Individual resilience as a strategy to counter employment barriers for people with epilepsy in Zimbabwe.

Understanding individual resilience helps to improve employment opportunities of people with epilepsy. This is significant because, in Zimbabwe, as in many other countries in the Global South, people with epilepsy encounter several barriers in a context of less-than-ideal public services. Despite this disadvantage, some people with epilepsy have better employment outcomes for reasons including level of seizure control, social background, employment support services, and individual resilience. This article reports on data from participants (n=8), who were part of a larger study (n=30) on employment experiences of people with epilepsy in Harare. The study used in-depth interviews with the participants, who were all service users and members of the Epilepsy Support Foundation (ESF) in Harare. The eight resilient participants comprised four males and four females aged between 26-48years, who were selected because, unlike the remaining 22 participants, they had overcome chronic unemployment. Seven of the eight participants were employed, while one had recently become unemployed. Views of service providers (n=7) were sought on the experiences of people with epilepsy through a focus group discussion. The service providers included two health workers, three social service workers, and two disability advocacy workers. Data were analysed using NVivo, a computer-assisted qualitative data analysis package. The study found that participants experienced barriers, such as a lack of medical treatment, yet this was important for education and training, lack of finances for training, and negative attitudes at workplaces. Despite these barriers, participants had overcome chronic unemployment due to their individual resilience characterised by: (i) a 'fighting spirit', (ii) being their own advocates, and (iii) having a mastery over, and acceptance of, their epilepsy. The research concluded that, where people with epilepsy faced barriers, as in Zimbabwe, individual resilience acted as a strong coping mechanism that resulted in better employment outcomes. This suggested service providers should strengthen resilience-building initiatives and make them more accessible to people with epilepsy. However, this is only a coping mechanism that should not stop service providers and service users from advocating for government-provided employment services.

An exploratory study into the application of psychological theories and therapies in Australian mental health occupational therapy practice: Challenges to occupation-based practice.

BACKGROUND: While legitimate practice tools have been the subject of debate within the profession, little attention has been paid to psychological frames of reference (PFsOR). Hence, this article explores the ways psychological theories and therapies shape occupation-based practice in mental health settings. METHODOLOGY: Narrative inquiry methods and thematic analysis were used to explore the career stories of nine occupational therapists who had worked in mental health practice for more than five years. FINDINGS: Respondents found it difficult to hold onto their occupational focus in the psychology-dominated world of mental health practice. The main themes to emerge were (i) tension between occupation and psychology; (ii) overwhelming pressures to adopt PFsOR; (iii) resistance to PFsOR; and (iv) using PFsOR to enhance professional repertoires. Findings pointed to the need to ensure PFsOR include occupational considerations for occupation-based practice in mental health. CONCLUSION: A occupation-based perspective means balancing PFsOR with occupation-based considerations, so service-user issues are holistically addressed. There is a need to critically review occupational therapists' use of PFsOR lest their most visible practical actions appear psychologically based rather than occupation based.

Factors that influence the professional resilience of occupational therapists in mental health practice.

BACKGROUND/AIM: Mental health practice can create challenging environments for occupational therapists. This study explores the dynamic processes involved in the development and maintenance of professional resilience of experienced mental health occupational therapy practitioners. It presents the PRIOrity model that summarises the dynamic relationship between professional resilience, professional identity and occupation-based practice. METHODS: A narrative inquiry methodology with two phases of interviews was used to collect the data from nine experienced mental health practitioners. Narrative thematic analysis was used to interpret the data. RESULTS: Professional resilience was linked to: (i) professional identity which tended to be negatively influenced in contexts dominated by biomedical models and psychological theories; (ii) expectations on occupational therapists to work outside their professional domains and use generic knowledge; and (iii) lack of validation of occupation-focussed practice. Professional resilience was sustained by strategies that maintained participants' professional identity. These strategies included seeking 'good' supervision, establishing support networks and finding a job that allowed a match between valued knowledge and opportunities to use it in practice. CONCLUSION: For occupational therapists professional resilience is sustained and enhanced by a strong professional identity and valuing an occupational perspective of health. Strategies that encourage reflection on the theoretical knowledge underpinning practice can sustain resilience. These include supervision, in-service meetings and informal socialisation. Further research is required into the role discipline-specific theories play in sustaining professional values and identity. The development of strategies to enhance occupational therapists' professional resilience may assist in the retention of occupational therapists in the mental health workforce.