Catherine.tottenggc.scot.nhs.uk cheryl.mcmorrisggc.scot.nhs.uk

2. Mentally disordered sex offenders and social inclusion - the value of Occupational Therapy Catherine Totten, Specialist Practitioner Occupational Therapist. Cheryl McMorris, Head Occupational Therapist NHSGGC

3. OT Role College of Occupational Therapy definition �OT is the treatment of people �.through specific selected occupation for the purpose of enabling individuals to reach their maximum level of function and independence in all aspects of life. The OT assesses the physical, psychological and social function�identifies dysfunction and involves in a structured programme of activity�� Distinction between �being busy� and Occupational Therapy.

4. Where OT�s work Mental Health � inpatient, forensic, acute, rehabilitation, community, Learning Disability Services Addictions Homeless services Head injury Prison (currently not in Scotland.) Child and adolescent Physical Health Social Work

5. Current patient group links. OT�s most closely linked to working with serious violent and sex offenders would be in Forensic Services The role of the forensic Occupational Therapist is based on evidence that engagement in meaningful everyday activity is important for promoting health, reducing symptoms of mental illness & reducing or managing risk and offending behaviour.

6. Standardised Assessments Model of Human Occupation (MOHO) Model of Human Occupational Screening Tool (MOHOST) Occupational Circuumstances Assessment Interview and Rating Scale(OCAIRS) Occupational Self Assessment (OSA) Assessment of Motor & Process Skills (AMPS) Evaluation of Social Interactions (ESI) Assessment of Communication & Interaction Skills (ACIS) Volitional Questionnaire (VQ) Occupational Performance History Interview (OPHI II)

7. Occupational Therapy Interventions Occupational Therapy Interventions are based upon individuals needs identified from the assessment process and can include: Functional assessment Task analysis, grading and application Activities of daily living -including self care, domestic skills etc Addressing motivation issues Purposeful engagement in meaningful activity Balanced lifestyle / structure to day / routine Communication & Interaction Skills Community integration and rehabilitation Vocational rehabilitation - Identifying and improving work skills, assisting patients to apply for jobs, stay in employment- including liaison with potential and current employers Educational Opportunities Leisure Planning

8. SOTP are traditionally facilitated by psychology and social workers and, in health settings, nurses. Occupational Therapists have the shared skills to co-facilitate these programmes to offer offence specific intervention but also have core skills that will address offence-related deficits. Occupational Therapy can maximise the potential of the individual to cope with non-deviant life experiences.

9. Is there a gap in current service provision? It was questioned at this year�s NOTA conference in Scotland whether SOTP are focused enough on Employment or constructive use of time Impulsivity Problem solving and coping Social support It was also muted what happens at the end of treatment?

10. Current Interventions Work as part of multi-disciplinary teams to assess and manage risk Use of activity that is purposeful and meaningful to the individual to develop skills Participate programme to develop communication and interaction skills Structure community integration, gradually increasing in intensity as skills and performance direct Vocational rehabilitation as per the vocational pathway on admission to services

11. Practical Application of a Vocational Pathway.

12. Questions Do you know if there are gaps in your service area? Is there a role for Occupational Therapy in a criminal justice service?

13. catherine.totten@ggc.scot.nhs.uk cheryl.mcmorris@ggc.scot.nhs.uk