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A grounded theory of intuition among occupational therapists in mental health practice
- Authors:
- CHAFFEY Lisa, UNSWORTH Carolyn, FOSSEY Ellie
- Journal article citation:
- British Journal of Occupational Therapy, 73(7), July 2010, pp.300-308.
- Publisher:
- Sage
This study explored nine occupational therapists’ (OTs) understanding and use of intuition, whilst interacting and connecting with mental health patients during the clinical reasoning process which guides their decision making on practice. Using a grounded theory approach and the evolving theories on clinical reasoning and CCT (the Cognitive Continuum Theory), the authors conducted qualitative, semi-structured interviews with participants recruited from mental health presentations at an Australian OTs conference. They were asked to describe an example of intuition in their everyday life and professional practice and discuss it further in response to the researcher’s probes and definitions. Participant demographic data and methods of data analysis are illustrated in Table 1 and Figure 1, respectively. From the data, intuition was defined as knowledge without conscious awareness of reasoning and was found to be embedded in clinical reasoning. Participants described it as “elusive and underground”, and suggested, in their own words in the text, that with greater professional experience, came more comfort in its use. Using intuition relied on therapists’ understanding of their own and others’ emotions and intuition partnered analysis within their clinical reasoning, say these authors. This paper concludes with a presentation of a grounded theory for the use of intuition in mental health settings (Figure 2), and proposes that intuition be considered with analysis as an important tool within a clinical reasoning framework.
Using the occupational performance history interview (OPHI): therapists' reflections
- Author:
- FOSSEY Ellie
- Journal article citation:
- British Journal of Occupational Therapy, 59(5), May 1996, pp.223-228.
- Publisher:
- Sage
Clinical interviews provide occupational therapists with sensitive and versatile sources of information; however, reliable means to collect and interpret this information are necessary for effective clinical decision making. The Occupational Performance History Interview (OPHI) is a semi-structured interview, designed to address the need for a reliable and clinically useful tool in occupational therapy. This article describes a qualitative research study, in which four experienced therapists reflected on their use of the OPHI to interview people referred to a psychiatric day hospital service.
Training novices to make expert, occupationally focused, community mental health referral decisions
- Authors:
- HARRIES Priscilla, GILHOOLY Kenneth
- Journal article citation:
- British Journal of Occupational Therapy, 74(2), February 2011, pp.58-65.
- Publisher:
- Sage
An essential decision making skill that has to be learnt by occupational therapy students is the ability to prioritise referrals according to an individual's level of need. This is particularly necessary for community mental health services, where referral demand far exceeds service availability. This study used expert occupational therapists' referral prioritisation policies, derived from judgement analysis, to train novices in the skill of referral prioritisation. The policies chosen were those that supported occupationally focused practice. Thirty-seven final-year occupational therapy students at a large UK university were asked to prioritise a set of referrals, before and after being trained with graphical and descriptive representations of these experts' policies. Prior to training, the students overvalued the client's history of violence and undervalued the reason for referral and the diagnosis compared to the experts. Post-training, the policies were better matched. The effect of training was demonstrated by: more accurate prioritisation scores when matched with expert ratings on the same referrals, improved consistency on repeat referrals and higher group agreement. The authors suggest that decision training may be useful in promoting the type of service that aims to target clients' occupational needs in the field of community mental health.
Occupational therapy in community mental health, Part 2: factors influencing choice
- Author:
- MEESON Beverley
- Journal article citation:
- British Journal of Occupational Therapy, 61(2), February 1998, pp.57-62.
- Publisher:
- Sage
Part 1 of this article examined how frequently various intervention media were chosen by occupational therapists working in community mental health. An emphasis on anxiety management, problem solving and supportive counselling techniques was evident. In part 2, these therapists' rationale for therapy choices is explored.
Therapist or public protector? - the dilemma of the professional in Mental Health
- Author:
- HEDGECOCK Wendy
- Journal article citation:
- Kent Journal of Practice Research, 1(3), September 1997, pp.51-56.
This article examines the dilemma in which the author, an occupational therapist, has increasingly found herself over recent months. The situation is question is that where the mental health professional has to decide whether their role as protector of public interest should take precedence over their role as therapist. Recent government legislation and guidelines such as the Care Programme Approach, the Supervision Register and Supervised Discharge have emphasised the need for good risk assessment and management. These recommendations reflect issues highlight in the published reports of inquiries into serious offences committed by people diagnosed as having severe mental health problems. Discusses how this emphasis on risk management has implications regarding the autonomy of both the client and the professional. It also invites the question as to whom the professional's first allegiance must be.