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New vacancies at Obair

logoJob Title:
Occupational Therapist in Vocational Rehabilitation

We have current vacancies in the North of England and in London

Up to £34,000 per annum (dependent on experience)

37.5 hours per week (part time pro rata considered)

Job Overview:
Are you interested in improving the health and employability of individuals who due to injury, health condition and/or disability are struggling to return to or remain in work? If so, then please read on…!

Obair is well recognised for our expertise in delivering evidence based health and work assessment & intervention services. Our services are aimed at addressing barriers to employability and improving an individual’s capacity for work.

We are looking for Occupational Therapists with proven skills in evaluation and rehabilitation, who are interested in: developing new skills in vocational rehabilitation and working with individuals to increase their employability and support a return to work.

You will join a dynamic team of highly skilled therapists and work on a variety of service provision and full training will be provided.

Job role criteria:
• Are you able to evaluate conditions affecting an individual’s physical, mental, intellectual and/or cognitive function?

• Are you able to critically evaluate evidence gathered during evaluations and from other service providers and use sound clinical reasoning to support an action plan and recommendations?

• Do you have excellent interpersonal and written communication skills and are interested in developing relationships with individuals and other service providers to facilitate a return to work?

• Are you interested in developing your existing skills, learning new skills, accessing training, and excellent CPD opportunities?

How to apply:
Please send your CV to: recruitment@weareobair.com

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A Hands-On Approach!

A hand injury can be a devastating experience. Not only does it result in physical pain and functional limitations, it affects a person’s interaction with his natural world. Our upper limbs are critical to completing basic activities of daily living, such as feeding, dressing and toileting and a loss of function in the hand can have a significant impact on a person’s level of independence and quality of life. In addition, dexterity is most often an essential work demand and compensating for upper limb impairment in the workplace can be challenging.

The human hand is the most developed prehensile organ among all living creatures.
– Ulrich Mennen –

Tracey Buchanan (Proclaim Care) and Anne Byrne (Obair) at a recent presentation to QBE claims handlers on the hand and upper limb services offered by Obair.

Tracey Buchanan (Proclaim Care) and Anne Byrne (Obair) at a recent presentation to QBE claims handlers on the hand and upper limb services offered by Obair.

Hand therapists are attuned to the needs of individuals who have sustained hand and upper limb injuries and geared for guiding them towards improved independence and function through a period of rehabilitation. Obair has identified the need for hand and upper limb rehabilitation, focused on improving residual function following a hand injury. Through improving range of motion, strength and functional use of the hand, the opportunity for a quicker return to work and productive lifestyle is provided.

Occupational therapists are particularly well equipped to provide this service, as they are dual trained in mental and physical health and can therefore make use of activities to improve function, as well as assist the client with processing the psychological impact of the injury. These activities typically include tasks that are familiar to the client, such as activities of daily living around the home and at work. Therapeutic goals aim to enhance performance, improve and maintain function and workability, and therapists seek to adapt activities to improve independence. As the client views therapy in relation to occupational abilities and roles, this further improves the client’s motivation to participate in rehabilitation.

Lara Wood (Rehabilitation Consultant, QBE) looking at a pain scale used during the evaluation.

Lara Wood (Rehabilitation Consultant, QBE) looking at a pain scale used during the evaluation.

A rigorous evaluation proceeds rehabilitation, with the aim of establishing a functional baseline and rehabilitation potential.  Clients may present with protective behaviour, as well as a fear or avoidance of using the upper limb in functional tasks. Furthermore, hypersensitivity or increased pain responses may be identified. The evaluation seeks to establish goals for intervention and also determine any psychosocial factors that may impact on hand function at home and at work.

Early identification of barriers that might prolong disability or absence from work is key in ensuring a successful rehabilitation outcome. In the case of hand therapy, early intervention is critical and may prevent secondary complications such as chronic regional pain syndrome, contractures and hypersensitivity, with subsequent non-use of the hand.

Anne Byrne demonstrating the use of equipment used during the hand and upper limb evaluation.

Anne Byrne demonstrating the use of equipment used during the hand and upper limb evaluation.

The training delivered was interactive and professional. The presenter was both knowledgeable and passionate about the subject and this was clear in her delivery of the training. Positive feedback was received from adjusters stating that the training was relevant and insightful.
– QBE rehab team –

Obair works along with a national network of occupational therapists with expertise in hand and upper limb rehabilitation to provide this service. If you are a hand therapist and interested in working along with us, please get in touch.

Written by Lezanne Fieuw

The Hand Book-A practical approach to common hand problems. Editors: U Mennen and C van Velze. (2008)

Reconceptualising Pain

Unsplash - Margarida CS_resize

Photo by Margarida CS; www.unsplash.com

Pain is an elusive subject, continuously shifting and changing as we as health practitioners become more informed and sharpen our tools in treatment thereof. We might find ourselves confronted with our own shortcomings as treatment modalities fail to provide the desired outcome and our efforts to relieve pain only result in disgruntled clients. Therefore, the functional evaluators at Obair seek to make recommendations based on evidence-based research and the latest findings in the field of pain research.

Lorimer Moseley and David Butler[1] at the Noigroup in Australia have long been interested in the way in that pain is addressed, particularly focusing their research on improving clients’ understanding of pain in an effort to reduce fear-avoidance behaviour and catastrophisation.

Photo by Tirza van Dijk; www.unsplash.com

Photo by Tirza van Dijk; www.unsplash.com

Moseley and Butler have recently released an article that will be published in the Journal of Pain, which takes a closer look at the strides made in the past 15 years with regards to Explaining Pain (EP), a range of educational interventions aimed at improving understanding of the physiological processes with regards to the development and persistence of pain. In the paper, Moseley and Butler seek to clear some of the misconceptions with regards to this treatment modality and shed light on the practicality and utility thereof.

From the outset, the researchers highlight the importance of explaining the biological processes underpinning pain, stating that traditional treatment modalities will be of little value whilst the client have problematic thinking or inaccurate beliefs regarding his or her pain.

EP is theoretically grounded in Engel’s biopsychosocial model with attention paid to psychosocial factors that contribute to the pain experience – pain is a biopsychosocial phenomenon, modulated by beliefs. The researchers note the increased usage of cognitive behavioural therapy (CBT) in addressing these thoughts and beliefs. However, they stress the difference between EP and CBT, indicating that the latter focuses on teaching individuals how to cope with their pain; taking the stance that pain is unavoidable and therefore CBT is aimed at managing rather than treating pain. This conflicts with the EP model, which proposes that pain can be modified, with pain being a result of perceived danger to body tissue.

Photo by Kendall Lane; www.unsplash.com

Photo by Kendall Lane; www.unsplash.com

Pain is seen as a way for the brain to protect the individual, interpreting ‘danger’ messages received from nociceptive information as well as other sources of information, such as the environment and thoughts and beliefs. Therefore, pain is dependent on meaning and influenced by context. Treating pain should therefore impart the knowledge that the development of pain is highly dependent on a combination of inputs that suggest the body is in danger, resulting in protective behaviour[2].

By providing information on the biological processes underpinning pain, the individual becomes aware that pain output is regulated by the way that the brain interprets ‘danger’ and therefore, noticing factors that decrease or increase pain is key to treatment. Indeed, the researchers use the acronym DIM for “Danger in Me” and SIM for “Safety in Me”, enabling individuals to identify which factors influence their pain experience[3]. These factors are highly individualised and will depend on each person’s lived experience. As stated by the researchers, “any credible evidence of danger to body tissue can increase pain and any credible evidence of safety to body tissue can decrease pain”.

Photo by Bảo-Quân Nguyễn; www.unsplash.com

Photo by Bảo-Quân Nguyễn; www.unsplash.com

Following the reconceptualisation of pain, the health practitioner can move towards including other treatment strategies, including pacing, graded activity participation and moving smart. In enabling clients to understand their pain and interpret the many contributing factors, health practitioners provide hope and move clients towards increased function and independence.

Written by Lezanne Fieuw

[1] Moseley GL, Butler DS, 15 Years of Explaining Pain – The Past, Present and Future, Journal of Pain (2015)

[2] http://www.bodyinmind.org/15-years-explain-pain-pt-2/

[3] http://noijam.com/2015/03/12/dim-sims/

Occupational Therapy: An Evolving Profession

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This week is Occupational Therapy Week in the United Kingdom and World Occupational Therapy Day was celebrated on the 27th of October with the World Federation of Occupational Therapists celebrating the essence of the profession.

Occupational therapy students being trained in weaving. Used with permission of Oxford Brookes University.

Occupational therapy students being trained in weaving. Used with permission of Oxford Brookes University.

Occupational therapy is synonym with improving the quality of life of individuals through engagement in activities and has its humble origin in the First and Second World War, with occupational therapists providing rehabilitation services to wounded soldiers with the aim of re-establishing them in the workforce.

During World War I, vocational services were provided to injured soldiers in the military hospitals in Canada and vocational workshops were set up by the Invalid Soldier’s Commission, whilst “young suitable ladies” provided activities to patients who were bedbound. In 1917, the United States founded the Society for the Promotion of Occupational Therapy, which is now known as The American Occupational Therapy Association, whilst Canada established short courses for the training of occupational therapists, then referred to as “ward aids” or “occupation aids”.  The Canadian Association of Occupational Therapy (now known as the Canadian Association of Occupational Therapists) was established in 1926.

Basket-weaving also formed part of the occupational therapy training course.

Basket-weaving also formed part of the occupational therapy training course. Used with permission of Oxford Brookes University.

Dr Elizabeth Casson played a vital role in the development of the profession in the United Kingdom and set up the first school of Occupational Therapy at Dorset House in 1930. Dr Casson understood the value of occupation and engagement in activities:

Dr Casson, aged 21. Used with permission of Oxford Brookes University.

Dr Casson, aged 21. Used with permission of Oxford Brookes University.

“When I first qualified as a doctor …I found it very difficult to get used to the atmosphere of bored idleness in the day rooms of the hospital. Then, one Monday morning, when I arrived at the women’s wards, I found the atmosphere had completely changed and realised that preparations for Christmas decorations had begun. The ward sisters had produced coloured tissue paper and bare branches, and all the patients were working happily in groups making flowers and leaves and using all their artistic talents with real interest and pleasure. I knew from that moment that such occupation was an integral part of treatment and must be provided.”

Quoted in The story of Dorset House School of Occupational Therapy 1930 – 1986, [Oxford: Dorset House School of Occupational Therapy, 1987], p.1

The original location of the Dorset House in Clifton, Bristol.

The original location of the Dorset House in Clifton, Bristol. Used with permission of Oxford Brookes University.

The Scottish Association of Occupational Therapists (SAOT) was founded in 1932, with The Association of Occupational Therapists (AOT) for England, Wales and Northern Ireland following in 1936.  These two organisations merged in 1974, forming the British Association of Occupational Therapists.

Nissen huts located on the grounds of the Churchill Hospital (Oxford), used for occupational therapy training since 1946.

Nissen huts located on the grounds of the Churchill Hospital (Oxford), used for occupational therapy training since 1946. Used with permission of Oxford Brookes University.

During World War II, two occupational therapists travelled from Britain to set up the first Occupational Therapy department in Johannesburg, South Africa. Despite enduring wild storms at sea and losing all equipment on the way, these brave ladies established a training course in 1943, with occupational therapists providing services to injured men in the military hospitals across in the country. The South African Association of Occupational Therapists (now known as the Occupational Therapy Association of South Africa) was established in 1945 and was one of the founder members of the World Federation of Occupational Therapists in 1852, with Vona du Toit being the first Vice-President.

Occupational therapy as a profession has undergone many changes since the use of activities within a hospital setting, and has evolved to provide services within various sectors. However, to the core of occupational therapy remains the belief in the value of occupation, as emphasized by Dr Casson:

Dorset House celebrated 21 years in July 1951.

Dorset House celebrated 21 years in July 1951. Used with permission of Oxford Brookes University.

“…to form a community where every individual was encouraged to feel that she had a real object; for a patient the object was to get well and go out to a worth-while life; for a member of the staff it was to serve others with all the talents she possessed; for a student, to develop all her capacities for her life as an Occupational Therapist and to find the individual job that only she could do.”

– Quoted in The story of Dorset House School of Occupational Therapy 1930 – 1986, [Oxford: Dorset House School of Occupational Therapy, 1987], p.3

To find out more about vocational services offered by Obair, visit our stand at the Occupational Therapy Show, taking place in Birmingham on the 25th and 26th of November 2015.

Written by Lezanne Fieuw

Why Matheson?

Occupational therapists use Functional Capacity Evaluations (FCE) to determine the current functional capability of an individual with regards to the ability to return to or being retained at work. Our expertise and experience in this area of practice is the reason why when Anne and Jain (Obair) wanted to develop a FCE training programme for the UK market. We approached Matheson and partnered with them to adapt their internationally renowned training to meet the unique needs of the UK market and have been offering training for the past 5 years+. No other FCE approach/system training has been specifically customised for the UK market.

UKFCE training underway.

UKFCE training underway.

In general terms, Matheson is an approach to FCE and is not an FCE system of which there are a number in use in the UK. Many of these FCE systems were developed by either a single practitioner or an organisation who developed their own tests, e.g. for lifting, for strength testing etc., or developed their own FCE equipment. These systems usually mean that you do their training and you have to use (and purchase) their tests or their equipment to do the FCE. The validity and reliability of many of these “own tests” have never been established and some, e.g. static strength testing used to measure manual handling capacity, is now well recognised as having no validity as a measure of manual handling capacity.

As an approach to FCE, the Matheson FCE differs from other FCE’s in: its ethos, its core elements, its core assessment tools, its evaluation protocols, in the evaluation training, in validity and reliability, in who can be trained etc.We thus decided to highlight some of the differences and the reasons for Obair endorsing the Matheson FCE.

Group discussing course material.

Group discussing course material.

The Matheson FCE:

Is an approach/ protocol and not a system: with Matheson, you learn how to do an FCE as well as how to administer and interpret the results of various standardised tests.

At its core it has a practice hierarchy: that places safety as its basis and includes: reliability, validity, practicality and utility and therefore the evaluator is assured that they keep the individual safe while still answering the referrer’s questions.

Is about training and producing thinking evaluators: and not practitioners who administer tests and use a computer to determine a score and thereby identify function, often in conjunction with producing a report with graphs and findings that can mean little to the referrer.

Has in excess of 19,000 trained Matheson FCE evaluators worldwide: so you are in very good company and there is a lot of international expertise available for new evaluators to tap into via Obair and the Matheson web site and resources.

Using a Jamar hand dynamometer.

Using a Jamar hand dynamometer.

Facilitates the evaluators’ continual professional development: once you have trained as a Matheson evaluator you have access to Matheson Evaluators’ group, which in turn allows you to access free Webinarsand current published research through the learning resources. Matheson also offers advanced training programmes.

Uses standardised tests whose validity and reliability has been determined and published in peer review journals: and there is no requirement to buy specific pieces of equipment or assessment tools as can be the case with FCE systems.

Offers an approach that can be customised: and Matheson evaluators, as thinking evaluators, can make use of any standardised test used in rehabilitation or medicine to determine function in all areas e.g. physical function, cognitive/perceptual function, mental health function.

Approach and software do not negate the clinical experience of the

evaluator: and cannot be carried out by a technician as it requires and relies on the expertise of the clinician.

Is the definitive FCE in a number of spheres in the US and Canada where Matheson FCE has been in use for 25 years+ and where the greatest number of evaluators are located.

Written by Anne Byrne (Clinical Director) & Jain Holmes (Training Director) September 2015

Obair’s Functional Capacity Evaluation (FCE) Credentials:

Anne: 37 years+ as an occupational therapist and 25 years working in vocational rehabilitation & occupational health in both

Demonstrating the use of FCE equipment.

Demonstrating the use of FCE equipment.

the UK and in Canada. Took her first FCE course in 1987 and has been using FCE in her practice since. Accredited in 2 FCE approaches/systems and has also completed post graduate training in 3 others.

Jain: 25 years+ as an occupational therapist and 15 years working in vocational rehabilitation and occupational health in the UK and the USA. Author of “Vocational Rehabilitation” and currently doing her PhD related to vocational rehabilitation. Accredited in 2 FCE approaches/systems and has also completed post graduate training in 3 others.

Between Anne & Jain, we are accredited in 4 different systems and have done post graduate training in 6 others. Therefore, at Obair we know a good FCE when we see one!

World Spine Day

October 16th marks the annual celebration of World Spine Day as part of The Bone and Joint Decade’s Action Week.  This year’s theme is “Your Back at Work”, which is fitting, considering the increasing socioeconomic burden of non-specific chronic low back pain.

Photo by Bethany Legg; www.unsplash.com

Photo by Bethany Legg; www.unsplash.com

Globally, back and neck disorders are on the rise, with jobs becoming more desk bound and computer based. At Obair, we perform display screen evaluations (DSE) and ergonomic assessments with the focus on improving sitting posture and the ergonomic layout of workstations. Having a workstation that matches your body’s characteristics can aid in preventing musculoskeletal discomfort and pain and in turn, improve work performance.

Photo by Benjamin Child; www.unsplash.com

Photo by Benjamin Child; www.unsplash.com

Obair offers advice on appropriate workstation ergonomics and self-management strategies at work. There are some basic factors to be considered when choosing an appropriate chair. First, you should be able to sit back comfortably with your back touching the backrest. The chair should be height adjustable to ensure that your forearms are parallel to the desk when typing. If your feet do not rest on the ground, a footrest should be considered. Armrests can be useful, but should not hinder you from moving as close to the desk as needed.

Photo by Rayi Christian Wicaksono; www.unsplash.com

Photo by Rayi Christian Wicaksono; www.unsplash.com

Attention should be paid to the height of your desktop or laptop screen monitor. Prolonged neck flexion places a lot of tension on the neck and back muscles and can lead to muscle spasms and discomfort. Make use of an adjustable screen monitor or laptop stand to ensure working at eye level. In addition, being able to touch type (i.e. type without looking at the keyboard) will also ensure that you keep your neck in a neutral position.

Although having a workstation fit to suit your needs is beneficial, having regular rest and stretch breaks cannot be underestimated. Our bodies are made to move and so, it is advised to stand up at least every hour to grab a drink of water or walk around the office. A good way of achieving this is to have routines in place, such as only filling your cup half way or setting your phone to vibrate.

In this way, we are being mindful of the way that we work and use our bodies. As part of #WorldSpineDay, you are invited to share a #spineselfie of #YourBackAtWork, demonstrating a healthy spine habit at work.