It’s a Roller Coaster Ride! A Metaphorical Analysis of Effective OT in Child Mental-Health and Learning Disability

This interpretive phenomenological research focused on the lived experience of eight experienced occupational therapists who specialized in working with children and young people with mental health/learning disabilities working in community and in-patient services. One of the aims of a multi-faceted study, was to gather metaphors (Ricoeur & Thompson, 1981) of the phenomenon of effective occupational therapy from participants and to offer an interpreted metaphorical explication of the phenomenon.

There is little research in the field on child mental health and eliciting metaphors emanated from the paucity of evidence of the use of outcome measures to help articulate the value of occupational therapy to children and young people experiencing mental health/learning disability issues. This meta-analysis of metaphors represents one of the methods used to illuminate the phenomenon of effective occupational therapy.

Occupational therapists were invited, as part of wider study, to describe a summative metaphor which captured what effective occupational therapy with children was to them. All participants chose to contribute and a thematic analysis of the metaphors elicited was undertaken. As a final stage in face to face interviews, more broadly eliciting examples of effective occupational therapy from past practice, occupational therapists were asked to sum up their contributions using a metaphor. Framing the question using clean language methods, participants were asked “effective occupational therapy …that’s like what?” Using a relational approach (Finlay & Evans, 2009), with the aim of eliciting descriptive detail, OTs were supported to share any sensory and dimensional elements, related to the metaphor they selected.

One of the five phases of descriptive analysis in the overall study, metaphorical data analysis, stemming from the original source metaphors used, required data to be coded and themed using Nvivo software. Further analysis was carried out using increasingly interpretive methods, in line with the methodological framework. This allowed more artistic and linguistic elements to enrich the understanding of the phenomenon, drawing insights from multiple data sources to contextualize and develop the interpreted metaphorical analysis.

Results identified themes from metaphors of obstruction and flow; learning and growth; creative complexity; containment; emotions and embodiment. A summative rollercoaster metaphor, based on one provided by a participant and incorporating themes from other metaphors, was collated, created and developed by the researcher. It encapsulates themes of respect, tenacity, working around a system not best designed for young people. It encourages the listener/reader to step into this world and travel alongside the OT and the young person to glimpse its meaning. It seeks to create an embodied, sensorial and emotional experience.The rollercoaster metaphor was adapted into a Rap to share the findings of the overall study with young people in specialist mental health services, in an age appropriate accessible way

IMPACT: The summative rollercoaster metaphor will be shared, with the intention of providing an experiential and creative perspective of the study of the phenomenon of effective OT with children and young people. It provides an important increase in insight and understanding of the lived experience of occupational therapists in mental health, whose voice is rarely heard.

This research primarily seeks to find more effective interventions to address the negative impact of emotional influences. It aims to improve the quality of life of young people with complex mental health needs and prevent the development of chronic mental health conditions to enable healthy transitions and development.

References

Ricoeur, P & Thompson, J. .B. (1981). Hermeneutics and the human sciences: essays on language, action and interpretation. Cambridge: Cambridge University Press.

Finlay, L & Evans, K. (2009). Relational-centred research for psychotherapists: exploring meanings and experience. Malden MA: J Wiley.