This blog began as a journal of a Winston Churchill Memorial Trust Travel Award visit to the USA to study how Lifestyle Redesign could be used in Occupational Therapy to improve the hospital/home interface for older people. It has continued to record developments and inspiration gained from that experience since returning from Los Angeles early in 2012.

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Sunday 22 April 2012

S is for Story...

 
Storytelling and Story making are my subject for today.

Occupational Therapy (OT) is a ‘doing’ not a ‘talking’ therapy, but ‘storytelling’ and ‘story making’ can be an important part of the process of change for individuals.

OTs see people as ‘occupational beings’, ideally fully engaged in the world of activity with a balance of work, rest and play. Illness, disability or old age can disrupt this balance, sometimes suddenly and catastrophically, sometimes gradually and imperceptibly. The strategies that someone used earlier in their life to overcome problems may no longer be viable.

OTs can help someone envision a new possible self. Story telling and story making may be used explicitly, or the OT may be alert to naturally occurring opportunities. Storytelling occurs very naturally during the ‘doing’ of activities, therefore it naturally happens in group based interventions. This can be facilitated into a discussion that allows consideration of new possibilities that are continuous with the previous occupational life of each person. One individual described the process as “recycling the old me into the new me” (Clark in Zemke & Clark 1996).

Storytelling provides valuable insight into an individual’s previous life, what they valued and why. This provides resources that can be used in the building of a new self-identity and future.

Story making uses these insights and may include ‘coaching’ and encouragement to develop what has been learned to develop a new occupational being. This process moves beyond the basic activities of daily living that often become the focus for rehabilitation and into the domains that make someone value their life and includes activities that promote health and well-being.

For anyone interested in learning more about this complex and fascinating process, a couple of key texts to begin with are:

Clark FA (1993) Occupation embedded in a real life: Interweaving occupational science and occupational therapy. American Journal of Occupational Therapy 47:1069

Clark F, Ennevor BL & Richardson P (1996) A Grounded Theory of techniques for Occupational Storytelling and Occupational Story Making in Zemke & Clark !1996) Occupationall Science: the Evolving Discipline. USA.

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