An `occupational therapist without borders`

OT Insight
Märamatanga whakaora ngangahau
Magazine of the NZ Association of Occupational Therapists (Inc)
Vol. 33 No.3
May 2012
Contents
Features:
1
An 'Occupational
Therapist Without
Borders'
8
How is Our World Doing? "The Music of Daily Life"
An ‘occupational therapist
without borders’
We are very proud
to introduce to you,
Frank Kronenberg,
key-note speaker at the
NZAOT Conference in
September this year Märamatanga Hou:
fresh perspectives.
10 Critically Appraised Paper
Review: 'Mild Traumatic
Brain Injuries'
11 Implications For ACC
Contractors - 'Can OT
Input Guarantee Return
to Pre-Injury Status for mTBI?'
12 Occupation in Action:
Primary Health Care
13 Masters Entry
Pre‑Registration
Programmes - What Are They?
15 NZAOT Graduate Award
Recipients
Regular Columns:
3
From the Editor
4
NZAOT at Work
16 Information Exchange
19 Sector News
20 CPE Calendar
The Kronenberg family
I
am Frank Kronenberg, oldest of four children of WW-II
survivors Theo and Nellie Kronenberg; father of Masana
Nelly (age 5) and Isha Tshiala (age 3); and husband to
Elelwani Ramugondo. I regard myself as an ’occupational
therapist without borders’.
I was born and grew up in a bakery milieu in the
Netherlands. One of the key lessons that I learned during
those foundational years is that ‘human beings cannot
do without each other’(!) Although I did not follow my
parents’ footsteps, I still regard much of what I do as being
about providing ‘daily bread’, be it that its ingredients
are not flour, salt, yeast and water, but a particular ‘set of
values’ that were instilled by my parents and the nurturing
environment in which I grew up.
After graduating from teacher training college at the
young age of 19, I did not feel ready to teach and prepare
‘young people’ for the world and life within it. During my
childhood, our school was frequently visited by Franciscan
missionaries who shared stories about their projects in so
called ‘third world’ countries. These had ignited burning
‘why’ questions which pushed me to conduct a kind of
experiential diagnosis of how our world was doing. I
embarked on almost a decade of travelling, living, and
working in Israel (kibbutz), Palestine, Nepal, Pakistan (homes
for children and adults with intellectual disabilities), India
(community development projects), United States (summer
camp and respite programme for children and adults living
with physical disabilities), and Mexico (programme for
children/youth ‘survivors of the streets’). After this intense
and enriching journey, I conclude that ‘whilst seemingly
waging war against itself and the planet, humanity
struggles on to keep what makes us human alive’.
Next I felt pulled to return to
university to learn anew what, and
how, I might contribute to lessening
our world’s widespread burdens and
confusions and to help maintain and
strengthen what already seems to be
working. Given my wide interests—and
inability to make up my mind on what
to study—after reading up on the ‘Hull
House-Chicago’ history of occupational
therapy, I chose to study occupational
therapy. However, as my training in
the Netherlands unfolded (1995-1999),
I became increasingly unhappy with
what I experienced as a problematic
narrowed-down vision of our founding
fathers and mothers. Hence, together
with Salvador Simó, I founded
‘Occupational Therapists Without
Borders’, in response to the challenge
of becoming a (more) socially and
environmentally responsive resource to
the societies in which we find ourselves.
Since 2006, my family and I are
committed to making Cape Town,
South Africa home, for ourselves and
the other people who live here.
For further insights into the mind and
workings of Frank Kronenberg please
turn to page 8.
ISSN 1174-6556
Vol.33 No3 May 2012 1
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From the Editor
Kia ora and welcome to OT
Insight for May.
‘Human occupassion!’ is exclaimed loudly by Frank
Kronenberg (page 8). He describes this concept as a
“theoretical and practical ‘home’” to him, and that
“‘human occupation’ can say and mean more than
speech”. That without it, “life is hardly worth living”.
Those are strong words - without occupation, life is hardly
worth living? Undeniably so!
‘Occupassion’ is alive for Vicky Smith in her
article “Occupation in Action” (page 12). Vicky lists
understanding, compassion and empathy as integral
aspects of humanity. Through occupational therapy, she
brings the opportunity to learn the skills to develop these
important and very human attributes to her "motley crew"
partaking in the vocational skills programme (named
PEERS) in Auckland.
Diary Dates of Note
NZAOT AGM:
Notices of motions due by 5pm, 8 June 2012
NZAOT Achievement Award nominations
due by 30 June 2012
NZAOT Council meeting 15-17 June 2012
OTKSS meeting 19 June 2012
NZAOT AGM
Thursday 20 September 2012, Hamilton
Consider your role, and how
occupation is explicit in what you do.
Consider those unique challenges
you face in your area of practice.
Where Vicky identifies the challenge
of group dynamics in her role, what
are the challenges in yours? The
theme “Occupation in Action” is one
we would like to see more of in the
magazine. We like to read about each
others’ work places - contact me,
so we can have an “Occupation in
Action” article in every edition!
OT Insight this month continues
to celebrate passion for human
occupation in recognising the
2012 NZAOT New Graduate award
recipients. Regarding post graduate
qualifications, clarify what a master’s
entry pre-registration programme is
exactly. mTBI, or the “mild” form
of traumatic brain injury induces
persisting neurological and cognitive
problems in a statistically significant
number of patients (page 10).
For ACC contractors in this field,
please read the implications of the
Concussion Service Statement of
Commitment you are required to
sign when treating presenting mTBI
(page 11). Find also in the magazine
that notices of motions for the AGM
are due early next month, plus our
new NZAOT
Achievement
award is seeking
Tina Larsen
nominations by
the end of June. And have you filled
in the survey on the NZAOT values
exchange? Council meet for strategic
planning mid June.
Winner!
Several of you had a go at the link
between the names Sunil, Tania, Tony
and Don in last months e-OT Insight,
however there was no correct answer
received! The link is that they represent
Im-Able, C1 South, Medi-Shower and
WS Medical, and they all advertised in
our first edition. Kate Caughley and
Sarah Lillas each supposed the link
between the names was that all had
the letter ‘N’ in them. Kate added that
“this is a ‘N’ew way of publishing OT
Insight”, and this won her the prize.
Congrats Kate!
It was fun to hear from all of you!
Thank you to Sunil from Im-Able and
Tony from Medi-Shower who have
advertised this month too – of course a
big thank you to all our advertisrs who
support the OT Insight.
Tina
[email protected]
NZAOT
NZAOT COUNCIL
NEW ZEALAND ASSOCIATION OF OCCUPATIONAL THERAPISTS
Founding Officer: Hazel Skilton Executive Director: Siobhan Molloy
President
Treasurer
Ma-ori Perspective
WFOT Delegate
Council Member
Council Member
Rita Robinson ph 07 889 6485
Email: birssy@
infogen.net.nz
Christine Pacey ph 03 445 0447
Email: pcpacey@
xtra.co.nz
Karen Gallagher ph 09 236 9033
Email:
karendgallagher@
gmail.com
Merrolee Penman
ph 021 735 239
Email:
merrolee.penman@
op.ac.nz
Ruth Spain ph 021 1825 363
Email: ruth@
shaqad.com
Yvonne Browning
ph 04 978 2857
Email:
Yvonne.Browning@
ccdhb.org.nz
SPECIAL INTEREST GROUPS: Convener contact details at www.nzaot.com
Acute Care: Sarah McMullen-Roach • Adults with Intellectual Disability: Helen Allen • Children and Young People’s Occupational Therapy: Rita Robinson Driver & Passenger Rehabilitation: Kevin O’Leary • Hand Therapy: Alison Derbyshire • Independent Practitioners: Seeking convener now! • Leaders and Managers: Tim Dunn Mental Health: Pam Schofield • Occupational Therapy Supervision: Marie Chester; Ann Christie; Merrolee Penman; Carolyn Simmons Carlsson
Occupational Therapy and Sustainability: Vicky Smith • Occupational Therapists Working With Older People: Petrouchka Schuurman • Neurology: Shona Paterson Oncology and Palliative Care: Tanya Loveard • Pain Management: Catherine Swift • Physical Community: Joanne Harper • Primary Health Care: Kirk Reed Rheumatology: Seeking convener now! • Spinal Cord Injury: Seeking convener now! • Vocational Rehabilitation: Grace Imiolek Wheelchairs and Seating: Maria Whitcombe-Shingler • World Federation of Occupational Therapy: Merrolee Penman
NZAOT OFFICE: Level 9, 85 The Terrace, PO Box 10493, Wellington 6143; Tel: 04 473 6510 Fax: 04 473 6513; E: [email protected]
EDITORIAL OFFICE: Editor: Tina Larsen. E: [email protected]. Submissions: Please refer to NZAOT website for author guidelines.
Letters to the editor may be abridged over 300 words.
Publishing & Advertising Management: Tasman Image/Adprint Ltd, Wellington, NZ. Advertising Manager: Pam Chin. Tel: +64 4 384 2844, Fax: +64 384 3265. Email: [email protected]
Dates: Distributed on or about 8-Feb, 14-Mar, 16-May, 20-Jun, 25-Jul, 29-Aug, 7-Nov, 12-Dec. Author submissions 5 weeks prior to publication. Exception apply, please contact editor.
Printed by Adprint Ltd, 60 Cambridge Terrace, Te Aro, Wellington 6011, NZ
Disclaimer: OT Insight is published by Tasman Image Publishing for the NZAOT (Inc). Views expressed in articles and letters do not necessarily represent those of the Association, and neither
NZAOT or Tasman Image Publishing endorse any omissions or errors on products or services advertised. NZAOT nor Tasman Image Publishing accepts liability for its contents or for any
consequences which may result from the use of any information or advice given.
Vol.33 No.3 May 2012 3
NZAOT at Work
T
Siobhan Molloy
Executive Director
HANK you for rejoining NZAOT. We really
value your membership, and all the hours
you give back to occupational therapy
through your participation with the association’s
various activities and special interest groups. For
those who choose not to renew, we know your
reasons are varied. We will miss you, and I regret
to say your membership benefits will lapse at the
end of May.
Active Association
Blue Sky Thinking: beyond boundaries / achieving
incredible goals together
A great thank you to members and non-members for helping to shape the
future of NZAOT – the NZAOT Strategic Survey is open until 4 June 2012. At
time of publication 60 people have had their say.
If you haven’t filled in the survey, there is still time – this is an opportunity for
you to breathe life into NZAOT plans and ambitions.
There are two steps - register with the NZAOT Values Exchange, then to fill
in the survey. Please go to http://nzaot.vxcommunity.com/ - the register link
is in the blue box on the right hand side, just to the right of the NZAOT logo,
under the “Social Networking with Brains” title.
Many thanks for taking valuable time to contribute, it is greatly appreciated.
More than just a name?
The NZAOT Issues SIG has had a robust discussion about the potential name
change for NZAOT:
n
Is this change for change’s sake?
Why use the term therapy as opposed to therapist in the title?
n Will this cost a lot?
n
Thanks for raising these valuable questions and helping in ensuring
reflection and transparency to our collective decision making. As members
you will ultimately decide by vote in the AGM at conference in Hamilton on
20 September 2012.
The draft new rules has suggested we become:
Occupational Therapy New Zealand / Whakaora Ngangahau Aotearoa
Why change the name?
n
To make NZAOT’s commitment to biculturalism more overt; and include a
Mäori translation into the brand of the association.
n
Translating three words rather than seven words.
n
The NZAOT council had a desire to develop a wording that succinctly stated
who we are. By stating up front - occupational therapy, it was felt that this
lent a strength to a new identity. It also is indicative of that the association
is a leading representation of occupational therapy in New Zealand; it is
the organisation of choice for occupational therapists,a place for accessing
resources and information for those interested in and supporting occupational
therapy, for members of the public and for government and health and
disability agencies - and our near neighbour: Occupational Therapy Australia.
n
It is consistent with a move by other allied health professional associations
to rebrand in a similar vein: e.g. Physiotherapy New Zealand and Podiatry
New Zealand.
n
The drafting of the new Rules was an opportunity to incorporate an
updated image matching our commitment to the Treaty of Waitangi.
n
Registrants at the Clinical Workshop (November 2011) and attendees
at the Show Your Ability roadshow (North Island – 2012) were asked
about a preference of keeping the current name or changing the name to
4 Vol.33 No.3 May 2012
Occupational Therapy New Zealand – and while the results
are unscientific – the votes were about 3 to 1 in favour of a
name change.
The current wording is a mouthful – The New Zealand
Association of Occupational Therapists – it is only on the 6th
and 7th word is it apparent what is being referred to.
n
Why change from therapist to therapy?
A great question - we need to be deliberate and mindful
about why the change in emphasis.
NZAOT is a member organisation for occupational
therapists. Without any members there is no association! However, the association is also the representative of
occupational therapy in New Zealand.
Much effort has been put in by many people over the
years to get the association to a place that it is the public
face of occupational therapy in New Zealand. It is where
members of the public come to when they have a query
or concern about occupational therapy. It is through
the association occupational therapy and the role of
occupational therapists is promoted to the public and to
government - a core part of our objectives. Indeed it is also
the place government and advocacy agents come when they
would like an occupational therapy perspective on some
issue.
The adoption of therapy over therapists is a demonstration
that we are looking outwards rather than inwards. It
reflects that we are concerned not just for issues regarding
occupational therapists and the profession but also issues
that impact on the client groups we serve. This is influenced
by the stated association value of occupational justice.
President Rita Robinson summed it up:
“As a council we are striving to be governance
focused. To be this means being very aware of the
contextual influences that surround us; influences that
impact on our practice today as well as in the future.
Governance is about making informed choices to
positively influence the future for the community we
serve. We are hoping that the move from therapist to
therapy reflects our commitment to good governance by
acknowledging the interrelationship between therapists,
context, and the profession.”
Costs associated with rebranding?
Rebranding does come at a cost but it does not have to be
prohibitive – and if members do desire a name change then
there will need to be a budget allocated to rebranding which
will include:
n
A new logo – we could potentially keep the image of
the fern leaf and simply reword which could be done
in-house.
n Letterhead and business cards could be replaced on an
as planned phased in time line – the rebranding can be
scheduled to take effect for example 1 April 2013 – giving
some time to use up current stocks. Use of letterhead is
already dwindling as the office streamlines and uses email
as much as possible.
n Web pages – once an updated logo is signed off – it is
likely that editing web pages will take only a couple of
hours to rebrand.
n Time resource to ensure legal changes are made to our
name/brand.
Thus the likely the costs are in the hundreds rather than
thousands. No consultants have been hired to consider the
name change, some professional overview is required for the
logo redesign. A minimum of paper waste can be managed
as a phased-in change.
ANNUAL GENERAL MEETING OF
NEW ZEALAND ASSOCIATION OF
OCCUPATIONAL THERAPISTS (Inc)
Active Representation
NZAOT Submissions
The AGM will be held on Thursday, 20 September 2012, in
conjunction with the NZAOT conference in Hamilton.
Notices of Motions
Members are entitled to submit an agenda item or notice of
motion for the consideration of the AGM. Such agenda items,
position papers, or notices of motion must be in the hands of the
executive director (acting on behalf of council) by 5pm, 18 June
2012.
All motions must be written in clear, positive language and
signed by both proposer and seconder – who will be members
entitled to vote at a meeting of members. All motions must be
accompanied by position papers/rationales to clarify the reasons
for the motions.
Address for Notices of Motion
Email notices of motion and position papers to:
[email protected]
Governance at Work
NZAOT members have been active in preparing detailed
submissions. All NZAOT submissions can be read here:
http://www.nzaot.com/publications/submissions/
recent.submissions.php
The Wider Journey:
The Rights of Disabled People
Engaging in society in a purposeful and meaningful way
and to having your voice heard is a basic human right.
The New Zealand Association of Occupational Therapists
fully supports strategies that empower people to do so. In
a just and democratic society each person’s right to access
information and have a voice should be equally valued.
No person’s right to participate and to vote should be lost
due to disability.
Green Paper on Vulnerable Children
In addition to NZAOT’s independent submission
reported on in March, it joined 17 Allied Health
Professional Associations Forum (AHPAF) members to
make a combined submission on the Government’s Green
Paper for Vulnerable Children.
March Council Meeting
Council had a full agenda for its March meeting. Some of the
highlights of the meeting include:
n
SWOT Analysis: NZAOT Issues SIG
Council discussed a presentation summarising the SWOT analysis
which accessed 68 members views (see OT Insight Vol 33, No.
2, March 2012, Professional Engagement: To Be or Not to Be a
MNZAOT: The Sustainability of an Association, page 10).
Council appreciated the richness of the analysis, and wish to
acknowledge and thank members Vicky Smith, Annie Baigent
and Gerard Chow for this great gift which will be invaluable for
strategic thinking.
n
R-400
Rear-Wheel Drive Power Chair
Policy updates
A key council task is creating policies that provide a sound and
cohesive framework for all of the association’s business. Usually
each council meeting includes review of old or creation of new
policies – members can find all policies on the web site: http://
www.nzaot.com/about/governance.documents/policies.php
Most recent updates include policies on Fraud [prevention],
General Expenses and NZAOT use of [member] Database.
n
Interprofessional Education and Collaboration
Thanks to members Kirk Reed and Brenda Flood, council accepted
a new position statement related to: Interprofessional Education
and Collaboration. See:
http://www.nzaot.com/publications/position.statements.php
A power chair with performance and manoeuvrability
Council next meets 15 – 17 June.
This will be a combined ordinary council meeting plus strategic
planning. Council will consider member feedback from the
strategic survey and our strengths, weaknesses, opportunities
and threats. Then council will touch base with the things that
underpin the association - our vision, values and mission. Finally
we will define the strategic goals and the outcomes required. We
look forward to sharing that outcome with members.
Freephone: 0800 828 033
Vol.33 No.3 May 2012 5
➤
➤
Points made included:
n
Support for increased information sharing
among health professionals
n That children should be protected from being
labelled “vulnerable”.
n Evidence-based research is not being used
often enough.
n A ‘joined-up’ approach between agencies is
needed.
n An emphasis on community involvement
should not lead to reduced involvement or
resourcing by the State.
n Concern that proposed welfare reform will
roll back access to services such as housing and
early childhood education.
Active Professional Development
The submission largely supported the views
of the Office of the Children’s Commissioner.
The Green Paper focused on the 15% of New
Zealand children who are at risk of not thriving
and achieving.
NZAOT has forwarded its submission to
UNICEF New Zealand who plan to pick up
on common high level themes from over
90 submissions and incorporate it into a
community/NGO briefing paper, (“Thriving,
achieving, belonging - what will it take?”). The
hope is that the final paper will influence the
direction of policy for children in Aotearoa New
Zealand for better in the near future and long
term.
“I am”
How many ways do you strengthen your identity as an occupational therapist?
I am an occupational therapist. You can tell this by what I do. I am an
occupational therapist as I am registered with the Occupational Therapy Board
of New Zealand. I am an occupational therapist because I keep abreast of new
information, emerging trends and ideas. I am an occupational therapist who
belongs to my professional association. I am an occupational therapist because
I seek out networks and conversation with other occupational therapists. I
am an occupational therapist because I give back to the profession by adding
into other peoples’ conversations. I am an occupational therapist because I
attend conferences and learning opportunities which strengthen my continued
socialisation and in turn the development of the profession.
All these aspects form my professional identity. For me being an occupational
therapist is defined by more than my pay cheque. As an occupational therapist
I have a strong professional identity. You would hope so, as I am the president
of NZAOT!
As the president, I encourage you to attend New Zealand's premier
occupational therapy conference – NZAOT's Märamatanga Hou: fresh
perspectives, 19 to 21 September 2012. Conferences offer the opportunity to
show-case advancement in practice, the sharing of emerging ideas,
and strengthening a sense of belonging. Learning opportunities pull
us forward; motivate us to enable people for another day.
Is your identity as an occupational therapist more than your
pay cheque?
Interior Platform Lift with quality construction
Attending conference and engaging in the professional
experiences and opportunities is a great
way to strengthen your professional
identity. When you are strong – the
Conference
profession is strong. A strong
Programme
professional identity means a stronger
Available Now!
voice for our clients and a stronger
The preliminary programme
voice for ourselves. Come and be
for the 2012 NZAOT
part of your profession. Be seen. Be
conference is now available:
seen by your peers and be seen by the
http://www.
people who transport you along the
nzaotevents.com/
way. Tell people where you are going,
what you are doing, and why it is so
Registrations will open on
important to do it!
June 1st, 2012
Strengthen your identity as an
For budget planning,
occupational therapist, strengthen
registration fees will be
occupational therapy within Aotearoa
$575 for an
New Zealand, attend Märamatanga
NZAOT member.
Hou: fresh perspectives. I look forward
to seeing you there.
Kind regards,
President NZAOT
Märamatanga Hou: fresh perspectives – Programme now online:
http://www.nzaotevents.com/
Freephone: 0800 828 033
6 Vol.33 No.3 May 2012
6th Asia Pacific Occupational Therapy Congress
Planning is underway including appointing Kirk Reed and Siobhan
Molloy as co-convenors. Opportunities for marketing the congress
have arisen already via members’ sabbaticals overseas, and in the
WFOT News. None of this can happen without a logo, so this is one
of the first projects undertaken.
Initially stickers, posters and letters will be graced with this logo.
The full identity includes a specific font and suggested layouts
and colours for future design requirements such as brochures and
eventually through to the main event handbook. The colours in the
identity have been selected from the spectrum within the thermal
waters of Rotorua, with a touch of blood red.
View the full identity in colour on our home page at
www.nzaot.com - the link is 'full concept design'.
The logo can be used in many formats, and the elements pulled
out for any purpose.
The typeface, called ‘Aller’, is bold, strong, professional and
modern.
The woven stroke is a visualisation of taniko weaving and yes, it
can also be viewed as embroidery stitches, but so too, in the vertical
they evoke elevation, or lifting. This reinforces the idea of Rotorua
as a significant cultural destination within the Asia-Pacific region,
and humans as occupational beings.
The geyser device also visualises Rotorua as a significant cultural
destination within the Asia-Pacific region and this is further
reinforced by the koru patterns. Its organic shapes are humanistic
and can be seen as speech bubbles - the conversations and sharing
of ideas that will be happening at the conference. It represents the
celebratory aspect of coming together, a fresh, inspirational, alive,
and modern profession.
With the geyser element enlarged and centred it looks fantastic
on a tee-shirt!
We have not had tee-shirts made to date, but we very much look
forward to them being available one day soon and seeing them
worn around the world (modelled by Clare and Dan at COTEC
perhaps).
CPE Online
The Able-X arm exercise system:
Our first foray into the permanent and ongoing online delivery
of professional development has started well with members and
non-members alike registering to take part in the Difficulties with
Handwriting course. A large proportion of New Zealand’s primary
school teachers have been invited to take the course, and it is a
delight to see education in occupational therapy philosophy and
practice being taken outside of the profession.
● was especially designed for neurological and
stroke recovery
● uses exercises embodied as computer games
to keep the user fully absorbed for high
exercise compliance
● complements traditional therapy and can be
easily used at home
● was formally tested on stroke patients at
Otago School of Medicine and all users gained
benefits, some more than others. Copies of
the clinical papers are available from
[email protected]
Siobhan Molloy
Executive Director
Visit www.im-able.com
or call 0800 000 639
Vol.33 No.3 May 2012 7
How is Our World Doing?
T
his is one of the questions Frank Kronenberg, key note speaker at Märamatanga
Hou: fresh perspectives, will be asking us in September. We have referred to
conference before as ‘soul food’, and when we put a few questions Frank’s way, he
gave us the following ‘nourishment’ back – great food for thought, thank you Frank.
Please tell us about your presentation at
the NZAOT conference.
What is your vision for occupational
therapy?
The title of my key-note is: ‘Doing Well—Right TOGETHER:
I am hesitant to articulate my vision for occupational
A Practical Wisdom Approach to Making Occupational
therapy. Although I do believe that it is important that all
Therapy Matter’. The question that lies at the heart of an
occupational therapists own (up to) their personal vision.
occupational therapy perspective of health and well-being is
I have been inspired by colleagues’ visions, for example
‘how are people doing?’
Adolph Meyer, Eleanor Clark Slagle,
As occupational therapists we seem
Mary Reilly, Anne Lang-Étienne,
be committed to becoming a (more)
and contemporaries such as Ann
socially and ecologically responsive
Wilcock, Rachel Thibeault, Salvador
resource to the societies we serve. This
Simo, Sandra Galheigo and Alejandro
requires us to both build on and move
Guajardo. But at the end of the
beyond the scientific and instrumental
day I think that all of us are
knowledge that we have about the
potential ‘founding fathers and
‘human condition’. In my talk I will take a
mothers’ of the profession. The
practical wisdom approach to conducting
words by the great late violinist Isaac
an ‘occupational diagnosis’ of our world
Stern about ‘being a true musician’,
and our profession.
beautifully capture what I mean (see
Isaac Stern
To reach a diagnosis, two questions will
insert).
be addressed: ‘how is our world overall
Extending Stern’s analogy, I view
“Every time you take up the
doing?’ and ‘how are occupational
occupational therapy as a particular
instrument, you are making
therapists doing in response?’ A key
‘instrument of change’. Being free
a statement, your statement.
challenge will be to find innovative ways
to draw from both the arts and
And it must be a statement of
to increase our and society’s occupational
the sciences, I believe that ‘human
faith, that you believe this is
consciousness. This refers to ongoing
occupation’ can say and mean more
the way you want to speak.
awareness of the dynamics of dominant
than speech and that without it, life
Unless you feel that you must
practices, an appraisal of how such
is hardly worth living. It is ‘the music
live with music, that music
practices may be perpetuated through
of daily life’ and health and wellbeing
can say more than words,
that music can mean more,
what we do every day, and how all this
can be generated through connecting
that without music we are not
affects our individual and collective
humans with and dancing to their
alive, if you don’t feel all that,
well-being.1 Traditional (dominant)
music.
don’t be a musician.”4
perspectives of occupational therapy will
be juxtaposed against emerging (dormant)
Are there practices or
perspectives of how, as health agents,
occupational therapists can contribute to
developments within
society’s responses to global-local socio-sphere and eco-sphere
occupational therapy that you regard
challenges.2 I will also share ‘without borders’ examples of
3
possibilities-based practices from Europe, Africa, and Asia.
with some caution? What is your passion within
occupational therapy?
‘Human occupassion’! This concept feels like a theoretical
and practical 'home’ to me. It is what makes life worth
living and sharing with others. Ideally, it is the ‘music of daily
life’. And it is (or can be) the privileged ‘job’ of occupational
therapists to enable people of ‘all walks of life’ to (re)connect
with their music and to dance to it.
My preferred short-hand definition of ‘human occupation’
is ‘being human’, or ‘enacted humanity or humanness’. And
to allow us to practically come to terms with our human
potential to the full extent, i.e. the best and the worst of the
human condition, I am particularly interested in contributing
to understandings of the politics of being human in relation
to fostering wellbeing, and understood in terms of ‘doing
well—right together’.
8 Vol.33 No.3 May 2012
Akin with human potential manifesting on a continuum
of ‘doings’ that are good and bad for Man and ‘Mother
Nature’, ever more rapidly advancing information
technology allows us to become more aware of and
responsive to the interconnected nature of the ‘global
village’ we live in. What concerns me most is that along
with other professions, occupational therapy seems to be
increasingly ‘pushed’ to dance to the prescribed tunes of
the neoliberal healthcare market. As a consequence, we
may become an (even) more exclusive provider of services
(mainly to those who can afford us). However, I prefer
to regard this negative tendency as a compelling ‘pull’
to (re)connect with those qualities that make occupation
human, and to contribute to fostering circumstances
that promote people-planet wellbeing through (perhaps)
‘humanising occupations’.
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What does the NZAOT conference
theme, Märamatanga Hou: fresh
perspectives mean to you?
I regard the theme “fresh perspectives” as an invitation
to ‘look anew’ from different positions, at who we are and
what we do on a daily basis as occupational therapists (and
as human beings), and how this affects our individual and
collective health and wellbeing. Juxtaposing and questioning
what we then find against our traditional understandings
and practices, may allow us to identify and re-affirm qualities
that are still relevant and ‘working’. And we may also
discover gaps in our discourses and practices, which call for
vision and commitment to address these.
Frankly speaking, I am also curious to learn if the
expression “märamatanga hou” is merely a Mäori translation
of ‘fresh perspectives’, or whether it holds additional
meaning(s). Many years of engaging with people in and
from different cultural (and language) contexts has taught
me that meanings can get lost in translation. And given
that meanings are a key component of our profession’s ‘life
blood’, i.e. human occupation, exercising sensitivity in this
regard seems warranted.
Is there anything in particular you
would like to experience while you are
in New Zealand? It will be my first ever visit to New Zealand. I am merely
‘virtually’ familiar with the natural and cultural splendors of
your beautiful country. Unfortunately my itinerary is as short
as it is already booked with; take a guess, that’s right: ‘OT
stuff’! But given that my best travel experiences to date
have come about by being open minded and allowing to
be surprised, I trust that real time encounters with people
in New Zealand will plant ‘relationships seeds’ that call for
additional visits…hopefully next time with Elelwani and
Masana and Isha.
Nga mihi nui Frank
References:
1. Ramugondo, E. L. (2009). Intergenerational shifts and continuities in
children’s play within a rural Venda family (early 20th to early 21st century).
Doctoral Dissertation, Cape Town: University of Cape Town.
2. Kronenberg, F., Pollard, N., & Ramugondo E. L. (2011). Introduction:
courage to dance politics. In F. Kronenberg, N. Pollard & D. Sakellariou (Eds),
Occupational Therapies without Borders Volume 2: Towards an Ecology of
Occupation – Based Practices, Oxford: Churchill Livingstone Elsevier. Pp. 1-16.
3. Kronenberg, F., Pollard, N., & Sakellariou, D. (Eds) (2011).
Occupational Therapies without Borders Volume 2: Towards an Ecology of
Occupation – Based Practices, Oxford: Churchill Livingstone Elsevier.
4. Lerner, M. (1980). From Mao to Mozart: Isaac Stern in China.
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Critically Appraised
Paper - Review:
Mild Traumatic Brain Injuries:
The impact of early intervention
on late sequelae.
A randomised controlled trial.
Andersson E E, Emanuelson I, Bjorklund R &
Stalhammar D A. (2007). Acta Neurochirurgica,
(149, 151-160).
By Maree Paterson, NZROT, MNZAOT,
Candidate in Masters of Health Science at AUT
University.
T
he aim of this review is to determine if early clinical
intervention for people following an uncomplicated mild
traumatic brain injury (mTBI) reduced the long term sequelae.
The Andersson et al (2007) study is a constructive attempt
to provide research which can guide treatment interventions.
Methods: A randomised controlled trial conducted
in Sweden, with a one year follow-up with an additional
comparison to the Swedish reference group. The control
group (n=131) received regular care which included an initial
medical assessment and advice but did not provide routine
follow-up of patients following an uncomplicated brain injury.
The rehabilitation group (n=264) received a medical assessment,
and were referred for individually tailored interventions as
required.
The majority of participants in the active treatment group
were referred to an occupational therapist for reassurance
that most symptoms would resolve in 2-3 months and for
assistance to manage the disruptions to daily activities and
work. Compensatory strategies taught included the use of
written schedules, use of a diary, fatigue management and
relaxation. Home visits and work/school based interventions were
implemented as required. The primary outcomes were achieved
by comparing the change in rate of post concussion symptoms
and in life satisfaction.
Results: 395 participants were randomly allocated to either
the rehabilitation or control group to the ratio of 2:1. After a
year there were no statistical differences between the intervention
and control groups. Participants who suffered several persistent
post concussion symptoms and accepted rehabilitation did not
recover after one year. The mTBI participants from both the
control and treatment groups obtained significantly (p<0.05)
lower scores than the Swedish reference group in all of the
domains on the Short-Form 36 Health Survey.
Conclusions: In this study, early active intervention and
support to resume pre-injury activities did not change the
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10 Vol.33 No.3 May 2012
outcome to a statistically-significant degree. A significant
number of people continued to report problems one year post
injury, whether or not they received individualised treatment.
This study by Andersson et al (2007), strengthens the body
of knowledge that there are no proven routine interventions
beyond a single education session reinforced with written
information, which reduce the incidence of persistent
concussion symptoms following a mild traumatic brain injury.
Commentary: The Andersson et al (2007) study is well
constructed, and carefully conducted. Blinding of patients and
clinicians wasn’t possible, but blinding of outcome assessments
was achieved via postal follow-up. The intervention and
control group were similar at baseline with a small proportion
lost to follow-up from both groups. The numbers treated
corresponded to the power calculation that was made prior
to the commencement of the study and the rationale for the
statistical analysis was well referenced. The weakness with the
retrospective estimates was explained.
One third of the people considered for the trial, including
those with previous brain injuries and histories of drug addiction
and psychiatric problems were excluded. The researchers
suggested that these people may have been more vulnerable to
the effects of minor head injury and might derive more benefit
from active early treatment. They also acknowledged that the
kind of problems that people report after a minor head injury
often have a strong emotional component and more specific
psychological interventions might have been helpful in some
cases.
Interestingly, another randomised treatment trial to determine
whether or not multidisciplinary treatment of mTBI improves
neurobehavioral outcome was conducted about the same
time in Canada (Ghaffar et al., 2006). In this trial people
with pre-injury psychiatric disorders were included in both
the intervention and control group and interventions had a
focused psychological component. Outcomes demonstrated no
statistical differences between the treatment and control groups
and replicated the finding that persistent symptoms remained
for a statistically significant portion of both the intervention
and control group participants. Treatment did however provide
benefits for a sub-group in the intervention group who had
pre-existing psychiatric disorders.
Neither of these studies utilised dynamic testing, or assessed
sustained occupational performance in complex environments.
Other forms of intervention may be effective and need
further investigation before determining that multi disciplinary
intervention is not beneficial in preventing persistent symptoms
and disability post mTBI.
References
E, Emanuelson I, Bjorklund R & Stalhammar D A. (2007). Acta
Neurochirurgica, (149, 151-160)
Concussion Service Contract ACC, 2010
Comper et al, 2005
Ponsford (2002)
Ghaffar et al., 2006
mTBI - Statement
of Commitment:
Implications
The ACC Concussion Service Statement
of Commitment has implications for
ACC contractors. Can occupational
therapy input guarantee return to
pre-injury status for mTBI?
T
he New Zealand Accident Compensation Corporation
(ACC), provides a comprehensive, no blame cover for all
people who sustain an injury in New Zealand as the result of
an accident.
The Concussion Service for early intervention following
a mild or moderate brain injury is currently operational.
Therapists providing treatment under this service are required
to sign the following Statement of Commitment:
“I declare that, with the provision of part or all
of the above services, I will be able to assist the
client to return to their routine of normal daily
living; including work or school and that they will
no longer need any further ACC services or supports
for this injury.”
NZAOT have concerns about this statement. In Maree
Patterson’s critically appraised paper (see page 10) Mild
Traumatic Brain Injuries: The impact of early intervention on
late sequelae notes clinical trials demonstrate that persistent
symptoms following a mild uncomplicated traumatic brain
injury continue for a small but statistically significant number
of participants, whether or not they receive comprehensive
rehabilitation interventions (Andersson E E, Emanuelson I,
Bjorklund R & Stalhammar D A. (2007). These symptoms
are severe enough to interfere with everyday activities and
work.
Requiring treating therapists to sign a Statement of
Commitment for a full return to pre-injury activities before
claimants receive stage two services, appears to be in conflict
with the available evidence and may be contributing to
negative consequences for some clients. This expectation
for full recovery appears to be particularly difficult for those
people who are not managing complex work commitments,
and/or for those who perceive:
n that
they have not tried hard enough and just need to
work harder to overcome the symptoms,
n that
others do not believe they have persistent debilitating
symptoms, and/or
n that
the therapists input is responsible for the less than
optimal outcomes.
Executive director, Siobhan Molloy met
with ACC who have acknowledged our
concerns and are genuinely keen to resolve
this issue around the current wording
of the declaration - NZAOT expects a
response form ACC in due course.
Vol.33 No.3 May 2012 11
Occupation in Action
Primary Health Care
By Vicky Smith, MNZAOT, Convenor, Vocational
Rehabilitation NZAOT Special Interest Group.
Vicky discovered occupational therapy
whilst leafing through the pages of the
recruitment section of a local English
newspaper. Her interest grew through
further web-based investigation - the
principals of occupational therapy deeply
resonated, and the prospect of a potential
career in occupational therapy excited her.
Since then she hasn’t looked back. Her
commitment to study and practice has been
a life changing experience, from moving
to another country, completing her studies
at AUT University and landing a job with
an Auckland North Shore based NGO. It
wasn’t until the last year of study that
Vicky realised her passion for occupational
justice and human rights and this has been
reflected in her first occupational therapy
role. Founded on principals of community
development, Vicky has been working
with a NGO and the parents of a group of
youth with disabilities to set up a vocational
skills programme named ‘PEERS’.
T
he main occupational issue that is being addressed within the PEERS programme is
occupational alienation and deprivation. The need for the programme was born out of
parental concern for their young ones sitting at home, unoccupied and isolated from their
community. This would undoubtedly increase vulnerability to mental and physical ill health,
contributing to health inequality. I view this as an ‘occupational rights’ issue, as all people
should have access to meaningful and enriching occupation for the benefit of health and
well-being.
The programme takes place
in a youth centre facility,
where the NGO resources are
used, and the parents pay for
their young person to attend.
As the occupational therapist,
I have designed and developed
objectives in collaboration with
parents that focus on building
independence and health
promotion. The youth that
participate in the programme
have a range of disabilities but
the focus of the programme
is not impairment, it’s about
inclusion, well-being and
quality of life.
The motley crew at PHAB’s PEERS programme.
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12 Vol.33 No.3 May 2012
Using occupation in an enabling way
Enablement takes form in the opportunity for individuals to learn
new life skills as well as learning tools for leading a healthy lifestyle.
Learning new life skills builds independence, increasing self esteem
and develops positive self concept. Health promoting activities
provide opportunity for individuals to learn about the importance of
living a healthy lifestyle whilst providing opportunity for individuals to
engage in occupations that optimise mental and physical health.
One of the challenges of the role is managing the dynamics of
the group and providing just the right challenge for all involved.
The group has such mixed abilities, ranging from high functioning
members who are able to use the bus independently and hold down
a part time job, to those that are severely disabled, and in need
for a care-giver to support participation. Although engaging all
members proves challenging, the upside is that mixed abilities
has provided opportunity for higher functioning members to
serve as role models and learn how to support the less able
members of the group. I believe this is an important life skill
and that encouraging group members to work with each other’s
differences develops understanding, compassion and empathy - all
integral aspects of humanity.
Another important part of the programme is connecting individuals
to the wider community—helping to build interdependence—
recognising that this is an important part of social well-being.
Engaging the group in conservation volunteering has been an apt
medium for achieving this, aligning with the sustainability aspect
of the programme. ‘Connection’ should be added as an additional
occupational therapy key enablement skill, and shared occupations
that help people connect with each other and the wider community
should be more comprehensively researched. Inter-dependence is
central to optimal wellbeing, and one way to access this is through
living a more sustainable lifestyle – a culturally meaningful goal in
terms of caring and protecting New Zealands environment.
Direction for more centred
occupational therapy practice
Although operating outside of the
healthcare system, my community based
role is a part of primary health. The
programme focuses on well-being and
health promotion, contributing to minimising
health inequality. At this stage the
programme is not putting any strain on the
healthcare system to provide resources. I
believe occupational therapists could play
a lead role in community development.
Facilitation skills are a pre-requisite to such
a role, but occupational therapists already
have outstanding communication skills,
an understanding of group dynamics and
principals of empowerment.
It’s an idealist vision but imagine a
world without the need for healthcare
services, where communities meet their
own occupational needs. As well as
facilitation, occupation therapists could
provide a consultation role, advocating
for the benefits of ‘occupation’ for
maintaining and promoting health,
wellbeing and quality of life.
A seedling a PEERS group member
planted during a conservation
volunteer session
Masters Entry Pre-registration
Programmes – is Aotearoa
New Zealand Ready?
by Kirk Reed, DHSc, NZROT, MNZAOT. Head of
Occupational Science and Therapy, AUT University.
T
he aim of this article is to inform and create discussion within the profession
about what a masters entry pre-registration programme is. Within a rapidly
changing health and social care context, entry level programmes are challenged
to prepare graduates so that they will best meet the needs of the people,
communities and populations they serve. The education of occupational therapists
around the word is constantly changing to meet these demands and Aotearoa New
Zealand is no exception.
International context
According to the World Federation of Occupational Therapists position paper:
Occupational therapy entry-level qualifications, an occupational therapy entry-level
qualification enables a person to practice as an occupational therapist (2008).
Occupational therapy entry-level programmes around the world currently include
diplomas, baccalaureate or bachelor degrees and masters degrees, with doctorallevel qualifications in parts of the United States (Benoit, Mohr & Shabb, 2004;Mu,
Coppard & Padilla, 2006).
Local context
Some of the changes and developments in occupational therapy education
in Aotearoa New Zealand are captured in the Legacy of Occupational Therapy
(Gordon, Riordan, Scaletti & Creighton, 2009). In more recent times the
qualification for entry to the profession moved from diploma level to a bachelor
degree in the early 1990s. Both of the current tertiary education providers that
offer occupational therapy education also provide post registration qualifications
from honours, masters and in the case of AUT University up to and including
doctorates.
In considering the future of occupational therapy in this country the
Occupational Therapy Key Strategic Stakeholders (OTKSS) identified in their
strategic plan that consideration needs to be given to the preparation of
occupational therapists for the future. One of the objectives of key theme 4
(Provide quality education that ensures registration and inspires occupational
therapists to reach their full potential) highlights that OTKSS will “identify
future pre-registration qualifications" (2010, p. 9). In response to this, and
as a stakeholder the Occupational Therapy Board of New Zealand (OTBNZ)
commissioned a research project to examine the preparedness for practice of New
Zealand new graduate occupational therapists (Nayar, Blijlevens, Gray, & Moroney,
2011). The report from this project identified a range of recommendations one of
which was to “educate the occupational therapy profession on what is involved
with a masters entry pre-registration programme” (p.72). This was perhaps due
to participants in the study indicating they were not clear what a masters degree
would entail.
So what are masters entry pre-registration programmes?
n A
qualification that leads to registration as an occupational therapist.
after the completion of a bachelors degree, the bachelors degree
may be in a field related to occupational therapy such as psychology or human
movement.
n It is a programme that would seek accreditation by the OTBNZ and approval
from the World Federation of Occupational Therapists.
n It would include fieldwork.
n Is focused on developing practice focused skills, knowledge and attitudes.
n It is not a bachelors degree in occupational therapy followed by a masters degree
in occupational therapy, the masters degree is a stand alone qualification in
occupational therapy.
n It is different to most of the post graduate qualifications that occupational
therapists currently access as these are post registration programmes undertaken
after becoming an occupational therapist.
➤
n Undertaken
Occupation is explicit in what we do
and occupations fall within the well
known categories of self care, leisure and
productivity. Examples of occupations
include; cooking, gardening (growing
and harvesting vegetables), social and
communication skills, employment skills,
mobility skills and health promotion, namely
exercise, nutrition and stress management.
Vol.33 No.3 May 2012 13
Why consider masters entry pre-registration
programmes?
➤
n Creates
a different pathway for entry to the profession for
those that have an undergraduate degree and are seeking a
career change.
n Creates career mobility both nationally and internationally.
n Has the potential to attract applicants who are more qualified
and mature.
n Graduates are seen to be better prepared to work in new
roles with greater responsibilities moving beyond working
with individuals to practicing at the systems level (American
Occupational Therapy Association, 1997).
This is an issue that needs robust debate in this country; there
are many pros and cons to this type of programme which have
been explored internationally. Giving serious consideration
to this issue has the potential to position the profession to
better serve communities and populations in health and social
care contexts that have decreasing resources and increasing
demands. Come and find out more at the NZAOT Conference
2012 panel discussion lead by Associate Professor Alison Wicks
from the University of Canberra “Building professional power of
occupational therapy through education: Can graduate entry
programmes strengthen the profession in New Zealand?”
References:
American Occupational Therapy Association. (1997). Postbaccalaurete entry
level: Task force shares feedback. OT Week, 12(36), 14-15.
Benoit, J.N., Mohr T.M., & Shabb, C. (2004). Entry level doctoral degrees:
Issues facing graduate schools. Journal of Higher Education Strategies. 2(1),
39-56.
Gordon, B., Riordan, S., Scaletti, R., & Creighton, N. (2009). Legacy of
occupation: Stories of occupation therapy in New Zealand 1940-1972. Auckland,
New Zealand: Gordon Ell.
Mu, K., Coppard, B., & Padilla, R. (2006). Graduate outcomes of first
entry-level occupational therapy doctoral programs in the United States. Education
Special Interest Section Quarterly, 16(1), 1-4.
Nayar, S., Blijlevens, H., Gray, M., & Moroney, K. (2011). An examination of
the preparedness for practice of New Zealand new gradate occupational therapists.
Prepared of the Occupational Therapy Board of New Zealand. Auckland, New
Zealand: AUT University.
Occupational Therapy Key Strategic Stakeholders Aotearoa New Zealand.
(2010). Occupational therapy strategic plan 2010-2015. Retrieved from http://
www.nzaot.com/downloads/contribute/otkssstrategyFINAL300410.pdf
World Federation of Occupational Therapists. (2008). Position statement:
Occupational therapy entry-level qualifications. Retrieved from http://www.wfot.
org/ResourceCentre.aspx
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14 Vol.33 No.3 May 2012
NZAOT Graduate Award
T
his award is for the highest level of achievement in completing the occupational therapy
programme. This prize in varying formats has been awarded since at least the mid 1960s. Initially
awarded to the overall top student from the New Zealand School of Occupational Therapy (the
programme offered by the Department of Health) the prize was transferred with the educational
programme to the Central Institute of Technology (CIT) when the programme moved from health to
education. In the 1990s when the programme at CIT was replaced with two programmes, the NZAOT
identified that it would make two awards, one for the overall top graduate from AUT University and
one from Otago Polytechnic.
For Otago Polytechnic, the award went to Magbh McIntyre,
and for AUT University, to Sarah Mann.
Our warm congratulations go to you both.
Sarah Mann
AUT University
Magbh McIntyre
Otago Polytechnic
I
was delighted to receive
the news about the NZAOT
Graduate award (Otago). My
student NZAOT membership
helped inform me about
the range of potential
career paths, professional
development opportunities,
and the changing
and developing
role of occupational therapy
in Aotearoa.
The Bachelor of Occupational Therapy at Otago Polytechnic
provided thorough practical and academic support for the
different pathways we chose to pursue after graduation. It was
inspiring to be taught by tutors who were passionate about
occupational therapy. I was offered a variety of fieldwork
experiences that enabled me to translate theory into practice.
I can’t speak highly enough of my fieldwork supervisors. I
really appreciate the opportunities they gave me to gain skills
and knowledge that I continue to draw on. For me, the key
strengths of the bachelors programme were its emphasis on
occupation-focused practice, the importance of critical reflection
and the implementation of evidence-based practice. A highlight
for me over the past three years has been the opportunity to
learn more about the importance of the Treaty of Waitangi
and my responsibilities both personally and professionally as a
bicultural partner.
What was essential to getting through the past three years of
study was how we all supported each other as students. Our
year group came from a diverse range of backgrounds and our
class discussions benefited from these divergent perspectives. I
really look forward to seeing the contribution my fellow students
will make to occupational therapy.
Since graduation I have been working as a rotational
occupational therapist at Hutt Valley DHB and I am currently
based in orthopaedics and general surgery. I really enjoy being
part of a team that works to facilitate patients returning to
their homes and valued occupations. Just how much there is
to learn is both exciting and challenging and I am lucky to work
alongside such supportive and knowledgeable colleagues. Hutt
Valley DHB is a great place to be a new grad with excellent
formal and informal supervision and a mentoring programme.
In my first year at polytech we were introduced to concepts
of client-centred practice and the perspectives of the disability
rights movement. My first five months out in practice have
affirmed the importance of listening to the individual experience
of illness or disability.
Thank you to my fantastic friends and family. I particularly
need to mention my partner, Treason, who inspires me with her
commitment to social justice and my Dad, Don McIntyre, for all
of his stories.
W
inning the NZAOT Graduate award
(AUT) was an awesome surprise. I’ll
admit I was aware I had done well throughout
my studies but I never expected this. When
it finally sunk in I was completely ecstatic! It
was nice to get some extra recognition for all
of my efforts and it convinced me to be proud
of what I have achieved.
The reason for my decision to study
occupational therapy isn’t particularly exciting.
I knew I wanted to study something in the
health science field, it was just a matter of choosing something that
resonated with me. The diversity of occupational therapy is probably
what stood out. However, in all honesty, I don’t think I really knew
what occupational therapy was until I started studying it. Fortunately I
then discovered occupational therapy was definitely for me!
The most challenging yet rewarding highlight of my studies was a
third year placement at Bay of Islands hospital. Stepping up and out
on this placement gave me confidence and assurance that I can be a
great occupational therapist. I have my supervisors, Clare Kirkham and
Jill Edmunds to thank for this. They are super talented occupational
therapist’s who were so supportive of me and my development as a
therapist.
I was also fortunate to have the support and encouragement of my
friends and family throughout my studies, especially through those
really stressful times. My parents, sister and extended family are
definitely my biggest fans and deserve a huge thank you. I also had
the privilege of studying with a great bunch of students and inspiring
lecturers who installed in me the “OT ethos” I strive to maintain today
as I start my career.
I’m currently part of the acute allied health, occupational therapy
team at Middlemore Hospital, Auckland. I started at the beginning of
April and so far so good! I’m working with a great bunch of people
in a fast paced, dynamic setting. I’m still finding my feet but it’s great
having the support of a team and learning a huge amount every day.
So far I’ve been based on a cardiology/rheumatology ward which
keeps me on my toes, and next I look forward to helping out on a
stroke ward.
In the future I hope to travel with occupational therapy, starting
with a working holiday in UK/Europe. On returning back to New
Zealand I hope to apply occupational therapy in more of a community
development and occupational justice field. I really enjoyed being
involved in a project for the homelessness sector of a non-government
organisation in my final year of study. The paper ‘Promoting
Occupational Justice and Participation’ offered by AUT University was
a brilliant paper that highlighted the huge potential occupational
therapy has to branch out into new areas, particularly working
with populations that are vulnerable and experiencing occupational
injustice. Fortunately I have maintained a few networks with
organisations which will hopefully help me enter such sectors in the
future. I’d encourage other occupational therapists and occupational
therapy students to do the same!
Finally, I would like to thank NZAOT for offering this award and for
being so encouraging when awarding it to me. This ended my studies
with a big high and gave me confidence when seeking my first
occupational therapy role.
Vol.33 No.3 May 2012 15
Information Exchange
Active Members
CarFit
Pearson Award Winner
Many thanks to members who attended
a CarFit training event in Taupo recently.
“Several of the occupational therapists
came from quite a long distance and they
were all really great in getting involved
and helping with the day… It was great
when one of them saw an actual client of
hers come out of the club with a walking
stick and took her off to the side to put
her husband through the process”, said
Kath Henderson, CarFit manager at the
Automobile Association.
These members had been alerted to the
value of CarFit from an OT Insight article
in June 2011, and when the invitation to
attend an event in their area came through,
they leapt at the chance.
Some of the attendees had been given
the time off by their workplaces to attend,
although passionate advocate Hazel
Robertson took personal time off! Hazel
was inspirational as she spoke about how
much she enjoys working with CarFit
because it aligns with the work she is doing
with older people, mainly in the mental
health field. She talked about how much
she feels it helps older people to keep
mobile and be protected from injury. Where occupational therapists are
already assisting community CarFit teams
around New Zealand centres, some are
volunteering their skills in their spare
time, others are released as a service to
the community, others have agreed to
negotiate a special remuneration rate to
take into account the community aspect.
If you are an occupational therapist in a
medical driving assessment practice you are
likely to raise the profile of your business
and gain new clients through CarFit. A
certificate of attendance is provided.
Congratulations to
member Glenda van
de Ven-Long who
was selected from the
three award finalists
by a panel of judges
following a rigorous
interview process.
Finalists were required
to demonstrate how
undertaking their
chosen activity with
the $5,000 study
grant would impact
on their clinical practice, improve the health and
well-being of New Zealanders and benefit the
wider occupational therapist community.
Glenda specialises in working with people with
a dual diagnosis where mental health illness,
substance use disorders and/or brain injury collide
and are seen as primary conditions. The study
grant will go towards advanced training sessions
and meetings with expert occupational therapists
working with people with a dual diagnosis in
Australia. During the self-guided study tour,
Glenda will investigate how mentorship and
clinical supervision programmes are run in order
to bring such knowledge, resources and skills
back to benefit New Zealand practitioners and
patients.
“My vision is to inspire other New Zealand
occupational therapists to up-skill in the area of
working with people who present with multiple
and complex behaviours and needs,” says Glenda.
We applaud Pearson Clinical Assessment
for the provision of this award, and Glenda
will be publicly acknowledged with an award
presentation at the New Zealand Association of
Occupational Therapists biennial conference in
Hamilton in September. Interprofessional
Caseload Management
Tool Project
The Canadian Association of
Occupational Therapists (CAOT), The
Canadian Physiotherapy Association
(CPA) and the Canadian Association
of Speech-Language Pathologists and
Audiologists (CASLPA) are the partner
organisations of the Interprofessional
Caseload Management Tool project,
funded by Health Canada.
Why develop a caseload
management tool?
With growing demands on services,
recruitment and retention issues,
caseload/workload management has
been identified by members of the three
professions as one of major significance
to themselves as health professionals,
to their patients and to the health
delivery system. Caseload/workload
management has and continues to
be determined primarily by economic
factors, that is, the funding allocations
available for occupational therapy,
physiotherapy, and speech-language
pathology positions. With global
budgets steadily diminishing, little
consideration is given to patient and
population health needs in workforce
planning for these professions. The
status quo or existing numbers of
funded positions are frequently used
as the gold standard despite reports of
therapists facing increased numbers of
patients with complex health issues.
This situation is leading to therapist
recruitment and retention issues and
patients experiencing lengthy wait times
and unmet health needs.
NZ Sign Language
Booklet for Health
Professionals
NZAOT occupational therapists at CarFit training: L-R, Anna Brealey
(community occupational therapist, Taupo), Jessica Wills (driving assessor,
Rotorua), Elsbeth Liebi (new graduate), Hazel Robertson (Mid Central
Health) and Fleur Baxter (community occupational therapist, Whakatane)
16 Vol.33 No.3 May 2012
To help medical staff communicate
with their Deaf patients, Deaf Aotearoa
has just released a New Zealand Sign
Language booklet full of helpful, relevant
signs. “Let’s Talk – NZSL for Medical
Situations” includes 25 basic signs that
are commonly used in medical situations.
Produced by Deaf Aotearoa, with the
help of the Waitemata District Health
Board and staff, the booklet offers
practical opportunities to learn some
basic NZSL vocabulary relevant to the
medical environment.
Telephone-based mental health
interventions for child disruptive
behaviour or anxiety disorders
Plans Underway for
Dunstan Hospital 150th
Celebrations
Dunstan Hospital will next year celebrate
150 years serving the Central Otago
community and planning is underway
to mark the occasion. Dunstan Hospital
opened on 8 August 1863 and the weekend
of 9-11 August 2013 has been set for the
sesquicentenary, said Central Otago Health
Inc. Chairwoman Ainsley Webb.
Expressions of interest in the 150th
celebrations can be emailed to nolanevill@
scorchotago.co.nz or mailed to Central
Otago Health Inc, C/- PO Box 355,
Alexandra 9340.
Electronic Medical
Records Help Keep Costs
Down
Unhealthy modern lifestyles, ageing
populations and struggling national health
services will combine to create huge
demand for Electronic Medical Records
(EMR), according to a new report by medical
intelligence company GBI Research.
The new report shows that information
communication technology (ICT) is to play a
leading role in future medical care, as more
efficient administration of diverse healthcare
practices will lower costs to countries.
Governments are expected to drive the
market by implementing national schemes
to bring medical records up to date in a
technological age.
Comments: (Wayne Miles) There is
considerable research and practice interest
in the use of web-based initiatives for
assessment and treatment of mental health
issues. These will require that the tools for
assessment (both diagnostic and outcome
type) are valid and reliable when used in the
on-line setting. There has been a tendency
to use tools designed for a face-to-face or
paper-based administration in the on-line
setting with an expectation that it will
translate. This piece of work should give
reassurance for use in the assessment of
depression. Hopefully this will stimulate
work in other areas of diagnostic and
outcome assessment.
(David Menkes) This model could readily
be adapted to NZ, and would fit particularly
well with linking to primary care which is
now essentially 100% computerised and
which, for better or worse, treats many
more cases of anxiety and depression than
do mental health services. It will be more
difficult, but no less important, to extend
this approach to patients with severe
mental illness. Reference: J Clin Psychiatry.
2012;73(3):333-8. http://article.psychiatrist.
com/dao_1-login.asp?ID=10007632&RS
ID=37542948561824
Cognitive behavior therapy,
exercise, or both for treating chronic
widespread pain
Authors: McBeth J et al
Summary: This study evaluated the
clinical impact of telephone-delivered
cognitive behavioural therapy (TCBT) alone
Web-based assessment of
or with exercise in patients with chronic
widespread pain. 442 patients were
depression in patients treated in
randomised to receive TCBT, graded exercise,
clinical practice: reliability, validity,
combined intervention, or treatment as usual
and patient acceptance
(TAU) for six months and were assessed
Authors: Zimmerman M, Martinez JH
for change in health using a patient global
Summary: This study investigated the
assessment scale. TCBT caused significant
acceptability, reliability, and validity of a
and sustained improvements in patients with
web-based administration of a depression
chronic widespread pain.
scale in 53 outpatients receiving ongoing
Comment: This is an interesting twist on
care for either major depressive disorder
providing pain management at a distance.
or bipolar disorder. All patients completed
The approach would lend itself to rural
a web-based and a paper version of the
practice and to variable hours, e.g. for the
Clinically Useful Depression Outcome Scale
working population. The follow up is short,
(CUDOS). The paper and Internet versions
at six and nine months, and it would be
of the CUDOS were equally correlated with
important to have more time to see whether
clinicians’ ratings on the Montgomery-Asberg
this result is sustained as often the early
Depression Rating Scale, the Clinical Global
results from pain management approaches
Impressions-Severity of Illness scale, and
are overly optimistic.
Global Assessment of Functioning at the
Reference: Arch Intern Med
time of the visit. Patients preferred internet
2012;172(1):48-57
administration over completing a paper
http://dx.doi.org/10.1001/
version in the office.
archinternmed.2011.555
Research Review Snippets
Authors: McGrath PJ et al
Summary: Children with oppositionaldefiant disorder, ADHD or anxiety disorders,
stratified by DSM-IV diagnoses, were
randomised to usual care or a ‘Strongest
Families’ intervention that consisted of
evidence-based participant materials
(handbooks and videos) and weekly
telephone coach sessions. Significant
treatment effects were seen for each
diagnosis in an intention to-treat analysis.
Comment: This could well be the way
of the future in primary mental health.
Non-professionals trained up to provide
the service direct to the home, at times
convenient to the family, backed up with
handbooks, videos and the weekly phone call
over 11 sessions. Why not a similar study to
be trialled in NZ to see if it is as acceptable?
The gift certificates that each family received
for participating wouldn’t go amiss!
Comment: In an environment of limited
resources (in this case, available time of
health professionals), it seems to me that
we are all constantly faced with the ‘jam
on toast’ problem (how thinly or thickly
to spread ourselves). It was heartening to
read this paper, despite some limitations,
especially as the families were reportedly
very satisfied and accepting of the distance
services. It will also be interesting as our
technologies continue to improve, although
I have no doubt that some direct face-toface contact will continue to be an integral
prerequisite.
Reference: J Am Acad Child Adolesc
Psychiatry 2011; 50(11):1162–72
http://www.jaacap.com/article/S08908567%2811%2900643-5/abstract
HWNZ Workforce
Innovation Microsite
This site has been established as a shared
web space for health professionals
who are interested in sharing
information on key workforce
initiatives and innovative
practice occurring in the
health sector, and for
sharing their views on the
shape of the future health
workforce. This site also shares
information on the demonstration
sites established as part of the Health
Workforce New Zealand (HWNZ) Workforce
Innovation Programme.
A simple search using ‘occupational’
came up with eight links to literature
- including aged care and health
workforce, support/rehabilitation
assistants, falls prevention and mental
health with children/adolescents.
Vol.33 No.3 May 2012 17
NZAOT
Achievement Award
Calling for Nominations NOW!
Close 30 June 2012
In recognition of:
◆ contributions to the development or
profile of the profession
Occupational Therapy Postgraduate Study
Check out what courses we have on offer.
We aim to meet all your postgraduate needs
wherever you are in the world!
100% Distance learning at its best!
➤
➤
➤
➤
Learning in your time at your place
Courses which will fit with your lifestyle
Opportunities to network with like minded Therapists
Select the courses that are relevant to you to create
your own unique PG Cert/Dip/Masters
◆ the provision of occupation-centred
therapy
Semester Two, 2012
◆ innovation in the delivery of
occupational therapy
Vocational Rehabilitation
The award is in the form of a certificate
for $1,000, provisioned from a collective of
individual sponsors from within the community of
occupational therapy in New Zealand/Aotearoa.
23 July—16 November (14 taught weeks plus breaks)
This course aims to provide both evidence based theory for effective
disability management and return-to-work planning, as well as the
foundation practical skills that therapists use to assist employees to
successfully return-to-work.
Occupation Therapy in Primary Health
http://www.nzaot.com/about/awards/occupational.
There are significant opportunities for occupational therapists to
work within primary health. This course will help therapists position
themselves to provide such services.
You can also access this from the www.nzaot.com
home page.
Using Sensory Processing Principles with Diverse
Populations
Download nominations form:
therapy.achievement.php
Sensory modulation? Sensory integration? This newly redeveloped
course will introduce occupational therapists to the neuroscientific
theories that underpin sensory integration and its application to
various settings.
Outcome Measures and Occupational Therapy Practice
This course will examine what an outcome measure is and the
multiple reasons for using them in practice. It explores how these
can be used to record the effectiveness of occupational therapy
interventions.
The Milford Person Lift by
Autochair (UK)
A Vehicle transfer lift made
of aluminium, the Milford body weighs just 8kg and comes in a
4-compartment padded carry bag for travel and storage!
Specially designed for lifting people from their wheelchair into a
vehicle and out again.
Specialty Practice
The aim of this course is to facilitate occupational therapists
with specialist experience to examine the diverse roles and
responsibilities of the specialist practitioner. Using examples from
their practice and exploring the relevant literature the course will
enable therapists to articulate and be more explicit about their
specialist knowledge and skills.
Negotiated Study
Portable Ramps for every
home, vehicle and travel
application. Dependable, durable and made in the USA.
Anywhere, anytime you need ACCESS.
Pathway, Tri-Fold, Suitcase, Threshold and Track Ramps.
Wheelchair & Scooter Lifts.
Lift, store and transport your
unoccupied wheelchair, scooter or power chair in every type of vehicle.
❚ Available Nationwide ❚
ACC Contractor, Enable, AccessAble, MOH & MinEd Supplier
Contact us for full product details or visit our website:
www.mobility.co.nz
t: 09 445 8401 f: 09 445 8403 e: [email protected]
Mobility For Independence
18 Vol.33 No.3 May 2012
This course provides students with the opportunity to explore in
depth a topic of special interest related to their occupational therapy
practice. Students must have already successfully completed two
postgraduate level courses to be eligible to enrol in this course.
*all courses running are dependent on a minimum number enrolling
Contact us now to discuss your study options or to receive
our regular Postgrad Post (newsletter). Contact:
Debbie Davie
Postgraduate Administrator
Email: [email protected]
Penelope Kinney Postgraduate Programme Coordinator
Email: [email protected]
Forth Street, Private Bag 1910, Dunedin
0800 762 786
www.otagopolytechnic.ac.nz
Sector News
Skills and Competencies Requirement
for Vocational Rehabilitation Services
We understand ACC will be doing more work on the
competencies over the next few months. For the purposes
of considering any post graduate qualifications they advise to
be guided by the Skills and Competencies Requirement for
Vocational Rehabilitation Services document. Access this on
the ACC website and search for “Skills and Competencies”.
Of note:
In the absence of published principles that can be used to
determine whether a qualification meets the requirements
for significant components of vocational rehabilitation, the
qualification sought should:
o Include
concepts of vocational rehabilitation, assessment
for vocational needs (including job analysis, ergonomic
analysis, identification of psycho-social and functional
barriers to rehabilitation), planning (return to work goal
setting), and intervention strategies for maintaining or
obtaining employment (psychological, vocational, social
and behavioural interventions, career and employment
counselling, career transition management) related to injury
based vocational rehabilitation. o
Include a focus on vocational rehabilitation equivalent to
30 credits* (or equivalent) within a post graduate academic
qualification.
o Be
level 8 or higher on the NZQA qualifications level
descriptors and qualification types within the NZQA
framework (i.e. post graduate level).
Any arrangements for credit transfer and recognition of prior
learning must be in accordance with the Criteria, Requirements
and Guidelines for Course Approval and Accreditation (NZQA,
Version 6: August 2010).
A NIDMAR qualification is not considered a post graduate
qualification on the NZQA framework.
* Note: 30 credits is half of a post graduate certificate - see:
http://www.nzqa.govt.nz/studying-in-new-zealand/nzqf/
understand-nz-quals/postgraduate-certificate/
NZAOT holds some information on post graduate options for
vocational rehabilitation - please contact: [email protected]
or 04 473 6510
Errata
Obituary
Nancye Bourke (née Dore) 1941- 2012, OT Insight, Vol
33, No. 2, March 2012, page 4.
The date Nancye Bourke commenced her occupational
therapy training, and the age she graduated was incorrect.
Nancye Bourke commenced her three year occupational therapy
training in January 1959, graduating in December 1961 at the
young age of 19.
Vol.33 No.3 May 2012 19
CPE
Continuing Professional Education Calendar
2012
May
7 – 11 ‘Towards Mastery’. Become an OT Coach: Learn
a Coach Approach for Occupational Therapy. 5 days face to face
training (8.30am to 6pm) plus 9 x 2 hour teleclasses. Sydney. http://www.towardsmastery.com/TM/occtherapy.html
24 – 27 ’Occupational Diversity for the future’ 9th
COTEC Congress of Occupational Therapy. Stockholm,
Sweden. For further information: E: [email protected]; W: www.cotec2012.se
26 – 26 9th Australasian Lymphology Association
Conference ‘Hot Topics in Lymphology’. Cairns, Qld. Australia. For further information: E: ala@thinkbusinessevents.
com.au; W: http://alaconference.com.au/index.php
29 – 30 Rehabilitation of the Neurological Upper
Limb Waitakere Hospital, Henderson Auckland. http://therapeuticsolutions.co.nz Ph: (03) 337 2092.
May/June
28 – 1 ‘Science & Art in Physical & Rehabilitation
Medicine’ 18th European Congress of Physical &
Rehabilitation Medicine. Thessaloniki, Greece. Congress W: www.esprm2012.eu or contact Congress Secretariat
E: [email protected]
June
1 – 3 Sensory Integration: the essentials to
understanding the theory, neuroscience and research
presented by Professor Anita Bundy and Shelly Lane, Sydney.
www.sensorypotential.com 5 – 6 Cognition and Brain Injury: Facilitating
rehabilitation from acute to community settings.
Cashmere club, Beckenham, Christchurch. http://therapeuticsolutions.co.nz Ph: (03) 337 2092
15 – 17 Sensory Integration: the essentials to
understanding the theory, neuroscience and research
presented by Professor Anita Bundy and Shelly Lane, Melbourne. www.sensorypotential.com 13 – 15 Wellbeing and Public Policy conference
hosted by the International Journal of Wellbeing in conjunction
with Victoria University of Wellington and the Open Polytechnic
of New Zealand. All queries and expressions of interest to: [email protected]; website: http://www.wellbeingandpublicpolicy.org/index.html
20
Visual Dysfunction and Brain Injury. Auckland. For further information: E: [email protected]; W: www.therapeuticsolutions.co.nz
21
Stroke Study Day. Auckland. For further
information: E: [email protected]; W: www.therapeuticsolutions.co.nz
21 – 24 “Recovering Citizenship’ 22nd Annual
TheMHS Conference. Cairns, Qld., Australia. E: [email protected]; W: www.themhs.org; Fax: +612 9810 8733
14 – 16 2nd New Zealand Applied Neurosciences
Conference. Auckland. Registrations now open. W: www.nzanc.aut.ac.nz
22 – 23 Cognition and Brain Injury: Facilitating
rehabilitation from acute to community settings.
Seminar Rm, Rehab Plus Pt Chevalier http://therapeuticsolutions.co.nz Ph: (03) 337 2092.
2-4
New Zealand Association of Hand Therapists
Annual Conference: Sense and Sensibility. Otago
Museum, Dunedin www.nzaht.org.nz
September
3 – 5 The Public Health Association of New
Zealand 2012 conference: Equity from the start –
valuing our children’ Wellington. Registrations open 6 May
and for further information go to: http://conference.pha.org.nz
11 – 14 International AMPS Symposium
‘Implementing evidence-based, occupation-focused
assessments and occupation-based interventions’
Copenhagen, Denmark. W: www.ampsintl.com for more
information and submitting a proposal.
12-14 September 2012 ReDo-programme:
Redesigning Daily Occupations. For occupational therapists who want to learn
more about the relationship between daily
occupations and health, and to learn how to
implement the occupational therapy treatment
programme Redesigning Daily Occupations©
(redo) for clients who experience stress-related
illness.
Brought to you by NZAOT
Contact Tina Larsen,
[email protected] or visit
www.nzaot.com for more information
16 – 17 Navigating adolescence: Working in
partnership to meet the needs of young people living
with brain injury and mental health challenges. St Lukes
Community Centre 130 Remuera Rd, Remuera, Auckland. http://therapeuticsolutions.co.nz Ph: (03) 337 2092.
August
13 – 17 ‘Towards Mastery’. Become an OT Coach:
Learn a Coach Approach for Occupational Therapy. 5
days face to face training (8.30am to 6pm) plus 9 x 2 hour
teleclasses. Sunshine Coast. http://www.towardsmastery.com/
TM/occtherapy.html
20 Vol.33 No.3 May 2012
15 – 17 Health & Wellbeing in Children, Youth and
Adults with Developmental Disabilities: Challenging
Behaviour – The Tip of the Iceberg. Vancouver, BC,
Canada. W: www.interprofessional.ubc.ca/HealthAndWellbeing/
default.asp or E: [email protected]
2013
February/March
27 – 1 1st Rehab Tech Asia 2013 – an international
exhibition and conference on Assistive Technology,
Integrated Care and Rehabilitation Engineering. Singapore. Call for papers: submission deadline 31 July 2012. Contact: Gwendolyn GOH by E: [email protected]
or W: www.singex.com.sg
Online CPE - participate in recognised professional
development in your own time, at your home or
workplace. Register at www.onlinecpd.co.nz
Courses available:
Difficulties with Handwriting: practical tips for
practical people presented by Rita Robinson.
13 – 15 ‘Ageing and Diversity’ Conference 2012. New
Zealand Association of Gerontology. Auckland. Call for Abstracts
close 25 April. W: www.nzag2012.co.nz
14 – 16 ‘Joint Matters: Topical issues on joint
function, disease, pain, treatment, rehabilitation’ NZ
Association Musculoskeletal Medicine 2012 Scientific Meeting. Wellington, NZ. Further information: www.musculosketal.co.nz
19-21 September
28th Biennial NZAOT
Conference 2012
Develop a Vision for your Business,
free to all those who register - you do not even
have to do a course!
IN-SERVICE TRAINING:
UPDATE YOUR KNOWLEDGE
ON STAIRLIFTS IN NZ
Two hour educational (not product)
in-service sessions including morning or
afternoon tea.
July
4 – 6
‘Changes & Challenges in Occupational
Therapy’ national Congress of the Occupational
Therapy Association of South Africa. Umhlanga, South
Africa. For further information E: [email protected] or view
W: www.otasacongress.co.za
November
Fresh perspectives:
• on people’s occupational professional
development
• on claiming professional power
• on existing practice
• on the profession’s scope
• on occupation
• on community and society involvement
• on responsiveness to Mäori
Please note: Any Occupational Therapist
may set this as an objective under their
Continuing Competence Framework for
Recertification (CCFR).
To arrange, please contact
Neil at Acorn Stairlifts,
0800 782 475.