Reflection: OT Exchange 2024
Highlights
Seeing OTs in person that I’ve been connected with for a while, but only met online, especially Bronwyn Paynter (Nature OT) and Bradley Bird-Williams (The Becoming Collective).
Making some new connections and being recognised from my Facebook page!
Meeting Senator Jordon Steele-John, a greens senator who is a wheelchair user, after listening to his amazing keynote talk.
Making a journey stick out of natural materials in Prue Spry’s (Play Naturally OT) wonderful workshop.
Day 1 - 13/6/24
Unlearning: The catalyst of tomorrow’s technological and work revolution - Judith Hewitson
Summary: New tools, mindset, skillset and knowledge set; AI and VR within support services, technology is changing our services, encouragement to be ready to unlearn, immersive technologies can support behaviour and attitude change; maintaining humanity within tech, ethics and intentionality.
Interesting talk and I can see the usefulness and application for some settings and areas of practice, however I’m also interested in how we can be in our bodies and in nature more and think we need to find a balance.
Tertiary education, the future workforce, the new horizon. It’s everyone’s business - Professors Mandy Stanley and Angus Buchanan
Summary: Diversity in the workforce begins with the students, needing more flexibility within training programs, increasing demand for access and inclusion support services, universities questioning what are reasonable accommodations, how to support while also ensuring competence and fitness to practice; ableism in the profession; need change across education and workplaces, support for placements.
I was glad to see them mention things like ableism in the profession, challenges with placements and placement poverty, good big picture view of the issues and a call to action for all OTs to support and uphold the development of the profession.
Navigating your path: A new grad’s guide to effective mentorship in OT - Angie Contreras
Summary: Difference between supervision and mentorship, supports matter to manage often big, mixed caseloads, reduce vulnerability to burnout; ethics, competencies, limitations, roles, knowledge, skills and process
I’m a big supporter of supervision and mentorship and it was good to see others talking about this too
Remote mentorship: Elevating OT practice for independent clinicians and private practices - Georgia Erchul and Angie Contreras
Summary: Need for mentoring for capacity building, non-judgemental space, scaffolding knowledge and skill building; evidence based benefits, including for remote mentoring; program with learning plans, mentoring program, summary reports and evaluations; helps develop professional connections, time for feedback, brainstorming, reflecting.
This one felt like a bit of a business pitch, but again glad to see people talking about this, especially interesting as mentoring and supervision is something I want to do more of.
Stories from the red dirt: Culturally sensitive service delivery - Shannon Hallatt
Summary: Need for culturally safe and accessible services by building a diverse workforce including indigenous AHA and key workers, ongoing learning and cultural training, providing services where they are meaningful for clients; best practice: family and client centred, see the person in context, collaborative, co-design, relationships, building capacity of support people, coordinated team, use different ways to support communication, be flexible, open and patient, build trust and connection, keep showing up.
Applicable for services for Māori peoples over here, good principles to follow.
Imposter syndrome: Owning your OT brain with confidence - Rachel Brimblecomb
Summary: Imposter syndrome can happen at any stage of your career; what it can look and feel like; 55% of women, higher rates in healthcare; strategies: acknowledgement, reflection on achievements and successes, seek out support, work on negative thinking patterns, growth mindset, set goals, know that we don’t have to know everything, can find things out, challenges are a part of growth and mistakes are learning opportunities.
Such a common thing to experience, glad to see some practical strategies discussed and how much it can impact.
Kujungkarrini brain map-ku: A co-designed crosscultural understanding of development, trauma and regulation to enable occupational participation - Tarin Dempers, Caitlin Prince, Natasha Surprise & Corina Jadai
Summary: Using a brain map as a framework for shared understanding of behaviour, regulation, trauma and healing, represent levels of the brain with cups (lizard, love, learning), way to share stories, learn, discuss regulation tools and resources.
Great practical way to talk about our survival responses and how our brain works, so glad to see co-design here.
Any questions? A co-designed project for people newly diagnosed with FND - Aimee, Ingram
Summary: Development of a resource of golden questions using co-design and consensus methods, things people with FND wish they had asked; categories: what does this mean? who can I turn to? what happens now? Aiming to create a resource around understanding FND, these questions help for guiding conversations but still need to bridge the information gap
Again so great to see co-design happening and this seems like a good step forward for creating a resource to support people with FND.
The quality of mobile health applications available for OTs to use for people with chronic pain - Jessica Smith
Summary: Used the MARS tools for evaluating different apps e.g. Calm, Orientate, Smiling Mind, Pain Trek, Pathways Pain Relief etc.; lack of regulation makes it difficult to determine the quality, many are not supported by research; deciding what to use based on research, and therapist and client experience/choice.
There’s a lot of apps out there and it can be confusing to know what to use. This didn’t give definitive answers, but the MARS is a potential tool I could use to rate different apps in addition to trying them out myself.
Paw therapy: Unleashing a hospital-based dog therapy visitation process for physical and mental health participants - Jennifer Evans and Karen Stiles
Summary: Animal assisted therapy/activity, benefits: improved MH, reduce anxiety, pain and loneliness, encourage mobilisation, active engagement and interaction, social connection, sensory experiences; pilot project with positive feedback; referral process: screening, problems list, animal etiquette guidelines, goals, outcome measure; importance of properly trained animals.
So great to see the evidence building and to have an example of a pathway with a standardised referral process.
Nature based OT in Uganda - Bronwyn Paynter
Indigenous perspectives of nature, different causes of death and life expectancy, 0.1 OTs per 100,000 people (Aus is 10 per 100,000), different nature; Serenity Centre, substance use treatment, uses MOHO framework and nature.
So interesting to see an example of what is happening in other countries and the use of nature.
Lived experience panel - Danielle Loizon-Lake, Sinead Bryant, Pam Minoh, Julianne Adams
Summary: Balancing personal needs, advocating and educating, disclosure, job access services, equipment and accommodations, highlighting the strength of lived experience, when to share and who, different job requirements; individual process and approach, AT can be disabling and have unintended consequences; our understanding of accessibility helps us know how to make things more accessible for clients, empathy, creativity, understanding, problem solving, INCU, learning the tech to teach the tech; flexible working hours, quarantining time, support from management and AHAs; fragile strong, persistence, comfort with discomfort.
Really interesting panel representing a range of experiences, nice to hear other people talk about the importance of lived experience and how it can be an asset to our practice.
Photo 1 - me wearing my sunflower lanyard and noise cancelling headphones holding up my conference lanyard with my name and business name. Photo 2 - a picture of the stage in the auditorium. There is a lectern and a screen. Photo 3 - a picture of the list of eposters with my one highlighted.
Day 2 - 14/6/24
Your OT roadmap for innovation success - Jenny Gribbin
Summary: Jenny’s experience developing a process for learner drivers, creating new ways of doing things and supporting neurodivergent learner drivers. Tips: cultivate your direct and indirect support networks, embrace collaboration, continuous learning and growth, utilise design thinking, lean in courageously, record your list of successes, values and actions.
Inspiring talk, takeaway phrases were “rising strong” and “big magic”. It was great to hear someone talking about taking risks and believing in the importance of your voice and ideas.
Personal and political reflections on 10 years of the NDIS - Senator Jordon Steele-John
Summary: Senator Jordon’s lived experience of the benefit of OT, championing OT in wider spaces, celebrating successes. 10 years of the NDIS, successes and victories in the small moments, but many barriers exist and improvements are needed. He spoke about the threats to success and the possibilities, needing co-design and a different approach, acknowledged to media smear campaign, called for safeguards, sustainability, collaboration, unity and exercising our political power.
It’s interesting to think back to this talk when finishing writing this in August, given all the changes that have been happening with the NDIS since June. It has been distressing to follow what has been happening and know the impact these changes have on so many people’s lives. I hope that some of what Senator Jordon was talking about will happen, but it is hard to hold the hope.
Building interoceptive awareness to enhance emotional regulation in adults with mental health challenges - Dominique Misso and Gabrielle Johnson
Summary: defined interoception, both homeostatic emotions (body) and affective emotions (mood). Interoceptive differences can be in the form of underresponsiveness, overresponsiveness or distorted (discrimination issue). Described the link between interoceptive awareness and emotion regulation, to regulate we need to understand what we’re feeling, notice and identify sensations and connect sensations to emotions. Went through hands and fingers activity from Kelly Mahler.
It was great to see other people applying the interoceptive work to adults, as much of what is out there is focused on children.
The double empathy problem: The role of OTs as social interpreters - Danni Gheorghe and Jaclyn Sikic
Summary: suggested OTs have a role as social interpreters, recognising the double empathy problem, understanding matches and mismatches and what social preferences and needs look like across environments. Social communication preferences include: interests, conversations, information delivery, thinking, interpretations of language, use of tone, interpersonal preferences. Tools: social importance scale, easy-tricky scale. Practices: exploring perspective taking, increasing awareness and acceptance of different communication styles, education around mismatches, celebrating strengths.
It was great to see this being presented in an affirming way, where it is both parties’ responsibility to understand and manage any communication mismatches and educating about different ways of communicating.
Come and play with nature! How playing naturally can bring people of all ages joy, meaning and abundant health and wellbeing benefits - Prue Spry
Summary: overview of the health and wellbeing benefits of nature, nature and OT are a great fit, our senses are a gateway to our brain, playing naturally with all our senses. Exercises: meet a leaf, journey stick.
This was such a fun and engaging workshop. A photo of my journey stick is at the top of this blog.
Risk assessment in outdoor OT: More than just physical safety - Bronwyn Paynter
Summary: WEIRD perspective, there are other ways of connecting and being, defining risk, doing robust risk assessments to build your confidence, how to identify hazards and assess risk, then eliminate or control risk, think about: physical, social, psychological, legal, professional, neurological/sensory safety.
I love the way Bronwyn presents and makes what can be a dry topic so engaging. It’s also great to see someone talking about more than just physical safety.
Nature doesn’t heal: How we can do better at communicating the evidence and outcomes for nature based OT - Bronwyn Paynter
Summary: we are OTs first, nature is our context, modality and co-therapist. Evidence for nature, health promotion, looking at our process and outcomes.
Always love listening to Bronwyn and her wealth of knowledge about the evidence for nature.
Neurodiversity affirming practice for OTs - Claire Britton
Summary: interactive workshop, key terms, common areas of support, affirming SMART goals, interventions and applications. We need to look under the surface, have guided discussion, we are supporting and the person is the expert, meeting people where they’re at, finding belonging with or without a label. ND affirming SMART goals - concrete, personalised to their experience, relevant, timeframe, occupation focused.
I’m not a huge fan of SMART goals but it was interesting to see another perspective of how they can be used. We had some good chats at our table, but not a lot of new learning for me as this is such a passion area of mine!
Photo 1 - myself with Bronwyn Paynter the Nature OT, with a couple of other nature OTs, in Bronwyn’s booth. We are all different heights, standing and smiling at the camera.
Photo 2 - myself and Senator Jordon Steele-John, we both have brown hair and glasses and are smiling at the camera. I am standing and he is seated in his wheelchair.
Photo 3 - myself and some of the OTs I met, one of whom follows me on Facebook and recognised me from my page! 5 people standing under a banner for the 2024 OT Exchange wearing conference lanyards.
On demand sessions
The conference sessions we available on demand for 45 days, so I was able to catch up on a few that I hadn’t got to.
Everyday LEAD: A human rights-centric approach transforming disability assessment - Madeline Hand and Hayley Hughes
Summary: disability assessment should be empowering and follow the principles of the UN convention on the rights of persons with disability. Development of the Life Enhancing Ability Development assessment and planning tool, explores participation and support intensity in 35 areas, select life tasks, rate support and participation, prioritise areas, vision setting with goals and aspirations, information collected to guide intervention and create outcomes
Sounds like a useful tool and good to see a focus on goal setting with aspirations and into the future. I’d be interested to learn more.
Impactful patient experiences: A journey with FND to destigmatise and improve the patient experience - Alexia Stewart
Summary: case study of a patient experience of worsening symptoms and health system dismissal, FND is a complex diagnosis, and our understanding is limited. FND is neuro-functional, multi-network brain disorder, software rather than hardware issue, get a transmission error in the neural networks, see alterations in the 5 main neural circuits (limbic/salience, self agency/multimodal integration, attentional, sensorimotor, pain matrix), abnormal constructs within the networks create symptoms, a response in one network can impact others. Allied health can make a difference, approach with humanity and genuine person centredness, not process driven, holistic care, see the context, inclusivity and understanding, predictive processing.
FND is something I am wanting to learn more about so this was an interesting taster.
Sleep well, feel well: Implementing a CBT-I group intervention for people with mental health conditions in an inpatient setting - Helen Ayres and Emma Pender
Summary: CBT-I is a structured program, first line treatment for insomnia, high rates of sleep disorders in the psychiatric population; used Sleep Well, Feel Well in Psychosis by Waters, Rae and Chin - structured program 4 sessions, learning about sleep, behavioural sleep skills, maximising energy, working on unhelpful beliefs about sleep, dealing with worries and a busy mind, relaxation, working with triggers for poor sleep, maintaining wellness; the program demonstrated improvements in insomnia severity and daytime sleepiness
Sleep is a topic I’m often talking about with clients so it’s always interesting to see what others are doing. I’d like to know more about the content to see if it acknowledges differences in sleep cycles and ways of getting to sleep.
The role of OT in addressing allostatic load: A complex systems approach to chronic stress and disability - Lauren Reinsfield
Summary: homeostasis: set point, an internal/external demand creates a response, allostasis is this adaptation to the demand, when we come back to homeostasis this is homeostatic recovery, an ongoing process. If demands are constant we can’t get complete recovery, allostatic load (wear and tear on the body and systems from ongoing demands/stress), body systems adapt, get a new set point, can miss cues, multiple system dysfunction and cascading effects. Repeated stress without recovery means it is harder to recover over time, wear and tear on the body systems results in developing conditions.
This was a really clear explanation with good visuals of homeostasis and allostasis and how ongoing stress can result in developing conditions.
Planning, Doing and Recovery
Doing something like attending a 2 day conference when you are chronically ill and neurodivergent doesn’t just happen on a whim. A lot of forethought, planning and supports go into making it possible.
Last year I created this graphic and related worksheet on ‘Doing a difficult thing’ and am using it again here as I find it a useful framework.
Planning/Before
When thinking about attending the conference I looked at where it fell in the week and planned backwards from there for what day I would leave New Zealand in order to leave some rest days before the conference. Getting to Perth on the Sunday gave me 3 full rest days before the conference on the Thursday.
I chose a flight that was the fewest number of connections and not a super early start to conserve energy as much as possible.
During the days between travel and the conference I focused as much as possible on enjoyable and nourishing activities: spending time with my friend and her puppy, going for a couple of gentle nature walks, and watching Living Big in a Tiny House.
I worked out my transport route and timing the day before and made sure I had enough food prepped for the 2 days.
Doing/During
I wore my sunflower lanyard and noise cancelling headphones throughout the 2 day conference, including the social event after the first day. Wearing the lanyard has helped give me confidence for speaking up for my needs and get more comfortable using the accessible toilets and priority seating on public transport. Due to an ongoing wrist injury I was also wearing a wrist brace, which felt like it helped with visibility of disability (which shouldn’t need to be a thing I know).
I brought my wheeled backpack so that I didn’t have to carry a bag on my back and so that I had something big enough to hold my notebook, food, water, fidgets and other support items. The venue staff asked me a couple of times if I wanted to check my bag and I was able to say clearly that it was my backpack and I needed to keep it with me due to my disability.
I sat at the back of the rooms, used the lift instead of the stairs as much as possible and made sure to have some outside time during the breaks. I picked the sessions I was most interested in but ended up rushing between things more than was ideal.
The exhibitor hall was the most overwhelming and noisy place so I tried to spend as little time in there as possible, while also saying hello to some of my OT connections. I kept my headphones on while in there. The food was also served in there, but there was a different table for dietary needs and as mine are so specific I tended to have something separate and didn’t need to stand in line.
Recovery/After
The day after the conference there was a nature OT meet up in the botanic gardens. Usually I would not do something social after a 2 day event, but this was an important chance to spend some time with OTs with similar interests and so I went and I’m so glad I did.
Nature time can support my recovery as well as meaningful connection.
I had booked my flight for the Sunday so I at least had one day after the conference. If I could have, I would have left another day or two but was constrained by a family birthday I needed to travel for.
Part of after care was also spending time alone, radical acceptance of increased symptoms and reducing demands and cognitive load.
Image description: a graphic headed ‘Supports I used to attend the OT Exchange 2024 in Perth’. Four vertical boxes are arranged across the page with bulleted lists of supports for before, transport, during and after. Above each of these headings is a symbol: Before is in red with an arrow to the left, Transport is in yellow with a car, During is in green with paper and pencil, After is in blue with an arrow pointing to the right.
What I would do differently
Thoughts for the next conference - while it was an amazing experience it was also exhausting. In many ways events like this always will be and there is only so much that I can do to mitigate this, ensuring I do lots of pre-emptive rest and have days off afterwards to offset the energy expenditure, but I do have some thoughts on what I could do differently at future conferences or other big events like this:
Planning sessions based on location to minimise walking so I’m not walking all around the conference venue
Staying in one room for the whole session instead of trying to get to multiple talks in a single session and rushing around
Taking more breaks to get outside and reset, including breaks where I don’t talk to anyone
Sitting on the floor when needed, doing stretches, taking a footstool
More days off afterwards
Getting contact details of people I want to connect with so I can still have a chat to them at the conference but not feel like I have to say everything and overextend my social battery
I’m sure there will be more things and learnings I will take away from future events.
My next conference will be the OTNZ-WNA Clinical Workshops in Hamilton, NZ in October, where I will be presenting 2 workshops and a poster.
I am also submitting a few things for the OTA National Conference in Adelaide, June 2025, so fingers crossed I will also be attending that!
