We spoke with Isobel Johnson, the Occupational Therapist at the Gloucestershire FDAC, about her role and the promise of occupational therapy within the Family Drug and Alcohol Courts (FDAC).
What is an occupational therapist, and what does that role look like in the context of FDAC?
Occupational therapists specialise in the link between activity and health. An ‘occupation’ just means any activity that is subjectively meaningful to the person performing it, so our focus is on helping someone perform an activity that is meaningful to them. If a person is experiencing difficulty doing what they want or need in their day-to-day lives, whether that activity is practical or for leisure, an occupational therapist can help identify barriers and support them to do those activities. In other words, occupational therapy is about finding out what someone really wants to do, what makes them feel good, and what they are struggling with, and then enabling them to do that. Occupation can reinvigorate people in a totally different way, and is rich with therapeutic possibilities.
In the context of FDAC, occupational therapy is an important therapeutic tool. Humans are occupational beings, and discovering new occupations or re-engaging in previously enjoyed occupations can be transformative. This is particularly important for individuals addressing their addiction and experiencing a lack of structure and routine. Especially if substance use was previously central to an individual’s life, they might feel an emptiness when they stop using substances. This emptiness can be both practical and emotional, and they may be looking for activities to provide an alternative focus from substance use cravings and to fill their days meaningfully. Occupation can be thought of as both the ‘means’ and ‘ends’ of therapeutic intervention; the activity might be purely an end in itself as an activity the parent finds enjoyable (e.g. going for a walk outside), or might be a means to achieving something else the parent is working towards (e.g. learning to cook for one’s family).
Abstinence from drugs and alcohol can also be thought of as an occupational goal. From an occupational point of view, you’re thinking about what purpose substance use serves for that person. Is it part of their daily routine? Is it part of their need for social connection? For example, parents might find that they are really lonely after giving up alcohol because it also means giving up on a circle of friends that go to the pub together. As an occupational therapist, you’re thinking about why someone does something, what need or validation that activity serves, and how that person can meet that need (such as their need for social connection) in another way.
Tell me about your professional background. What inspired you to join FDAC?
I have always been interested in non-traditional roles for occupational therapists. I have a psychology degree and previously worked with young women in residential treatment for eating disorders. My manager there was an occupational therapist, which inspired me to pursue a Masters in occupational therapy. After that, I worked as an occupational therapist in a psychiatric intensive care unit in Gloucester and then on a CAMHS team specialising in youth justice. While I was on maternity leave, I saw the advert to join the Gloucestershire FDAC. The advert was for the general mental health practitioner role and said they were especially interested in someone with an occupational therapy background. The occupational therapy role is really complementary to the ethos of FDAC, so it was a no-brainer for me. I’ve been working part-time in the Gloucestershire FDAC team since May 2021.
What is your role in the FDAC team?
I have general Mental Health Practitioner responsibilities, and the work I do as part of the general team is informed by my occupational therapy background. I also do occupational therapy work specifically. Currently, I’m working with four FDAC families in total. My work is centred on exploring parents’ interests and potential hobbies or activities that they might like to become involved with. For example, one FDAC parent has a practical hobby that could potentially become a professional pursuit. That parent also has a history of confrontational behaviour, and historically has had difficulty forming social relationships which do not then escalate into conflict. I’ve been supporting the parent to engage in peer-based learning projects, which serve a dual purpose of consolidating their skills whilst providing a safe, social environment in which to spend time with others.
What are the challenges of being an occupational therapist in FDAC?
Articulating what it is! The work of occupational therapists is not easy to explain as the practice is so diverse and interventions can be literally anything; it can be hard for others to grasp what it actually is. Also, the work we do might seem like “common sense,” but involves a lot of “behind the scenes” clinical reasoning. A carefully designed intervention can appear to be just a nice activity, but is actually designed to meet that particular person’s needs.
What advice about occupational therapy would you give to other FDAC sites?
I would recommend that you consider recruiting an occupational therapist to join the team! If that’s not possible, consider what meaningful activity your parents have in their lives/day-to-day routine – what are they interested in (or used to be interested in)? What are they good at? What are their values? What are they passionate about? What do they do that meets the human need for physical activity, creativity, or self-care? Sometimes asking these questions is an intervention in itself, because they might not be questions the parent has thought about before. I would also encourage practitioners to have conversations with parents to explore their capacity for occupational engagement, and what might get in the way. It may pay dividends to tap into what sparks their motivation, as this can be instrumental in recovery.