Occupational Therapy and Arts Therapies
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/25
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Item Exploring the Potential for Developing Person-Centred Practices in a Child and Adolescent Mental Health Inpatient Unit: A Qualitative Research Protocol(SAGE Publications, 2025-03-04) Attard, Christie; Elliot, Michelle L.; Grech, PaulannDue to a drastic increase in child and adolescent mental health difficulties worldwide, there is a constant need to evaluate current practices and further develop person-centred practices. The importance of person-centred practices is highlighted in research worldwide. This study will look into the potential development of person-centred practices within a child and adolecent mental health in-patient unit, the Young People’s Unit. Initially the current care practices, and person-centred moments were explored, which then lead to the development of pathways to create person-centred practices. This study followed a philosophical inquiry based on the SECI model and the concept of Ba developed by Ikujiro Nonaka. Data was collected from 15 young persons admitted to the Young People’s Unit. 15 main caregivers and the healthcare professionals which were part of the multi-discplinary team within the unit. 3 Different methods were used, the Draw, Write & Tell with the young persons, semi-structured interviews with the main caregivers, and observations by the researcher using the WCCAT-R tool and the world cafe method with the multidisciplinary team. The use of different methods ensured that the methods used were age appropriate. The externalistion and combination stage of the SECI model were done collaboratively with two young persons, two main care givers and 2 healthcare professionals who were initially participants in the data collection of the research. The involvement of different stakeholder in the data analysis resulted in the investigation of different aspects of the data which otherwise may have been missed. This study also looks into how Ba was created throughout the research process, and shows how this is congruent with the principles which are adopted in person-centred research.Item Questioning loneliness: an exploration of the research discourses related to stroke survival in a remote rural community in Scotland(2024-02-26) Carin-Levy, Gail; Elliot, Michelle L.; Sagan, OliviaThis paper reflects on a pilot study exploring the loneliness experiences of stroke survivors living in remote rural communities in Scotland. Empirical evidence gathered at the time of establishing this study demonstrated that there were no studies published around the subjective experiences of stroke survivors living alone in remote rural Scottish communities. Yet, stroke survivors in rural settings in other parts of the world report a longing for social contact as well as the experience of a reduction in participation in shared activities, suggestive of potential loneliness and isolation. This paper focuses on our experience interviewing one participant recruited in the early stages of the COVID-19 pandemic. Due to the pandemic, the study had to be terminated, but we were left with data gathered from this one conversation which revealed a rich narrative centred around past and present occupations. At no point was there any sense of loneliness expressed, despite the context within which this participant lived: alone, in a remote community, experiencing a degree of communication difficulties and unable to leave the house independently. All commonly hallmark ‘warning signs’ of a person at risk of loneliness. In this reflection we offer perspectives on assumptions and expectations of loneliness that are problematically constructed by the dominant narratives and theories at the time.Item Chapter 14: Walking the talk: stepping into difficult conversations in occupational therapy education(Critical Publishing, 2023-05-26) Elliot, Michelle L.; Akhtar, Zaynab; Marcus, Geetha; Van de Peer, StefanieItem Adopting the concept of ‘Ba' and the ‘SECI' model in developing person-centered practices in child and adolescent mental health services(Frontiers, 2022-01-05) Attard, Christie; Elliot, Michelle L.; Grech, Paulann; McCormack, BrendanThe concept of knowledge is divided into explicit and tacit knowledge; explicit knowledge refers to the knowledge that can be articulated, written and stored, while tacit knowledge refers to personal experiences, values, beliefs and emotions of an individual. By Nonaka's theory, explicit and tacit knowledge do not lie separately but interact together by interactions and relationships between human beings. Thus, the SECI model is based on the assumption that knowledge is created through the social interaction of tacit and explicit knowledge; known as knowledge conversion. The SECI model is based upon four modes of knowledge conversion; socialization, externalization, combination and internalization. 'Ba' is considered to be a shared platform for knowledge creation. 'Ba' is a shared space, be it physical, mental or a combination of both that serves as a foundation of knowledge creation. Ba involves sharing of tacit knowledge i.e. emotions, feelings, experiences and mental images. It also involves the formation of a collective relationship which is open to the sharing of practices, values, processes and culture. This concept focuses mainly on the individual as a person who holds the knowledge rather than just on the knowledge itself. It aims to create a common space to bring people together where they can dialogue to share and create knowledge. As in the relationships formed in person-centered practices, relationships formed in Ba are based on not just the sharing of objective knowledge but also on sharing values, beliefs, and emotions. It also reflects the formation of a person-centered environment as a basis for person-centered research where healthful relationships with the participants are formed. Furthermore, Ba will aid in creating a sense of connectiveness and dialogue, thus focusing on the idea that the development of new practices is done with others rather than to others. In this article we will discuss how these Eastern concepts can be adapted and used to develop person-centered practices within child and adolescent mental health services, specifically related to rehabilitation and recovery. The concepts of personhood will be discussed, followed by a reflection on current practices adopted when working with children and adolescents.Item Authors in dialogue - Why race matters: Then, now and for the future(Taylor & Francis, 2020-10-11) Nicholls, Lindsey; Elliot, Michelle L.Item In the shadow of occupation: Racism, shame and grief(Taylor & Francis, 2018-10-10) Nicholls, Lindsey; Elliot, Michelle L.In Freud’s seminal paper on mourning and melancholia, he distinguished between those who are able to mourn (i.e. relinquish their loved object or an idealised self) and those who become melancholic (i.e. forever lamenting the lost ‘object’). Freud also wrote of the ‘shadow of the object’ that denotes dark or hidden facets that could be considered around occupation. This paper adopts these theoretical perspectives in support of a deeper analysis of meaningful encounters that occurred within qualitative research studies with occupational therapy professionals and students. The authors describe researcher and participant moments of shame, loss, and grief in relation to encountering aspects of race and racism within their respective studies. Data were analysed utilising theories of intersubjectivity, critical feminist and race theory, and psychoanalysis within the qualitative research traditions of reflexivity. The paper proposes that the acknowledgement of the potential separation from or loss of the ‘other’ (research participant), of oneself (idealised researcher or professional) and/or the professional endeavour can allow for an authentic relationship and new learning to occur. The authors suggest that within a professional rhetoric of positive outcomes that can be achieved through empowerment and enablement, a shadow of a disavowal may be cast on complexity and complicity, which could prevent or limit the painful and necessary process of mourning to proceed. Our experience suggests that occupational science research and professional discussions which include stories of shame, grief and loss/failure can enable the development of ethically reflexive professionals who can learn from misunderstandings and their (inevitable) mistakes.Item Finding the Fun in Daily Occupation: An Investigation of Humor(2013-08) Elliot, Michelle L.Humor as a human phenomenon has long been explored for its perceived therapeutic benefits. To date, occupational therapy's contribution to this exploration has been limited, despite attention to rapport-building. This article provides an overview of the humor literature, particularly highlighting the neuroscience of humor, laughter, and fun, to craft an argument that humor is biologically, socially, and contextually grounded and influential in affecting the experience of occupational engagement. Translation of humor and fun into daily activity through clinical examples from an eating disorder program are introduced, along with the possibility of using fun to support social, emotional, and behavioral change.Item It Is Not Wit, It Is Truth:- Transcending the Narrative Bounds of Professional and Personal Identity in Life and in Art(2016-09) Elliot, Michelle L.Taking inspiration from the film Wit (2001), adapted from Margaret Edson's (1999) Pulitzer Prize-winning play, this article explores the particularities of witnessing a cinematic cancer narrative juxtaposed with the author's own cancer narrative. The analysis reveals the tenuous line between death and dying, illness and wellness, life and living and the resulting identities shaped in the process of understanding both from a personal and professional lens. By framing these representations of illness experience within the narrative constructions of drama, time, metaphor and morality, the personal stories of intellectual knowledge converging with intimate and embodied knowing are revealed.Item Being Mindful about Mindfulness: An Invitation to Extend Occupational Engagement into the Growing Mindfulness Discourse(2011) Elliot, Michelle L.This paper provides a rationale for the recognition of mindfulness in the occupational science discourse. There is a plethora of diverse scholastic interest in mindfulness, however not within the occupational science discipline. Mindfulness has a natural fit with occupation; its informal practice of awareness cultivation facilitates heightened engagement in and attunement to activity and the formal practice of mindfulness through meditation is itself an occupation. This paper reviews mindfulness and its contribution to enhancement of life quality and personal well-being. Additionally it speculates why mindfulness is not adequately represented in occupational science literature and research, and provides rationale for the inclusion of mindfulness into the discipline's field of investigation. In constructing this rationale, mindfulness is differentiated from the psychological concepts of flow, consciousness, and presence which in the literature are more commonly associated to participation in occupation. The author's own mindful experience while engaged in occupation serves as a backdrop against which to support the inclusion of mindfulness into occupational science scholarship.Item Figured world of eating disorders: Occupations of illness(2012-02) Elliot, Michelle L.Background. The biomedical diagnosis of eating disorders signifies a mental illness with complex physical symptomology. The socio-cultural determinants and impact of eating disorders on daily occupations are not adequately addressed in this classification. Purpose. This paper introduces the concept of a figured world as a framework for how eating disorders exist in daily activity and social discourse. How occupations become ascribed with meaning generated by an eating disorder will be proposed through the voice of a composite character in the figured world. Key Issues. Central elements to contextualizing figured worlds include positional identity, self-authoring, and semiotic mediation. The generation of meaning in illness arises from the integration of these elements into this specific figured world. Implications. The competing agendas of the biomedical model and figured world permit a new understanding of the challenges associated with recovery. For occupational therapists, these challenges require the reattribution of meaning of daily occupations.