• Alan Hirons- Occupational therapy clinical specialist

• Rachel Rose- Journey service user

Rachel• Childhood

• Resentment

• No life

• Mental health services– DBT– Diverse Pathways

Referral to Journey• Feeling worthless

• Doing nothing

• Sitting thinking about the past

• No motivation or energy

• Pushing people away

Aim of Journey

To assist group members to develop and implement

Individual occupational action plans

which contribute to and facilitate adaptation and recovery

Objectives

• Developing understanding of the relationship between occupation and health

• Developing skills of occupational self analysis• Engaging in occupation and purposeful activity• Becoming conscious of and engaged with ongoing

occupational narratives

Content of Journey

• Purpose of groups• Time use• Health priorities• Personality disorder and occupation• Environmental contexts• Narratives • Creative breaks• Service user evaluations

Occupational Action Plan• What is your plan?• Why?• What are the best physical and social environments

for the plan?• What is the desired outcome at three months into

the plan?• How does the plan fit with your life narrative?• What are the challenges?• What support will you use in doing the plan?

Rachel's occupational action plan

• To explore different ‘exhilarating’ sports with the purpose of facing ‘danger’ and surviving it.

The experience of Journey

• Wondering what it will do for me

• Group work

• Adapting vs. feeling pissed off

• Impact of family circumstances

• Physical disability

• Difficulty of endings

Outcome measuresRachel Rose- OSA

0

10

20

30

40

50

60

70

80

90

100

competence values

OS

A o

utc

om

e c

lien

t m

easu

re

before (14/08/08)

after (11/02/09)

6 months (27/08/09)

Outcome measuresRachel Rose- WHOQOL

0

10

20

30

40

50

60

70

80

90

100

physical psychological socialrelationships

environment

Domain

Tra

nsfo

rmed

Sco

re (

0-1

00)

before (14/08/08)

after (11/02/09)

6 months (27/08/09)

Immediately after Journey

• Abandoned

• Direct payments

• Continued climbing regularly

Ripples

• Better relationships

• Recovery

• Reflect more- asking questions

• Allotment

• Psychiatrist

In a bubble?

• Am I doing it?

• Is it really happening?

• Will it last?

• When will the bubble burst?

• How will I manage challenges?

My metaphor now

“ moving from a victim to survivor, but still a way to go”