The Occupation Matters Programme was developed by the occupational therapy service within the trust in 2011.  The programme aims to enable  people with a severe and enduring mental health difficulties to redesign their lifestyle, develop healthy activities, pursue meaning occupations and acquire a life worth living.  It is delivered in community mental health recovery services by 2 occupational therapists.  The programme was inspired by Lifestyle Redesign © and the evidence from 2 randomised control trials - Well-Elderly Study Occupational Therapy Program (1998) and Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people (2011).

The programme comprises of 20 group and five individual sessions over a 6 month period and is based around modules which enables each programme to uniquely meet the needs of the people attending.  There are 2 compulsory modules – Occupation Matters and Endings Matters.  Participants then chose 3 of the 5 optional modules – Being Active Matters, Routine Matters, Community Matters, Meals Matter and Roles Matter.  Each module comprises of activities which meet the participant’s aims and ends with an outing where learnt skills can be practiced supporting radiating change.  

The 2 occupational therapists support the therapeutic direction but are also considered as group members.  Woven throughout are key components related to increasing confidence with using public transport, occupational risk-taking, managing finances and goal setting, along with the core elements including group processes, peer exchange, personal reflection, occupational storytelling, and story-making, and occupational self-analysis.

Power and responsibility are encouraged as participants choose modules to explore, the aims of these modules and the planning of outings. Responsibility is encouraged by developing additional roles for participants to engage in, both inside and outside of the group. This ownership of roles has enabled people to remain connected to the group even when they want to withdraw and has increased their attendance. This has validated the enormity of the lifestyle changes that are required for a life worth living and has increased participants engagement and achievements.  Individual goals are developed by participants and the group setting is used to practice skills necessary to achieve the goals.

 

 

Participant’s progress are measured through:

  • Personal goals
  • Model of Human Occupation Screening Tool
  • Occupational Self-Assessment
  • CORE Measurement Tool

These measures have demonstrated that people are able to make significant improvements which support their mental health recovery.

Model of Human Occupation Screening Tool 

  • 67% participants improved expectations for success
  • 64% participants improved appraisal of ability and choices
  • 63% participants demonstrated improvements in routine, responsibilities, relationships and social groups.​​​​​​

Occupational Self-Assessment

  •  Most significant improvements were working towards goals, having a role, having a satisfying routine, accomplishing what I set out to do and effectively using my abilities. 

CORE

  • A paired-samples t-test showed a significant change in score from the start to the end of the group.

Themes of participant’s achievements

  • Developed a sense of belonging 
  • Increased access their community
  • Re-engagement with past, and new engagement, in meaningful occupations and roles
  • Development of social skills
  • Development/maintenance of meaningful relationships
  • An identity beyond their condition
  • Goal-setting skills
  • Problem-solving skills
  • Increased motivation

Quotes from participants:

“and I did it (going on a bus), and I did it on the way back as well, we achieved something. We did all achieve it. … Um, like a … collective victory!”
“It is important to accomplish something… there’s always some reason we’re in this world… I’m a photographer, I’m a graphic designer, I go out for a photo shoot... the programme has given me reason to go out.” 
“ I guess, when you’ve isolated yourself for a while and have mental difficulties, knowing that you actually can still be accepted by the group and have confirmation of that… There’s some form of deeper connection.”

Research Outcome

A interpretative phenomenological analysis indicated that the Occupation Matters Programme was influential in four participants’ recovery, offering a more authentic existence, improving mood and well-being. The participants described the activities enabled them to find their place in an opened-up world by connecting with others and through a changing sense of self; seeing themselves as more ‘normal,’ whole people, rather than as an illness. 

Quotes from participants:

“We were just getting more like human beings again, rather than just ghosts or not there people.” 

“Maybe I’m not that abnormal.”

Reference: Newport, A and Clarke, C (2020) The experiences of people with severe mental health conditions participating in the Occupation Matters Programme: An interpretative phenomenological analysis, BJOT, 83 (10).

Impact of Occupational Therapist

The programme has provided a clear intervention for occupational therapists working within our Community Mental Health Recovery Services and enabled them to develop their professional identity.

Quotes from occupational therapist:

“It has been great not only for our sense of work satisfaction but also for developing our OT pathway.”

“Facilitating the group enables participants to talk freely about their occupational experiences and challenges. Friendships have been made, sustained, differences embraced, and inclusion experienced. “

National Developments

The occupational therapy service is keen that other people who are experiencing severe and enduring mental health difficulties have access to this innovative intervention as the evidence shows it has a positive impact on recovery and developing a life worth living.

The programme and a training package are available to other mental health trust who would like to implement this programme within their organisation.  The outcome measures from these programmes are used to support the growing evidence for this programme.

For more information please contact:
⦁    Louise Wiggins (Professional Lead for Allied Health Professionals and Associate Director of Hospital and Specialist) louise.wiggins@sabp.nhs.uk
⦁    Alison Newport (Leadership Development Lead) alison.newport@sabp.nhs.uk