1. The recovery Constellation
A Patient Workshop

2. Foundation of Nursing Patient First Project
Dec Present
Project Leads:
Rhea Peart (Occupational Therapist) & Tom Stamp (Community Psychiatric Nurse)
Community Therapy Services (CTS)
Oxford Health Foundation Trust
Windrush House
Windrush Industrial Park
Burford Road
Witney
Oxon
OX29 7DX

3. About CTS……
CTS is a rehabilitation service dedicated to enabling and maximising patient’s independence in the community. CTS pride themselves in being able provide holistic support, inclusive of physical and mental health issues, mobility and accessibility and social situation.

4. The Recovery Constellation
Oxford English Dictionary, Definition:
A Constellation is a group of associated people, or things; no two patients ever show the same constellation of symptoms.
We wanted to come up with a unique name that capture the premise of our project

5. Rehabilitation Recovery Self discovery Empowerment Inclusion
Our Project Key Words:
Rehabilitation
Recovery
Self discovery
Empowerment
Inclusion

6. What we observe in practice…
Feelings of isolation and loneliness
Not feeling part of local/wider community
Difficulty navigating Health and Social Care when their needs change.
A lack of sense of belonging to something or sense of purposefulness
A lack of meaningful activity / strategies to self-manage anxiety symptoms
We see that this can lead to anxiety and depression. Contributing factors can include changes to physical health, frailty, changes to mobility, a lack of community services and resources.

7. From suffering to meaning. Strategies to Tackle loneliness:
Reduce symptoms of isolation
• Promote self-discovery and self-management of symptoms
• Provide guidance and education about health and wellbeing
• Supporting the GP surgery to reduce recurrence of patients visiting their GP with these issues

8. Aims & OBJECTIVES
To design and implement a patient led 6 week mental wellbeing and health promotion group for patients over 65 years old within West Oxfordshire.
identify current gaps in mental health and wellbeing
liaise with stakeholders
identify potential patients suitable for the group pilot
Interview patients to gather patient stories
raise the profile of mental health
create an environment which empowers patients
promote and provide early intervention support
To promote partnership working

9. Our inspiration….
Viktor Emil Frankl (1905 –1997)
Talk about Frankl

10. Our inspiration: Logotherapy in a nutshell…
Frankl’s concept is based on the premise that the primary motivational force of an individual is to find a meaning in life. The following list of tenets represents basic principles of logotherapy:
Life has meaning under all circumstances, even the most miserable ones.
Our main motivation for living is our will to find meaning in life.
We have freedom to find meaning in what we do, and what we experience, or at least in the stance we take when faced with a situation of unchangeable suffering

11. Psyche, Somatic, Noetic - ‘tri-dimensional ontology’
The body: Sleep, nutrition, exercise etc
The mind: our intellect and emotion
Spiritual dimension: Meaning, for example; nature culture, art
The integration of soma psyche and noös that creates wholeness

12. raising the profile of mental health within Community Therapy Service
Through the Fon’s project we have been able to provide a 2 day workshop held by Dr Stephen Costello from the Institute of Logotherapy Dublin
We intend to use the knowledge we gained to apply some of the principles of Logotherapy for our patient workshop group.
On undertaking this training we have been able to apply the values of Logotherapy in one to one work with our patients

13. Outcomes
To identify gaps in Mental Health and Wellbeing groups within West Oxfordshire
Through research, the project leads identified that there are limited resources available to older adults in west ox, particularly group settings that support anxiety management whilst addressing themes of social isolation. Voluntary and charitable organsiations where well established but are not clinically led and did not liaise with other organisations

14. Outcomes to date
To create an environment which empowers patients to be able to share personal experiences and identify self-management strategies and techniques to promote their mental and physical health
Through the two day Logotherapy workshop, attendees engaged within a range of exercises focussing on the meaning of suffering and anxiety management.. The techniques and activities used by the facilitator are transferable for use within the project leads patient group.
Patients attending the group will be provided with a workbook which will be referred to during and between sessions. The workbook will include simple exercises such as looking at the nature of thought, emotion and patterns of anxiety. As part of this, the patient will explore realistic and meaningful goals which they can work towards during and after the group has finished.
Patient stories will be carried out with patients on a one to one basis within their own home prior to the workshop. It is hoped that this helps to build rapport and to reduce any anxiety that the patient may have in relation to attending a group setting.

15. Outcomes
Liaising with stakeholders in order to help steer the direction of the group
stakeholder meetings have been invaluable in how the project has evolved.
moving away from a structured and fixed content to a more organic approach whereby there would be more freedom for the patients to direct the group.
Challenges – resignation of project lead
Whilst this has been a challenge to the project, there has been an expressed interest in the project from other mental health practitioner
Decision to create a loosely structured content for the initial pilot workshop. this will inspire confidence of those facilitating and those attending the group and that patients are empowered to shape the project over time.
Approval from GP’s: providing early intervention support / reducing the need for secondary care

16. Outcomes cont…
At an early stage of the project, leads identified that being able to represent the success of the project to different groups of people would be important. This would involve measuring both qualitative and quantative data. One of the leads started developing knowledge and skills surrounding economic assessment through webinars led by FON’s. Due to the complexities and demands of the clinical role, undertaking this training became a significant challenge and the decision was taken to focus on qualitiative data, eg, to focus on patient experience.
Project leads are currently exploring self rating scales such as The Recovery Star as a method of collecting qualitative data. A self rating scale could be used prior, during and following the groups.

17. Outcomes cont…
raising the profile of mental health within Community Therapy Service
Focus group with CTS clinicians to establish their understanding of the role of mental health practitioners. Project leads were reassured to receive accurate understanding of the role. Discussion was generated surrounding provision of holistic assessment and intervention. I
A poster presentation was carried out for allied health professionals meeting where innovative work was on display for the attendance of Suzanne Rastrick, Chief Allied Health Professions Officer for England.
project and role promotion has been carried out at a local GP surgery and with CMHT.
Outreach work has been carried out with voluntary/charitable sector to provide information and stimulate interest in CTS and the project.
The project has allowed for regular agenda items within monthly team meetings, clinical leads meetings and quarterly mental health practitioner meetings.

18. The next steps: FoNS celebration event Continue to gather referrals
Carry out patient stories and establish if suitable for the group (offer 1:1 if unsuitable for group)
Selected patients to complete self-rating scale prior to group
Invite mental health practitioner from another locality to become involved in project
Complete patient workbooks – these will evolve
Facilitate groups
Partnership working with charitable organisations whilst at group venue
Patients to complete self rating scale following group
Project leads to carry out follow-up visit to patients to gather feedback
Offer follow-up GP stakeholder meeting to present findings following group
Present findings of project to wider integrated locality team to consider this being implemented county wide
Attend and present project at innovation and recognition events