How to maintain CPD from the beginning.

This month I would like to discuss CPD and the importance of starting from now to record your two years of learning activities and reflective practice as you learn, in order to keep your profile up to date.

As you are aware CPD is a mandatory requirement for all AHP’s to remain on the HCPC register to evidence how they meet CPD standards. Each allied health profession is audited every two years and I am sure you are aware that Occupational Therapists were audited in October. If selected for audit, this can become a very stressful time if you are unprepared as gathering two years of evidence is time consuming in order to collate your CPD profile. This may result in your CPD profile not providing a true reflection on your professional learning as reflective practice was not completed at the time of the CPD activity. Maintaining CPD is paramount as an allied health professional as this enables you to provide evidence how you keep your professional development updated and give you the opportunity to share your learning experiences and reflect on your learning activities.

CPD can be seen as a ‘chore’ and the audit process can be viewed as ‘daunting’ as you are required to pass to continue practicing as an allied health professional. I would like change the negative view of CPD into a positive as CPD should be used to highlight and evidence all the hard work and learning you gain throughout your career. Each allied health professional participates in CPD activities on a daily basis within their work role, either through a work based activity, training opportunity, reading articles, and many more activities. The issue in why people get stressed when it comes to the audit process is that the reflection process is neglected at the time of the CPD activity, making it difficult to compile CPD profile.

In order to help others with CPD maintenance, I would like to share the six key tips in keeping CPD updated over the next two years in order to keep an updated CPD portfolio.

  1. Get supported- discuss your professional learning with your supervisor/ facility lead or other colleagues. Join CPD learning groups, journal clubs and so on to broaden your professional development.
  2. Know your role- have a good understanding of your role within your profession and also multidisciplinary team in order to make the most out of your learning and skills.
  3. Simple structure- when completing reflective practice, use clear headings and simple structure to keep your learning clear and concise.
  4. Date your diary- record all learning activities so you do not miss any when collating your two years of professional learning.
  5. Get to the point- when reflecting on your learning be concise with relevant information. Its quality not quantity.
  6. Learn from others- share your learning with others to seek support and guidance on learning.



My advice regarding CPD is to keep it clear and concise. Reflect regularly on your learning to provide an accurate view of your professional development. Reduce the stress by keeping your CPD portfolio up to date and be proud of your professional growth. Share your experience with others and support your colleagues with their professional journey also. Remember, CPD is not always work based. Reflective practice can also be from a life experience that will contribute to your professional development or benefit your service provider. You can view shared experiences within our reflection templates in order to help focus your learning.


  • CPD is an opportunity to evidence your professional development and growth
  • Reflect regularly and record all learning activities
  • Share your learning and support one another in your career.



The Mind is a busy place full of activity and without any effort we jump from thought to thought in a matter of seconds. If our minds become too busy this flow of thinking can become too much for an individual to take and can feel overwhelming.

Different people have different ways of coping with a busy mind for example some people try to relax by watching TV, having a cup of tea or exercising.  Although these are all good forms of coping strategies it also important that we take time to be mindful to understand the state of mind we are in to help us make positive decisions.

To do this be need to be aware of our various states of mind and what risks or potential these can have. This understanding can have a great impact on how we deal with different stressors in our lives

Linehan 1993 introduced the theory of “Wise Mind” Which is the part of our mind where our “reasonable mind” and “emotional mind” come together.

Reasonable mind helps us to make logical and rational decisions usually based on facts and evidence. On the other hand emotional mind is controlled by our emotional state where our thoughts can be unhelpful and not logical. Emotional mind is not all negative, and we do need to consider our emotional needs in order to make wise decisions i.e. being in “wise mind”

A third section was then introduced – “risky mind”. This is when we let our emotional mind take over and our actions our dictated solely by our emotions.

When we feel upset or stressed we can react without thinking about the consequences and our behaviours we use to help us cope can often be self-destructive e.g. self harm, over eating, under eating, harm to other etc.

These coping strategies can often be a vicious circle which can be incredibly hard to break as these actions can lead us further into emotional mind and then again onto risky mind.

As health professionals we aim to help our clients/service users to develop more appropriate coping strategies. To do this we are required to help our clients understand the various frame of minds and be able to determine what frame of mind they are in and when they feel they are being controlled by their emotional mind. It important to try and react when clients are in emotional mind and intervene with coping strategies  before they enter risky mind – Remember being proactive is more effective than reactive!

History of Occupational Therapy

It is said that “those who cannot remember the past are condemned to repeat it” (Santayana, 1905, p284).  This statement tells us that history will be relived and we can reflect on the past; learn from our mistakes and progress.  To understand occupational therapy fully as a profession, we must consider the past; acknowledge the roots and how they contributed to development of occupational therapy as it is today.  This account considers key parts of occupational therapy history and sets it in the context of how knowledge of the past informs contemporary practice.

Although many believe occupational therapy is a relatively new profession, occupational therapy principles and practice go back to the late eighteenth, early nineteenth century (Tuner 2002).  At that time, new ways of thinking changed the treatment of mental asylum inmates from isolation and torture to a moral treatment (Friedland 2007; Turner 2002).  For occupational therapy, treating individuals morally, with dignity and respect, is still a vital concept, reflected in the code of ethics which outlines treating patients with individuality, self-respect and dignity (College of Occupational Therapists 2010).  Philippe Pinel and William Tuke introduced this new humane way of thinking (Bing 1981).  Noting faster recovery in those participating, Pinel believed exercise and manual work should be prescribed as an act of treatment; thus introducing occupations for treatment which, to this day, is a key concept of occupational therapy practice (Mayers 2002; Turner 2002; Cara & MacRae 2005; Paterson 2007; 2010).  This was the start of the link between occupation and health which today is a strong concept.  The development of such treatments spread and influenced practice in many different countries.  An example of this can be seen in the introduction of occupational therapy to Scotland.  David K Henderson, worked closely with the founders of Occupational Therapy in America, Eleanor Clarke and Adolf Meyer, and they influenced his understanding and principles of Occupational Therapy (Paterson 2007).

The twentieth century saw introduction of education and training as a method of developing occupation as therapy in practice.  Training courses were introduced for student nurses in the treatment of psychiatric conditions (Tuner 2002).  World War One, in particular, contributed hugely to the development and establishment of a new avenue of occupational therapy – physical disabilities (Jelic & Eldar 2003).  In the British Empire alone there were over 2 million injured, due to development and battlefield use of new destructive weapons leading to large numbers of ex-military with physical disabilities needing treatment  post-World War One  (Public Broadcasting Service 2010).  The concept already developed in previous century for those with mental health problems – humane treatment through use of occupation – was applied to physically disabled ex-combatants.  Thus, occupational therapists adapted their lessons to a different setting.  For example, the concept of occupation as a means of treatment is reinforced when Sir Robert Jones, an Inspector of Military Orthopaedics in World War One, sets up workshops in hospitals.  Emphasising learning from other countries as an aspect of development of occupation therapy, Jones was influenced by work done in America to provide rehabilitation and move injured soldiers back into a work place (Yakobina, Yakobina & Harrison-Weaver 2008; Friedland 2007).  Common principles were developing, directing the development of occupational therapy – occupation and treating individuals as individuals with respect and dignity.  However, this steady march of progress of occupational therapy in physical settings was interrupted by Great Depression of the 1920s and 30s (Paterson 2010).  Low budgets and staff cuts meant occupational therapy in physical settings being cut and occupational therapy returning to its roots in mental health settings.  Despite these drawbacks the development of education in occupational therapy took a large step forward.  Gartnavel Royal Asylum, Glasgow, introduced the term ‘occupational therapy’ in 1922 and within Aberdeen Royal Asylum there was the first allocation of an occupational therapy post in 1925 to Margaret Barr Fulton (Paterson 2010).  After experiencing occupational therapy within Gartnavel Hospital, Glasgow, and, in a further example of knowledge from one country informing practice of another, in American Occupational Therapy centres, Elizabeth Casson opened the first Occupational Therapy school – Dorset House – in 1930 (Fraser-Holland 1990; Tuner, Foster & Johnson 2002; Friedland 2007; Paterson 2007).

In 1939, war again provided impetus for occupational therapy development. World War Two brought a surge in the need for occupational therapists to rehabilitate men injured in the war (Paterson 2007).  The concept of rehabilitation grew in World War Two, with the requirement of professionals working together as a team (Paterson 2010).  The success of multidisciplinary team working has been carried on as a successful way of working, still happening today.  Today, professionals working together and using each other’s strengths promotes successful team working within care settings.  The word rehabilitation is a buzz word today, with principles of rehabilitating people to maintain independence in their daily life.  Occupational therapy education also took a step forward.  Emergency courses were run to meet the demand for occupational therapy in rehabilitation (Yakobina, Yakobina & Harrison-Weaver, 2008).  In 1939 Elizabeth Casson opened a curative workshop in Bristol which also aided education as students studying at Dorest House would now experience physical and mental occupational therapy in practice (Paterson 2010).  This is a major step for occupational therapy education influencing the role of occupational therapy today with treating the patient holistically which includes mental and physical wellbeing.  This also was a step forward for occupational therapy as a profession, enhancing the role and evidence of occupational therapy in physical settings.

Many of the foundations of current occupational therapy practice were laid at this time.  Use of arts and crafts was further explored and employed by Occupational Therapists as a form of treatment (Friedland 2007). Theory was also being developed to inform practice.  William Morris discussed the outcomes of developing a product from start to finish which was to build on physical difficulties but also the sense in pride of doing this (Paterson 2010).  John Colson, a physiotherapist and occupational therapist explored theory relating to the use of occupations.  Therapists adapted and graded craft activities to suit each individual (Paterson 1998; Paterson 2010).  The developments introduced the basic occupational therapy skills- activity analysis and graded activity to enable successful outcomes for individuals which are the basis of current practice.

Due to the increase in the mining within the UK in the 1930’s, physical injuries related to mining were becoming increasingly common (Paterson 1998).  Occupational Therapists adapted their knowledge and treatment of injuries related to the war to accommodate rehabilitation of miners.  Occupational therapists extended the use of treating individuals as individuals and through the use of occupation into a setting out with mental health and military; a move which has been happening ever since.  Theory development also continued with two professional bodies being set up in Britain- the Scottish Association of Occupational Therapists, formed in 1932 and the Association of Occupational Therapists, formed 1935.  The Association of Occupational Therapists launched the first British occupational therapy journal in 1938 (Paterson, 1998) and articles were produced to acknowledge the concepts of Occupational Therapy and the rise in Occupational Therapy as a treatment for physical and mental health issues.  Spreading knowledge was always part of occupational therapy development and articles and journals, helped build a body of theory and evidence widely available.  Co-operative learning, so influential in the early occupational therapy development, continued, new teaching courses were established and, along with journals and articles, the principles and concepts of occupational therapy developed from the beginning were formalised and taken forward to today’s practice.

Concepts and principles that were introduced from the start included acknowledging the link between occupations, health and wellbeing; the use of occupation as a form of treatment; exploring the balance in people’s life and client centred practice (Mayers 2000; Paterson 2010).  These concepts have provided a foundation for occupational therapy principles.  These principles have informed contemporary practice through the development of models within occupational therapy which link aspects of how different occupations can affect health.

A concept used within occupational therapy treatment historically, acknowledged by the moral treatment era, is the treatment of the patient as an individual.  Occupational Science when coupled with psychology and sociology gave occupational therapists a greater understanding of the importance of individualised treatment as occupational science explores humans as occupational beings (Wilcock 2001; Clark 1997).  This development has influenced occupational therapy code of ethics as individualised treatment – client centred practice – is today the centre of occupational therapy practice and key to our code of ethics (Hammell 2001; College of Occupational Therapists 2010).  Through the identification of a person as an individual, therapists now work in conjunction with patients to direct a treatment plan and select occupations meaningful to them.

Throughout occupational therapy as a profession, their knowledge and core skills, although remain the same, are adapted to meet the requirements of the current population’s needs.  Initially, introducing physical occupational therapy during war times with the rise in tuberculosis and amputations and later when the increase in the mining population in the 1930’s required occupational therapists to discover new avenues.  Within today’s society, in the UK, there is an increasing aging population, problems relating to inequality such as depression and alcohol drug dependency and obesity all which have potential for occupational therapy input through our transferrable skills (Hanlon et al, 2011).

Another strand in the history of development of occupational therapy is the role of government.  Government policies and funding for, future health of key groups have often influenced direction taken by occupational therapy.  When the National Health Service was set up, their vision was to treat people within the community.  This vision appears still to be present with a move to community rehabilitation as health is created in the community.  The change from the past to present is that the government are trying avoiding people coming into hospital through prevention strategies prior to illness whereas, in the past, individuals would have been admitted are help received if they were ill. Currently, re-ablement – maintaining individuals at home instead of care homes or hospitals – is shaping current practice (Department of Health 2011).  A large population of re-ablement customers will be elderly.  Occupational Therapy posts are now being created within re-ablement teams which influence a new avenue of practice.  This has been the case for occupation therapy practice today with ever evolving populations in need.  The change in society shapes current practice in occupational therapy however; foundations set back in the 19th century still are core.

Occupational therapy can be said to have done a full loop.  The war in Iraq and Afghanistan requires occupational therapists to explore this area again decades on from the initial occupational therapy in physical disabilities (Clark et al 2007; Canadian Association of Occupational Therapists 2009).  Issues are much the same with occupational therapists looking at moving veterans back to the community and back into a workplace (Canadian Association of Occupational Therapists 2009).  The concepts of rehabilitating people back into a workplace developed through the curative workshops has similar strands in a new concept of occupational therapy – vocational rehabilitation- which not only relates to veterans but those suffering from long term sick, ex- offenders and substance misuse – to name a few.

In conclusion, occupational therapy, although having developed greatly over the centuries, still has the same key foundation of occupational therapy principles – use of occupation, client centred practice and the link between occupation and health.  Occupational therapists have the skills to adapt to the needs of society and provide services to meet expectations.  This again has been shown in the move from mental health to physical health in the war, to mining injuries and now today to meet the needs of the aging population, mental illness, obesity, alcohol and drugs.  Therefore, acknowledgement of occupational therapy in the past has provided occupational therapy with solid foundation of principles that remain today and contribute to the ever changing societal needs.

Hope you have enjoyed reading this months blog. We would welcome any discussion on the above and how OTs past has shaped present practice on the blog or view our discussion forum



NB: Views as of my own.

Importance of Meaningful Activities in the Road to Recovery

Within this month’s blog I would like to discuss the importance of meaningful activities in service users’ road to recovery both in physical and mental health services.

Through my experience in working within a vocational rehabilitation centre with adults with physical and mental health problems, it has opened my eyes into the importance of intervention being meaningful and appropriate to service users’ needs.  As Occupational Therapists, we are well trained in analysing activities and adapting activities/ tasks as required to meet individuals’ needs.  However do we always take into consideration what interests our service users have and if they are interested in the topic of activity within their intervention or do we carry out tasks within our intervention as this is the tasks previously carried out?

When service users have an interest and meaning behind doing an activity or task they appear more motivated in participating and they will put the time and effort into successfully completing the activity or task. Individuals with physical health problems tend to be more motivated within intervention than individuals with mental health problems.  However for adults with mental health problems, to engage them in successful intervention, meaningful activities are required in order to increase participation.

An example of this being within a medical ward and before discharge, an occupational therapy assessment is completed.  A kitchen assessment is generally completed to identify whether the service user is safe within the kitchen environment.  An example of a task the service user may be required to complete is to make a hot drink successfully.  The occupational therapist would be observing and assessing the service user in completing the task, identifying whether they are safe using electrical equipment and boiling water, observing the sequence used to complete the task and if the correct equipment, utensils and products are used.  For many individuals, this is a ‘basic’ and ‘normal’ task however if this is not a meaningful task to an individual, or if they do not regularly make a hot drink, is this an appropriate method of assessment?  Within the older generation, it was generally the females who worked within the kitchen environment while the males worked outside of the home environment.  Is this a meaningful activity for an elderly male to complete if he was never within a kitchen environment?   Is this a meaningful task?

Within the above example, various other assessments could be completed to identify safety and security for a service user returning home.  This is where it is important to gain good insight into service users normal routines and interests to gear their intervention around their interests and abilities.  As Occupational Therapists, we adopt a holistic and client centred approach to try and get a complete and accurate observation of a service users abilities and interests.

Do you feel your intervention is client centred and geared towards meaningful activities to aid the road to recovery for you service users? How do you adapt your intervention to ensure tasks are meaningful? Or are we struggling with time due to increasing workloads, which then influences our practice and ability to be fully client-centred?

I would like to hear from you experiences and how you meet the increasing demands of managing caseloads, adapting intervention to be client centred.

Positive Risk Taking in Practice within a client centred approach

The topic I am exploring this month is positive risk taking within a client centred approach and if this is something we actually follow through with when in practice.

In order for our clients to develop their skills, positive risk taking is an essential part of our work. It is very evident in most of our theory work (for example university work or case studies) but do we as health professionals actually take these risks to enable our clients to develop a higher level of independence?

This aspect of care is relevant to all settings however due to the increasing ageing population within the UK I am going to focus on the support given within care of the elderly.

This older population have caused a higher demand for long term care settings within the UK and so the government have been working toward an increase of opportunities to enable people to be care for within their own homes – to do his however it is essential that our older population maintain a level of independence for as long as possible.

Scotland are working toward making their older population as independent as possible with the introduction of the reablement scheme. With this scheme they hope to take positive risks with support in order to develop individuals skills rather than just caring “for” them. The hope if that they will increase independence for this more dependant population and relieve some of the pressure and demand on care facilities on a long term basis. (Nothing Ventured Northing Gained, 2010. Better outcomes for older people, 2005).

Healthcare settings are all extremely busy places with both time and staff constraints on many health professionals. With these constraints in the workplace it can be seen as much easier, faster, and safer to complete activities FOR individuals rather than supporting them to develop the required skills to increase independence. An example of this which I have saw in many settings is dressing practice with the elderly. Due to time contracts in the morning of a busy nursing/residential home it is tempting to do activities for the residents like putting on items of clothing without even assessing wither of not that resident is able to complete that tasks themselves or not.

It is here we have to ask ourselves as allied health professionals if we are taking enough positive risks in order to develop and or maintain that individuals skills. In order to provide a client centred approach we have to  weight up the risks with the benefits of each activity. If the benefits for that particular clients outweigh the risks then we should be supporting that client to complete the activities – along conducting risk assessments and minimising any potential risks to client.

By taking these risks we are giving our clients the opportunities they need to develop and maintain skills – if we take these risks away by completing activities for our individuals, how will they get opportunities to maintain their skills?

If we look as Maslows hierarchy of needs, we aim to to support our clients to reach self actualisation. Maslows first level is biological and physiological needs which include our everyday activities that we do to survive. Maslow’s hierarchy explains that if an individual is not supported to complete this level they connect move up to reach self actualisation. So although a task may seems small it is important as health professionals we assess the risks to enable our clients to complete activities as independently as possible.

As allied health professionals we are focused on client centred approaches and so not only do we have to take positive risks to give clients opportunities to complete tasks, but we also have to ensure they are they meaningful activities to that particular individual. If we look at the Model of Human Occupation (MOHO) this reinforces the importance of motivation, roles, routines and environment to develop an individuals performance capacity.

From this we need to access the whole person for example if we have a client who suffers from fatigue we can encourage a client to dress themselves which will help them reach Maslows first level, however if they are not motivated to complete this themselves but would rather be supported with a social task then we can give them more support to dress, leaving energy to complete a social activity that is meaningful to them.

In order to give our clients the support they need we need to look at each person individually to access what is meaningful and motivates them. From this we can take positive risks in order to enable that individual to be as independent as possible with that particular activitie, supporting them to reach performance capacity along with Self actualisation.

As the old saying goes “Give a man a fish, feed him for a day. Teach a man to fish and feed him for a lifetime”

An Occupational Perspective of Substance Use in Socially Deprived Areas

The topic I have chosen to explore and blog about is an occupational perspective of substance use in socially deprived areas. Firstly, I will provide some statistics to link why this is a contemporary issue today and what this means for occupational therapists. This will follow by thoughts around addiction in socially deprived areas. I will consider occupational risk factors, the policy directors and how OT can meet these. Finally acknowledging barriers to recovery and summarising the topic.

Scotland has a major problem with drug use.  It is sixth worst country in the world for illicit drug use (University of Glasgow 2010) and gaining over 10,000 new users a year (Scottish Drugs Misuse database 2009/10). Recent NHS, government and Scottish Drugs Forum policy documents link substance abuse and social deprivation.  In its Road to Recovery document published in 2008 by the Scottish Government has acknowledged scale of the problem and made tackling substance use a key and contemporary issue directing health and social care services.  Social and cultural problems influence health and social care issues.  Like other physical and mental health issues, substance use results in occupational disruption.  Occupational therapist skills are transferrable and OTs must respond to society and meet its demands by moving into new areas, such as substance use. For the purpose of this blog, I will define addiction as an involvement with drugs, or alcohol, so overwhelming it harms the addict, society, or both (Alexander 2008).

This makes the Road to Recovery a key driving force for addiction services today.

I reflect back to the documentary which was perceived almost as a comedy sketch to many of its viewers – BBC 1’s ‘The Scheme’. For those who haven’t watched the programme, the documentary follows the lives of individuals who live within a housing estate in Kilmarnock (You can find clips on youtube- I want to make you aware there is strong language and images of needles in this.  While watching this documentary, I reflected on the social and physical environment, and possible issues affecting the individual and the family.

My reflections led of this led to my following thoughts:

Kilmarnock has gone through deindustrialisation- a decline in industrial industry, in the 1960s was the decline in shipping industry as fierce competition from Germany and Japan- previously had the shipping industry on the river Clyde. This is similar of the fishing industry in Peterhead. This can link into issues surrounding un employment, lack of opportunities etc. They are bored, lack routine and meaningful roles so turn to drugs as a way of meeting the unsatisfied occupational needs.

Following this discussion through conceptualisation of issues using MOHO, I further considered our knowledge of occupational science.  Wilcock, 2006, considers occupational risk factors to be – occupational deprivation, alienation and imbalance.  Deprivation occurs when external forces prevent engaging in an occupation: in terms of this clientele, these external forces could be reduced employment opportunities, lack of resources and poverty.  Occupational alienation results from feelings of loneliness, lack of meaning and disconnection when cut off from normal society routines.  For this clientele, alienation could mean using addictions to cope.  When individuals are unable to meet occupational needs, imbalance occurs and this clientele may turn to addictions to satisfy unmet need.  Addictions become individual’s main role and identity.  Their routine of sourcing money for drugs gives a meaning and direction for the day, although not a positive one.  Therefore, their life is imbalanced.  All these risk factors can inhibit the persons ability to reach occupational competence.

Individuals respond to their immediate bodily need which is why it can be so hard to break the cycle of addiction, preventing them from developing skills to manage in the community and thus not reaching their occupational potential.

As stated early the government has the road to recovery policy which aims to direct services and promote recovery. From reading national and local policies, it is clear that there is a definite role for occupational therapists on the road to recovery.

There are issues however that can present as barriers on the road to recovery and in sustaining recovery in the community. These closely link to social deprivation and environmental factors such as the strong drug culture in the community, drugs are widely available, old social networks are still near and availability of resources remain the same. Moreover, they will still be in poverty which my limit the activities they undertake for enjoyment and housing issues remain the same.

Furthermore, stigma of those with addictions or past addictions is present within society and those trying to get a job may stumble with employers perceptions of those with previous addiction issues- they may also have criminal records which will limit employability opportunities.

The aim of this blog was to identify from an occupational perspective, issues relating to individuals with substance use within socially deprived areas, the role of the occupational therapist in this setting and barriers to recovery.

I believe it is important to state that whether or not addictions are a primary interest for you, you will in your practice come across those whose substance use must be addressed in order to improve their occupational performance.

I would like to leave you with this thought: in 1980s, Bruce Alexander studied two sets of rats from birth – one set in isolated cages and the other in a rat colony environment. Both sets had equal access to tap water and morphine.  The rats in isolated cages consumed considerably more morphine than those in the colony, and after 57 days were addicted.  Alexander then moved half of them into the colony where they began to choose tap water.  The former isolated rats found the morphine inhibited them undertaking their usual rat activities.  What does this say about the impact of environment and occupations?!

Looking forward to hearing anyones comments relating to the topic!

Thanks for reading!


NB Views are my own.


Hello folks,

Welcome to our blog! Here we plan to ‘blog’ about topics and issues relating to Allied Health Professionals. We are the creators of CPD Active ( and so will ‘blog’ about new features and changes, but also about the activities we are undertaking.


We are 100% new to blogging, so please bare with!!


Hope you enjoy our forthcoming posts! We look forward to any comments and feedback you may have- feel free to join in 😀

Cara, Catherine and Arlene