’s CEO Samantha Hunter wrote to the Federal Health Minister, the Hon. Greg Hunt, about this on 20 March. It was heartening when the Health Minister announced on 23 March that all health professionals who previously provided services as part of the MBS, and who are themselves deemed vulnerable to COVID-19, could deliver care by telehealth and attract an MBS rebate. On the weekend of 28-29 March, it was announced that health professionals would be able to deliver their usual services by means of telehealth consultations. After some confusion, AHPA was able to confirm that this included allied health professionals. Given the substantial number of occupational therapists who provide services on the MBS, this was the major breakthrough we had been advocating for. While allied health professionals were obliged to bulk bill clients and refrain from applying a co-payment, this was nonetheless very significant—it amounted to official recognition of the fact that allied health has a vital and ongoing role to play in the support of public health. Some ten days later, it was also confirmed that allied health professionals would be allowed to apply a co-payment once Services Australia had been able to update its billing technology. Initially, the Federal Government precluded co-payments for particularly vulnerable clients or those under the age of 16, a decision that seriously undermined the viability of those allied health practices that support such clients almost exclusively. After further lobbying by the sector, the Health Minister reversed this decision on 20 April. All the while, OTA and our fellow allied health peak bodies were acutely aware that there were advocacy battles to be fought on other fronts. Across Australia’s eight states and territories, there were compensable schemes wondering how much of the care that they oversaw could be safely and effectively

In the case of one [PHI] fund, OTA successfully persuaded it to reverse a decision not to include occupational therapy in its suite of telehealth services.

delivered by telehealth. And, similarly, the nation’s Private Health Insurance (PHI) funds were starting to reach out to the professions, asking precisely the same question. With AHPA busy coordinating the federal government activity, each association engaged with its state and territory-based compensable schemes to advocate for their professions. The unique collaborative environment of AHPA allowed each association to maintain connection and dialogue with each other, keeping up to date with the trials and triumphs of their lobbying efforts. At the time of writing, some schemes have embraced telehealth more readily than others, but OTA members can be assured that we have been proactively engaging with their respective workers’ compensation and traffic accident insurance schemes. In the case of the PHI funds, AHPA played a less central role in advocacy efforts. AHPA alerted its member associations to a request from Private Healthcare Australia (PHA) for information about the viability of telehealth. OTA drew on the expertise of clinicians on staff, and the considerable experience of some OTA members, to produce a submission to PHA outlining the many areas of occupational therapy which can be effectively delivered by telehealth. We are pleased to report that this submission supported very productive engagement with individual PHI funds, and that in the first ten days of April most major funds, and a number of smaller profession-based funds, announced that those of their members

with occupational therapy as part of their package would now be able to receive that care by telehealth. In the case of one fund, OTA successfully persuaded it to reverse a decision not to include occupational therapy in its suite of telehealth services. At the time of writing, access to Personal Protective Equipment (PPE) remains an issue of urgent importance to members. While priority has been given to those health professionals working in acute care, a compelling case is being made that many interventions must be delivered face-to-face, and that given the severely compromised health of many clients, our members must have access to appropriate PPE as a matter of urgency. Once again, this is fundamental to ensuring the safety of occupational therapists, their clients and families, and to avoiding hospitalisations at a time when every hospital bed is precious. At every point in the journey to date, the importance of inter-professional collaboration has been manifest. Be it discussions around the security of competing telehealth platforms, the responsiveness of a given state insurance scheme to telehealth, or the fate of student placements at this time of unprecedented change, the ability to confer with other allied health peak bodies and share in real time has been invaluable. The allied health professions are in effect a multi-disciplinary team, collaborating as effectively as possible in rapidly changing circumstances to safeguard and support the future of multi-disciplinary healthcare.

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P R O F E SS I O N A L P R A CT I C E & STA N D A R D S U P D AT E

Leading the Way for our Clients, our Colleagues, our Profession, and our Community Carol Jewell, Acting National Manager: Professional Practice and Development

he global impact of COVID-19 is a stark reminder of the compounding effect that the environment can have on health, well-being, activity and participation. A dichotomous effect where barriers and enablers in the environment can afford and/or press adaptation to engage in meaningful occupations (Kielhoffner, 2009). This concept is deeply embedded in our practice and is the cornerstone of our profession. It is therefore no surprise that many occupational therapists have emerged as leaders during this crisis. They are collaborating, connecting and modelling personal and professional resilience. Leading the way not only for our clients, our colleagues and our profession, but for the broader community at large.

(Miller, 2001). A stand out example of such leadership was clearly shown by Lorrae Mynard (occupational therapist and Monash University PhD candidate). Her insightful leadership and her avid desire to enhance people’s resilience during this uncertain time led to the development of her exemplar guide Normal life has been disrupted: Managing the disruption caused by COVID-19. This plainlanguage guide is based on the core principles of occupational therapy and has been highly sought after nationally and internationally. In fact, the guide has been so popular that translations are being made into Italian, Korean, Hebrew, Czech, Slovakian and French. This is an exceptional example of how one person can reach out, inspire and connect the global community when it is most needed.

Leadership

Collaboration and Teamwork

A good leader is adaptable and can navigate change successfully while empowering, motivating and inspiring those involved (Cantwell, 2015; Gill, 2002). These skills and qualities have been seen in our profession in very good measure. One such example has been the high level of commitment shown by experienced telehealth providers to guide, support and enable clinicians to transition to telehealth services. This was exemplified by the strategic and visionary leadership shown by Cathy Love (occupational therapist and allied health business coach) with her pop-up telehealth webinar delivered in the very early stages of the crisis. Strong leadership with commitment and resolve is central to successful major change 8 otaus.com.au

Teams offer the potential to achieve more than any person could achieve working alone by capitalising on the variety of knowledge, skills and abilities available (Mao et al, 2016). Mao (2016) established that teams do their collective best through effective communication, coordination and collaboration. This can be seen in our profession by the way that occupational therapists are connecting and supporting each other, the way they are sharing resources, adapting to change, and flexibly responding to clients’ needs. This can also be seen in the way that Occupational Therapy Australia has worked together with other allied health professional associations and government bodies to

ensure members receive the best advice and resources to effectively and safely respond to the challenges brought on by the COVID-19 crisis. The collective knowledge, skills and experience gained through this collaboration has resulted in the development of comprehensive and well-considered resources to support clinician adaptation to changes in the way they work (such as our COVID-19 resources, telehealth resources and frequently asked questions). This collective effort was also evident in the substantial work carried out to jointly secure telehealth funding for allied health clinicians (e.g. Medicare, Transport Accident Commission, and private insurance). Occupational therapists have a deeply embedded understanding of how the environment can impact on health, wellbeing, activity and participation. With these insights, many occupational therapists have acted as change agents in recent times—leading the way not only for their clients, colleagues and profession, but also for the broader community. This clearly demonstrates that when it most matters, you can count on occupational therapists. As a profession we should take great pride in this. References Cantwell, J. (2015). Leadership in Action. Melbourne Univ. Publishing. Gill, R. (2002). Change management—or change leadership? Journal of change management, 3(4), 307-318. Kielhofner, G. (2009). Model of human occupation. Mao, A. T. & Woolley, A. W. (2016). Teamwork in health care: maximizing collective intelligence via inclusive collaboration and open communication. AMA journal of ethics, 18(9), 933-940. Miller, D. (2001). Successful change leaders: what makes them? What do they do that is different? Journal of Change Management, 2(4), 359-368.

C P D U P D AT E

Being Connected Lindsay Vernon, Professional Adviser: Learning and Development

he theme for this issue of Connections, collaborate and connect, was established some months ago yet seems increasingly relevant as we adapt to restrictions being placed on our occupations and activities as COVID-19 spreads throughout the world. I wrote myself some rough notes when the theme came through and one was on social connectedness. There has been a lot of media coverage on needing to be socially distant from people, but what is actually required is safe physical distance from others. Our social connectedness needs to remain strong and robust, and it turns out that as a community we have been innovative in our ways to do this while adhering to restrictions and rules to keep us safe and well. We have seen multiple examples of people engaging with each other in social activities across balconies, on opposite sides of the road, through windows and online. Social connectedness has been an intentional activity for people. While previously it was a routine and habitual component of our daily activities, it is now something we have needed to think about a bit differently and I hope this has enabled people to appreciate it a bit differently, too.

In having to be more considered in how we undertake these activities, I hope everyone has stopped to appreciate the diversity of opportunities they have to be connected. If you haven’t done this yet, I encourage you to take a minute to reflect on who you have stopped to check in with, how you have done this and why that has been important for you. I encourage this because I also want us to think about those who, for a variety of reasons, don’t have too many opportunities to be socially connected or many options to have those needs met. For those people it is important for us as therapists, as citizens, to be cognisant of checking in with them or assisting others to check in with them. Why? What do we get from being connected? Being connected in positive relationships can provide us with: • A sense of belonging • Support • Feedback • Help • Friendship • Love Being connected can help keep us grounded in our sense of self.

I encourage you to take a minute to reflect on who you have stopped to check in with, how you have done this and why that has been important for you.

Over the past few months we have tried to offer you professional development opportunities to not only help you adjust to the new challenges that COVID-19 has brought with it, but to help you think about your needs and how you can support yourself. Our social media platforms are full of links (we have shared numerous opportunities from other organisations, from the Department of Health and OTBA, right through to smaller local businesses who have taken the initiative to develop and/or share resources). Our website has a dedicated COVID-19 resource section and the OT Blog has some thoughtful reflections on the recent changes life that has brought about for us all. I hope you have been able to access them. If not, please do go to our webpages, or scroll back through any social media platforms you engage with as a number of these are free to access for all. Our workshops have, where able, been transferred to online learning and this has been a smooth transition for all involved. I have to say a very big thank you to those presenters who had a very short turnaround time in March to restructure how they delivered their material which enabled us to run four online workshops that month. We then ran one in April, three in May and have three planned for June. We continue to support a webinar program and the new tea pOT talk (journal club) series (see page 14). We will continue to explore how we can use online modalities more effectively to support occupational therapists in the hope that our professional development is accessible for all. This has been a huge opportunity for us all to learn how to use technology more effectively, so we have taken that opportunity and hope to enhance our program in the long term as a result.

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W F OT U P D AT E

WFOT Update Adam Lo, WFOT 1st Alternate Delegate

Collaborate and Connect to Overcome the COVID-19 Pandemic At the time of writing, the COVID-19 pandemic is having a drastic impact on the lives, health and wellbeing of individuals, families and communities across the world. As occupational therapists, we recognise the consequences and changes that are occurring in how people access and undertake their occupations as a result of the pandemic, whether it be in their activities of daily living, modes of communication, issues of mobility and accessibility, social activities and networks, as well as play and leisure pursuits. Additionally, many individuals, families and communities—especially the more vulnerable groups such as our remote communities and people with disabilities— are now isolated, displaced or have run into financial hardship. As a profession, we have the knowledge and skills to work with these affected groups, to facilitate their ongoing access to meaningful occupations and to promote of good physical and mental health. This includes the effective use of assistive technology and telehealth modalities, as well as appropriate social and environmental adaptations. WFOT has established a dedicated online platform to collaborate, share and develop resources regarding the impact of COVID-19 and its relevance to the occupational therapy profession. The forum is available on the Occupational Therapy International Online Network (OTION) which can be accessed here: https://wfot.link/covid19 WFOT also has additional resources and publications to assist occupational therapists and others providing services during this pandemic. The following are available from the WFOT Resources (wfot.org/resources): Position Statement: Occupational Therapy in Disaster Risk Reduction Position Statement: Occupational Therapy in Disaster Preparedness and Response Position Statement: Occupational Therapy and Mental Health Position Statement: Occupational Therapy and Assistive Technology Position Statement: Occupational Therapy and Telehealth Publication: WFOT Guide for Occupational Therapy First Responders to Disasters and Trauma Online Forum: OTION COVID-19 Online Learning Module: Disaster Management for Occupational Therapists Endorsed Publication: Early Rehabilitation in Conflicts and Disasters Endorsed Publication: Responding internationally to disasters Endorsed Publication: Disaster and Development: an Occupational Therapy Perspective MORE INFORMATION

A full list of WFOT Position Statements is available here: https://www.wfot.org/resources/list-of-position-statements

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WFOT 2020 Council Meeting Postponed Every two years the WFOT Executive Management Team and the official Delegates of the Member Organisations meet at a formal Council Meeting to govern the responsibilities and strategic direction of the Federation. The next one was initially scheduled to be in Hong Kong in March 2020, which has been tentatively rescheduled to August 2020 due to the global outbreak of COVID-19. Associate Professor Lynette Mackenzie, the Delegate for Occupational Therapy Australia to WFOT, as well as I, the First Alternate Delegate, will be in attendance. The Council Meeting allows representatives from member countries to share ideas, resources and knowledge, providing a global voice for occupational therapists and helping set the standard for our practice.

Updated WFOT Online Module: Disaster Management for Occupational Therapists This self-paced program uses real-life simulations to discuss the complex issues faced in disaster management from an occupational perspective. The module is interactive, multimedia and story rich, designed to immerse participants in the challenges faced by occupational therapists and survivors. The course is available on desktop or mobile at a cost of USD $99. A WFOT certificate is offered on completion. More information and registration details are available here: https://dmot.wfot.org At the time of writing, WFOT is providing free access to this course for individual members for a limited time. Please note that members of Occupational Therapy Australia automatically qualify as members of WFOT. Members should follow the instructions available in the following link to learn more about the module and how to enroll, before the limited time offer expires. https://www.wfot.org/resources/disastermanagement-for-occupational-therapists

A O TJ R E P O R T

Collaboration and Connections in the Australian Occupational Therapy Journal Associate Professor Kate Laver, ARC Discovery Early Career Research Fellow, Flinders University

he Australian Occupational Therapy Journal (AOTJ) is published primarily for readers who work as occupational therapy clinicians, educators, researchers and policy makers. However, the connections of the journal reach far and wide. Articles published in the journal are read and used by other health professionals and policy makers. For example, in 2005, Carolyn Unsworth and colleagues published a paper in the AOTJ that reviewed tests contributing to the occupational therapy off-road driver assessment. The paper has been cited internationally in two books and 44 times by journals from the fields of psychiatry, rehabilitation, gerontology, medical education, accident analysis and prevention. The impact that this paper has had on research in the field of driving is substantial. It is not possible to measure the impact that the paper had on clinical practice, however papers such as this which address clinically relevant questions are highly prioritised by the journal and are of great value to clinicians. Another example of the journal’s connections is illustrated when we consider the multidisciplinary work published in which occupational therapists and other health professionals work together to conduct cutting-edge research. In this February’s edition of the AOTJ we published a paper by Julia Sterman and colleagues about the Sydney playground project. This article described how adapting the playground

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environment through placing recycled materials on the playground and engaging parents and educators in risk reframing increased play choices and inclusion. This project reflected collaboration between occupational therapists, parents and educators (as well as the participants in the study). The published research article involved researchers from the fields of occupational therapy, disability and education. By working together and sharing knowledge and skills, multidisciplinary clinical and research teams can create the most innovative and worthwhile work. In the coming months the AOTJ will be collaborating with the Cochrane Collaboration to assist occupational therapists to access and interpret the latest research evidence in health care. The mission of the Cochrane Collaboration is to promote evidenceinformed decision making by producing highquality systematic reviews. The methodology involved in producing a Cochrane Review is considered to be the gold standard. The production of Cochrane Reviews involves a team of authors, editorial group advice, information specialist input, statistical and consumer review and many months of work. Cochrane Reviews are considered a trustworthy source of information as the group does not accept commercial or conflicted funding. Yet Cochrane Reviews are often under-utilised, and clinicians are often unaware of the presence or findings of these

reviews. There is great potential to increase the impact of these high-quality reviews and improve outcomes for members of the public who require health-care services. In 2020, the AOTJ will be introducing a Cochrane Corner to help bridge the gap between evidence and practice. Our aim is to increase the awareness, accessibility and relevance of Cochrane Reviews for readers of the journal. Our Cochrane Corner will feature a summary of a topical Cochrane Review. This will be followed by a commentary written by an occupational therapist which places the findings of the review into context and describes implications for practice. We see the Cochrane Corner as another opportunity for occupational therapists to contribute to the journal. We will be reaching out to experts in the field and calling for expressions of interest from occupational therapists who would like to write a commentary within the Cochrane Corner. This is a unique opportunity for occupational therapists who may not have authored a journal article before to develop their skills and share their knowledge. We look forward to sharing more information about the commencement of Cochrane Corner in upcoming communications from the journal. Please follow us on Twitter (@AusOTJournal) to stay up to date with the latest information, events and papers published in the journal.

F E AT U R E

The Call Up: Sharing

Our Knowledge and Skills to Make a Difference Professor Gail Whiteford (BAppSc; MHSc: PhD) FOTARA

recently read a piece by well-known social commentator Waleed Aly. In it, he described us as “an anxious public dealing with something well beyond its experience and at the very limits of its understanding”. Generally speaking, he’s right: the COVID-19 situation is not one we could have imagined, nor one we were probably prepared for. However, if there was a collective of people who did have experience and understanding of the impacts of dramatically altered patterns of occupational participation— which is what is happening at a mass level—that would be us. Think about it. We have the knowledge base and the skill set that is highly relevant for the scenario we are living through right now. I find this deeply reassuring and hope you do, too. Also, like me, I hope you were both pleased and proud to see the release of the OT COVID-19 Guide developed by Lorrae Mynard. It’s excellent, and I have heard from colleagues overseas that they have accessed it, distributed it (very quickly it seems) and found it a beacon of hope personally and professionally. However, being pleased and reassured is not enough. Given that we have this professionally unique knowledge base and skill set, we have a moral and societal obligation to share what we know, and do what we can to make a difference. In particular, it seems to me that we have to attend to the impacts of various levels of inequities in society and how they are impacting on individuals, families and communities in the current context.

If we use the CORE Approach (see Pereira et al, 2020) which requires us to consider Capabilities, Opportunities, Resources and Environments, then it becomes apparent very quickly that whilst we are all facing diminished opportunities for occupational participation right now, a real divide is evident with respect to resources and environments. There are many groups of people who were vulnerable before the current crisis. People who did not have either access to resources or environments to support diverse forms of occupational participation. Their situation has worsened considerably. In particular, although we will all experience occupational deprivation to some extent in the current situation, vulnerable groups are more likely to be impacted more profoundly. So, as well as sharing our knowledge and skills in occupational and environmental adaptation, we can also share our professional understandings of what occupational deprivation is and what its impacts can be. I urge you to think about it, talk about it and then consider what you might do to help reach that small but comparatively silent army of (very occupationally deprived) people out there who are really doing it tough. If ever there was a time in which our profession has had a collective call-up, that time is now. POSITION STATEMENT ON OCCUPATIONAL DEPRIVATION

Access OTA’s National Position Statement on Occupational Deprivation under the ‘Other OTA Position Papers’ section here: https://www.otaus.com.au/practicesupport/position-statements

Vale Rachel Norris On Sunday 1 March, Rachel Norris passed away peacefully, surrounded by loved ones including her husband Garth. Rachel had been battling uterine cancer for a number of months, and had returned home after exhausting all options from her care team. Rachel was passionate about our profession and this association, dedicating many years, across many roles, to advance occupational therapy in Australia. As OTA CEO (2012-2018), Rachel’s leadership and commitment to members and the wider profession was an inspiration. She tirelessly advocated for, and took up, every opportunity to promote the worth of occupational therapy— particularly the positive impact on people receiving occupational therapy services. Rachel’s collaborative skills and extensive knowledge of our professional landscape were second to none. She championed occupational therapy across Australia, presenting to government inquiries and royal commissions, and lobbying politicians and funding organisations. She collaborated with international occupational therapy associations and developed a close working relationship with the World Federation of Occupational Therapists. She worked with AHPA and the CEOs of other allied-health professional associations to advocate and promote allied health. Rachel was an exemplary ambassador for occupational therapy and our values. Her professionalism, integrity and ethical behaviour shone through in all her dealings with members, staff, board and those outside the profession. Rachel was laid to rest following an emotional celebration of her life in Wollongong on Monday, 9 March. The funeral was attended by past and present OTA staff, presidents, colleagues, friends and family from around the country. Her warmth, compassion and bubbly personality will be missed by all those who knew her. We send our condolences to her husband Garth and family. CONNECTIONS WINTER 2020 13

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OTA’s Tea pOT Talks: Supporting Knowledge Translation Lindsay Vernon, Professional Adviser: Learning and Development In March, we commenced our tea pOT talk sessions. Tea pOT talks were born out of the desire to support clinicians in accessing a defined space to think about knowledge translation in their daily practices. Tea pOT talks in the first instance are an opportunity to be guided through an article review process and be included in the critical discussion regarding the topic. The eventual aim of these sessions is for participants to be able to support this process independently of OTA and/or iCAHE. Participants will be able to continue to undertake this process by themselves or start their own tea pOT talk series with their team. The sessions aim to be: • Time efficient • Available to all • Evidence-based • Collaborative OTA has partnered with iCAHE, the International Centre for Allied Health Evidence, to deliver these sessions. iCAHE is based with the University of South Australia and “works locally, nationally and globally to create new knowledge and translate evidence into safe, quality health care. [They] partner with researchers, clinicians, educators, policy makers, government, industry, professional

and consumer groups and the broader community”. Learn more about iCAHE here: www.unisa.edu.au/research/HealthResearch/Research/Allied-Health-Evidence/ iCAHE and OTA commenced the partnership in late 2019 and worked together to develop the monthly sessions and a process that would work remotely with a diverse range of clinicians. We have limited the number of participants to 20 in each session/series with the aim to enable all participants to engage in discussion or ask questions. iCAHE refined the journal club process to ensure that ‘not only does it focus on the steps in EBP, but more importantly on ‘local context’ to implement evidence more effectively’. All tea pOT talk sessions have dedicated time to consider: • Can the results be applied to the local population? • Were all important outcomes considered? • Are the benefits worth the harms and costs? • What do the study findings mean to practice (i.e. clinical practice, systems or processes)? • What are your next steps? • What is required to implement these next steps?

Tea pOT talks were born out of the desire to support clinicians in accessing a defined space to think about knowledge translation in their daily practices. 14 otaus.com.au

OTA delivered two introductory talks (in March and April) and set dates for two series of talks that are running May–September 2020 and October 2020–March 2021. Both the introductory sessions were very well received and places filled fast. The series offer attendees the opportunity to present a clinical question to the iCAHE team, which then undertakes a thorough review of the relevant literature (using the PICO process to search the literature: P – Patient, Population or Problem, I – Intervention, C – Comparison/Control, O – Outcome) to focus on an article that best addresses the question being asked. Possible questions might be: 1. How can we use supervision time to support clinical change? 2. What models are available to support change in a well-functioning occupational therapy team? (e.g. due to reduction in staff, implementation of EBP, or a new clinical guideline) 3. What is the efficacy of vocation-based interventions for people with severe mental illness? 4. What are the contraindications for… 5. Which assessment tool will help me measure… 6. What is the best treatment pathway for people with… 7. How can I support a change process in my workplace (outpatient paediatric setting)?

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iCAHE then provides a summary of the article which enables clinicians in the session to explore translation-to-practice opportunities and/or hurdles.

Unpack, Unfold and Go

Our introductory topics and staff mentoring and professional resilience. Our talk series are on: • Mentoring and Capacity Building • Aged Care

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iCAHE provides plenty of information and educational resources on why it uses the processes it does and the forms and checklists are all available via their website. They are genuinely passionate about supporting people to develop their critical-appraisal skills and to be using these skills independently of the centre. All participants in the tea pOT talks are requested to undertake three pre-requisite tasks before the first session in their series. These tasks have been hand-picked to enhance the experience of the series and are as follows: Read: Bennett, S 2000, ‘The process of evidence-based practice in occupational therapy: Informing clinical decisions’, Australian Occupational Therapy Journal, vol. 47, no. 4, pp. 171. Watch: A pre-recorded iCAHE journal club process (provided upon registration). Review: iCAHE Evidence-Based Practice (EBP) modules 1–4 available through the iCAHE website.

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We have chosen to step participants through the review process, commencing approximately three weeks out from the event date. We:

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SCA34422_R

1. Ask participants to undertake the prerequisite tasks 2. Provide the article reference 3. Provide a blank review form for participants to start recording their own findings

Once we have that one article, though, we can use it to find others. We can look toGeneral key words used within it and do an independent search, we can1/4/20 2:32 pm SCA34422 Scooters OT_Oz_119x87mmW_REVISED.indd 1

4. Provide the completed review form approximately one week before the session 5. Talk to the findings in the session 6. Leave plenty of time for the transition-to-practice discussion Feedback from our first session was positive. The discussion was helpful and the article proposed raised plenty of questions for people. Of course, often there is not one article that exactly answers the questions we pose so we need to think about the best fit. In doing so, it can lead to considerations we may not have previously thought about. Our tea pOT talks are open to all, so we have participants from a range of practice areas and workplaces. This is one of the strengths of the sessions, allowing us to challenge each other’s thinking in ways that are different to those who may work in the same domain as us or know us well.

review the reference list or seek to find other articles the authors may have written on the topic. By finding that one article that is the best fit and thinking about it in a critical and objective manner, we have taken a step to enabling ourselves to expand our learning and knowledge of resources available. We are looking forward to the tea pOT talk series, where participants get to ask the questions and we get an insight into the challenges you are facing and what you want to address in your work. We are looking forward to assisting you in critically exploring those questions and how, in your workplace, evidence-based practice can be implemented. For further information on tea pOT talks, please see OTA’s CPD webpages: www.otaus.com.au/cpd iCAHE JOURNAL CLUBS

Learn more and access journal club resources here: https://www.unisa.edu.au/research/Health-Research/ Research/Allied-Health-Evidence/Services/JC

CONNECTIONS WINTER 2020 15

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Peers Empowering Peers to Get Up and About Debbie Hewson, MOT, Up and About Project Manager

The Problem: Why It Is the Way It Is Many of us find it hard to achieve our ideal state of physical health. For those experiencing symptoms such as depression, anxiety or psychosis, the barriers are even greater. Severe mental health issues are often associated with increased risk factors for poor health, low socioeconomic status, poor nutrition, increased smoking and high rates of cardiometabolic disease. This is compounded by the metabolic and often sedative sideeffects of psychiatric medications. Poor physical health can have a profound impact on consumer wellbeing, morbidity and mortality, with life expectancies reduced by an average of 25 years (Firth et al., 2018). First-line strategies recommended for weight management and the prevention of chronic disease in adults with severe mental illness are lifestyle interventions, including increased physical activity (WHO, 2018). However, mental health services have struggled to put these interventions into routine practice.

As an experienced occupational therapist employed in a longer-term mental health inpatient rehabilitation unit, whose specialties lay outside the realm of exercise prescription, I managed a variety of activity programs with varying results. To further improve programs, I looked toward co-design and a more consumer-directed care approach.

The Experiment: Consumer Engagement in Program Design, Free Access to Facilities and Exercise Physiology During a group discussion with consumers regarding our collectively expanding waistlines and physical inactivity falling somewhat short of national guidelines, Matt (a consumer who had been a semiprofessional sportsman) offered his skills to develop a low-impact, consumer-driven exercise group. Thus, the idea was born. Armed with an $800 Get Active Program grant and good networking skills, I was able to offer

Throughout the program we use a celebratory model to promote healthy habits and lifestyle achievements 16 otaus.com.au

consumers free access to their local PCYC and employ an exercise physiologist to provide evidence-based exercise interventions and support to Matt in delivering the group. Matt helped identify and address local barriers to participation and provided an informal peer-mentor role, encouraging and supporting others to engage.

The Program: ‘Up and About’ An informal evaluation of the program led to a successful Sports Australia Grant developed in collaboration with Richmond Fellowship Tasmania, with support in program design and evaluation from the University of Tasmania, and advice from staff at NSW “Keeping the body in mind” project (Fibbins et al., 2019). Up and About expanded the program to all regions of Tasmania and offered free weekly exercise physiology groups in a local gym, access to 1:1 exercise physiology sessions (tailored to consumer needs), the loan of a Fitbit (smartwatch activity tracker), and health coaching with the occupational therapist. Consumers also received free or heavily discounted gym membership post-program. Throughout the program we use a celebratory model to promote healthy habits and lifestyle achievements (reductions in smoking, improved healthy eating goals and increased exercise and confidence). The Up and About program has aimed for consumer engagement at every level, through

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Stephanie (peer support worker), Brigid (Flourish consultant), and Debbie at the Redefining Health Conference, March 2020, Tasmania

development and design, implementation and evaluation. Matt, the original developer of the program, still attends groups in his local region, is a paid member of the steering committee (along with other consumers from Flourish, a not-for-profit organisation for people with lived experience of mental illness in Tasmania) and has joined us in presenting at a redesigning health conference.

‘Up and About’ 2.0: The Impact of Peer Mentors The expansion of the program required adjustment as our first groups were small, shy and (at times) struggling to connect. There is a large amount of evidence that shows the value of peer support in the mental health system (Chinman et.al., 2014). Participants who completed a six-week group were encouraged to re-join subsequent groups as peer mentors and provide hope and support to newer members. We had neglected an important element: supported peer support.

By the second round of groups we had seen our error and collaborated with some of Tasmania’s paid peer support workforce in the government and non-government mental health services as a means of empowering and upskilling consumer peers. The peer support workers opened referral pathways, spread word of the benefits of the program, and increased community support. They supported consumer participation, including at their local gym after the program. They also became a symbol of hope, inspiring participants to think beyond their own circumstances.

What was the Impact? At the start of the program, 87% of the participants were classed as inactive. Many reported that they would sit for 10-12 hours a day and sleep the remaining 12 hours. Within three months, 123 participants had completed the program across Tasmania. After

the program, 65% of participants reported that they were more active than they had been in the last 12 months, and over 24.4% of those said they were now far more active. One older participant commented: “Before, I struggled with my stairs to get outside my house. I thought people would laugh at me in the street. Now I am stronger, I can use my steps without holding on. I know I can do this... I am determined to stay out of a wheelchair!” Positive outcomes of the program included an increase in physical activity and motivation, the achievement of health goals, greater confidence and strengthened social connections. Peer mentorship has built resilience, enhanced self-belief and enabled people to use physical activity to engage and integrate with their communities. This was exemplified by an 18-year-old participant at the end of the program: “I have not left my house for a year... But now, [smiling CONNECTIONS WINTER 2020 17

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Where to From Here?

at another participant at his local gym] I reckon I’m gonna come here every day!”

While recurrent funding for the program is still uncertain, our dreams of improving access and support for consumers to manage their physical health is not. Enabling an integrated lifestyle intervention program for mental health with peer support workers and exercise physiologists offers an affordable and scalable intervention (Stubbs, & Rosenbaum, 2018).

Already, four participants are enrolling in official peer support worker training since the program.

‘Up and About’ 3.0: COVID-19 and Beyond Like many, the effect of COVID-19 has seen our program move online through a private Facebook group providing a ‘health hub’, which was quick to set up and easy for consumers to navigate. Mental health support has increased. Together we are navigating the effects of home isolation, breaking down roles and routines, and rebalancing our disrupted lives. Our exercise physiologists continue to share their live Facebook workout sessions via Zoom. Phone connections for health coaching have increased. Participants have also increased their engagement through texting ‘exercise buddies’ to provide support and encouragement, posting healthy recipes, tips, and encouraging each other through online classes. Greater community interaction is being observed. Classes and Facebook posts on wellbeing continue to be shared amongst friends online. We are also in the initial stages of setting up a “virtual fun run” to help groups across the state work together and increase motivation. As we forge through these uncertain times, learning to utilise and rely upon technology more heavily whilst being physically disconnected, we struggle but we witness inspiration and innovation. The additional skills we are all developing will add a further layer of resilience beyond the restrictions imposed by COVID-19.

What Key Learnings Can You Take Away? Collaborations with a wider multi-disciplinary team including exercise physiologists and peer support workers in mental health are

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There are many areas for further research. Our current focus is on integrating online formats and assessing the faceto-face support necessary to sustain the program and outcomes.

Kahlia, one of the Up and About exercise physiologists teaching how to use the TheraBand

essential in addressing the physical health inequities for mental-health consumers. As occupational therapists embedded in mental-health systems, we can create stronger pathways and advocate, support and mentor these newer professions into the system. Peer support workers are an incredible workforce. They are key to engaging and empowering consumers to be involved. They need to be included in program design and funding from the outset. Designing in the right connections and the right support is important. Consumers are passionate about being involved in physical activity, to feel in control of their physical health and to make positive changes in the health system. There is a range of technology and online programs out there we can tap into, but it takes courage and determination and ongoing problemsolving to help people access them. We started small, with limited resources. We didn’t always get it right, but we tapped into the power of consumers to problem-solve. Smallscale evaluation helped secure additional resources. Our connection with the University of Tasmania was invaluable setting up program logic, process and outcome evaluations.

To conclude with a comment from one of our amazing peer support workers, “The group is a metaphor for change. No one can exercise for you. When we achieve this, we know we have the power to take control of our own health.” About the Author Debbie Hewson has worked around the globe for over a decade as a mentalhealth occupational therapist. Now by good fortune she has turned OT Project Manager for the Up and About Program, with Richmond Fellowship Tasmania. References Chinman, Matthew, Preethy George, Richard H. Dougherty, Allen S. Daniels, Sushmita Shoma Ghose, Anita Swift, and Miriam E. Delphin-Rittmon. “Peer support services for individuals with serious mental illnesses: assessing the evidence.” Psychiatric Services 65, no. 4 (2014): 429-441. Firth, Joseph, Najma Siddiqi, Ai Koyanagi, Dan Siskind, Simon Rosenbaum, Cherrie Galletly, Stephanie Allan et al. “The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness.” The Lancet Psychiatry 6, no. 8 (2019): 675-712. Fibbins, Hamish, Oscar Lederman, Rachel Morell, Bonnie Furzer, Kemi Wright, and Robert Stanton. “Incorporating exercise professionals in mental health settings: An Australian perspective.” Journal of Clinical Exercise Physiology 8, no. 1 (2019): 21-25. Stubbs, Brendon, and Simon Rosenbaum. Exercise-based interventions for mental illness: Physical activity as part of clinical treatment. Academic Press, 2018. World Health Organization. “Management of physical health conditions in adults with severe mental disorders: WHO guidelines.” (2018).

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ECU Paediatric Occupational Therapy Clinic: A Clinic for the Community, in the Community Jacqui Hunt, Occupational Therapist and Coordinator of the ECU Paediatric Occupational Therapy Clinic

am sure that the start of 2020 has taught us all many things, not the least of which is the knowledge, or more likely a reminder, of the importance of feeling connected. Communities all over the world have been growing closer whilst we have all simultaneously been subjected to increasing levels of physical isolation. I doubt that I am on my own when I say that in difficult times, I have found great comfort in the knowledge that we are all in this together. As occupational therapists, we have long understood the connections and interactions between human participation and engagement, physical and emotional wellbeing and the social, physical, cultural, economic and natural environments that surround them. Thankfully, our occupational therapy training and practice experience has helped us to prepare for the social, physical, financial and emotional support that is now required, more than ever by so many of our friends, family members, colleagues and the recipients of our services. We have faced many challenges thus far in 2020 and we cannot be certain of the additional challenges that lay ahead, but our training and our clinical experience hold us in good stead to face those challenges head-on. Most of us have travelled a steep learning curve in 2020 as we have explored new and innovative means of service provision, often establishing new policies and procedures ‘on the fly’ so that we may use digital platforms to stay connected and continue our service provision online. At a university level, we have also been required to think outside the box,

ECU students work with the pre-primary participants in the ‘Ready, Steady, Succeed’ school program making fairy bread to celebrate the final week of the program

to use virtual environments to teach our next generation of occupational therapists a full range of units, many of which typically include lessons in ‘hands-on’ therapeutic techniques. My experience this year has been that university staff and students have embraced online learning and found unique ways to remain engaged with each other and with the curriculum content, whilst our practices continue to evolve. For me, one of the biggest challenges has been trying to maintain a connection to the children and families that we work with at the Edith Cowan University Paediatric Occupational Therapy (ECU-POT) clinic. Traditionally, the clinic provides individual assessment and group programs for school children from kindergarten to year three. The clinic was designed in consultation

with local paediatricians and child-health services, and in using this collaborative approach we have been able to learn local priorities and target areas of unmet need. ECU clinic rooms are not located on campus. Rather, they are situated in the local hospital and this has facilitated access to services and provides the local community with a sense of cohesion among service providers. Our free clinic assessment and treatment is offered to children attending schools within 10 kilometres of the hospital, which has helped to nurture the relationships that Melanie Day (1st and 2nd year placement coordinator, ECU) has built with the schools in our local community. The schools welcome ECU-OT students for clinical placements and, in turn, refer their primary-school students CONNECTIONS WINTER 2020 19

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to our clinic program. In addition to school and parent referrals, we also receive referrals from the local Child Health Services and from local paediatricians who collaborated with us in the formative years of the clinic.

home, and it is a great time for all occupational therapists to work closely with parents in their own environment and to value parental expertise. The move to online services has, in my experience, been quite achievable, albeit very time consuming. We have been able to share our clinic ideas with the families online with minimal variation to the program.

As a free service, we find many families who attend have had limited access to therapy prior to our clinic, and parents often express gratitude for the increased knowledge about their child’s occupational performance.

Activities-based interventions are also easier to deliver online because many homes do not have a therapy ball or a mini-trampoline, but every household is sure to have a pair of shoes to tie and a knife and fork to hold. It has never been a better time to embrace the task-specific, ‘top-down’ therapies, which are strongly supported in the literature1. Our adapted clinic service is by no means ideal, and resources have not allowed for true telehealth practices, however, I am happy that we have been able to provide some level of service to children and families throughout this time.

We have found that in addition to knowledge about their child, we also have a unique opportunity to inform parents about occupational therapy itself: “I had no appreciation of the field of child OT at all prior to this. Amazing” (Parent, 2018) In over five years of operation, the clinic has provided occupational therapy assessment and intervention to hundreds of local children and families. Hundreds of ECU-OT students have participated in hands-on learning, taking the theory learnt in class one week and applying that to practice the very next week. From the beginning, the clinic has been well regarded by students: “It provided me with the opportunity to apply what I had learnt at university in a supported setting surrounded by approachable and highly experienced professionals who were both generous in their time and knowledge. The clinic definitely strengthened my passion to work within paediatrics…” (New graduate, 2016) Numerous honours students have been able to complete their research at the clinic, hoping to have an impact on the lives of the children and families with whom we work: “[The clinic provided me with] an opportunity to collect data from over 100 children, something that would be practically impossible in any other working clinic environment in such short periods of time” (Honours student, 2017) Now in 2020, for the first time in years, the clinic doors are closed and for the first time I find myself developing programs to be delivered via video and email. These are just a couple

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Primary school student in the ‘Ready, Steady, Succeed’ program

of my own ‘firsts’ among the many ‘firsts’ that we all (worldwide) are experiencing. I find myself missing the fun and laughter that the clinic groups bring to staff, students, children and families, but amidst the challenges that we all face, I also find myself feeling grateful for so many brilliant silver linings. Many of us have learned new ways to interact with the children and families with whom we work. Social media is packed full of occupational therapists connecting and freely sharing ideas with one another. Forums are full of discussions about telehealth platforms and procedures, and all manner of resources are being shared amongst therapists worldwide. It is nothing short of inspirational. In the world of telehealth, a family-centred approach is key, and although only 13% of paediatric occupational therapy interventions were once directed at the parents1, I would hazard a guess that number has risen exponentially in the current environment. Our clinic, like so many others, provides therapy ideas that are easy to reproduce in the

I am passionate about the ECU-P-OT clinic, which for years has delivered a good mix of teaching, learning and clinical practice with a dash of research. The clinic has allowed ECU staff and students to work with our local community, within the local community. Whilst I truly value the learning and the experiences that 2020 has afforded, I look forward with great enthusiasm to the human connection that will come when the clinic doors open again. About the Author Jacqui Hunt is an OT with 25 years of clinical experience working in mental health, neurology and paediatrics. Jacqui is currently a lecturer in paediatrics and neurological rehabilitation at Edith Cowan University and has been the coordinator of the ECU paediatric occupational therapy clinic since its inception in 2015. Melanie Day works alongside Jacqui to deliver the clinic programs. References 1. Novak, Iona, and Ingrid Honan. 2019. “Effectiveness of Paediatric Occupational Therapy for Children with Disabilities: A Systematic Review.” Australian Occupational Therapy Journal 66 (3): 258–73. https://doi.org/10.1111/1440-1630.12573.

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A Conversation with OTs in Central Australia Susan Brooks, Manager Adult Allied Health Team, Community Allied Health and Aged Care Division, Primary Health Care, Central Australia Health Service

ccupational therapists work in a range of different places, with different age groups and with different functional impairments. In some remote areas, work opportunities can be limited, but don’t let that dissuade you from exploring all the great places far and wide across Australia. Alice Springs is one such place. It is both a small town with a population of around 24,000, yet also a regional hub. The two closest cities are at least a two-day drive in any direction. As a result, the town has the resources of a much bigger centre, including a hospital with acute and rehabilitation services. There are many government and NGO services across the age span. Many occupational therapists have visited and worked here, but what is it about Alice that makes so many people stay? I interviewed three local occupational therapists to learn a little about their story of working in Central Australia.

When Did You First Start Working in Central Australia and What Brought You Here? Lisle Grimwood: I started working in Alice Springs in June 2018, moving from Melbourne where I had been working in a communityhealth setting. With an interest in social justice, I saw the role in Alice Springs as an opportunity to offer my practical occupational therapy skills within a context where people face a range of challenges due to geographical location and social circumstances. I was

Lisle Grimwood

Sarah Shipp

also open to learning about a remote context, its people and history, along with the experience of living away from the urban environment that I had always known. Jane Hunter: It was 2007, I had been working as a new graduate paediatric occupational therapist in remote Queensland for two years and decided to move to Alice Springs for an occupational therapy role at the Children’s Development Team. I made the move to Alice Springs as it was my home town where I had grown up, and I have family and friends here. Sarah Shipp: I moved from Melbourne to Central Australia in 2015. My husband got a job in the Northern Territory and when we got to preference locations, Alice Springs was our first choice. We wanted to come to Alice for the amazing landscape, great outdoor activities, and country-town lifestyle.

Jane Hunter

What Roles Have You Had in Central Australia? Jane: I started as a Professional One (Grade 1) Occupational Therapist on the Children’s Development Team. I then moved into a Professional Two Occupational Therapist role and I now manage the Children’s Development Team. In my time here I also did a non-clinical role for a short while in our intake team. Sarah: Since moving to Central Australia I have worked at the Alice Springs Hospital as an occupational therapist. I worked as a Professional Two Occupational Therapist for a year, and then in a newly created Senior Occupational Therapist role for a few years. I’m currently acting in the manager role which has been a fantastic opportunity to build my experience and broaden my perspective. CONNECTIONS WINTER 2020 21

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Lisle: I have worked as a Professional Two Occupational Therapist in Community Allied Health for Adults.

What Do You Consider the Highlight of Working Here? Jane: The incredibly broad and diverse caseload. Being able to help children and families who have limited access to services due to their remote location. And the autonomy and flexibility that you have as a therapist. Also, the opportunities that I’ve had for career progression and further study. I have completed my Masters and a Diploma of Leadership and Management with support from my employer. Lisle: For me, a highlight of working in Central Australia is having the privilege to serve others within their home environment by making even a small difference in their ability to carry out their everyday lives. I also value the connections that are forged with clients over the period that I am working with them in my role as an occupational therapist and I enjoy learning from clients, whether it be hearing their stories or learning about culture and language. Sarah: I love working in Alice. I have developed a whole new set of skills in communication, flexibility, and problem solving. It’s also been such a privilege to learn from so many Indigenous patients, and expand my horizons about typical occupations. Things like hunting or making a cuppa in a billy on the campfire. I enjoy trying to find a balance between the hospital and the bush, for instance using damper-cooking as a cognitive assessment.

What Are the Challenges of Working Here? Jane: Difficulty developing specialised occupational therapy skills due to the generalist nature of many of the roles. High staff turnover due to the transient nature of the town. Sarah: Logistics can be challenging. Supporting a patient with a disability to get home, with their equipment, to a 22 otaus.com.au

“A highlight of working in Central Australia is having the privilege to serve others within their home environment by making even a small difference in their ability to carry out their everyday lives,” Lisle Grimwood community that is hundreds of kilometres away certainly challenges my problemsolving skills. Nothing is ever simple, but that’s why the job is so interesting. The broad range of clinical areas that we cover in a remote hospital can also be challenging. We need to be able to cover areas that would usually have specialty teams in the cities and be ready for anything (such as when large numbers of trauma patients present to the hospital following the Finke Desert Race). Lisle: Navigating the web of services that exists in order to bring about change for my clients. However, once I formed the relevant connections, I have found that my day-to-day job tasks run more smoothly.

How Have You Managed to Connect With and Collaborate With Your Profession Whilst Working in Such a Remote Location? Lisle: Whilst working in this role I have been provided with the opportunity to explore other avenues and activities in addition to my clinical role such as undertaking training to become an Aged Care Assessor, participating in recruitment processes and recent participation in the Occupational Therapy Australia NT Divisional Council. Jane: Developing networks with other occupational therapists in town, and those working elsewhere in the Territory for peer support and supervision. Online study and professional development has also helped, for instance I did my Masters by Distance Education.

Sarah: Collaborating with other occupational therapists in Central Australia through our regional network has been very valuable. Working in a small team has also meant that we often need to go outside of our own team for clinical support. I have done this through remote supervision, as well as contacting clinical specialists for advice when needed. I have found that physical isolation is not necessarily a barrier to connection, but a catalyst to reach out.

What Advice Would You Give OTs Considering a Move to Central Australia? Lisle: I would advise occupational therapists who are considering moving to Central Australia to be open to the challenge. There is so much to learn here in this rich part of Australia. Living and working in Central Australia has opened my eyes to the wider context of occupational therapy practice within Australia and I am better off because of this experience! Jane: Just do it! There are so many opportunities. The work is unique and rewarding. The people are friendly and welcoming. The lifestyle is relaxed, and the work-life balance is so much better than in a big city! Sarah: If you are looking to stretch yourself professionally and personally, and keen for an adventure, then Central Australia is a great place to live and work. We are part of a very supportive community and get to enjoy some amazing experiences. We do find it difficult to recruit to our jobs given our isolation, so we are always looking for passionate occupational therapists to join our teams!

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Working From Home Tips Aon

ver the years, experts have highlighted numerous benefits of working from home—from improved work/life balance, reducing traffic congestion and even helping reduce the cost of office rent. The current social-distancing measures and restrictions as part of COVID-19 may have meant that some occupational therapists have started providing their services remotely, including via telehealth. If this is the case, there are a few boxes you’ll want to make sure you’re ticking to ensure you’re having the best experience and prepare your business for some additional complexities that remote working can bring. 1. You still need to be mindful of your health and safety If you have employees, even if they’re not in your office physically, as long as they’re on your payroll, receiving a pay check from you, and have been asked to work from home, you have a duty of care ‘as reasonably practicable’ to ensure their health and safety while working from home, the same as you would be if they were working in your office. It is therefore your duty of care to ensure the environment they’re working in is safe, set up ergonomically and does not pose a risk to their health and safety. We also suggest focusing on your mental health. For further information on mental health support, visit: www.healthdirect.gov.au/mental-illness. 2. Public liability is still a risk When the words public liability are mentioned, the first things that come to mind for many people are tripping and falling, which might not sound relevant if you don’t have an office where you host clients. However, some occupational therapists may still be performing some services in person, and even conducting home visits, and this carries liability risks.

For this reason, public liability should still be a key part of your coverage to help cover any potential exorbitant outof-pocket costs you could incur from a small oversight. While your home and/ or contents insurance may also include a level of public liability cover, if you have a home office, incidents that occur as part of your work or business may be excluded under personal insurance policies. 3. You may be susceptible to cyber risks Cyber risks apply to any business that uses the internet to perform any part of its work or stores any data—regardless of where you work. For example, if you work from home and have younger children (or even teens), all it would take is one of them accessing your laptop and unintentionally downloading malware to send your entire IT system into meltdown. Even if you don’t have children, you’re not immune to these threats as cyber criminals have become so sophisticated that phishing emails are nearly impossible to distinguish from genuine communications. Cyber Insurance has been designed to help protect your business against financial losses arising from cyberattacks and crime and, in our opinion, should be seriously considered when deciding which insurances to take out. 4. Your business equipment might need to be insured separately Working from home usually involves a laptop, and while the cost of a single laptop might not seem like a lot to you, if you run a practice where you have multiple staff working from home, and an event leads to them being damaged or lost, the cost to replace multiple laptops would be a big bill. When insuring your portable electronic devices and other equipment, it’s important to clarify with

your broker whether they’re covered for loss of damage while they’re outside your office or at an employee’s home. If this isn’t standard coverage under your policy, then you may be able to select it as an optional extra. Even if you have them listed under your home contents insurance, personal insurance products often exclude damage which occurs to products while in use for business purposes. 5. You still need a business interruption plan Remote working is often a contingency plan when an event leads to a business premises being inaccessible or locked down. However, it’s also a good idea to have a back-up plan if for some reason your remote-work plans fail. For example, if your own home or your employee’s home is damaged due to a weather event, or you have a crucial meeting that needs to be held in person, you might want to have a back-up plan, or a teleconferencing system to ensure you can keep your business running smoothly. © 2020 Aon Risk Services Australia Limited ABN 17 000 434 720 AFSL no. 241141 (Aon) This information is intended to provide general insurance related information only. It is not intended to be comprehensive, nor does it, or should it (under any circumstances) be construed as constituting legal advice. You should seek independent legal or other professional advice before acting or relying on any of the content of this information. Before deciding whether a particular product is right for you, please consider the relevant Product Disclosure Statement (if applicable) and full policy terms and conditions available from Aon on request or contact us to speak to an adviser. Aon will not be responsible for any loss, damage, cost or expense you or anyone else incurs in reliance on or use of any information contained in this article. CONNECTIONS ONLINE

Browse the digital version of Connections to explore in-article links: www.otaus. com.au/member-resources/publications

CONNECTIONS WINTER 2020 23

CPD CALENDAR

CPD Calendar June – August 2020

Please note: The information below is correct at the time of printing, and is subject to change given the evolving situation with COVID-19.

Workshops – Online DATE

COURSE

19 June

Home Modifications: Ramps and Rails

17 August

Home Modifications: Introduction

18 August

Home Modifications: Advanced

eLearning – Live Webinars DATE

COURSE

28 May

Sexuality, Intimacy and Relationships

3 June

Constraint Induced Movement Therapy

12 August

Business Basics: Establishing an Occupational Therapy Private Practice

30 September

Understanding Stroke Recovery: From Knowing to Doing

8 October

Positive Behaviour Support and Participation Following Acquired Brain Injury (ABI)

NATIONAL CONFERENCE EVENTS 14-15 September 2020 Virtual OT Exchange 2020 [Online] 16 November 2020

OT Mental Health Forum [Melbourne, VIC]

23-25 June 2021

OTA 29th National Conference and Exhibition 2021 [Cairns, QLD]

24 otaus.com.au

CPD CALENDAR

To support clinical decision-making, continued learning and professional engagement, OTA offers a range of evidence-based CPD webinars, workshops and online resources. To browse and register for upcoming CPD events, visit: otaus.com.au/cpd Thank you for your understanding and please check online for the most up-to-date listings.

AREA OF PRACTICE

INTERESTED

REGISTERED

INTERESTED

REGISTERED

INTERESTED

REGISTERED

Assistive Technology, Modifications/Access Assistive Technology, Modifications/Access Assistive Technology, Modifications/Access

AREA OF PRACTICE Disability, Neurological Conditions, Palliative Care and Oncology Neurological Conditions Private Practice, Policy and Process Neurological Conditions Neurological Conditions AREA OF PRACTICE Driving, Environmental Modifications, Paediatrics and Rehabilitation Mental Health All Areas of Occupational Therapy

CONNECTIONS WINTER 2020â&#x20AC;&#x201A; 25

CPD CALENDAR

CPD Calendar

eLearning Recorded (CPD Library) COURSE An Introduction to the Management of Common Hand Conditions

AREA OF PRACTICE Hand Therapy, Knowledge Translation, Leadership/Management

OT in Palliative Care: An Overview of Current Evidence & Clinical Practice

Palliative Care and Oncology

Navigating the NDIS: eLearning Package (includes 4 webinars)

NDIS

NDIS 101

NDIS

NDIS Business Essentials

NDIS, Private Practice, Policy and Process

NDIS Assistive Technology and Home Modifications (Parts 1 & 2)

NDIS

Introduction to Soft Tissue OT

Rehabilitation

Occupational Rehabilitation

Occupational Rehab

Introduction to Functional Assessments - NDIS

NDIS

Occupational Therapy â&#x20AC;&#x201C; Foundations and Models

Foundation skills

Family Caregiver Intervention Study: Outcomes for Patients with Delirium

Aged Care Practice

Can our OT Models of Practice fit a Funding Model such as the NDIS?

NDIS, Private Practice, Policy and Process

Implications of the 2017 National Stroke Guidelines

Neurological Conditions

Understanding the Relationships Between Housing & Health for Older Private Renters

Aged Care Practice

Culture in OT Theory & Practice: An Ongoing Conversation

Cultural Competency, Foundation skills

Occupational Therapy Principles of Practice in the ICU

Acute Care Rehab/Hospital

1000 Norms Project: Measures of Physical Function

Rehabilitation

Navigating the NDIS with People who have MND

NDIS, Neurological Conditions

Is Private Practice For Me?

Private Practice, Policy and Process

What is Health Economics (and Why Should OTs Care)?

Leadership/Management, Research/Education

Talking Toileting

Paediatrics

Introduction to Sensory Approaches for Mental Health

Mental Health inc forensic AOD and refugee

Supporting People with ASD & Their Families

Paediatrics

Learning Through Codesign

Mental Health inc forensic AOD and refugee

SleepAbility: Promoting Positive Sleep Practices with Children

Paediatrics

Normal Life has Been Disrupted

General

Sexuality, Intimacy and Relationships [available from 4 June]

Disability, Neurological Conditions, Palliative Care and Oncology

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Access the CPD Library here: otaus.com.au/cpd

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The Abilities OT team during its annual two-day PD event in our beautiful Barossa Valley

Collaboration in Rural Practice Carly Clarke, Director/Senior Occupational Therapist, Abilities OT

ollaborate and connect seems an appropriate theme for occupational therapists given the hours we often spend doing just that! In fact, I believe that as occupational therapists, it’s one of our greatest attributes. I have often wondered what it is about our training that makes us so good at engaging the key stakeholders and helping to ‘pull it all together’ to get the best outcomes for our clients. Is it our holistic approach? Our engaging conversation skills that facilitate rapportbuilding and connection? Our creativity? Our critical thinking? Our organisational skills? The fact that the client is at the centre of everything we do? It is highly likely that it is all these things. In health care it is generally believed that collaborative efforts yield better health services and outcomes for the populations that are served (D’Amore et al, cited in Bart et al 2005)1. Littlechild and Smith (2013, cited in Bart et al 2005) state that collaboration

leads to improved efficiency, improved skills mix, greater levels of responsiveness, more holistic services, innovation and creativity, and a more user-centred practice.

requested assistive technology (AT). The number of examples of collaboration and connection with the participant and their key stakeholders was astounding, including:

Collaboration is particularly important in our predominantly rural setting. Our busy adult private practice covers a large part of rural South Australia from Whyalla down to Mount Gambier. Therapists may reside many hours from their clients, and whilst distance may be an issue, our ability to collaborate and connect with participants and key stakeholders remains paramount.

1. At the initial assessment, engaging with the participant and their carer to establish their needs and goals utilising our rapport building skills to facilitate connection.

In a recent audit, we tabled the process that happens from initial assessment to discharge with one of our NDIS participants who had

2. Emailing the report to the participant and their support coordinator. 3. Further liaison with the support coordinator about funding available within the NDIS plan for the AT. 4. Telephone calls to the equipment suppliers to discuss the best options for trial.

Being connected with our team is essential for our own growth, development and wellbeing in the workplace. CONNECTIONS WINTER 2020 27

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5. Using our problem-solving and criticalthinking skills with Abilities OT therapists about other possible solutions to ensure all options have been explored. 6. Emailing examples of the different AT options to the participant and supporting the participant in the selection process. 7. Using our organisational skills to book the trial with the equipment supplier and participant. We collaborated with other Abilities OT therapists regarding the trial date so the equipment supplier could see multiple clients for trials on the same day. 8. Trialling the AT with the participant at their home and working with the participant and equipment supplier to find the best solution using our critical-thinking, problem-solving and decision-making skills throughout. 9. Liaising with the equipment supplier to request a quote. 10. Completing the AT request and emailing it to the participant for review to ensure the information the OT provided was accurate and they were happy with the quote. 11. Emailing the AT request to the support coordinator or NDIS. 12. Telephone contact from the participant advising the AT had been approved. 13. Liaison with the equipment supplier regarding delivery date. 14. Liaison with the participant to book a review visit.

Collaboration is key!

15. Review visit with participant, carer and occupational therapist once the AT was delivered to ensure it was suitable and meeting the intended goal. Fifteen examples of collaboration for one piece of AT equipment. And this was an example of a client who only needed one piece of equipment, one trial date, and was savvy in using email as a communication tool!

Collaborate and connect seems an appropriate theme for occupational therapists given the hours we often spend doing just that! In fact, I believe that as occupational therapists, it’s one of our greatest attributes. 28 otaus.com.au

When you add multiple AT requests and/ or home modifications into the mix, the collaboration that occurs between the participant, participant’s representative, Local Area Coordinator (LAC) and/or support coordinator, equipment supplier and occupational therapist is quite amazing! Much of the collaboration we do after the initial visit happens via telephone and emails due to the rural nature of our work. Head office is always a hive of activity with frequent telephone calls occurring on administration days! Another key example of when we collaborate is between our fellow therapists. Being connected with our team is essential for our own growth, development and wellbeing in the workplace. Some of our therapists work in regional areas and don’t have the advantage of sharing an office space with other occupational therapists. We have a strong focus on ensuring that everyone feels supported and part of our team despite the distances involved. We do this by:

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Abilities OT at a video conference team meeting. When COVID-19 hit, we felt ready to embrace the technology wholeheartedly as it wasn’t completely foreign to us

• Encouraging our therapists to get on the phone, email or video link whenever they require support or advice with a tricky situation in addition to their regular supervision sessions. • Having fortnightly team meeting/case studies by video conference to encourage inclusiveness and to ensure that team culture is present and at the fore. Staff link into these meetings via telephone if they are on the road at the time. • Holding an annual Abilities OT two-day professional development event in our beautiful Barossa Valley where we have a combination of external speakers and internal workshops mixed with delicious food and wine. Staff have commented that they leave this event feeling more inspired and connected to the profession and their fellow colleagues than ever before. • Introducing a wellbeing afternoon held every three months where staff engage in an activity together such as a bush walk or meditation workshop.

It is another wonderful opportunity that promotes connection and collaboration between the team. Collaboration between the wider occupational therapy community is also something we actively encourage. All staff are members of Occupational Therapy Australia to ensure they are familiar with current occupational therapy news and upcoming external professional development. We encourage regular professional development, which not only has the benefit of new skills being learnt, but is also another chance for our team to make connections with other occupational therapists. All staff are members of various occupational therapy Facebook forums and use this valuable resource to gain knowledge as well as posting to questions to the “brains trust” when required. Finally, we look for opportunities to collaborate with our local communities. Whether it be representing our company and profession at local disability or aged-care events, working with the Department of Rural

Health with university student placements and projects, or being a member of the local disability inclusion group, our therapists are active and involved in their local community. As occupational therapists, so much of what we do is done in a collaborative way. To quote Henry Ford: “If everyone is moving forward together, then success takes care of itself.”2 About the Author Carly Clarke is Co-Director of Abilities OT with Skye Quin. The busy private adult rural practice is Barossa-grown and shared in the North and South East regions of South Australia. Learn more at www.abilitiesot.com.au References 1. Bart N. Green and Claire D. Johnson (2015) Interprofessional collaboration in research, education, and clinical practice: working together for a better future. Journal of Chiropractic Education: March 2015, Vol 29, No. 1, pp 1-19 2.

A-Z Quotes (viewed 2020). TOP 25 HENRY FORD QUOTES ON BUSINESS AND LIFE. Available at https://www.azquotes. com/author/4992-Henry_Ford

CONNECTIONS WINTER 2020 29

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Members of the acute occupational therapy team outside the Royal Darwin Hospital. The acute team covers the Royal Darwin Hospital and Palmerston Regional Hospital sites

OT Life in Darwin: Thinking Outside the Box Vickie Elliott, Senior Occupational Therapist, Top End Health Service, NT

came to Australia from the UK in 2014 in search of a different lifestyle and employment opportunities. At that time I never thought that would lead me to the Northern Territory, and yet here I am almost six years later. I had worked in the UK NHS (National Health Service) after completing university. This was as an acute occupational therapist working across various hospital sites and rotations. I thought I had a good grasp of what it meant to work as part of a multidisciplinary team and the challenges that are faced by allied health in the medical environment. I was looking for something new, something different and challenging in new ways, and I most certainly found that in Darwin.

30â&#x20AC;&#x201A; otaus.com.au

Darwin is a beautiful place to live and is also an extremely interesting place to work. Located in the top end of Australia, it has remoteness, a transient population and a tropical environment. Although I chose to continue working in an acute setting, work here differs so much between the UK and the NHS. Iâ&#x20AC;&#x2122;ll be honest and say that my first couple of months were extremely challenging. I had gone from building up my confidence in the UK to working in such a unique and different setting! The Royal Darwin Hospital (RDH) is the only tertiary hospital for the top end of Australia. Occupational therapists working here cover such a vast range of clinical areas. In the UK, the neuro-occupational therapist would

see the neuro patients, the hand therapist would treat any hand injuries (often at the relevant hospital site). Whereas in Darwin, occupational therapists manage a range of conditions across specialities on a daily basis. This is extremely difficult at first, however the learning opportunities are amazing. Since working in Darwin over the last five years I have had the opportunity to work across multiple clinical areas. So far this has included specialty areas such as hand therapy, burns and scar management, surgical wards, neurology and oncology, and working within the fast-paced ED environment. In recent years, I have had the opportunity to further develop my leadership skills and become a senior therapist.

A highlight of my time here would be managing the burns and scar-management caseload. As the sole dedicated burns therapist for the top end, my time was split between working on the wards and in the outpatient setting. We cover both adult and paediatric burns. This involves a large proportion of case management, and overseeing patients from a huge geographical area including many remote communities. Telehealth is often utilised, and you develop good links with staff from remote health clinics. Patients often wish to return to their homeland as soon as possible, which can be difficult for the treating therapist. As with many of our patients, English may not be their primary language, or even second language. Working closely with interpreters, Aboriginal Liaison Officers and Aboriginal Health Workers is vital to ensure you can provide appropriate education to the patient, family and/or carers. Staff past and present have located or developed extremely useful resources to provide education, such as videos and recordings in language, picture books on scar management and healing processes post burn injury. Whilst covering a wide range of clinical areas is a challenge, I have an even deeper appreciation for how broadly skilled and adaptable our therapists are, which should help in this current climate. COVID-19 is changing the way we work and live, and I am sure it will have implications for all occupational therapists around Australia and beyond. Staff caseloads have changed quickly, in line with recommendations about protecting

Vickie (right) treating a patient within the hand-therapy clinic

vulnerable staff and changes to process and even structurally within the hospital. Community based therapists have commenced working within our sub-acute hospital site to allow increased staffing at RDH. Our triaging and prioritisation skills are being put to the test, in both inpatient and outpatient settings to ensure efficient patient flow through the hospitals, but also to ensure we are reducing any unnecessary outpatient traffic through the hospital. We have used telehealth to provide occupational therapy services in the Territory for some years now as we have a significant population of rural and remote patients who require follow-up. As we are confident in using telehealth, we are looking to expand this service to patients who would have been traditionally seen in person in clinic settings, in particular our vulnerable patients. To work in Darwin (as I am sure in many other regional areas), you often need to â&#x20AC;&#x2DC;think outside the boxâ&#x20AC;&#x2122;. For example, recommending, prescribing and providing assistive equipment is one part of our role, but when your patient lives on a remote island or an agricultural block you need to think about how you can actually make that happen. This flexible approach to working, and being familiar with regular problem-

The acute occupational therapy team demonstrating social distancing

solving means our therapists are equipped to deal with new challenges that face them and adapt their approach accordingly. We are lucky to have a brilliant team, all with varying skills and experiences to offer. This includes our trauma occupational therapist, who has recently returned from working in the Middle East. They have brought new ways of thinking, which is particularly beneficial during this current time when we need to consider management plans and how to support our patients and staff as the COVID-19 pandemic continues. About the Author Vickie Elliott is from the UK and completed a Bachelor of Science (Occupational Therapy) with honours at the University of Teesside, Northern England. During her third year of study, she completed a student placement in Townsville which ignited a desire to work and live in Australia. After initially working in the NHS to gain post-graduate experience, Vickie travelled to Australia with her partner and found work in Darwin. Vickie has an interest in burns, scar management and surgery and is currently working within outpatient handtherapy services based between the Royal Darwin Hospital and the new Palmerston Regional Hospital, which opened in 2018.

Vickie Elliott showcases artwork on display at Palmerston Regional Hospital CONNECTIONS WINTER 2020â&#x20AC;&#x201A; 31

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Innovative OTs in Education: Collaborating to Build Educator Capacity in South Australia Sarah Enthoven, Anna Forgan and Carla Koay, Occupational Therapists at the Department for Education, South Australia

n February 2018, our team of two full-time equivalent (2FTE) occupational therapists was employed on an ongoing basis within the Department of Education Student Support Services for the first time in South Australia. This was following a trial project and needs analysis that was conducted in 2016 and 2017. These ongoing positions were created in order to establish, implement and evaluate a model of paediatric occupational therapy service delivery in the South Australian Department of Education preschools, schools and high schools. While the trial project guided the initial scope of our work, with a very small team we had to develop a servicedelivery model that would be sustainable and responsive to ongoing change.

We invested time to develop a proactive service-delivery model centred on building the capacity of education staff including classroom teachers, student-support officers, early childhood workers and school/preschool leadership. Given the limited capacity of our team, each therapist is positioned to support specific sites with complex and diverse needs. Consequently, the primary area of service delivery is using a trauma-informed lens to support students’ self-regulation in order to engage in learning, and the emphasis is on whole-of-class or whole-of-site approaches. The initial package of work developed and delivered was a three-part workshop series including practical, proactive strategies for education staff to try in between each workshop and a site visit from their 32 otaus.com.au

occupational therapist to further support strategy implementation. The workshops adopt a three-pronged approach to regulation; focusing on emotional development and relationship building, sensory processing and executive functioning. This has been adapted for, and offered to, a different cohort of education staff each school term from preschool through to high school. As a team we have since created a broader catalogue of services comprising a range of proactive and targeted support options for educators. These include one-off training and development sessions, workshop series as well as ongoing coaching and support to implement evidence-based programs and strategies to assist all students to engage and achieve outcomes at school. To date, training has been delivered to more than 1,400 teachers, leaders, studentsupport officers and early-childhood workers across four partnerships (regional clusters of educational sites) which includes 26 preschools, 28 primary schools, eight high schools and one special school. Given the limited capacity of the occupational therapy team, the proactive, whole-of-class and whole-of-school approach to service delivery has proven to be an efficient way to impact a significant number of children with diverse needs within South Australian preschools and schools. As a team we value ongoing reflection on practice approaches and investing time in

planning a service delivery model that has capacity building, coaching and collaborative practice as its essence. Our work demonstrates that occupational therapists offer a unique perspective in education, with an ability to share discipline-specific knowledge, including physical, cognitive and social-emotional aspects of child development, and skills in task analysis and environmental modification. Discipline-specific expertise is combined with an understanding of the educational context to deliver evidence-informed approaches which address barriers to participation. One of the challenges we have faced working in the educational context has been the need to expand educators’ understanding of occupational therapy and the diverse way occupational therapists can work to support schools and preschools at a broader level, beyond individual student support. In stepping away from ‘traditional’ therapeutic interventionist approaches, strong relationships have been built and a noticeable increase in site-specific requests for service delivery has been observed in addition to the whole-of-partnership training and development offered each term. Training has also been provided to many of our colleagues from other disciplines within the Student Support Services teams (special educators, behaviour coaches, psychologists, speech pathologists and social workers) so they are informed about the services we provide and our opportunities to work collaboratively are increased.

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This is a unique service-delivery model in Australia, with South Australia being one of the few states to employ occupational therapists within their education department. South Australia is leading the way in solely adopting a capacity-building model to support all students rather than providing direct therapy or consultative services to individual students with diagnosed disabilities. There is a high demand for occupational therapy input beyond the current allocated service delivery regions. We have placed great importance on developing a cohesive service across the respective regions that is able to be replicated and easily transferred to other sites and partnerships when options for service expansion exist.

Anna Forgan, Sarah Enthoven and Carla Koay (together with Belinda Jankowiak, not pictured) were the Williams OT – Innovative Service Delivery Award winners in December 2019

These staff will regularly seek out the occupational therapy team for information, support and education which can be passed on to sites, families or children they work with. A collaborative professional relationship with colleagues from the School of Occupational Therapy at University of South Australia has been an invaluable support for the team to effectively evaluate outcomes of service delivery and for professional guidance on service development and evaluation. Evidence collected through formal evaluation processes of the three-part workshop series thus far indicates a statistically significant increase in participant knowledge and use of core strategies as a result of training we provide. The ongoing support and coaching aim to facilitate the transfer of this knowledge into practice for sustainable change.

As a result of the services provided, early feedback and evidence suggests that educators have increased capacity to identify and address the sensory and emotional needs of students. Preschools and schools are also better able to design and provide learning environments that optimally support children’s development, participation and learning. Further evaluation is planned regarding the implementation and sustained use of strategies as well as student outcomes over time. It is thought that developing an ongoing model of support following the workshops could also further the implementation of strategies. The review of the workshop series could also guide whether a similar model of service delivery could be transferred to other areas of child development.

In establishing the occupational therapy service for South Australian preschools and schools, it has been a challenge to ‘build the plane while flying it’. The many learnings along the way have strengthened each of us as individual practitioners but also as a team. In December 2019, our team was honoured to receive the Williams OT Innovative Service Delivery Award through Occupational Therapy Australia. This was a great acknowledgement of the hard work that has been done so far in establishing this unique service-delivery model and presents us with many ongoing opportunities to further develop the profile of occupational therapy in the South Australian Department for Education. We are excited to be a part of the future of occupational therapy in education and plan to continue growing our catalogue of services to further support educators and students in preschools and schools. About the Authors Sarah Enthoven, Anna Forgan and Carla Koay are occupational therapists who are employed by the Department of Education in South Australia. Together they bring a wide range of paediatric experience from Disability Services, Community Health, Department of Education Queensland, non-government organisations and private practice. They are passionate about developing the role of occupational therapy in education in South Australia. CONNECTIONS WINTER 2020 33

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Creating a Healthier Relationship with Your Mind Strategic Communications Branch, Queensland Health

ood mental health and wellbeing allows us to cope with the stresses of everyday life. It also helps us to realise our abilities, participate in the community and work productively. Most of the time we experience good mental health and wellbeing, however, from time to time we can also experience lower levels of wellbeing. This year we have experienced significant changes to the way we live our lives. These changes will be different for each person and how we cope or embrace these changes will also vary. While we adjust to our new ways of living, it’s important to be aware of how we are feeling and making sure we ‘make for time you’. A person’s mental wellbeing is the unique way they handle their emotions, respond to stress and also their general outlook on life. Having a healthy sense of mental wellbeing has many benefits—it lifts mood, promotes resilience in difficult situations and helps a person get the most out of life. It doesn’t matter who you are, where you live or how you’re feeling, taking a few moments for yourself each day will help you be a happier and more resilient you. While there are a number of support services, initiatives and programs to help improve the lives of people with, or at risk of, mental illness, there are a few simple, daily activities we can all weave into our everyday lives to prioritise our mental wellbeing. And it all starts with making some ‘me time’. 34 otaus.com.au

The Building Blocks There are six building blocks to help respond to the range of mental tasks you face every day, in a unique and powerful way. Just like it takes a range of skills to build a house, each trade plays a different role in getting the job done, from carpentry to plumbing. Your mind works the same way. When combined, the building blocks contribute to strong mental wellbeing. Get healthy Taking good care of your body is one of the most important things you can do to improve your mental wellbeing. How we think and feel depends directly on how well our brain is functioning. A healthy, active, well-nourished and rested body provides the foundation for your mind to function at its best. Keep learning Keeping your mind engaged with new ideas and experiences is an important part of your mental wellbeing. Your ability to reason and make good decisions depends on how well your brain interprets and processes information. Doing regular mental challenges trains these mental pathways, improving their effectiveness and refreshing old or unhelpful thought patterns. Show kindness Studies have shown that when you do a kind deed, it actually delivers a bigger happiness boost to you than the person you’re helping by triggering the release of oxytocin. This stimulates the area of your

brain associated with social connection and trust, which makes you feel good. Connect more Regular, positive interactions stimulate the production of a feel-good chemical in your brain, boosting your mood. Fostering stronger relationships and connections to your community will also strengthen your social networks for the times you might need extra support. Take notice Mindfulness is about connecting with your immediate thoughts and feelings without judging them. Studies have shown that mindfulness has a strong positive effect on your mental wellbeing. By directing your attention to what is happening in the present, you’re less likely to focus on worrying about things from the past, or things that might happen in the future. Embrace nature Spending time in nature has big benefits for your mental wellbeing. Studies have shown that spending time in nature can improve your mood and reduce stress. Exposure to the sun helps produce moodstabilising chemicals like serotonin and also gives your vitamin D levels a boost, which helps regulate your sleep-wake cycles.

Connect More The fourth building block (‘connect more’) is about connections to people, groups, places and culture. Humans have evolved to live in tight bands or family groups, with a need for

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Dear Mind social media graphic

[The] Dear Mind campaign demonstrates to people what positive mental health and wellbeing looks like, and encourages them to build their resilience and ability to cope with life’s challenges constant social interaction hardwired into our DNA. Now that we live more independently, many of us may feel disconnected or lonely. There are plenty of ways to make meaningful connections with people, including: • Putting your phone down when you’re talking to people so it doesn’t distract you from your conversation. It will make them feel better too, knowing they have your full attention • Aim to give at least one genuine compliment every day. You’ll feel good and so will they. • Switch off the TV after dinner and play board games with your family or house mates • If you can’t connect with people face-toface, organise a time to catch up with family and friends via video chat or phone call

Dear Mind To help adults prioritise their mental wellbeing, Queensland Health is running a campaign encouraging people to create a healthier relationship with their mind by using the six building blocks. Unlike previous campaigns which focused on mental illness, Queensland Health’s Dear Mind campaign demonstrates to people what positive mental health and wellbeing looks like, and encourages them to build their resilience and ability to cope with life’s challenges through simple, daily activities. Evidence has shown that positive mental wellbeing can help prevent behavioural and mental-health problems, and act as an important ‘buffer’ to the risk of mental illness. The resilience that comes from good mental health and wellbeing provides the foundation for safer and healthier families, schools, workplaces and communities; higher education achievement; and improved relationships and personal dignity.

Mental Wellbeing Activity Deck Through the Dear Mind campaign website, visitors can build their own personal mental wellbeing activity deck—a collection of daily activities listed on cards to help improve mental wellbeing. Based on the six building blocks, users are encouraged to select the activity cards they would like to try, and practise two to three of the chosen activities each day. Activities can be filtered by the number of participants (by myself, with a friend, with a group, or with kids) and by duration (under 15 minutes, under one hour, over one hour). Users are then encouraged to check in with how they are feeling in one month. The recommended activities are based on extensive research that indicates people respond better to simple, tangible tasks, rather than overwhelming lifestyle changes that are not sustainable in the long term. To find out more about the Dear Mind campaign and to build your own mental wellbeing activity deck, visit: qld.gov.au/mentalwellbeing About the Author The Strategic Communications Branch is responsible for leading communications, media, and marketing for Queensland Health. The branch’s public health campaigns are informed by research, designed to influence behaviour change and to support the health of all Queenslanders.

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Implementing Animal Assisted Therapy to Reach Goals and Promote Wellbeing Claire Dickson, BA, MOccThy (Assistance Dogs Australia, Sydney) Melissa Y. Winkle, OTR/L, FAOTA (Dogwood Therapy Services, New Mexico, USA) Karen Ni, OTD, OTR/L (SunDog Therapy Services, California, USA)

n 2019, Connections featured two articles about animal-assisted therapy (AAT). The first provided an introduction to AAT, while the second article described the first three tiers of Winkleâ&#x20AC;&#x2122;s (2011) tiered approach to AAT (Figure 1), including Resource Building, Preparatory Phase and Supervision/ Mentoring. This article, the last in the series, describes the final steps therapists can take to plan, implement and monitor outcomes of Animal Assisted Therapy. Upon completion of the first three tiers, occupational therapists may consider third-party evaluation of their professional human-animal team in the context of their

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scope of practice. Development of formal processes for AAT program implementation including participant screening, goal setting, session planning and documentation now begin. This includes procedures to ensure animal wellbeing is maintained, and plans for ongoing professional development. Winkle, Ni & Uchikoshi (2017) describe that the evaluation of dogs for professional practice builds upon all the work the team has done up to this point, and is formulated according to the interactions and activities that the dog is expected to do with the population and within the environment.

Case Example Cody is an 11-year-old boy with a history of multiple foster placements and diagnosed developmental delay. At his first occupational therapy session he refused to participate, but you notice he kept looking at the photograph of your canine colleague on the wall, and then his eyes sparkled when he saw the dog walking by with an assistant. He begins asking questions and you assure him that he may meet the dog during the next visit. Upon his arrival, the dog approaches him and drops a ball at his feet while happily whimpering in anticipation of a game of fetch. This may be one of the few times that this boy has observed anyone to be so excited to see him. The cycle continues with each visit. Each time the dog approaches him with a soft cloth bag that contains the therapy activities for the day. He is eager to participate in the therapy plan, and begins to make some progress towards his goals.

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Claire plays ball with a child and Ike

Examples of test items for dogs include: • Interest in working directly with participants and following cues given by participants to facilitate communication goals • Ability to walk through treatment environment without disrupting other sessions, maintain control around favorite toys and food, controlled exit crossing thresholds or doorways, and reliable recall during distractions (Winkle, Ni & Uchikoshi, 2017; Hill, Ziviani, Cawdell-Smith & Driscoll, 2019) Graduated off-lead work is a desired skill. This means the animal responds to verbal cues and may have several interactions with others under control while off lead. While there is some risk to working with an animal off lead, it should be a calculated risk as the team has had ample formal training experiences. Controlled greetings are important, and in therapy an animal approaching the participant is sometimes part of the therapy plan. There are many other evaluation items that could be recommended, but ultimately the occupational therapist should approach the dog’s job as several task analyses in which they identify the equipment, activity modifications, potential precautions, and what the dog received additional training for, such as people on therapy balls or children

Food experiment with child and Bentley

yelling in glee on a trampoline. The dog’s everyday interactions and activities should be evaluated (Winkle, 2011a; Hill et al., 2019). Team re-evaluations occur each year or any time there is a change in population, environment, therapists, or extended breaks from participating in AAT. Animal Assisted Intervention International (AAII) offers professional level standards, competencies and an accreditation process for guidance (AAII, 2018). The University of Queensland Animal Assisted Interventions Research Unit has Minimum Standards for Conduct of Animal Assisted Interventions (2019).

Intake, Screening and Initial Evaluation Winkle (2011a) recommends that animals not be present during initial contact and only introduced once the occupational therapist has collected information about history and attitudes towards animals to determine if the participant is appropriate for AAT and that it will be conducive to treatment goals. Occupational therapists should specifically ask about factors that may impact the participant’s ability to interact safely with animals, including: • Medical factors: allergies to animals or products common in treats and toys

(latex), asthma, respiratory disorders, immunodeficiency, blood disorders, compromised skin integrity, and zoonosis • Physical factors: poor balance, grasp and release, and motor control • Cognitive factors: difficulties following directions, impulse control, or safety awareness • Psychological, social, emotional, and behavioral factors: fear of animals, history with animals and pets, personal/family/ cultural attitudes towards animals, and history of abuse/neglect (with animals, with people, or by people), difficulty with empathy, poor self-regulation, and history of aggressive behaviors and violence (Winkle, 2004; Winkle, 2011a; Winkle, 2018; IAHAIO, 2018) Some of these factors are contraindications and will not be conducive to AAT, while other areas may be addressed during treatment and AAT can be implemented when the participant makes progress and demonstrates ability to interact safely with animals.

Treatment Planning Occupational therapists with advanced knowledge and experience in human-animal interaction and animal behavior, training, handling, and welfare, are well equipped to

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incorporate animals into treatment sessions to promote improved functioning and participation in activities of everyday life. Practitioners must keep in mind that AAT should be meaningful, intrinsically motivating, and participant-centred, which aligns with the values and practices of occupational therapy (Hart & Yamamoto, 2015).

AAT Implementation Methods Animals may have differing levels of engagement with participants based upon the animals’ abilities and interests. When incorporating AAT, practitioners should encourage natural, spontaneous, dogdriven and participant-driven interactions. It is ideal if participants are taught to recognise signs of stress, discomfort, or fear and can advocate and care for the animal’s wellbeing including giving the animal a break if needed, until determined by their handler that they are safe and ready to return to the session. Ideally, the handler recognises that the dog needs a break long before the signs of stress are obvious. Observational checklists such as the Pet Assisted Therapy-Welfare Assessment Tool (PAT-WAT) can be an effective method of assessing animal welfare as they are able to provide detailed information on the animals in a non-invasive manner (Ng, Albright, Fine & Peralta, 2015). It is ultimately up to the animal to decide the parameters of being in each session, and when breaks are needed. The animal does not always need to be present in AAT. Instead of direct interaction during the animal’s down-time, there are many activities that can be done for the animal such as making toys or treats, playing animal-themed games, learning

Lauren (OT at ADA) and child preparing food for Bentley

about animals, or having the animal be the subject matter of an activity to encourage interest and participation.

Measuring and Evaluating Outcomes As with any other treatment activity, client progress and suitability are continually reassessed. Each session may vary in the amount of AAT interaction and activity as some clients may become over-aroused or distracted. In these cases, traditional therapy activities may be used with AAT delayed on a reward system. In other cases, such as a client becoming aggressive or possessive of the

Practitioners must keep in mind that AAT should be meaningful, intrinsically motivating, and participant-centred, which aligns with the values and practices of occupational therapy 38 otaus.com.au

animal, or putting themselves and the animal at risk, participation in AAT must immediately be ceased. Animals should not be left alone with participants, under any circumstances. Occupational therapists must also consider how to handle situations where the therapeutic relationship between the participant, animal, and therapist is altered or ended due to treatment plan changes, moving or even death of the animal. Participants and therapists will need varying levels of support to process these transitions (Winkle & Fine, 2018). Animal Therapies Ltd (2020) has created a database of Australian animal-assisted service providers where therapists can find allied-health professionals in their state or local area providing AAT. By late 2020, the Animal Therapies website will provide information about training providers and job opportunities for therapists in AAT.

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About the Authors Claire Dickson is one of two occupational therapists at Assistance Dogs Australia (ADA). She is involved in AAT research with the University of Sydney and is co-chair of the Animal Therapies Ltd NSW-ACT Committee. Her AAT education includes ADA training course and international courses and conferences with Dogwood Therapy Services, Centar Silver and Animal Assisted Intervention International. Melissa Winkle OTR/L, FAOTA, CPDT-KA has 20 yearsâ&#x20AC;&#x2122; experience as an OT and dog trainer. She is President of Animal Assisted Intervention International and Dogwood Therapy Services. She is an international researcher, author and continuing education provider in the areas of AAT and Service Dogs. Karen Ni OTD, OTR/L is an occupational therapist and dog trainer in her private practice at SunDog Therapy Services. She completed two years of AAT internship and contract work at Dogwood Therapy Services, where she continues to contribute and coauthor articles, book content and international presentations.

References Animal Assisted Intervention International. (2018). Standards of practice. Retrieved from https://aai-int.org/aai/standards-of-practice/ Animal Therapies Ltd. (2020). Animals Helping Humans. https://animaltherapies.org.au/ Hart, L.A. and Yamamoto, M. (2015). Recruiting Psychosocial Health Effects of Animals for Families and Communities: Transition to Practice. In: Fine, A., Ed., Handbook on Animal Assisted Therapy: Foundations and Guidelines of Animal-Assisted Interventions, 4th Edition, Elsevier, Amsterdam, 60. https://doi.org/10.1016/B978-0-12-801292-5.00006-7 Hill, J., Ziviani, J., Cawdell-Smith, J. and Driscoll, C. (2019). Canine Assisted Occupational Therapy: Protocol of a Pilot Randomised Control Trial for Children on the Autism Spectrum. Open Journal of Pediatrics, 9, 199-217. https://doi.org/10.4236/ojped.2019.93020 International Association of Human-Animal Interaction Organisations. (2018). IAHAIO Position statement regarding domestic violence and related animal abuse. https://iahaio.org/wp/wp-content/uploads/2018/06/iahaio-positionstatement-regarding-domestic-violence-and-related-animal-abuse-final-2.pdf Ng, Z., Albright, J., Fine, A.H. and Peralta, J. (2015) Our Ethical and Moral Resonsibility: Ensuring the Welfare of Therapy Animals. In: Handbook on Animal-Assisted Therapy: Foundations and Guidelines for Animal-Assisted Interventions, Elsevier, Amsterdam, 357-366. https://doi.org/10.1016/B978-0-12-801292-5.00026-2 University of Queensland Animal Assisted Interventions Research Unit. (2019). Minimum Standards for the Conduct of Animal Assisted Interventions.

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Winkle, M. (2011a). Tiered Approach for Education and Skill Development for Healthcare and Human Service Providers. Symposium conducted at the development meeting for Animal Assisted Intervention International. Groesbeek, Netherlands. Winkle, M. (2018). Professional Applications of Animal Assisted Interventions: Golden Dog Book. Albuquerque, NM: Dogwood Therapy Services. Winkle, M., & Fine, A. (2018). Losing an animal in practice: Supporting participants and ourselves during the period of loss. OT Practice, 23(6), 22-24. Winkle, M., Ni, K., & Uchikoshi, K. (2017). Evaluation of dogs in professional animal assisted therapy settings. Unpublished manuscript. Dogwood Therapy Services, Albuquerque, NM.

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CONNECTIONS WINTER 2020â&#x20AC;&#x201A; 39

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Connecting, Collaborating and Adapting OT Practice in a COVID-19 World Nick Warren, Manager of Marketing and Community Relations at Solve Disability Solutions

Occupational Therapists are Fundamental Members of Essential Health Services Working alongside or in collaboration with other practices, allied health professionals are a health-system juncture where interconnected practice and multi-disciplinary teamwork adapt and move in unison in a rapidly changing world. From the days of ‘business-as-usual’ to the introductions of new and reformed health systems (such as the NDIS) and disaster response, allied-health professionals are pivoting on the back foot of a global crisis by introducing dynamic approaches and strengthening networks to ensure the continuity of their essential services. In Victoria, occupational therapists at Solve Disability Solutions (solve.org.au) leverage their assistive technology specialty to work across a multi-industry community of technical volunteers and experts to support clients Victoria-wide. Collaborating with industries and professionals (such as bio-medical engineers, architects, welders, electricians, commercial AT suppliers), our occupational therapists build and connect to networks and knowledgebanks of expertise, working together to design and deliver fit-for-person solutions to help their clients achieve their goals.

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Rosemary Nolan, Deputy CEO – Solve Disability Solutions, manages a team of statewide occupational therapists and OT student placements, specialising in custom-assistive technology and capacity-building therapy services (Kew, Victoria)

Staying Connected Working as part of a national network of therapists (TAD Australia), occupational therapists go beyond borders to stay connected to expansive networks of allied health professionals through memberships with peak bodies, alliances, associations and communities of practice including:

• National Assistive Technology Alliance (NATA): NATA was initiated in April 2017 and is now a community of practice of nearly 20 peak national stakeholders collaborating and connecting with the AT sector in response to rapid policy change. • Australian Rehabilitation and Assistive Technology Association (ARATA): ARATA is a national association whose

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purpose is to serve as a forum for information sharing and liaison between people who are involved with the use, prescription, customisation, supply and ongoing support of assistive technology. Outside their active roles in professional networks, Solve occupational therapists connect and liaise with local equipment providers who complement their ‘better outcomes through fit-for-person solutions’ philosophy to identify and access safe, innovative and tailored technologies for their clients. If it’s not available, safe or suitable, our occupational therapists turn to their internal technical team to build it from the ground up.

Shane Hryhorec, Managing Director – Push Mobility, delivers a national information and education webinar to 300 allied-health professionals across Australia (Abbotsford, Victoria)

New Ways to Connect

“It’s all about building relationships with other providers who understand their products and the people that use them,” says senior occupational therapist Liz Doyle.

that is ‘fun, exciting and pushes the boundaries of what disability equipment should be’. Collaborating with therapists and end users is an essential part of their business and service.

Connecting with providers and allied-health networks is more than collecting business cards at expos and taking note of the name of the provider you placed an order with. It’s about connecting and building relationships using a variety of methods and technologies.

National mobility specialists Push Mobility (pushmobility.com) take a person-centred approach in the selection and provision of disability equipment. Owned and operated by wheelchair users, Push Mobility focuses on increasing access to assistive technology

In early April 2020, Push had two state-based community engagement events scheduled in Melbourne and Brisbane. Within days of the Level-3 COVID-19 lockdown restrictions, the Push team quickly restructured both events into virtual format to broadcast nationally from their Abbotsford (Victoria) warehouse. An impressive 300 allied-health professionals and students across Australia registered for a national education and professional development day as a part of their continued education. “On a good day (when there isn’t a pandemic happening), we have anywhere from 30 to 40 therapists on hand, so to get over 300 people involved in a single event is pretty great,” says managing director Shane Hryhorec. The virtual event featured Assistive Technology (AT) suppliers, AT users and occupational therapists who shared their unique experiences, collaborative processes and tips for adapting practice in the times of natural disasters such as the recent bushfires and COVID-19 pandemic. “Assistive technologies and allied health services are essential – the only option for us was to find the best platform to engage with the widest audience of therapists,” says Shane Hryhorec.

Mary, Need Knower – TOM: Melbourne Makethon (2019) demonstrating her custom exercise machine with her Maker team at FAB9 (Footscray, Victoria) CONNECTIONS WINTER 2020 41

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Telehealth in Practice In 2011, the Australian Government introduced a Telehealth initiative. Designed to use telecommunication technologies to exchange health information and provide health-care services across geographic, time, social and cultural barriers, its primary purpose has been to improve access to health-care services for patients who live in regional, rural and remote areas. Today, Telehealth services are being widely implemented into practice in instances where services are disrupted, delayed or inaccessible, as experienced in the 2019-20 bushfires and more recently during the COVID-19 outbreak. Video-conferencing is one of the main methods for delivering telehealth services offering access to clients and providers using everyday devices. Telehealth appointments are also now fully endorsed and funded through Medicare and the National Disability Insurance Scheme (NDIS). “Integrating new technologies helps expand, strengthen and diversify services,” says Shane Hryhorec. Since the 2019-20 bushfires, the NDIS has been rapidly prioritising and implementing disaster-relief supports with reasonable and necessary (budget) flexibility to ensure NDIS participants can flexibly use their funding to access the essential services, technologies and support they need, especially in times of crisis. Most recently, budget flexibility was extended to include communications devices such as tablets, monitors and cameras.

Collaborating to Build a New Service and AT Marketplace Our occupational therapists stay ahead of the innovative curve by teaming up with the global community, Tikkun Olam Makers aka TOM: Melbourne (tommelbourne.org). TOM creates and builds products that improve the lives of people living with a disability, where there is no obvious or current market solution. They work with people with a disability who have a specific need (‘Need-Knowers’) and connect 42 otaus.com.au

Makers, Team COVID-19 PPE Solutions – TOM Global, demonstrate their 3D-printed PRUSA Protective Face Shield – RC3, developed to address global PPE shortages during COVID-19

them with a diverse group of professionals, including engineers, industrial designers, health professionals and tradespeople (‘Makers’). Together they design and build products that solve a complex problem and improve the everyday life of the Need-Knower. Applying clinical expertise as part of a Makers team, occupational therapists play a vital role in TOM’s immersive hackathonstyle co-design activities to develop safe, new and innovative assistive technology solutions to be shared with the world. Once a solution has been identified, built, trialled and tested it is added to a global open-source product database (tomglobal.org), enabling other individuals, health professionals and communities around the world to have equitable access to a vast collection of innovative solutions and concepts.

open-source solutions to support hospitals, treatment centres, and households. Within days of the World Health Organisation (WHO) announcing the COVID-19 outbreak was indeed a pandemic, TOM: Melbourne created an online TOM Support Network via Facebook to keep their community of therapists, Makers and Need Knowers connected. “This (Facebook group) is a safe place to share, express and interact during the COVID-19 pandemic. We encourage posts from Need-Knowers and Makers needing support and wanting to offer a helping hand to others,” says TOM: Melbourne

Collaborating to Combat COVID-19

Whether you are an occupational therapist in metropolitan or regional Australia, a student, or building a private practice or working as part of a large allied-health team, there are ample opportunities to connect, collaborate and adapt your practice and improve outcomes for your clients. It’s a challenging time for the world but also an exciting time to be an allied-health professional in Australia.

As the global response to the COVID-19 crisis put restrictions on the public, frontline healthcare workers experienced a different type of restrictive impact, lacking essential protective equipment such as masks and shields. TOM connected with communities across the globe to identify immediate challenges relating to the Coronavirus and co-developing

About the Author Nick Warren is a marketing and communications professional based in Melbourne. Currently, Nick is the Manager of Marketing & Community Relations at Solve Disability Solutions, Project Manager for TAD Australia, and serves on the Board of Directors of Accessible Beaches Australia.

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The Scientific Program Committee invites you to submit one or more abstracts in accordance with the Conference instructions that are provided on the Call for papers webpage. The closing date is 6 September 2020, so submit your abstract now! Simply go to www.otaus2021.com.au and click on Call for Papers.

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Call for papers close

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