Occupational Therapists: their lived experience of the phenomenon of Effective Occupational Therapy with children and young people

Avantaggiato-Quinn, Maria (2016) Occupational Therapists: their lived experience of the phenomenon of Effective Occupational Therapy with children and young people. Doctoral thesis, Northumbria University.

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Abstract

Despite regulatory requirements for occupational therapists (OTs) to appraise the effectiveness of their service, there is little empirical evidence to suggest that they do so. This relativist research addresses the need to understand the phenomenon of effective occupational therapy with children and young people (CYP) with complex mental health needs/learning disabilities, in the lived experience of OTs.

Assuming an interpretivist epistemological perspective, a Heideggerian (1962) interpretive phenomenological methodology guided a reflexive relational approach (Finlay and Evans, 2009) to in-depth interviews carried out with eight OTs working in specialist CYP services. Using threefold analytical methods: thematic (Van Manen, 1997a), metaphorical (Ricoeur and Thompson, 1981) and Lifeworld (Ashworth, 2003), results were contextualised using an occupational perspective of health (Wilcock and Hocking, 2015).

Effective occupational therapy with young people identified issues of occupational injustice and was child centred. It supported the development of a sense of occupational being through having an authentic relationship and time and space during therapy. Opportunities to improve health through occupational doing were created through micro grading of activity-based interventions. Utilising their expertise in grading the environment enabled OTs to facilitate young people to set and reach personally meaningful goals to become the experts in themselves and develop a sense of self-hood.

Consequently, outcome measurement toolkits were designed to capture patient and clinician reported experience and outcome measures. Such tools may enable occupational therapists to provide assurance that they are addressing issues of effectiveness as part of their statutory and ethical obligations, planned next stages are to pilot their use with clinicians and children. An important contribution of this study is that it supports the necessary bridging of the areas of paediatric, physical OT and MH/LD specialist OT, to enhance effective holistic occupational therapy.

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