HH2800 - 1041530

HH2800 Enabling Health and

Wellbeing through Occupation
Element 1
A reflective portfolio considering
Occupational Terap! "or# "it
tree life stages$
%&romoting and assessing critical tin#ing 2012'
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Index
Introduction &age 3
Section 1 : Preparatory e!lection &age 4
Section 2: e!lection" in action &age (
Older Adults &age (
Adultood &age 11
)ildren and *ong &eople &age 15
Section #: etro"pecti$e e!lection &age 1+
e!erence" &age 22
%ppendix 1 , -roup &rotocol , Older Adults &age 24
%ppendix 2 , -roup &rotocol - Adultood &age 2+
%ppendix # , -roup &rotocol , )ildren and
*oung &eople
&age 33
Introduction
Te follo"ing portfolio as tree main sections in "ic . "ill reflect upon m! practice
as an Occupational Terap! student$ . "ill "rite five different reflective pieces
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trougout te essa! and under tese eadings related to te group-"or#
underta#en during tis module$
Te first section is a preparator! reflection "ic "as underta#en /efore te module
started and "ic accounts for te vie"s . ave a/out m!self as a learner and to te
e0tent . "ould participate and engage in tis particular module$ Tis "ill also reflect
te s#ills and strategies . could /ring to te group-"or#$
Te second section - reflections in action - reflects on tree separate student led
topics$ Eac topic pertains to a different life stage as outlined in te module %older
adults1 adultood1 adolescents and cildren'$ 2itin eac life stage reflection3 a
particular model of reflection "as used to enance te 4ualit! of reflection and to
give guidance to te reflective e0ercise itself$
Te tird section of tis reflective portfolio accounts for a retrospective reflection of
m!self as a learner during te entire module3 te learning outcomes and te
recommendations for improving m! professional conduct$
Section 1 : Preparatory e!lection
2or#ing in groups is paramount to Occupational Terap! as it is one of te deliver!
metods used /! professionals to engage clients %5inla! 2001'$ As a student .6m
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loo#ing for"ard to enancing m! group-"or# s#ills and /uilding m! current
#no"ledge regarding group teor!$ . ope to /ecome a"are of m! learning needs
"en placed in te position of a professional "o is running groups as tis module
re4uires %)ole 2005'$ 5or tis reflective piece3 . "ill focus on m! current #no"ledge
and s#ills regarding group-"or#3 "at m! e0pectations are and "at concerns . ave
to underta#e tis module$
.6m a"are of differing teories for group-"or#3 suc as 5inla! %2001' and )ole %2005'
and teir respective "or#s regarding groups$ 7! professional life as an Occupational
Terapist Assistant in a mental ealt setting3 as given me te opportunit! to
o/serve group-"or# teories in action$ . ave e0perienced suc practice groups
/eing facilitated /! senior Occupational Terapists staff from "om . ave learned a
great deal and . can see "! certain group activities conform or fit in "it te
differing teories$
8ince attending te &rofessional 9evelopment module underta#en in level one of
:8c %Hons' Occupational Terap! course and /eing allo"ed to facilitate a group
session and aving /een provided "it feed/ac# from te seminar leader3 . /elieved
. ave enanced m! teoretical #no"ledge$
)oo#ing3 gardening3 art or potograp! are su/;ects tat .6m comforta/le "it and
feel safe in e0ploring furter during tis module$ .6m eager to design and create
appropriate sessions for eac of te life stages and . /elieve tat tis "ill elp me
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e0perience different group-"or# perspectives as suggested /! )ole %2005' in -roup
9!namics in Occupational Terap!$
:efore underta#ing tis particular module3 m! concerns related to te "a! in "ic
te sessions "ere going to /e facilitated and te #ind of strategies used tat "ould
elp me remain focused trougout te session$ Accordingl!3 <onson and <onson
%2000' states tat it is usual and normal for ne" group mem/ers to /e concerned
a/out "at is e0pected of tem and te nature of te group6s goals$ 7! concern "as
tat .f some of te activities involve participants aving to /e intimate3 . "ould find
tis t!pe of engagement uncomforta/le$
Having a safe audience to anal!se3 criti4ue and point out m! strengts and
limitations to after running a group3 "ill /e an effective "a! to understand m! group
s#ills and elp evaluate o" . can lin# te teor! into practice %)ole 2005'$ Tis
opefull! "ill provide me "it a clear understanding of te areas . need to develop or
improve in order to /ecome a /etter group facilitator$
.n conclusion3 . /elieve tat tis module "ill provide me "it an insigt into m! s#ills
as a facilitator=group leader and "ill give me te opportunit! to sare m! findings
"it oters$ 8elf-a"areness "ill elp me to criti4ue and develop evaluative s#ills in
order to deliver te /est care to m! clients$ >nderstanding te group d!namics "ill
cange m! understanding as to te importance of group "or# in te conte0t of a
terapeutic activit! and to te profession of Occupational Terap!$
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Section 2: e!lection" in action
Older %dult"
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9uring tis life stage te critical incident tat occurred "as te structure of t"o group
session aving to colla/orate$ Te incident "ill /e loo#ed at in more dept
trougout tis essa! to provide scope for m! reflection$
Te model . "ill /e using for tis particular reflection is :oud and 2al#er %Alsop and
@!an 1++?'$ .t focuses te e0ercise of reflection on tree different stages1 A/eforeB3
AduringB and AafterB te activit!$ Te follo"ing diagram of te 7odel intends to provide
te perspectives ta#en during tis e0ercise3 suc as3 ApreparationB3 Ae0perienceB and
Areflective processesB$
5ig$ 1 , :oud and 2al#er reflective model %)E:E 2012'
&reparation stage
:efore te activit! too# place our group assem/led to discuss and e0plore options
and strategies tat "e "ould use for our coo#ing session$ -roup roles suc as
leader=facilitator3 participant and o/server "ere allocated$
Te leader delegated te initial strateg! for our reference reading3 "ic included
materials tat could /e used for te elderl! group "o ad impairment suc as
stro#e$ Te session "ould focus on participants /a#ing scones using adaptive
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e4uipment and at te end of te coo#ing session3 te group "ould come togeter to
reminisce and eat te scones %see appendi0 1'$
)O&A7 %)ree# and :ulloc# 2008' "as te main teor! used to e4uip us "it tools to
centralise te activit! upon our selected age group$ Eri#son life stage6s teor! "as
also used %-ross 2005'$ .ntegrit! verses despair as te final life stage of tis teor!
"as ta#en into account "en organiCing te structure of our activit!$ To provide
directions to our structure "en designing te session te team leader allocated
different tas#s to eac of te group mem/ers3 for e0ample researcing te informing
teor! and rational %)ole 2005'$
E0perience 8tage
Our group "as te second group presenting a coo#ing session and te room "as
prepared after te first group ad finised$ Te critical incident tat occurred involved
te first group incorporating part of teir coo#ing session into ours$
7! group discussed tis issue and "e decided it "as going to /e more appropriate if
"e allo"ed te first group an allocated amount of time to dis out teir food /efore
"e ended our coo#ing session$ 2e informed our seminar leader a/out tis incident
and our cange of plan and "e "ere advised to inform participants a/out te
canges$ Te participants stated tat te! didn6t mind adapting to tese alterations in
our coo#ing session$
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@eflective &rocesses 8tage
Te cange to our programme made our group feel uncomforta/le and gave our
team leader a stressful situation to manage$ Tis "as /ecause "e "anted to
facilitate te session in a "a! tat "ould not compromise te participants6
performance3 participation and "ell-/eing as tis cange could impact on te "a!
tat our group "ould facilitate te session %&ar# 2010'$ Ho"ever3 informing te
participants a/out te canges prevented an! confusing and=or conflicting situations
%)ole 2005'$
.nvolving participants into te decision resulted of a Agroup decision ma#ingB
momentum$ -roup decision ma#ing3 uses te resources of te group mem/ers3 tus3
allo"ing participants to control te outcomes and to /e more involved in te group
directions %<onson and <onson 2000'$
As a group "e met te da! after and discussed "at could ave /een done
differentl! during our activit!$ 2e concluded tat te t"o groups presenting on tat
da! sould ave spo#en "it eac oter to find out "at eac group "as doing$ Tis
"ould ave avoided te stressful situation tat our group "as su/;ected to$
.n summar!3 tis reflective piece3 as called m! attention for te need to ave a plan
A:B prior to delivering a session$ . ave learnt tat it is important to assume canges
in structure and to inform participants a/out it %<onson and <onson 2000'$
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HH2800 - 1041530

%dulthood
5or tis life stage3 . "as appointed as group leader and te area of learning tat . "ill
/e reflecting on is te Asession6s aimsB and o" to effectivel! deliver tem$ One of
our group mem/ers "as not present for tis session "ic impacted on o" "e
acieved te overall aim$
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5is3 T"inn and &urr %Alsop and @!an 1++?' model "ill /e used for tis reflective
piece$ Tis model as 4 different strands of reflection tat allo"ed me to loo# at te
area of learning tat "as cosen for tis life stage$ Te 4 strands of tis model areD
AfactualB1 Asu/stratumB1 AconnectiveB and AretrospectiveB$
5actual 8trand
Te session "as designed for adults in an acute mental ealt unit "ic is part of
an eigt "ee# educational course$ Te session6s aims "ere related to "or# and
vocation as demonstrated /! 9avis and @inaldi %2004' researc1 suc researc
provided our group "it te main arguments to coose te aims for our sessions$
:efore te session started3 our group "ere informed tat one of te facilitators "as
not attending due to ill ealt$ Te ice /rea#er needed to /e canged and te
facilitation to one of te su/-groups "ere compromised$ As te group leader3 . too#
upon /ot roles of leader and su/-group co-facilitator to carr! on te functions of te
missing co-facilitator and carried out te canges to te group protocol %see
appendi0 2'$
Overall te session ran smootl! despite te a/sence of one of te co-facilitators1
te ice /rea#er "as a success according to participants6 feed/ac#$ Te main activit!
"as related to )urriculum Eitae "riting s#ills and dress code and participants "ere
o/served using a range of communication s#ills tat enanced te 4ualit! of
engagement levels "itin our session %Hagedorn 2000'$
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As "e "ere forced to cange te session3 te aims and te "a! te session "as
delivered also canged$ &articipants "ere onl! allo"ed to discuss in te /igger
group te dress code %main activit!'3 instead of e0ploring it in te su/-groups as
planned$ 5inle! %2001' argues tat "or#ing in su/-groups is a "a! to engage
participants in furter activities and to maintain participants6 engagement at
optimised levels$ Tis cange to te original plan put me under muc stress$
8u/stratum 8trand
Te fact tat one of our group mem/ers did not attend te session impacted on our
group d!namics$ Ho"ever3 tis "as overcome /! te rest of te facilitators6 actions
as te! improvised and delivered a session in a "a! tat te participants "ould not
feel tis impact$
As . "as divided in te roles of leader and participant3 . /ecame concerned a/out
o" to manage m! feelings as facilitator$ .t "as important for me to /ecome a"are of
m! feelings and emotions "en attending to te group6s needs$ Accordingl! <onson
and <onson %2000' states tat is important to manage feelings and emotions as tis
"ill give facilitators te notion of a session flo"ing as Afeelings are great sources of
information about what is happening within the group and what sorts of problems are
occurring in the relationships among members %p$ 532'$
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)onnective 8trand
@eflecting upon learning for tis session as given me te insigt o" to prepare
and organise group-"or# in te future3 pa!ing special attention to leadersip roles
and te reallocation of roles "itin te sessions6 d!namics ave /ecome clear to me
%5inla! 2001'$
Te fact tat one of te co-facilitators "as not present to deliver te session3 made
me focus more on m! role as leader and session deliver! tr!ing to compl! "it te
initial aims$ Tis reflection opened m! understanding to te "a! . /eave in front of a
group as to maintain te client centred approac %)ole 2008'$
@etrospective 8trand
Foo#ing at te entire event and te process as a "ole . can see tat as a leader .
"as a/le to sift from te initial aims to aims tat suited te participants "itin te
conte0t of tat da!$ Tis sifting of aims and session structure "as completel!
improvised under an enormous amount of stress$ Tis made me reflect tat . need to
develop sensitivit! to"ards o" participants involved in te activit! felt and te "a!
te! vie"ed it as a "ole %<onson and <onson 2000'$ . sould gain te a/it of
considering a range of different perspectives during m! practice as advised /! 5inla!
%2001'$ 5urtermore3 loo#ing at te fact tat . "as feeling stressed "en running te
session could ave made participants feel uneas! "it me$
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According to participants3 te session "as a success and te! felt tat te! ad
attended a Areal groupB$ 7a!/e m! over confidence to dissimulate m! stress and
tension made participants engage promptl! "itin te session and its tas#s$
&ro/a/l!3 m! peculiar st!le of delivering te session "ere . created empat! "it
oters ma! ave created a flo" in te session$
.n conclusion . ave learnt tat it is important to gain #no"ledge of o" to deliver a
session as to provide flo" and /e more fle0i/le to"ards te deliver! and ela/orate
upon a st!le tat is more fluid and less concerned a/out te structure$ Tis
e0perience as elped me to consider different approaces "en tings don6t go
according to plan or "en one element is missing$
&hildren and 'oung People
As used previousl! in te adult reflection3 te model for tis reflective piece3 "ere
students "ere "or#ing "it cildren3 5is3 T"inn and &urr %Alsop and @!an 1++?'
"ill /e used$ 5or tis particular session3 . "as one of te participants=o/servers and
m! role "as to /e one of te su/-groups facilitators and to supervise te "or# tat
"as done$
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5actual 8trand
Te session "as designed for cildren aged /et"een + and 11 !ears old and of
mi0ed etnic and religious /ac#grounds %see appendi0 3'$ Te client group "as
considered to /e a Aealt! populationB "ic means tere "as an a/sence of an!
significant disa/ling medical or cognitive condition tat could affect teir a/ilit! to
consent to and participate in tis activit!$
Te client group "ere pupils attending a particular primar! scool in a Gort East
Fondon deprived area tat as seen a rise in crime levels3 povert! and
unemplo!ment$ &articipants "ere reminded /eforeand tat tis "as an e0ercise
done "it AstudentsB and tat te circumstances "ould /e different "ere if to /e
done "it real participants suc as cildren %)ole 2005'$ 5acilitators e0plained tat it
"ould /e important to consider in real life ris# assessment to te cildren attending
suc sessions as to ma#e sure tat staff and oter participants "ere safe "en
attending suc sessions %)ree# and :ulloc# 2008'$
2ile students "ere "or#ing on te allocated tas#3 "ic as#ed tem to use
scissors to cut open plastic /ottles to /e used as pots and containers for planting
seeds3 participants "ere o/served struggling "it te e4uipment$ Tis "as an
e0periment and te students attending tis session "ere full gro"n adults and tis
alone sould reflect tat cildren "ould ave serious pro/lems to manipulate and
acieve te final end result as#ed from tem$
8u/stratum 8trand
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.t is important tat all materials and tecni4ues used during te activities sould /e
pre-tested /! facilitators and if an! fault or difficulties arise3 te facilitators sould
ave an alternative tat "ould compl! "it principles of dealing "it ris# and
environmental aCards %Hagedorn 2000'$
According to Hagedorn %2000' and )ole %2005'3 it is important tat participants
attend te session in a safe place to engage "itin te session and te activities$
Te simple fact tat te participants are safe and te facilitators provide for tem3 it6s
ver! important$ Accordingl! <onson and <onson %2000' states tat is important to
manage te group ris# as providing not onl! a safe environment /ut a space for
developing learning as aimed /! te session leaders$
Tis does not reflect te fact tat te facilitators "ere not a"are or "ere
irresponsi/le "en preparing te session for tis #ind of client population$ .t "as
assumed /! facilitators tat participants "ere a/le to manipulate te e4uipment in a
safe "a!$ . realise tat one sould never assume /ut3 instead test suc e4uipment to
ma#e sure tat it is safe to /e used %&ar# 2010'$ As tis "as a student e0ercise3 .6m
glad tat suc pro/lems arose as tis gave facilitators and participants a valid
learning curve tat .6m sure "ill /e part of our su/conscious "en preparing future
sessions$
)onnective 8trand
1?
HH2800 - 1041530
Tis reflective piece as elped me to loo# at te "a! sessions are prepared and te
"a! te room is set out for te participants$ A Amental reearsal e0erciseB needs to
/e considered as o" to run te session as tis "ill give facilitators te idea of "at
needs to /e canged or modified to acieve te /est end results "it te participants
in a safe environment %)ole 2005'$
@eflecting no" on te use of scissors during te activit!3 it is o/vious tat tis "as an
issue of ealt and safet!$ Te co-facilitators tat "ere at eac ta/le to elp
participants to do te tas# elped tem andling te e4uipment$ .n a real life
situation3 cildren could cause arm to temselves or oters /efore te co-facilitators
even ad te opportunit! to elp ten "it te tas#$ Te ealt and safet! of
participants /eing overloo#ed "en scissors "ere put on te ta/le could ave
caused a massive pro/lem tat professionals are accounta/le for %:OAT 2010'$
@etrospective 8trand
Foo#ing /ac# to te da! "en te activit! too# place3 it is o/vious tat facilitators
overloo#ed some important ealt and safet! considerations and tis could ave
impacted on te safet! of participants and on te "a! tat te session "as run$
7uc of te effort of facilitators to design a session for cildren from a deprived area
in Fondon "as ade4uate and directed to"ards orienting participants to promoting
1(
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ealt and "ell-/eing %)ole 2008'$ Got /eing toroug enoug "it ris#
assessments and ealt and safet! for tis particular session gave me an insigt into
o" to /ecome an effective professional in future %)ree# and :ulloc# 2008'$
Section #: etro"pecti$e e!lection
-roup "or# in Occupational Terap! is paramount to acieving terapeutic results
"it an! client group$ .t "as o/served tat clients /enefit from attending suc
sessions and professionals sould use tese sessions as important tools tat elp
clients to acieve recover!$ 5or tis retrospective reflection te 5is3 T"inn and &urr
%Alsop and @!an 1++?' model "ill /e used$
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5actual 8trand
>niversit! modules provide a good e0perience of te range of "or# involved in
designing and setting up a group session and tis ma! elp to alla! some of te
student Hs fears and misunderstandings a/out "at is e0pected of tem$
As an undergraduate Occupational Terap! student . ad concerns a/out te
running and delivering of te session3 and o" to identif! te needs for a specific
client group$ After attending te module3 it /ecame clear tat suc e0perience gave
me a valua/le insigt into "at to do "it a client group and o" to /eave in
professional ealt settings as advised /! )ole %2008'$
As a future professional3 engaging in suc learning sessions gave me e0perience
and called m! attention to "at areas . need to improve to /ecome a professional
tat uses is o"n s#ills in a more terapeutic "a! %)ole 20083 Hagedorn 2000'$
8u/stratum 8trand
>nderstanding te "a! people react to a different group "or# "as important to
appreciate$ As a student tis module offered me a starting point from "ic to
develop m! practice and ta#e on ne" roles$
)onnective 8trand
Te purposes of tis module /ecame clear to me after te initial sessions as it "as
relevant and allo"ed me to e0plore from te perspectives of Occupational Terapists
1+
HH2800 - 1041530
te group-"or# itself$ :! aving insigt into te current and emerging perspectives
and roles of Occupational Terapists "en "or#ing in groups3 as also given te
motivation to researc suc su/;ects in full in a near future$
@eflecting "ee# after "ee# upon te "or# done "it m! fello" students gave me a
larger understanding as to "ere to develop m! engagement s#ills and to develop
inter and intra-personal s#ills %)ole 20083 Hagedorn 2000'$
@etrospective 8trand
. ave learned tat as a future Occupational Terapist . need to callenge m! o"n
vie"s3 values and practices as it is an essential part of m! continuing professional
development$ . "ant to callenge m!self3 as a professional in ealtcare3 not to
/ecome immune to oterIs needs$ >sing reflective processes ma! also /e one "a!
to continue to tin# a/out "at . #no"3 "at . need to #no" and o" . "ould put tis
#no"ledge into practice for te /enefit of m! future clients$ Terefore on-going self-
reflection3 self-evaluation and researc3 suc as te reading of case-studies3 "ill
ensure tat . sta! open to "ere . ma! need to cange$
.n conclusion . can sa! tat attending tis module gave me a different insigt into m!
a/ilities and capa/ilities as a session leader and as a facilitator for future practice$ .t
also gave me a different perspective a/out group "or# tat . migt ave oter"ise
overloo#ed in te past and it also motivated me to e0plore group-"or# furter as to
enance te 4ualit! of m! "or# "it clients$
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2ord countD 3525 %e0cluding inde0 page3 references and appendi0'
e!erence"
Alsop3 A and @!an3 8$ %1++?' 7a#ing te of field"or# educationD a &ractical
approac$ )apman J Hall$ >K
)ree#3 <$3 :ulloc#3 A$ %2008' )apter 53 Assessment and outcome measures in
)ree#3 <$ and Fouger3 %Eds' Occupational Therapy and Mental Health3
fourt edition3 )urcill Fivingstone3 >K
)E:E 2012 %2012' ttpD==ce/e$cf$ac$u#=:&:G=casestud!=salfordLtla2ii$tm Maccessed
2+=03=2012N
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)ole3 :$ %2005' Group Dynamics in Occupational Therapy The theoretical Basis
and Practice pplication of Group !nter"ention# Tird Edition3 slac# .nc$3 >8A
)ole3 :$ %2008' )apter 1(3 )lient-centred groups$ .n )ree#3 <$ and Fouger3 F$
%Eds' Occupational therapy and mental health# )urcill Fivingstone3 >K
:ritis Association of Occupational Terapists %2010' $ode of %thics and
Professional $onduct$ Te )ollege of Occupational Terapists$ Fondon
9avis3 7 and @inaldi3 7$ %2004' >sing an evidence-/ased approac to ena/le
people "it mental ealt pro/lems to gain and retain emplo!ment3 education
and voluntar! "or#3 British &ournal of Occupational Therapy3 ?(%('3 pp$ 31+-
322
5inla!3 F$ %2001' Groupwor' in Occupational Therapy3 Gelson Tornes3 >K
-ross3 @$ %2005' Psychology the (cience of Mind and Beha"iour) 5
t
edition3 Hodder
Arnold3 >K
Hagedorn3 @$ %2000' Tools for Practice in Occupational Therapy) )urcill
Fivingstone3 >K
<onson3 2$ and <onson3 5$ %2000' %*periential +earning &oining Together Group
Theory and Group ('ills# &earson Education .nc$3 Fondon3 >K
&ar#3 8$ %2010' )apter 8$ -oal setting in occupational terap!D a client-centred
perspective$ .n 9un#en3 E$ %Ed$' ('ills for Practice in Occupational Therapy#
)urcill Fivingstone3 >K
&romoting and assessing critical tin#ing %2012'
ttpD==cte$u"aterloo$ca=teacingLresources=tips=promotingLandLassessi
ngLcriticalLtin#ing$tml Maccessed 2+=03=2012N
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%ppendix 1 (roup Protocol Older %dult"
&E%)I*E &OO+E' ,O HE%-)H %./ WE--01EI.(
%uthor: -roup O
Se""ion: 8cones and 7emories
In!or2ing theory:
)anadian 7odel of Occupational &erformance %)7O&' %&olata;#o3 To"nsend3 200('
focuses on d!namic interactions /et"een tree areasD person environment and
occupation1 canges in an! of tese influence occupational performance and role
e0pectations$ )7O& empasiCes on ena/ling participation in areas of self-care3
productivit! and leisure$

Terapist "or#ing "it a group of clients focuses on occupations tat individual
needs or desire to engage "it and /arriers "ic ma! influence occupational
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HH2800 - 1041530
performance$ Attention to productivit! and leisure is necessar! to empasiCe on
transition in p!sical capacit! and level of participation in social net"or#s among
older adults$ Effective terapeutic intervention "ould assist in overcoming tose
/arriers occurred from natural aging process and ac4uired disa/ilities during te life
span$
According to Eri#son6s life stage teor!3 %-ross3 2005' te mem/ers of tis group are
in te last developmental stage of life$ 9uring tis stage te conflict "ic impacts
older people is Hintegrit! vs$ despair6$ .ntegrit! can /e seen as a ealt! "a! of
reflecting upon life and is te inner sense of P"olenessP deriving from 4ualities suc
as onest! and consistenc! of caracter$ .t is up to te individual to coose to reflect
upon tese coices and to /e successful in activel! aging "ic "ill promote a
feeling of inclusion in societ!$ Occupational terapists provide a safe and
appropriate intervention tat give participants emotional support %)ole 2005'$
Purpo"e:
Te purpose of te H8cones and memories6 /a#ing group is toD
1$ 9iscuss te /enefits of aving a ealt!3 /alanced diet using te Htraffic ligt6
nutrition la/els$
2$ 9evelop and=or relearn te necessar! s#ills prepare and /a#e a food dis$
3$ Empo"er mem/ers to ma#e decisions3 co-operate "it oters and to follo"
set guidelines to acieve te desired end result$
4$ &romote ealt and safet! "itin te #itcen environment
5$ .ntroduce mem/ers to particular adaptive e4uipment and=or tecni4ues "ic
"ill ma0imise teir independence in tis activit!
?$ )ome togeter as a group at te end of te session to eat te finised scones
and to encourage mem/ers to sare an! memories te! ave regarding
/a#ing$
(roup 3e2ber"hip:
Tis group is open to older adults %aged ?5 and over' of /ot genders "o are
recovering from a cere/ral vascular accident %stro#e'$ Te group "ill aim to
accommodate clients from all cultural and socioeconomic /ac#grounds$ Te group
"ill ta#e place in te terap! #itcen area of te local stro#e rea/ilitation unit on an
outpatient /asis$ Te group is set to run on a "ee#l! /asis ever! Tuesda! at 11am$
)lients can /e eiter /e referred /! a ealtcare professional suc as teir
occupational terapist3 stro#e nurse or -$&$ or te! can also self-refer to tis group
providing tat te! meet te criteria$
24
HH2800 - 1041530
Te criteria for referral to te group is as follo"sD
An! older person "o as suffered a stro#e "itin te 12 monts and is no"
discarged from acute ospital services$
Te person as an interest in food preparation and is motivated to attend on a
"ee#l! /asis
Te person as te mental capacit! to consent to and participate in te group
.s not acutel! p!sicall! or mentall! un"ell at te time of referral
Te clients need for occupational terap! intervention is identified as emiplegia
%unilateral "ea#ness' "ic can result in impaired range of movement3 strengt3 pain
and s"elling$
A ris# assessment "ill /e carried out "it eac client /ased on te information
availa/le from te referral source to determine an! ris# to self or oter mem/ers of
te group including te leaders$
Te group "ill /e run /! t"o 4ualified occupational terapists and t"o occupational
terap! assistants and "ill /e availa/le for a ma0imum of 12 mem/ers and a
minimum of 3$ Tis "ill /e an open group "it mem/ers /eing a/le to ;oin at differing
stages of teir rea/ilitation1 tis "ill promote a support net"or# and at te same
time allo" mem/ers to see o" oter stro#e survivors ave progressed troug teir
rea/ilitation$
ationale:
Te group aims to increase confidence levels in individuals and improve teir
communication s#ills "ic "ill facilitate social inclusion$ Te rationale is to maintain
occupational performance in te client group %i$e$ older people "o ave suffered a
stro#e' and decrease te possi/ilit! of occupational deprivation$ According to te
Gational .nstitute for Healt and )linical E0cellence %G.)E'3 depression is
appro0imatel! t"o to tree times more common in patients "it a p!sical ealt
pro/lem tan in people "o ave good p!sical ealt %200+'$ :eing depressed
migt in turn cause te person to avoid parta#ing in teir usual routine due to lac# of
motivation$ :a#ing scones "as cosen /ecause it "as eas! to ma#e it provides te
opportunit! for te clients to interact "ilst en;o!ing te end products after"ards$ A
recent stud! tat e0plored service user6s engagement in /a#ing deduced tat te
opportunit! to ac4uire ne" s#ills and confidence "ile producing an end product "as
a motivator in attending sessions %Ha!le! and 7cKa! 2004'$ 5inall!3 providing
25
HH2800 - 1041530
a"areness of food !giene procedures "en "or#ing in te #itcen as ever!one
"o andles food must ave te igest possi/le standards of personal !giene to
avoid contaminating food and causing illness %Gas3 200?'$ Te importance of
maintaining a ealt!3 /alanced diet is "ell documented in te prevention of furter
stro#es and maintaining te ealt and "ell/eing in te older population %G.)E3
2008'$
%i2":
:! te end of tis session participants "ill /e a/le toD
1$ >nderta#e a tas# "ere scones "ere made in eac group
2$ .ncrease confidence levels
3$ .ncrease communication s#ills "it te group mem/ers
4$ @emain focused trougout te session$
5$ E0periment "it adaptive e4uipment in order to ma0imise independence
?$ >nderstand and appl! #no"ledge of te traffic ligt nutrition la/els on food$
($ Have formed a support net"or# /et"een group mem/ers$
8$ 5eel confident and comforta/le in saring memories "it oter mem/ers of
te group$
Outco2e &riteria:
&articipants "ill produce a num/er of scones made accordingl! to ealt and safet!
regulations$ Gutritional value of produced food "ill /e addressed3 and issue of
ealt! food consumption "ill /e part of te discussion$ &articipants during te
discussion3 "ill demonstrate understanding of coo#er! as a creative activit! and its
influence upon social inclusion and p!sical activit!$
Te success of te activit! group "ill /e evaluated /! a feed/ac# 4uestionnaire
given to te participants after teir final group session$ Te clients "ill also ave an
opportunit! to give feed/ac# to te group leaders during te last part of te group as
"ell as to reflect on teir o"n e0periences of te group$ Tis is essential in
ascertaining "eter te group as met te client6s individual aims and goals as "ell
as possi/l! influencing o" te activit! ma! /e altered to meet te aims more
effectivel!$
2?
HH2800 - 1041530
,or2at and /e"cription
)I3E %&)I*I)' S4PP-IES
%./ &OS)
5 2in" I.)O/4&)IO.
.ntroduce te facilitators
8ession aims
Healt and safet! procedures
5ire drill
5 2in" W%3 4P tra!!ic light "y"te2 !ood
-ive to eac group an envelope and as#ed tem to
e0plain its content to te rest of te group$
5acilitators e0plain te traffic ligt s!stem food in a
simple "a!$
# en$elope"
20
2in"
3%I. %&)I*I)' Scone"6 &rea2 and Stra7berrie"
or 8a2
9ivide group into tree smaller groups of four$
&reparation of one /atc of scones per group plus
"ipped cream and stra"/erries sliced$
1$ &repare scones using stove
2$ 9emonstrate "eiging3 measuring and #neading for
doug
3$ :a#e
4$ 2ipping te cream
5$ 8licing te stra"/erries
?$ )lean and tid!
Scone"
recipe
102in" /IS&4SSIO. and S.%&+
e2ini"ce 2e2orie" , as# participants to tal# a/out a
particular memor! "ile eating scones
)herapeutic %pplication , o" tin#ing a/out !our past
e0periences ma#e !ou feelQ
Plate"
+ni$e" and
,or9"
5 2in" &lean6 )idy and Pac9 a7ay
5 2in" &-OS4E
2(
HH2800 - 1041530
e!erence":
)ole3 7$:$ %2005' Group dynamics in occupational therapy ,
rd
ed$ Torofare G<D
8lac# incorporated
-ross3 @$ %2005' Psychology- (cience of Mind and Beha"iour$ FondonD Hodder J
8tougton$
Ha!le! F and 7cKa! EA %2004' H:a#ing gives !ou confidence6D >sers6 vie"s of
engaging in te occupation of /a#ing$ British &ournal of Occupational
Therapy) ?(%3'3 125 , 128$
&olata;#o3 H$<$3 To"nsend3 E$A3 %200(' Ena//ling Occupation ..D Advancing an
occupational terap! vision for ealt3 "ell-/eing and ;ustice$ )OAT
&u/lications A)E3 Otta"a3 OG$
Gas3 )laire %200?' H5ood 8afet! 5irst &rinciples6 >nited KingdomD )artered
.nstitute of Environmental ealt$2$4?$54
Gational .nstitute for Healt and )linical E0cellence %200+'3 Depression in adults with
a chronic physical health problem- Treatment and management Availa/le atD
ttpD=="""$nice$org$u#=nicemedia=live=1232(=45+0+=45+0+$pdf MAccessed 18t
<anuar! 2012N$
Gational .nstitute for Healt and )linical E0cellence %2008'3 8tro#eD diagnosis and
initial management of acute stro#e and transient iscaemic attac# %T.A'
Availa/le atD ttpD=="""$nice$org$u#=nicemedia=pdf=)-?8G.)E-uideline$pdf
MAccessed 1+
t
<anuar! 2012N
28
HH2800 - 1041530
%ppendix 2 (roup Protocol 0 %dulthood
(roup Protocol: (roup" in action 0 -i!e "tage 2
%uthor: -roup O
Se""ion: Eocation sensation
In!or2ing theory:
Te focus of te group is for clients to re-esta/lis a meaningful productivit! and
develop competence in vocational s#ills suc as preparation for a "or# intervie" and
"riting )E s#ills$
Tis group is /ased upon te 7odel of Human Occupation %7OHO' and te primar!
occupational domain addressed is Producti$ity$ Te group focuses on
&o2petence level of engagement$
Overvie" diagram of te groupD
Pri2ary
Occupational
/o2ain
3OHO Exploration &o2petence
2+
HH2800 - 1041530
-e$el o!
Engage2ent
*olition
Habituation
S9ill
En$iron2ent
8elf-care
&roductivit!
Feisure
8elf-care
Producti$ity
Feisure
Te 7OHO is also lin#ed to client-centred teories of recover!3 focusing on
recognition of a/ilities and meaningful activities3 and providing opportunities for
cange3 reflection and discover! of ne" values3 s#ills and interests %7ental Heal
5oundation3 2012'
Purpo"e: Te purpose of tis session is to raise te clients6 a"areness of various
factors "ic "ill influence teir success in appl!ing for a ;o/$ Tis session "ill focus
on communication s#ills and appropriate dress code re4uired for a formal intervie"3
and provide information of )urriculum Eitae %)E' "riting s#ills$
(roup 3e2ber"hip:
A total of 8 , 10 male and female adults aged 18 , 55 "it mental ealt conditions
in an acute setting$
R2o are not activel! ps!cotic=suicidal$
RAre a/le to concentrate and complete tas#s "itin te session
RAre read! for discarge
ationaleD
Tere is muc evidence to suggest tat unemplo!ment as an adverse effect on a
person6s ealt and "ell/eing %2arr 1+84'$ .n addition it as /een so"n tat
unemplo!ment results in an increased ris# of suicide in te general population %Fe"is
and 8loggett3 1++8'$ Te Gational 8ervice 5rame"or# for 7ental Healt %9H3 1+++'
stipulates tat services sould e0ist to prioritise emplo!ment amongst individuals
"it mental ealt pro/lems as "ell as to reduce te discrimination associated "it
tis client group and promote social inclusion$
30
HH2800 - 1041530
Tis session cites te social model of recover! "ic is focussed on ena/ling clients
to regain teir roles and activities "itin teir communities$ 8ocial inclusion is a vital
part of recover! as ta#ing part in mainstream activities suc as emplo!ment
%i2":
:! te end of tis session participants "ill /e a/le toD
1$ .dentif! and discuss appropriate communication tecni4ues for ;o/ intervie"s
2$ .dentif! suita/le dress code for ;o/ intervie"s
3$ -ain advice on o" to "rite an effective curriculum vitae %)E'
4$ :e motivated to activel! reflect on te processes involved in gaining
emplo!ment
Outco2e &riteria:
Eer/al feed/ac# from participants at te end of te session$
Occupational 8elf-Assessment %O8A'
5ollo" up revie" of participants after ? monts
,or2at and /e"cription
)I3E %&)I*I)'
S4PP-IES %./
&OS)
5 2in" I.)O/4&)IO.
5acilitators introduce temselves and te aims
of te session
Healt and safet!
)onfidentialit!
31
HH2800 - 1041530
10
2in"
W%3 4P
@ole pla! activit!D <o/ intervie" communication
tecni4ues "it OOO
:rief discussion
20
2in"
3%I. %&)I*I)' 1
.n small groups read troug 3 )E6s and
igligt an! areas "ic ma! need canging
and "!3 allo" participants to suggest tings to
/e included in te )E$ One facilitator=co-
facilitator per groupQ
15
2in"
3%I. %&)I*I)' 2
.n small groups participants are to /e so"n a
variet! of potos of people in various outfits$
-roup mem/ers to "rite on te paper and
discuss "at is appropriate=not appropriate for a
formal intervie" and "!$
O to arrange
printouts of potos
5 2in" /IS&4SSIO.
Outcome measureD ver/al feed/ac#
5 2in" &-OS4E
32
HH2800 - 1041530
e!erence":
)ree#3 <$ %2008' Te Occupational terap! and 7ental Healt 4
t
ed$ FondonD
Elsevier )urcill Fivingston
)ole3 7$ %2012' -roup 9!namics in Occupational Terap! 4
t
ed$ Torofare G<D
8lac# .ncorporated$
9epartment of ealt %1+++' Te Gational 8ervice 5rame"or# for 7ental Healt$
FondonD 9H
Fe"is3 - 8loggett3 A %1++8' suicide3 deprivation and emplo!ment in te 1+30s and
te 1+(0s$ Bulletin of the British psychological society3 323 30+-14
7ental Healt 5oundation %2012' recovert MonlineN$ Availa/le atD
ttpD=="""$mentalealt$org$u#=elp-information=mental-ealt-a-
C=@=recover!=$ Accessed on 22=02=2012$
2arr3 & %1+84' <o/ loss3 unemplo!ment and ps!cological "ell-/eing$ .nD E$F$ Allen3
E van der Eilert3 eds$ @oles transitions$ Ge" *or#D &lenum press$
33
HH2800 - 1041530
%ppendix # &lient Population and (roup Protocol
&hildren and 'oung People
&lient population
Population choice
Te client coice for te gardening group is /o!s and girls aged /et"een + and 11
!ears old and of an! etnic or religious /ac#ground$ Te client group "ill /e from te
Healt! population6 "ic means tere is an a/sence of an! significant disa/ling
medical or cognitive condition3 "ic "ould affect teir a/ilit! to consent to and
participate in te activit! session$
Te clients "ill all /e pupils attending a particular primar! scool in te Gort East
Fondon /oroug of Hac#ne!3 an area "ic as ig levels of crime3 povert! and
unemplo!ment3 Terefore3 te cildren ma! /e at ris# of a/use or neglect and
possi/l! ma! /e alread! #no"n to te local autorit! cild services team$
&ontext
Te session is part of an educational programme tat is run for 8 to 12 "ee#s$
Tis is an open group3 and it is availa/le to all students from te primar! scool$
Te participants can /e referred /! social services and from teir personal tutors at
scool$ Te students ave /een assessed3 and an appropriate ris# assessment as
/een done to determine te eac participant6s suita/ilit! to attend te session$
&ultural: &articipants attend te session t"ice a "ee#3 as part of a terapeutic
programme "itin after ours6 scool activities$
Phy"ical: te clients are to attend te session in te Terap! room 1 "ic is easil!
accessi/le3 "ell-lit3 "it sufficient cairs3 and resources for te intended activit!3 as
"ell as a garden space located outside in te scool grounds$ Tools are stored in te
terap! room and in a small sed3 in te garden$
34
HH2800 - 1041530
Social: te group is run /! t"o OT6s$ 7a0imum mem/ers "ill depend on staff
availa/ilit! /ut is recommended tat no more tan 10 participants attending te
session$ Te students ma! old social e0pectations1 esta/lis roles "itin te group
and create friendsips "it oter mem/ers$
Per"onal: participants aged +-11 !ears3 /ot male and female from te same scool
"it poor socioeconomic and educational status$
.eed !or Occupational )herapy:
Application of approac , Hprevention rater tan intervention6$
@eferrals from local agencies social services3 ealt visitor3 scool teacer parents3
and carers$
)o 2aintain:i2pro$e:encourage:
8upports to environment , /ecome eco-friendl!- rec!cle
5urter educational programs on living te scool
Fa"-a/iding and positive /eaviour in and out of scool
Healt! lifest!le
)o reduce:
8ocial isolation
9eprivation
@is# of crime and anti-social /eaviour in and out of scool
)o de$elop:
@esponsi/ilit!
8ense of /elonging
Enterprising /eaviour
&ositive relationsips
)oice not to /ull! or discriminate
%pproache" to inter$ention:
35
HH2800 - 1041530
Te /eavioural approac can /e used to as a motivator in engaging people in
activities$ 8#inner states tat providing positive reinforcement "ill enance and
maintain appropriate /eaviour in te cildren %-ross3 2005'$ .n tese sessions3
apart from getting appropriate feed/ac# from facilitators3 te re"ard for te cildren6s
ard "or# "ill /e produce tat can /e eaten in a fe" "ee#s6 time and also used to
feed teir pets$
As stated /! Al/ert :andura in social learning teor!3 /eaviour is learned from te
environment troug te process of o/servational learning$ )ildren o/serve people
around ten /eaving in different "a!s and "ill imitate te /eaviour tat te!
/elieve "ill earn approval %-ross3 2005'$
Te ground rules of te session "ill /e agreed at te /eginning and /! providing a
safe environment for te cildren to interact after scool3 I-reens for me3 and m! pet6
"ill promote independence and prevent antisocial /eaviour$
(roup Protocol: (roup" in action 0 -i!e "tage #
%uthor: -roup O
Se""ion: -reens for me and m! pet
In!or2ing theory:
Occupational terap! intervention is /ased on te 7odel of Human Occupation
%7OHO'$ 7odel e0plains persons6 desire to participate in occupation %volition'3 o"
/eaviour patterns influence activit! %a/ituation'3 and persons6 e0perience of te
"orld troug o"n /od! %performance s#ills'$ According to 7OHO3 environment
%social and p!sical' as an insepara/le element of person6s life3 offers opportunit!3
recourses or constrains to participation %Kielofner3 2008'$
7otivation %Eolition' for gardening involves opportunit! to demonstrate o"n creativit!
"ile designing te plant pot3 indentif! "ort attaced to te pro;ect and desire to
participate in gardening$ .t is influenced /! student en;o!ment1 effectiveness "ile
performing and satisfaction from participating in gardening$
Ha/ituation refers to patterns of /eaviour influence o" activit! "ill /e performed$
8tudents integrate teir individual p!sical3 cultural3 social and temporal conte0t
during gardening and learn a/out a/ituations of peers$
3?
HH2800 - 1041530
&erformance capacit! is te a/ilit! to participate in activit! /ased on p!sical and
mental ealt components$ .t focuses on su/;ective e0perience of performing ,
students6 communication3 interaction and perceptual motor s#ills "ill ena/le to learn
ne" s#ills$

Environment3 for tis session3 "ill referrer to involvement in a social group and
engage in cange$ 8tudents "ill ave an opportunit! to e0plore group interactions
and its impact on individual /eaviour3 roles and e0pectations$
Purpo"e
8ession promotes social interactions3 pla! in safe environment3 creativit! and sense
of acievement$
As a group pro;ects opportunities are created for uni4ue roles3 responsi/ilities for
eac mem/er to gro" individual pot "it vegeta/le$
(roup 3e2ber"hip:
Te group is open to +-12 cildren of mi0ed se0 and facilitated /! an occupational
terapist and 2-3 assistants as co-facilitators$ Te ratio of cildren to facilitators is
al"a!s at least 3D1$
ationaleD
Tis session is /ased on te government6s initiative Hcange for life6 "ic aims to
get families to /e ealtier and appier /! /ecoming more p!sicall! active and
preparing meals from fres products3 %GH83 2012' H-reens for me and m! &et6
aspires to incorporate te responsi/ilit! of gro"ing vegeta/les "ic "ould /e
arvested after a fe" "ee#s3 used to prepare salads=sand"ices and also feed te
cildren6s pets$ @esearc evidence suggests aving specific3 acieva/le goals can
enance and sustain motivation and lead to improved levels of performance
%@odger3 2010'$
3(
HH2800 - 1041530
8ince it is an after scool session tat is run t"ice a "ee#3 it "ill provide a safe
environment for te #ids to /e p!sicall! active and enance teir creativit! "ilst
giving parents a /rea# from cildcare$ Te session "ill also give cildren a cance to
enance teir interpersonal s#ills and provide a sense of /elonging %@e/eiro 2001'$
)ildren ma! e0perience occupational deprivation due to te social environment and
teir status$ Occupational Terapist %OT' "ill "or# "it local scool to fulfil potential
regardless of /ac#ground$ &lacing attention to cild "ell-/eing in earl! life3 OT
creates opportunities for successful development and prevents ris# of developing
damaging a/its or /eaviour$ 5or e0ample3 after scool group for cildren affected
/! povert!3 poor ousing and isolation provide steps to"ards occupational cange3
gro"t and encourage to positive communit! contacts and prevents gang culture
%9epartment of Education and 8#ills3 2004'$
%i2":
o 5acilitate ver/al social interactions and social s#ills
o 9evelop a sense of self-efficienc! and acievement
o 5acilitate concentration and attention
o Teac responsi/ilities3 ne" s#ills3 and ne" interests
o @aised a"areness a/out ealt! eating and rec!cling
o &rovide opportunities to pla! in out of scool rs3 in a safe environment
o 5acilitate creativit!
o @eceive effective support earlier if difficulties arise
Outco2e &riteria:
At te end of te session3 eac cild "ould aveD
o 7aintained concentration trougout te session
o Activel! listened to instructions and complete tas#s appropriatel!
o )ommunicated appropriatel! "it peers and facilitators
o 8ared e4uipment6s and oter materials "it group mem/ers
o Adered to ealt and safet! procedures "ilst using e4uipment provided
o Attend and en;o!ed scool and after scool session
o 9evelop feeling of safet! 3en;o!ed and acieved gro"t of desired vegeta/le
o Agreed to loo# after plants after in-/et"een sessions$
,or2at and /e"cription
38
HH2800 - 1041530
)I3E %&)I*I)'
S4PP-IES %./
&OS)
5 2in"
I.)O/4&)IO.
Healt and safet!3 toilets
-round rules
>se of e4uipment
@oles
10
2in"
W%3 4P
To pitc a penn! into a pump#in
Preparation: )arve out a pump#in %alternative
use a large /o"l' and line te inside "it plastic
or aluminium foil$ 7a#e te top opening /ig$
Playing the (a2e: &lace te pump#in %/o"l' a
couple feet a"a!$ -ive eac pla!er one to t"o
pennies$ Ever! time a penn! goes into te
pump#in3 a piece of cand! is "on$
Farge /o"l or
pump#in$
A/out fift! penn!
coins
15
2in"
3%I. %&)I*I)' 1
)reating plant pot from rec!cle materials and
decorating it$
7a#ing a "atering can from rec!cle materials
@ec!cle materials
li#e mil# /ottles3 ;uice
/o0es3 cand! tins3
!ogurts pots$
7ar#ers3 pens3
paper3 glue or tape$
2 2in"
1E%+
&!sical e0ercise activit! , stretcing
10
2in"
3%I. %&)I*I)' 2
&lanting up
2itin te su/group discuss o" care for
vegeta/le
8oil
seeds
10
2in"
PESE.)%)IO. O, WO+
E0planation of created pots
)ompare pots and group coice of most creative
one
3+
HH2800 - 1041530
5 2in"
&-OS4E
)leaning te room
e!erence":
9epartment of Education and 8#ills %2004' Ever! cild mattersD cange for cildren$
Availa/le atD
ttpsD=="""$education$gov$u#=pu/lications=standard=pu/lication9etail=&age1=9fE8=10
81=2004 MAccessed on 1+t 7ac 2012N
-ross3 @$ %2005' Psychology- (cience of Mind and Beha"iour$ FondonD Hodder J
8tougton$
Kielofner3 -$ %2008' A 7odel of Human OccupationD Teor! and Application3 4 t
ed$ :altimoreD Fippincott 2illiams and 2il#ins$
GH8%2012' Healt! Fiving Tips$ Availa/le atD
ttpD=="""$ns$u#=)ange4Fife=&ages="!-cange-for-life$asp0
MAccessed 1+
t
7arc 2012N$
@e/eiro K %2001' Ena/ling occupationD te importance of an affirming environment$
$anadian &ournal of Occupational Therapy3 ?8%2'3 80-8+
@odger3 8 %2010'$ Occupation.$entred Practice with $hildren- practical Guide for
Occupational Therapists$ >nited KingdomD 2ile!- :lac#"ell$ 11?$
40