bluuebunny/crossref_metadata_2025 huggingface dataset:
Assistive Technology Assessment and Planning for Children with Multiple Disabilities in Educational Settings
Authors: Copley Jodie , Ziviani Jenny
Published: April 2015

A number of critical elements have been identified in assistive technology assessment and planning to optimise its integration into the educational environments of children and hence address their functional goals. These elements are as follows: adopting a collaborative think-tank team approach to which all educational team members contribute equally and where technology experts are consulted once the need for specific technical support or training is identified; involving the family by establishing mutual expectations and using effective communication strategies; and conducting in-depth assessment that identifies clear goals, includes task analysis within daily environments, examines the child-device interaction closely and investigates the resources available to implement assistive technology use.

With this backdrop, this paper reviews existing assessments and proposes that the Lifespace Access Profile (LAP) (Williams et al 1993) and Lifespace Access Profile (Upper Extension) (LAPUE) (Williams et al 1994) satisfy many of the criteria for effective assessment and planning advocated in the literature.
Occupational Therapy in Occupational Health: Factors Influencing Referral
Authors: Joss Malcolm , Pratt Joanne
Published: April 2015

The early management of ill or injured workers, including occupational therapy, could help to reduce the costs and minimise the negative consequences of sickness absence. In an occupational health service that employed an occupational therapist, 37% (92) of the workers referred to occupational therapy over a 3-year period had been absent for more than 6 months. The occupational therapist was keen to examine the reasons that employees were not referred earlier and a questionnaire was sent to the human resource advisers who contracted with this service. The results of this small-scale survey suggest that referrals are delayed by several factors, including poor awareness of the skills of occupational therapists, poor awareness of the effectiveness and cost-effectiveness of therapy and confusion over the different skills that occupational health professionals have.
A Standard Terminology for Occupational Therapy
Authors: Creek Jennifer
Published: April 2015

A standard terminology is the authorised system of words and phrases used in a definite sense within a science or subject. The need for a standard terminology for occupational therapy in the United Kingdom was identified in relation to three projects: the Garner Project (College of Occupational Therapists 1999), the Systematised Nomenclature of Human and Veterinary Medicine — Clinical Terms (SNOMED-CT) and Occupational Therapy Defined as a Complex Intervention (Creek 2003).

In May 2004, the College of Occupational Therapists commissioned the development of a standard terminology for occupational therapy, to include definitions of between 5 and 12 key terms plus the term occupational therapy. Two sources of data were used: occupational therapy literature and a panel of expert practitioners. The primary literature sources were the College of Occupational Therapists' publications, the European Network of Occupational Therapists in Higher Education's website and the World Federation of Occupational Therapists' website. A Delphi approach was chosen as an appropriate method for obtaining consensus on the definitions among 42 expert occupational therapists.

It was found that the Delphi approach, whilst appropriate for producing a set of six definitions of key terms, failed to produce a single definition of occupational therapy. Instead of the number of possible definitions decreasing in each round, it expanded as panel members struggled to find a way of capturing the complexity of occupational therapy within a short definition.
The Casson Memorial Lecture 2006: Telling Tales — How Stories and Narratives Co-Create Change
Authors: Smith Graeme
Published: April 2015

The Casson Memorial Lecture 2006, given on 22 June at the 30th Annual Conference of the College of Occupational Therapists held at the Cardiff International Arena, Cardiff, Wales.
‘Rigour’, ‘Ethical Integrity’ or ‘Artistry’? Reflexively Reviewing Criteria for Evaluating Qualitative Research
Authors: Finlay Linda
Published: April 2015

Qualitative researchers contest and reject the criteria used by quantitative researchers when evaluating their work: those of reliability, validity and generalisability. Instead, qualitative researchers have developed alternative criteria responsive to their specific research ideals. These criteria encompass various dimensions of ‘rigour’, ‘ethical integrity’ and ‘artistry’.

This article attempts to show something of the range of evaluative criteria available to qualitative researchers, arguing that their choice of criteria needs to be compatible with the special nature of the research in question (its methodology, aims and assumptions). Occupational therapists are encouraged to be clear, thoughtful and reflexive about their position and values when evaluating their research. To this end, recent occupational therapy research is reviewed to identify the criteria that authors favour. I also proffer my own reflexive voice towards critically evaluating my approach in this article.
Brief Motivational Counselling for Alcohol Abusers Admitted to Medical Wards
Authors: McQueen Jean , Allan Linda , Mains Diane
Published: April 2015

Within the United Kingdom the number of individuals abusing alcohol is continuing to increase. Alcohol abuse is linked with long-term health problems, with the potential to have an impact on work, relationships and the ability to function in daily life. Occupational therapists working within general hospital environments have regular contact with alcohol abusers, although there is limited evidence of effective interventions in this clinical setting.

This article reports on a feasibility study, which investigated the potential role for occupational therapists in delivering brief motivational counselling to alcohol abusers admitted to medical wards. Consideration is given to the practicality of delivering such an intervention. The outcome measures used were the Fast Alcohol Screening Tool (FAST), self-reported alcohol consumption and participant's rationale for change. A small sample of 40 participants was recruited. Although the results presented are not statistically significant, this feasibility study will be important in assisting clinicians to plan future research in this area.
Measuring Outcome in Psychiatric Rehabilitation
Authors: Schofield Pam
Published: April 2015

Outcome measures are becoming an essential component in the everyday practice of occupational therapy. Within mental health rehabilitation this can present as a challenge, because quality of life needs to be balanced against quantifiable data from standardised assessments. Determining what is considered to be a positive outcome can demonstrate differences for each client and, as such, intervention needs to be provided in an individualised manner. This opinion piece explores the challenges of using occupational therapy outcome measures within psychiatric rehabilitation, including examples from the author's practice.
Enabling Older People to Stay at Home: How Adaptable are Existing Properties?
Authors: Goodacre Kate , McCreadie Claudine , Flanagan Susan , Lansley Peter
Published: April 2015

A multiprofessional research project examined in detail the factors that affect the adaptability of existing housing and explored issues relating to the introduction of assistive technology into the existing homes of older people in order to provide them with the opportunity to ‘stay put’. The research reported here investigated the feasibility of adapting the existing stock of social housing and the resulting costs and outcomes of introducing assistive technology.

This paper outlines that part of the project that examined in detail the adaptability of 82 properties representing a variety of property types to accommodate the needs of seven notional users, characterising the most common range of impairments of older people. The factors that affect a property's adaptability include property type and specific design and construction features. The implications for housing providers, clients and occupational therapists are discussed.

The research identified the unique expertise of occupational therapists, spanning the areas of housing, older people and assistive technology, and it introduced methods and tools that can help to determine best housing outcomes as well as cost implications. It is crucial that the profession is proactive in contributing to the development of housing policies that address the needs of an ageing population effectively.
Peer Review: It's Time for More Openness
Authors: Duncan Edward A S
Published: April 2015

The British Journal of Occupational Therapy strives to publish high quality research and scholarly papers. The journal faces a challenge in how best to meet this aim in the future. Regardless of the choices it makes, the focus on quality cannot be lost. One of the key features of quality is the peer review process, which all submitted articles must undergo. This paper reviews the policy of double-blind (anonymous) peer reviewing and suggests that an open peer review policy would provide greater transparency, accountability and credit, thereby enhancing the quality of the journal and strengthening its position for the future.
Payment by Results: Implications for Occupational Therapy Practice
Authors: Horton Ayana
Published: April 2015

Payment by Results represents an important change in the way that the National Health Service reimburses health care providers for services in England. The purpose of this new payment system is to pay health care providers fairly and transparently while rewarding efficiency, encouraging volume growth and supporting patient choice initiatives. Payment by Results will have a profound effect on occupational therapy practice, particularly regarding cost containment, documentation and patient-centred practice. Therapists working under the Payment by Results scheme require a better understanding of financial opportunities and constraints to ensure that occupational therapy services flourish under this new payment system.
Occupation, Education and Community-Based Rehabilitation
Authors: Pollard Nick , Sakellariou Dikaios
Published: April 2015

Occupational therapy is rethinking its paradigm of human occupation to take account of the social, political, economic and environmental influences on communities and the effects that these have on opportunities for being and doing. One way of bringing this element into undergraduate curricula may be to develop programmes around community-based rehabilitation (CBR) and human rights. Recent position papers from the World Federation of Occupational Therapists, in combination with occupational justice arguments, may support an orientation of professional thinking towards community needs. Some suggestions are made for the accommodation of CBR perspectives in education, particularly through the development of practice placement opportunities.
Client-Centred Practice: Ethical Obligation or Professional Obfuscation?
Authors: Hammell Karen Whalley
Published: April 2015

Occupational therapists claim to practise in a client-centred and needs-led manner, yet disabled people can perceive occupational therapists to be accountable not to their clients but to their employers. This opinion piece argues that the profession has failed to address the ethical implications of being gatekeepers to the resources that clients need while professing to be ‘needs-led’; and contends that we must choose either client-centred or therapist-centred practice (in which occupational therapists protect their own interests). Because therapist-centred practice contravenes the existing Code of Ethics and Professional Conduct, either appropriate censure or a rewriting of the Code is required.
Developing a Preceptorship Programme for Newly Qualified Occupational Therapists: Action Research
Authors: Morley Mary
Published: April 2015

This action research study used three focus groups and one interview to explore the experiences of five recently qualified occupational therapists, four supervisors and five occupational therapy managers. The participants were asked to identify the perceived development needs of new practitioners and the mechanisms that supported or hindered these being met.

The findings showed that the recently qualified occupational therapists experienced satisfaction at making a difference in their first posts. However, for some, their first post had fallen short of their expectations because they faced challenges when moving from student to practitioner, sometimes with limited support. The participants identified development needs that they felt were common to other new practitioners and also the factors that constrained or enabled the meeting of these needs.

These findings informed the second phase of the action research study to design a preceptorship programme that was compliant with the revised National Health Service employment contract (Department of Health 2005) and would improve the transitional experience of occupational therapists. This paper presents the focus group results and the rationale for the preceptorship programme, which was launched as a pilot evaluation study with occupational therapy staff from over 20 organisations in Autumn 2005.
Getting to Grips with Evidence-Based Practice: The Ten Commandments
Authors: Bannigan Katrina , Birleson Angela
Published: April 2015

There is an expectation that all occupational therapists will be evidence-based practitioners. This paper reports on an education intervention that has helped therapists working in clinical practice to respond to the challenges posed by evidence-based practice. The intervention was developed for a group of clinicians who had already undertaken an evidence-based practice course. The aim was to enable them to apply evidence-based practice skills to their practice settings. The intervention, which used the problem of evidence-tinged practice as a focus, is described and the ten commandments generated by the clinicians involved are presented for others as a potentially useful tool.
Using Accreditation of Prior Experiential Learning (APEL) to Replace a Practice Placement: A Controversial Option?
Authors: Tempest Stephanie , Cordingley Kevin , Craik Christine
Published: April 2015

The Accreditation of Prior Experiential Learning (APEL) is established in higher education, but there are no studies on its use in occupational therapy. Brunel University wanted to investigate whether APEL could enable occupational therapy students meeting certain criteria to be exempt from the first-year practice placement, and so devised an APEL proposal. Practice placement educators and students were invited to give their opinion on the proposal through a questionnaire; additionally, the students attended a nominal group discussion.

Three themes emerged from the six practice placement educators who agreed to participate: logistics, student experience and learning opportunities. The three students who participated valued APEL for confirming and recognising learning from previous experience. The low response impedes establishing any definite views on the topic, but could suggest that APEL is not a controversial option to practice placement educators and students. Further study is required on the adoption of APEL in occupational therapy education.
An Investigation into the Leisure Occupations of Older Adults
Authors: Ball Veronica , Corr Susan , Knight Judith , Lowis Michael J
Published: April 2015

Participating in leisure is known to enhance physical wellbeing, mental health and social functioning. There is, however, little knowledge of the current level of engagement in leisure occupations by older adults in the United Kingdom. Therefore, the aim of this study was to explore the current leisure occupations of adults over 60 years who considered themselves to be healthy and to identify the motivations that underpinned participation in those occupations.

Structured interviews were conducted with 70 adults with a mean age of 72 years. The majority of the participants (51, 73%) reported engaging in leisure occupations. The range of leisure occupations was wide and included walking, sailing, listening to music, emailing and volunteering. Of these, 23% were active leisure, 18% passive leisure, 24% social leisure, 20% hobbies and 15% other leisure occupations. Content analysis was adopted to explain the motivators for taking part in these leisure occupations. It was found that enjoyment, pleasure and relaxation were the key motivators.

This study shows that the majority of well older people are participating in leisure occupations and feeling positive about doing so. Further research is required to establish the role that occupational therapists can have in encouraging older adults to continue with or develop new leisure occupations to enhance health and quality of life.
The Disability Profile of Adults Who Receive Adaptive Equipment from Local Authority Occupational Therapy Services
Authors: Brittle Nicola , Lett Karen , Littlechild Rosemary , Sackley Cath
Published: April 2015

Little is known about the disability profile of people who receive adaptive equipment or about the efficacy or cost-effectiveness of provision. A cross-sectional survey of the records of eight purposefully chosen local authority occupational therapy departments in the Midlands, England, was conducted. The Barthel Activities of Daily Living Index was then used to describe the self-care dependency characteristics of 342 community-dwelling adults in receipt of the equipment provided, following an assessment by one of 24 occupational therapists or 8 assistants. The results indicated that the majority of service users were older than 65 years (78%) and experiencing difficulty in more than one domain. The median Barthel Activities of Daily Living Index score was 14.5, IQR 11–17, with greatest dependency in bathing, climbing stairs, dressing and transfers. Information about the population can help not only to plan service provision but also to underpin further evaluations of the effects of policy changes on the service.
75th Anniversary of the Founding of the Scottish Association of Occupational Therapists
Authors: Paterson Catherine F
Published: April 2015

This article celebrates the 75th anniversary of the founding of the Scottish Association of Occupational Therapists. It tells the story of how this came to be, how the organisation developed, and the events that led to the formation of the British Association of Occupational Therapists in 1974.
Priorities for Occupational Therapy Research in the United Kingdom: Executive Summary of the POTTER Project
Authors: Bannigan Katrina , Boniface Gail , Doherty Patrick , Nicol Margaret , Porter-Armstrong Alison , Scudds Rhonda
Published: April 2015

The College of Occupational Therapists commissioned the POTTER project to inform its work and the work of its research foundation. The aim was to identify its members' views about the current national priorities for occupational therapy research in the United Kingdom. A five-stage study was conducted. The main method was a national survey of the professional body's membership (n = 7000); 2,661 completed questionnaires were returned (38% response rate) and the respondents represented the current membership. The main research priority was a need for research into the effectiveness of occupational therapy. The findings have implications for research capacity building and the commissioning of occupational therapy research.
Evaluating Psychosocial Interventions in First-Episode Psychosis
Authors: Turner Niall , Whitty Peter , Lydon Caroline , Clarke Mary , Browne Stephen , Larkin Conall , Waddington John , O'Callaghan Eadbhard
Published: April 2015

Little is known about what influences the success of psychosocial interventions for first-episode psychosis. One possible explanation for the mixed results of clinical trials is the influence of confounders on outcome. Psychosocial functioning prior to the onset of psychosis (premorbid adjustment) is one possible confounder. In order to examine the importance of premorbid adjustment to occupational therapists providing and evaluating psychosocial interventions, this study compared the baseline characteristics and premorbid adjustment of the people with first-episode psychosis referred to psychosocial rehabilitation with those of the people not referred, and the outcomes of both groups.

All people with first-episode psychosis (n = 171) were assessed at baseline, including their premorbid adjustment. The participants were followed up 4 years later. A subgroup (n = 44) had been referred to psychosocial rehabilitation. The baseline presentation, premorbid adjustment and outcomes (symptoms and functioning) at 4 years of both groups were compared.

The results showed that the people referred to a psychosocial rehabilitation programme had a poorer premorbid adjustment and fewer years in education than those not referred. Unsurprisingly, those not referred had better outcomes 4 years after initial presentation. It was concluded that premorbid psychosocial functioning is influential in determining the likelihood of referral to psychosocial rehabilitation and can influence evaluations of psychosocial interventions.
Implications of Hoist Provision when Planning Discharge Home from an Acute Hospital
Authors: Benten Jane , Ellis Diane
Published: April 2015

Occupational therapists within an 800-bed acute hospital identified that discharge planning involving hoist provision required attention. A decreasing length of stay and the absence of guidelines in this area led to an evaluation of practice. Standards were set in partnership with the multidisciplinary team. An audit process was started against these standards on 15 cases over a 4-month period. The audit process identified areas where changes could provide a consistent interdisciplinary approach to discharge planning.

The most useful tool to emerge from this evaluation of practice was seen as the proforma devised for an access home assessment in a risk assessment format. Feedback from subsequent staff supervision sessions has demonstrated that occupational therapists have been enabled to provide a uniform approach to discharge planning for this group of patients, in a time of ever-increasing pressure to speed discharges and abide by manual handling legislation. The article aims to disseminate the risk assessment to therapists and other health care staff in acute and community health care.
Challenging Knowledge Reproduction: Problem-Based Learning for Evidence-Based Practice
Authors: Halliwell Victoria
Published: April 2015

This opinion piece supports the use of problem-based learning (PBL) as a teaching and learning method that can be used to support evidence-based practice. The PBL process reflects that of evidence-based practice: by engaging in this process, the occupational therapy student can gain the skills, ability and confidence to use his or her personal and professional knowledge, existing or new, in challenging and changing practice environments.
Upper Limb Rehabilitation following Brain Injury: Complex, Multifaceted and Challenging
Authors: Kuipers Kathy , McKenna Kryss
Published: April 2015

Neurological upper limb rehabilitation is influenced by a diverse range of factors within the practice environment. Clinical reasoning is the means by which occupational therapists make sense of such factors in order to make decisions that promote individual occupational goals. However, changes in neurological knowledge, the limited availability of research evidence and the need to maintain a focus on client-centred practice in rehabilitation settings are factors that contribute to clinical reasoning uncertainty. A protocol that aims to structure clinical decision making in the light of such diversity has been developed to guide upper limb rehabilitation after brain injury.

As part of a larger study designed to determine the conceptual usefulness of the protocol, 11 expert occupational therapists were asked to describe the challenges that they faced in their practice. Four themes emerged from the focus group data, described in terms of (a) the complexity of domain-specific knowledge and the paucity of evidence for practice; (b) the diversity of upper limb presentation; (c) the need to balance client-centred practice and professional duty of care; and (d) uncertainty regarding clinical decision making.

Although the data supported the participants' expertise, they nevertheless articulated a need for guidance in structuring the clinical reasoning and decision making underlying neurological upper limb rehabilitation. Various strategies are described that can be used to guide clinical reasoning, including research evidence, the differentiation of situations requiring the application of artistic or scientific knowledge, reflective and reflexive practice, and the application of system aids such as decision-making protocols.
Use of Standardised Assessments and Outcome Measures among a Sample of Irish Occupational Therapists Working with Adults with Physical Disabilities
Authors: Stapleton Tadhg , McBrearty Ciara
Published: April 2015

This study was carried out to explore the current usage of standardised assessments and outcome measures by occupational therapists working with adults with physical disabilities. A survey research design, using a postal questionnaire specifically designed for the study, was employed.

Completed questionnaires were returned by 109 occupational therapists working in a variety of settings, including acute care, community and inpatient rehabilitation. A range of standardised assessments and outcome measures was in use, with an average of four different measures being used by the individual respondents. The most commonly used measures were the Mini Mental State Examination (Folstein et al 1975), Rivermead Behavioural Memory Test (Wilson et al 1985), Functional Independence Measure (Uniform Data System for Medical Rehabilitation 1999), Barthel Index (Mahoney and Barthel 1965) and the Chessington Occupational Therapy Neurological Assessment Battery (Tyerman et al 1986). However, the consistency of use tended to be low. The barriers to a more consistent use of standardised assessments and outcome measures included time restraints, the unsuitability of the available measures and a lack of sensitivity of the available measures to capture the effectiveness of occupational therapy.

The findings support those of previous studies exploring this issue among occupational therapists from different areas of practice. The respondents in this study highlighted the need for a multifaceted approach, encompassing educational, managerial and individual responsibility, to address the issue of the usage of standardised assessments and outcome measures among occupational therapists.
Help or Hindrance? The Use of Fair Access to Care Services Eligibility Criteria within a Primary Care Trust Setting
Authors: Challis Tim
Published: April 2015

With the relocation of local authority roles to primary care trust occupational therapy services, an additional set of criteria for aids and adaptations has been introduced alongside the existing criteria used by health-based occupational therapists. This has led to questions over implementation and use, and highlighted the need for further training. The use of Fair Access to Care Services eligibility criteria potentially enables a wider range of interventions by the occupational therapy service and gives access to a greater range of services. However, the implementation has been inconsistent and further appropriate investment in training and support is required.
School Participation of Pupils with Physical and Psychosocial Limitations: A Comparison
Authors: Egilson Snæfridur , Hemmingsson Helena
Published: April 2015

Several features in the school environment affect pupils with disabilities, serving as either supports or barriers to their school participation. The purpose of this study was to investigate and look for differences in the pupil-environment fit of students with physical and psychosocial limitations, using the School Setting Interview (SSI). The SSI is a client-centred instrument, which focuses on school activities where adjustments need to be made to accommodate pupils with disabilities and to enable their participation. Descriptive statistics and Mann-Whitney U tests were employed to compare the fit of the two groups and their school environment.

The results reveal that, in order to participate actively, both groups of pupils required adjustments to many school settings. Pupils with physical limitations frequently need adjustments, but their needs were met by the schools to a more satisfactory extent than were the needs of pupils with psychosocial limitations.

The findings support the usability of the SSI for pupils with various types of limitations. They also stress the importance of eliciting the perspectives of the pupils themselves in order to facilitate the planning and implementation of client-centred occupational therapy interventions in school.
Role-Emerging Placements are an Essential Risk for the Development of the Occupational Therapy Profession: The Debate
Authors: Cooper Rachel , Raine Rosi
Published: April 2015

There is an increasing awareness of the use of role-emerging placements within occupational therapy education. A greater number of higher education institutions are recognising the value of their students undertaking at least one of their practice placements within a role-emerging setting. Similarly, students are developing a sense of the depth of the learning experience that can be gained from these placements. However, with these developments are the inevitable challenges, posed to academic staff, students, clinicians, staff within the voluntary sector and the profession as a whole. This opinion piece discusses both the challenges and the opportunities posed by the increasing use of role-emerging placements within the United Kingdom, and whether or not role-emerging placements are actually essential to the development of the profession.
Guiding for the Physically Handicapped
Authors: Luker Margaret
Published: April 2015

Based on a project submitted by Miss Luker, then a student at Dorset House School for her Association of Occupational Therapists' Final Examination in 1958. This has of necessity been modified as the practical examples and illustrations have had to be omitted in this publication.
An Evaluation of a Self-Care Unit
Authors: Cooper M. C.
Published: April 2015

Miss Cooper, Head Occupational Therapist, describes an experiment at Winford Orthopaedic Hospital, Somerset, which is in the country seven miles from Bristol. Its 230 beds cater for acute orthopaedic cases. Out-patient treatment is limited to the few patients who live in the immediate vicinity.
Major Overhaul of Whitley Council System
Authors: Nixon Christopher
Published: April 2015

The long awaited McCarthy Report on the working of the Whitley Council machinery was published on December 2. It has 144 pages including appendices and is priced at £1.15, obtainable from the Department of Health & Social Services, Room 333, Friars House, 157–168 Blackfriars Road, London, S.E.1.

Lord McCarthy was appointed by the Secretary of State for Social Services in April 1975 as a special adviser to the Department of Health and charged with the specific task of reviewing the workings of the N.H.S. Whitley Council machinery and reporting to the Secretary of State. Lord McCarthy is a Fellow of Nuffield College and Oxford Management Centre and is an acknowledged expert on industrial relations. His main findings and recommendations are summarised here.

Whitley negotiations are carried out by a Whitley General Council and eight functional Councils which deal with various groupings of N.H.S. staff. Occupational therapists are represented on the Whitley P. T. ‘A’ functional Council. Approximately one million N.H.S. staff are represented on all Whitley Council.
The Function and Effectiveness of a Local Authority Day Centre in the Rehabilitation of Psychiatric Conditions
Authors: Toke E. , Clews D.
Published: April 2015

There is nothing new about the concept of day centre treatment for psychiatric patients but this article gives an account of how two members of the Association established one and their findings in relation to its viability and success. The Journal believes that readers working in a similar set-up will gain something from reading about the authors' experience. They may contact the authors to make constructive criticism in the light of their own particular experiences.
Methods and Problems of a Stroke Rehabilitation Trial
Authors: Sheikh K. , Smith D.S. , Meade T. W. , Brennan P. J.
Published: April 2015

There are conflicting views on the effectiveness of rehabilitation after stroke; several studies have attempted to compare progress following intensive therapy with that following community care1–6 or no formal treatment,7–9 but for a number of reasons the evidence is inconclusive. Consequently, we have been engaged in a randomised controlled trial of the effectiveness of different intensities of out-patient rehabilitation following stroke. This paper outlines the design, methods and problems of the study.
Primal Therapy
Authors: Eiloart Gail
Published: April 2015

To date, although there are people in the U.K. who give what is called ‘Primal Therapy’, there are no properly qualified practitioners, and there is no way of training to become a Primal Therapist apart from at the Primal Institute in Los Angeles and New York. At the same time the writer believes that Primal Therapy is the most significant of recent developments in psychotherapeutic techniques, and the following article is written more from an interest point of view than an immediately practical one.
The Continuum of Fieldwork Experiences in Occupational Therapy Education
Authors: Shah S. K.
Published: April 2015

Supervised fieldwork experiences form an integral part of the educational programme and are a continuous process. They are directed towards the acquiring of critical thinking abilities and skills, and maximising the personal and professional growth of the student. The fieldwork experiences continuum have four distinct levels. The first two emphasise experiential learning as opposed to performance. The subsequent two levels emphasise the application and consistent integration of the academically acquired knowledge. The interspersing of the fieldwork experiences in didactic teaching and fieldwork objectives are discussed.
Ready for Work?
Authors: Bailey Diana
Published: April 2015

This report is the result of a special project undertaken in October 1979 during clinical placement at Chase Village Mental Handicap Unit.

It is presented in two parts. The first part, in this issue, includes a survey of agencies concerned with preparation of mentally handicapped adults for work or with providing a work setting; and a discussion of effective pre-work training, employment placement and follow up service.

Part two, in next month's journal, discusses assessment of work-related skills and offers ideas for an assessment procedure with a report form.

Conclusions and suggestions are based on reading and visits. It is hoped that suggested methods will form the basis for practical development of work skill assessment and training programmes for mentally handicapped adults.
Ready for Work?
Authors: Bailey Diana
Published: April 2015

This report is the result of a special project undertaken in October 1979 during clinical placement at Chase Village Mental Handicap Unit.

It is presented in two parts. The first part, in last month's journal, included a survey of agencies concerned with preparation of mentally handicapped adults for work or with providing a work setting; and a discussion of effective pre-work training, employment placement and follow up service.

Part two, in this issue, discusses assessment of work-related skills and offers ideas for an assessment procedure with a report form.

Conclusions and suggestions are based on reading and visits. It is hoped that suggested methods will form the basis for practical development of work skill assessment and training programmes for mentally handicapped adults
A Proposed Programme of Physical Rehabilitation for Patients Undergoing Toe-to-Hand Transfer Operations
Authors: Ping-Ching Leung , Wong Alice , Chi-Yin Wan
Published: April 2015

After the considerable experience of treating 38 patients with toe to hand transplantations, the authors work out a protocol for the rehabilitation, of such patients. Discussions of this nature are not available in the literature. The discussions are preceded by a brief description on the technical details of the surgical procedures. The physical rehabilitation consists of physiotherapy and occupational therapy. The physiotherapist and occupational therapist work in close co-operation in the motor and sensory training of the transplanted toes. They are also concerned with the functional assessments and the evaluations of progress of individual cases. The time taken from the operation to the resumption of work averaged nine months.
Early Experiences of Femoral Cast Bracing in Nottingham
Authors: Bish Jenifer M. , Drever Catherine
Published: April 2015

A retrospective study of the results of cast bracing 41 cases of fractured shaft of femur between January 1978 and 1980. This study was carried out in January 1981. It included clinical and radiological examination, functional assesment, patient's subjective appraisal of this method of treatment and our conclusions.
Access
Authors: Rogerson Robert
Published: April 2015

This article on Access for the Disabled seeks to draw attention to this important problem and is written by the Chairman of the Scottish Committee on Access for Disabled People which was set up on 16th May 1980 by the Secretary of State for Scotland as a committee of the Scottish Council on Disability.
Which Way? The Way Ahead
Authors: Willson Moya
Published: April 2015

Early in 1981 the College of Occupational Therapists assembled a working party of four people, Leigh Atkinson, Averil Stewart, Carol Underwood and myself. The remarks which follow are therefore not personal opinions but the result of four people working in tune with each other.
Toward a Wider View
Authors: Mabel Aunt
Published: April 2015

At this time of year, when Agag is on Holiday, it has become Traditional to Intercept a Letter from Aunt Mabel to her O.T. Niece in Australia.
Occupational Therapy in Child and Adolescent Psychiatry the Future
Authors: Jeffrey Lily I. H.
Published: April 2015

Taking “The Way Ahead” Report as a basis for discussion, the author examines one clinical field. Child and Adolescent Psychiatry, from the point of view of Occupational Therapy's future development within this speciality over the next ten years. The aim of clinical excellence in any field is to provide essential and appropriate therapy for that client group, whether in geriatrics, mental handicap, neurology, paediatrics, etc. By presenting the past, present and future development of this one field, the author hopes that this will stimulate discussion regarding planning in all clinical specialities and bases her views on four main areas, the clinical role of the Occupational Therapist, correct staffing and facilities, post registration studies and research.
Exploding the Myth: The Literature Search Explained
Authors: Gillott Hilary
Published: April 2015

Research methods were discussed with occupational therapy students, using handouts. Students learned to use indexing journals and abstracts to undertake a literature search. The results were collated and submitted for publication as a review article.
Making Social Skills Work with Outpatients
Authors: Davis Sue , Keene Nick
Published: April 2015

Several items have appeared in this journal concerning the application of social skills training to various types of client. This article aims to share the experience of establishing a system of social skills training for use with psychiatric outpatients having difficulties in their social and personal interactions. The authors give an account of a method of running a group and offer some observations regarding its effectiveness.
Profiles of the Members of the College of Occupational Therapists'
Authors: Board Advisory
Published: April 2015

The College of Occupational Therapists is fortunate in having a number of distinguished and knowledgeable people on its Advisory Board and short ‘profiles’ of them are to be published in this and subsequent issues.

Any reader wishing to seek the advice of a member of the Advisory Board on clinical, educational or other matters must ADDRESS THE REQUEST (typed please) c/o 20 Rede Place and not directly to the individual concerned. This is to ensure that the duplication of similar requests does not occur; and that no single member of the Advisory Board is over-burdened with requests for advice. (Any query which can be answered without reference to an Adviser will be dealt with by H.Q. staff.) There exists a fund of experience and knowledge upon which to draw and the use of it should benefit the profession.
The Critical Role of Occupational Therapy in the Treatment of Depressed Women
Authors: Lougher Lesley
Published: April 2015

This article was prompted by the author's experiences as an occupational therapist in acute psychiatric units and an adolescent unit, and as a sociologist, feminist and mother of two young children. It is an interpretation of the high incidence of psychiatric disorder in women and discusses the critical role of occupational therapy in their treatment.
A Simple Device to Encourage the Unwilling Child to Wear a Pressure Garment
Authors: McLean Neil R , Warren Elizabeth A
Published: April 2015

This brief report describes how, with commendable psychological insight, the father of a child recently treated in our burns unit adopted a very simple device to encourage his youngster to wear a pressure garment to deal with hypertrophic scarring.
Freedom of Choice for the Mentally Handicapped
Authors: Bodenham Jenny
Published: April 2015

This article deals with the resettlement of long-term mentally handicapped patients into independent living in wardened accommodation at Priory Court. The emphasis has been on ‘survival‘ and every person thought suitable for the project was given the opportunity to expand his concept of living and be discharged from a long-stay institutional environment. Motivation was the key factor, and staff and patients learnt much from the opportunity. The author gives an outline of the course taken and discusses some of the difficulties and triumphs. It was 3 years ago that long-stay institutional patients were discharged to the freedom of choosing a fuller way of life and from a distance the training team are able to see that these people are succeeding.
Explaining Psychiatric Occupational Therapy: An Art in Itself?
Authors: Madden Angela
Published: April 2015

This article discusses the particular problems involved in explaining psychiatric occupational therapy to patients and other professionals, and considers that insufficient attention is paid to doing so clearly and well. An experiment was carried out in which students and new staff made tape recordings explaining the department and its therapeutic possibilities, as they would to patients. An analysis was made of these tapes and revealed jargon, repetition, and vagueness to be among the main problems. A list of points for consideration when describing occupational therapy is provided and the author concludes that much benefit can be derived from attempting to improve presentation.
Occupational Therapy in the Treatment of Anorexia Nervosa: A Contractual-Coping Approach
Authors: Giles Gordon Muir , Chng Chwee Lye
Published: April 2015

In this article the authors claim that there is no single adequate treatment for anorexia nervosa. They examine some treatment strategies and suggest a contractual-coping model which emphasizes the essential input of the occupational therapist. Finally, they make some recommendations for the assessment and practical treatment of the anorexic patient.
Microcomputers in Occupational Therapy Departments: The Therapeutic Application
Authors: Hume Clephane
Published: April 2015

In response to the developments in technology relevant to occupational therapy and the provision by the Department of Trade and Industry of microcomputers for evaluation, it was decided that current use should be investigated in order to facilitate planning for student training. A localized study, centred in south-eastern Scotland, was carried out by Clephane Hume and Mora Reid in November last year, when the first DTI computers had been placed in Scotland. This report discusses the factors hindering development, and lists the present and potential applications of microcomputers as shown by the study. It concludes that the therapist of the future must be aware of the therapeutic potential of the microcomputer.
Problems Encountered by a Child with Congenital Limb Deformities
Authors: MacDonald Jenny
Published: April 2015

This article is based on the experiences of a paediatric occupational therapist who found herself in the position of helping a child with severe congenital limb deformities. She describes the initial occupational therapy assessment and the treatment programme, which was aimed at developing independence as far as possible. The equipment used is discussed, including adaptations required at home and in school. The child has now largely adapted to his physical problems, but is emotionally very dependent on stable relationships with adults.
Occupational Therapy and Assessment of the Elderly
Authors: Szekais Barbara
Published: April 2015

This paper examines the assessment process as the basis of treatment for geriatric occupational therapy. The need for assessment of the elderly, especially comprehensive assessment, is reviewed, and a framework for considering basic issues in assessment is provided. The role of the occupational therapist in the assessment of the elderly client is discussed.
Assessment and Moderation: The Development and Present Organization in Occupational Therapy Schools
Authors: Hudson Betty
Published: April 2015

In any period of change many people not directly involved may be, not surprisingly, bewildered by the differences in the old and new systems. This article outlines the examination systems currently in use in England, Ireland and Wales and in Scotland.
How to Be Interviewed: The Selection Interview
Authors: Pinder T H
Published: April 2015

This is the first of three articles on interviewing with the general title of ‘Both Sides of the Table’. It takes the candidate through the five stages of the pattern for success: Applying for the job, preparation, arriving for the interview, the interview itself, and the conclusion of the interview. Subsequent articles in this series will discuss ‘How to Interview’, and will include the selection interview, the appraisal interview, the counselling interview, and the disciplinary interview.
Body Image: Anorexia Nervosa Patients and Occupational Therapy Students
Authors: Martin Joan E
Published: April 2015

The subject of body image is discussed with reference to reported studies on anorexia nervosa patients and ‘normal’ subjects. These results are compared with those of 25 occupational therapy students. Reference is made to the use of occupational therapy activities which explore the area of self-perception.
Relaxation Training Techniques — A Review Part One: What is Relaxation?
Authors: Keable Diana
Published: April 2015

This article is part one of a literature review of relaxation training techniques. Firstly, the concept of ‘relaxation’ and its mental and physical effects are discussed. Secondly, the major relaxation training techniques and their theoretical bases are described. (Part two of the review will deal with evaluation and will include examples of experimental studies concerning the effectiveness of relaxation training techniques.)