Suggestions for OT-based research topics

I get contacted from time to  time  by mainly students looking to  do projects/dissertations on OT and hoarding. This is fantastic and hopefully will gain momentum  to lead to published research and an evidence base for the profession. Basically the door seems wide  open in terms of research  needed into OT and hoarding , however I've put down a few thoughts below of  questions /areas that  could  be explored and developed further. Please  feel free to add other  suggestions for research topics.


- Potential use of  OT models - how do they relate to the current  evidence base? Is there a need for a specific model  in OT?

- Are OT interventions  cost -effective?

- Interventions focussing on restructuring of roles and routines and the evidence base for these?

-Are  OTs  too   focussed on the physical environment  when  working  with people who hoard?

- Are there certain hoarding traits or behaviours  which OTs are well placed to  work with?

-S.User/family experience   of OT interventions


Lets hope  we'll  be able to answer some of these questions  further down the line

Has anyone used the KAWA model?

I'd be interested to know whether anyone has used the KAWA model in the assessment/ treatment of hoarding. It  looks like a potentially  useful way of establishing  clients' perspectives and priorities as well as establishing more of a therapeutic rather than directive  relationship. So would be great to hear about  any clinical   experiences. Obviously if I get the chance to use it  myself, I will keep you posted. 

Motivational Interviewing Questions

Although motivational interviewing  is not  specific to OT or hoarding , I have found the following  questions helpful to take along along to assessments or sessions  as a prompt sheet to  establish readiness for  change or introduce the possibility of change in hoarding behaviours. As always, please feel free to make  any comments or suggestions.

Motivational Interviewing Questions

DARN may elicit change talk

D- Desire   What do you wish/hope etc?

A- Ability    What can you do?   What is possible? How confident are you that you can change?

R- Reasons  Why would you make this change?  What risks would this decrease?  What benefits ?

N-Need       How important  is this change? How much do you need to do it?

Change Questions

Why might you want to make this change?

If you did decide to make this change how would you do it?

What are the 3 most important benefits to making this change?

Rating Scales

How ready/confident  so you feel (0-10) ? How important is it  making this change (0-10)?

What would need to happen for the number to go up?

Why did you not answer lower?

Decisional  Balance

What is good about the situation staying as  it  is ?
What is not so good?
What concerns   do  you  have  about  the  change?
What  are  the  good  thing  about  change?

Summarise pros and cons

Follow up  “Where does that leave you now ?”

What do you intend to do?

If not ready to make changes.......

Hypothetical questions?

What might it take for you to make a change?

Let’s imagine you did. How would your life be different?

Suppose you continue without making any change . How would your life be in 1 year , 5  years , 10 years ?

 If you were in my shoes ,what would you be saying?

Giving  information  and  advice
Remember  to  try  eliciting  a person's   understanding  before   providing   information or  advice.

E.g   What  do  you  understand   about  the  risks  of  the  current   situation?
         What   do  you  know  about  strategies  to   manage  situations  like  this?

As permission  to  give  advice
Is  it  ok  if  I  tell  you  about....?

If  you have  to   give information  or  advice try  to prefeace   it  and offer  an  element  of   choice of  when  to  receive  the information.

Eg  There  is  something  I need  to  tell you  ....  would  you  like  me   to  tell  you  now  or  later  in  the  session?

This  may  or   may  not   concern  you  but.........

References

Miller,  WR and Rollnick S. (2013) Motivational  Interviewing:  Helping  People  Change.  (3rd  ed) New  York: The Guilford  Press

Rollnick, S., Miller, W.R., and Butler, C.C. (2008)  Motivational Interviewing in Health Care: Helping Patients Change Behaviour.  New York: The Guilford Press