“Feeling good through what we do”: evaluating occupation based workshops on self-esteem for women who use mental health services in Ireland

Background: Mental health occupational therapists claim to be strongly person-centred and recovery-oriented in their service provision. The design, delivery and evaluation of occupational therapy practice needs to reflect these key features. This study was carried out by a senior occupational therapist in the Irish Mental Health Services. It evaluated an occupation-focused intervention developed for women who use the services. The programme comprised four two-hour sessions over two weeks. Method: The conceptual framework guiding this qualitative study comprised Critical Disability Theory, Person Environment Occupation model, and the CHIME recovery framework. This programme evaluation consisted of six pre and five post intervention interviews with workshop participants. Interviews were also completed with two occupational therapy facilitators. The creative pieces designed by participants in the workshops were used to assist the interview process. Results: Thematic analysis yielded three core concepts: 1) the importance of responsive service design and participatory facilitation; 2) the potential of occupational engagement in mental health practice; 3) the centrality of peer connections and shared experience in mental health recovery. Conclusion: Engaging in creative occupations has the capacity to transform the lives of women with mental health difficulties through reflecting, learning and sharing experiences. Programme design that is responsive to service-user need and participatory facilitation enhances outcomes for participants. Traditional notions of ‘expertise’ in mental health service provision are challenged. The power of shared experience and peer support need to be embedded in service delivery models. Recovery-oriented evaluation of services is essential. Further exploration of ‘shared vulnerability’ is required in relation to recovery-oriented practice. Application to Practice: This project demonstrates the value of using creative occupations in mental health practice. Occupational therapists are encouraged to use the value of shared experience and peer connections that are facilitated through this type of participation. The notion of ‘shared vulnerability’ requires further exploration in recovery-oriented practice.