Clinical forums

The Eating Disorders Clinical Forum aims to support delivery of best practice for occupational therapy across the UK for people working with adults with an eating disorder. We have representation on the Quality Network for Eating Disorders (QED) advisory group and the national Eating Disorders Advisory Group, and feed into the work of the Specialist Section.

• Providing a national network of occupational therapists working or have an interest in eating disorders
• Supporting the development of the evidence-base for occupational therapy for eating disorders
• Provide resources and information via the website, social media and e-Newsletters
• Provide learning events and opportunities to learn and share practice
• Raising awareness of the occupational therapist’s role with eating disorders

Prevalent in contemporary society, it is estimated that at least 1.25 million people in the United Kingdom are affected by eating disorders such as anorexia and bulimia nervosa (Beat 2022). It is however interesting to note that the most prevalent eating disorder is Other Specified Feeding or Eating Disorder (OSFED), with approximately 47% of cases falling into this diagnostic criteria. This is followed by Binge Eating Disorder, which accounts from around 22% of cases, then Bulimia, which is around 19% and Avoidant/Restrictive Food Intake Disorder (ARFID) accounting for around 5%. The cases for which Anorexia account for are one of the lowest percentages, sitting at around 8% (Hay et al 2017).

The Role of Occupational Therapy in Eating Disorders
The profession of occupational therapy has been involved in this field for over 40 years (Martin 1978; Costa 2009; Roberts & Wolfenden 2015). In treating this population, the aim of occupational therapy is to use an activity-orientated approach to maximise the client’s level of psychosocial functioning (Giles and Allen 1986). The invaluable contribution of the profession in the treatment of eating disorders has been continually asserted by numerous authors in the occupational therapy literature (Giles and Chng 1984; Giles 1985; Giles and Allen 1986; Orchard 2003; Costa 2009).

Main Areas for OT Intervention

• Skills Development – assertiveness, anxiety management, confidence, self-esteem
• Motivational Enhancement
• Life Balance & Routine – often issues with overvaluation of productivity and less so with self-care/leisure
• Menu Planning, Meal Preparation & Cookery – separating mood from food
• Sensory strategies/interventions – link between Autism and Anorexia
• Adaptive coping strategies – to replace unhealthy coping skills (i.e. restriction, over-exercising, binging/purging, etc) with healthy ones (i.e. distraction, journaling, self-soothing techniques, etc)
• Body Image – Emotional & pragmatic interventions
• Roles and Identity – supporting individuals to explore new life roles & re-engage with current to increase sense of self
• Goal Setting

Considerations
There is a lack of Occupational Therapy research within eating disorders, and so it is crucial that we attempt to bridge the gap, as clients, their carers and clinicians subjectively report the invaluable contribution that the profession can have in eating disorder recovery.

For more information, please reach out to either, Clare M Steedman or Abigail Cardwell, Co-Chairs of RCOT Specialist Section – Mental Health Eating Disorder Forum.

If you are interested in getting involved or finding our more information then please contact the Clinical Forum leads:

Abigail Cardwell, Lead OT for Eating Disorders at South West London & St Georges Mental Health NHS Trust (abigail.cardwell@swlstg.nhs.uk)

Clare M Steedman, Co-founder & Clinical Director of The Eating Disorder Specialists TEDS (clare@edspecialists.co.uk)

Forensic and prison based occupational therapy is concerned with the occupational wellbeing of those who have a history of, or who present as a risk of offending.

Forensic and prison based occupational therapists predominantly work with service users who are experiencing mental health, cognitive and/or social difficulties in a range of secure environments and forensic community teams.

Within these environments, an occupational therapist uses occupations to provide assessment and interventions that aim to maintain, restore or improve an individual's occupational performance, with regards to promoting independence, self-esteem and self-efficacy and addressing related aspects of offending behaviour.

The assessment and management of risk underpins the occupational therapy process within all forensic and secure settings. Occupational therapists in these settings recognise the environmental constraints and barriers to occupational opportunities. They adapt, create and provide occupational engagement and opportunities for those with whom they work.

The Forensic and Prison Forum is a sub group of the Specialist Section - Mental Health that exchanges information, evidence, views and ideas relevant to occupational therapists working in forensic mental health and in prisons.  

• Support and facilitate communication between members via a range of platforms 
• Provide and promote networking activities relevant to forensic and prison occupational therapists 
• Support development of clinical knowledge and skills among forensic and prison occupational therapists through educational opportunities, such as study days and conferences. Currently due to COVID – the forum is meeting monthly on zoom and will meet in person when safe to do so, following Government guidelines  
• Develop the occupational evidence base in forensic and prison occupational therapy by supporting research and enhancing research capacity 
• Provide expertise related to forensic and prison services to the Royal College of Occupational Therapists 
• Comply with College of Occupational Therapists Governance on specialist sections 

In order to benefit from being a part of the forum, you must be a member of the Royal College of Occupational Therapists Specialist Section for Mental Health.

Benefits of joining the Specialist Section Mental-Health and accessing the Forensic and Prison Forum include:

• the opportunity to meet and communicate with other forensic occupational therapists across the United Kingdom and in the devolved nations
• receive discounted rates for events hosted by the Forensic and Prison Forum and Specialist Section Mental-Health
• Be first to hear of changes and dwevelopments in the field of forensic and prison based occupational therapy
• have your views represented at national level
• contribute to feedback to the Royal College of Occupational Therapists and national governments.

All these websites have helpful publications, resources and mailing lists that can help you access new evidence being published, or seek the consensus of your colleagues in similar services.

• Forensic Managed Clinical Network (Scotland)
• Royal College of Psychiatrists Forensic Faculty
• Quality Network for Forensic Mental Health

Use these Quality Network Standards to demonstrate how occupational therapy helps your service meet quality expectations. There are standards for all levels of security, different genders and service users with complex needs (e.g. deaf, learning disability and substance misuse).

Quality Network Standards at The Royal College of Psychiatrists

A few handy sites that summarise and publish guidelines for practice – they often seek information to update their guidelines. If you catch any calls that we miss, let us know at the Forensic Forum so we can make occupational therapy contributions together.

• National Institute for Health and Care Excellence (NICE)
• Scottish Intercollegiate Guidelines Network (SIGN)
• Collaboration for Leadership in Applied Health Research and Care (CLAHRC)
• The Mental Elf

Vacant

Significant financial investments and ambitions set out by the Five Year Forward View for Mental Health (NHS England, 2014) from has seen the radical development of new and existing community specialist perinatal mental health services and mother and baby units. With an expansion of services and workforce there has been a rapid growth of occupational therapists practicing in this exciting and fast developing speciality.   

For many years a committed group of perinatal mental health occupational therapists established and engaged in a network which offered peer support, training, and sharing of best practice. Following the growth of this network and efforts of committed members, it is a now an established Clinical Forum within the Royal College of Occupational Therapists Specialist Section for Mental Health and is a dedicated organisation of occupational therapists working in associated areas of practice.

• To support a national network of occupational therapists working or who have an interest in perinatal mental health.
• Provide learning events and networking opportunities to develop clinical knowledge and skills and share good practice.
• To support the development of the evidence-base for occupational therapy in perinatal mental health care.
• Provide resources and information via the website, social media, and e-Newsletters.
• Raise awareness of the occupational therapist’s role within perinatal mental health services.
• Provide expertise related to perinatal mental health services to the Royal College of Occupational Therapists.
• Comply with Royal College of Occupational Therapists governance of Specialist Sections.

In order to benefit from being a part of the forum, you must be a member of the Royal College of Occupational Therapists Specialist Section for Mental Health. Membership gives you the opportunity to network with occupational therapists from across the country who shares your special interests and common challenges.

There is a membership offer of half price for all new perinatal occupational therapists joining the Specialist Section-Mental Health, from 1^st October to 6^th December 2019

Get support from our committee representatives and become involved in our activities including:

• Organising, attending and presenting at networking events and conferences
• Writing regular updates for the Specialist Section newsletter
• Establishing and supporting regional sub-groups
• Receiving up-to-date information via the Specialist Section’s e-newsletter.
• Contributing to promoting best practice and raising the profile of occupational therapy in perinatal mental health regionally, nationally and internationally.

Membership is open to Royal College of Occupational Therapists members.

This e-learning course was developed by members of the clinical forum with Health Education England’s e-Learning for Healthcare. It can be accessed by anyone with an NHS email address or an Open Athens account (including students) and will be of interest to occupational therapists working in perinatal mental health and those who would like to work in this specialist area of practice. 

The e-learning course includes: 

• information about perinatal mental health and the role of occupational therapy 
• indications for referral to occupational therapy 
• occupational therapy assessment tools and approaches 
• occupational formulation and goal setting 
• occupational therapy interventions 
• discharge planning and evaluating occupational therapy outcomes. 

Each session includes information and interactive activities to promote understanding, case studies and a self-assessment enabling participants to apply and check their learning, and links to additional information and resources. Participants are encouraged to write a ‘personal action plan’ identifying how they will continue their learning and develop their practice.  

To find out more about the forum, please contact:

Leanne Davies - leanne.davies2@nwbh.nhs.uk