Domestic Abuse Occupational Therapy: A Project in Response to COVID-19
The increased incidence of domestic abuse, following Coronavirus, jeopardizes service user’s physical and emotional wellbeing and affects daily social and cognitive function, affecting relationships, employment and daily living skills. Oliver et al., (2019) estimated the cost of domestic abuse to the economy as £34,015 per victim, per year.
The Occupational Therapy Department within the East area of BCUHB were successful in securing funding from the Elizabeth Casson Trust for a Band 5 Occupational Therapist, experienced in domestic abuse, to work within the local DASU. Our intention was to provide rehabilitation, through Occupational Therapy, to victims of domestic abuse, allowing them to re-engage in daily social, educational, occupational, behavioural and cognitive activities, helping to rebuild their identity and life.
This project aimed to provide an Occupational Therapy service, co-located within DASU to:
- Provide early intervention and mental health rehabilitation ’upstream’, embedding self-management strategies to support wellbeing into daily routines, for people recovering from the trauma of domestic abuse.
2. Use a person-centred approach to identify individually meaningful occupational goals for daily living following domestic abuse, overcoming barriers, and enabling development of occupational identity through meaningful activity and roles within home, family and community life.
3. Harness a network of health, social care and third sector providers to deliver appropriate prudent support to individuals seen.
This new service took additional time to establish due to the ongoing ‘lock down’ for COVID-19. Service users had to prioritise home schooling, and had difficulty attending 1:1 appointments. Not all service users were able to use virtual support, dependent on their ability to have privacy and access to digital technology. Many community activities, supports and 3rd sector services remained closed or with limited virtual programmes. Consequently, no group work was offered and networking with partners was done in small groups and remotely.
In addition, it became apparent through the project, that prudence would be improved through employing additional Occupational Therapy Assistant Practitioners, to support practice of skills developed within therapy.
Approximately 500 people from partner organisations contacted, influenced or educated about Domestic Abuse, the Domestic Abuse Safety Unit and service, and the role of the Domestic Abuse Occupational Therapist
Feedback from multidisciplinary/ agency colleagues within and without DASU has evidenced the positive impact of the Domestic Abuse Occupational Therapist on moral, engagement and multi-agency working (Click on link below)
Documents and processes for use within an Occupational Therapy pathway, from referral through to discharge have been created for this service, in readiness to adopt and spread the service across Wales.
30 people have been seen by the Occupational Therapist across the period of the project pilot. All of working age, and all female. (Click on link below)
8 onward referrals made to manage significant risk.
20* people engaged with Occupational Therapy intervention. *(1 person declined to complete scores)
15 people made significant* improvement with their ability to perform their chosen occupations as measured with the Canadian Occupational Performance Measure (COPM) (Carswell, A. et al. 2004). See Chart 1
*(A score of 2 or over is considered statistically significant as measured by the COPM).
Chart 1. Changes in ‘Performance’ scores for people following Occupational Therapy intervention on the COPM.
18 people made significant improvement with their satisfaction with their ability to perform chosen occupations as measured with the COPM (Carswell, A. et al. 2004). See Chart 2.
(A score of 2 or over is considered statistically significant as measured by the COPM).
Chart 2. Changes in ‘Satisfaction with performance’ scores for people following Occupational Therapy intervention on the COPM