The Hidden Depths of Occupational Therapy in Eating Disorders – LSBU Student Conference

Following on from our presentation at the College of Occupational Therapists Eastern Region ‘Dark Side of Occupational Therapy’ study day, Mary Cowan and I met today to prepare our presentation for the London South Bank University student conference. The theme of the conference is ‘The Power of Occupation: Maintaining Professional Identity in the Face of Change‘ and it will take place at the university on Friday 3rd February 2017. We are very excited about this presentation, as it is on a topic very close to our hearts – occupation focused practice with people with eating disorders. As always, we will be using  metaphor in our presentation. This time, it will be the metaphor of an ice diver.

Click here to download a PDF of the slides

Click here to read tweets from the day


Image from

‘Eating Disorders and Occupational Therapy: the Hidden Depths’

The Step Up to Recovery programme (South London and Maudsley NHS Foundation Trust) is an occupational therapy-led intensive day service for people with long-standing eating disorders. The programme seeks to understand individuals’ subjective experience of their eating disorder and its impact on their everyday life and work with individuals towards their goals.

The service is underpinned by the assumption that “occupation is as necessary to life as food and drink” (Dunton, cited in Mandel et al., 1999, pg. 12) and that it has the power to transform lives. This presentation will explore the impact that eating disorders can have on individuals’ occupational lives, for example creating new occupations, or infusing existing occupations with illness-derived meaning (Elliot, 2012). This will include a discussion of the concept of the dark side of occupation (Twinley, 2013).

Delegates will gain an understanding of some of the challenges in remaining occupation-focused in practice, and consider foundations that enable occupational therapists to stand firm amidst constant change (Molineux, 2011).

Learning Outcomes

* Understand the power of occupation in eating disorders and its impact on health and wellbeing

* Understand the value of exploring the dark side of occupation in eating disorders

* Understand the challenges to remaining occupation-focused in practice and identify strategies to ‘stand firm’


Elliot, M.L. (2012) ‘Figured World of Eating Disorders: Occupations of Illness’, Canadian Journal of Occupational Therapy, 79(1), pp. 15-22. DOI: 10.2182/cjot.2012.79.1.3

Godfrey, N. (unpublished) ‘The Occupational Impact of Anorexia Nervosa: Altered Occupational Meaning, Motivation and Engagement’, MSc Dissertation

Lock, L. and Pepin, G. (2011) ‘Eating Disorders’ in Brown, C. and Stoffel, V. (eds) Occupational Therapy in Mental Health: a Vision for Participation. Philadelphia: FA Davis Co. pp. 123-142

Mandel, D.R., Jackson, J.M., Zemke, R., Nelson, L., Clark, F.A. (1999) Lifestyle Redesign: Implementing the Well Elderly Program. AOTA Press: Maryland

Molineux, M. (2011) ‘Standing Firm on Shifting Sands’, New Zealand Journal of Occupational Therapy, 58(1), pp. 21-28

Cowan, M. and Sorlie, C. (2016) ‘Exploring the Dark Side of Occupation’ presentation at College of Occupational Therapists Eastern Region ‘Dark Side of Occupational Therapy’ study day, 30th September 2016. Slides available at this link

Turner, A. and Alsop, A. (2015) ‘Unique Core Skills: Exploring Occupational Therapists’ Hidden Assets‘, British Journal of Occupational Therapy, 78(12), pp. 739-749. DOI: 10.1177/0308022615601443

Twinley, R. (2013) ‘The Dark Side of Occupation: a Concept for Consideration’, Australian Occupational Therapy Journal, 60(4), pp. 301-303. DOI: 10.1111/1440-1630.12026


‘Occupation Matters in Eating Disorders’ – References for Plymouth University Presentation

Presentation: Sorlie C, Biddle L, Cowan M (2015) ‘Occupation Matters in Eating Disorders’, presentation on 18th March at Plymouth University


Elliot M (2012) ‘Figured World of Eating Disorders: Occupations of Illness‘, Canadian Journal of Occupational Therapy, 79(1), 15-22

Lock L, Pepin G (2010) Eating disorders. In: in Brown C, Stoffel VC, eds. Occupational therapy in mental health: a vision for participation. Philadelphia, PA: FA Davis Company. 123-142

Mandel DR, Jackson JM, Zemke R, Nelson L, Clark FA (1999) Lifestyle redesign: implementing the Well Elderly Programme. Bethesda, MD: AOTA Press

Molineux M (2011) ‘Standing firm on shifting sands‘, New Zealand Journal of Occupational Therapy, 58(1), 21-28

Park S (2014) ‘Outcome evaluation and documentation process in occupational therapy: occupation-based, client-centered and context-relevant’, Harrison Training.

Pierce D (2001) ‘Occupation by design: Dimensions, therapeutic power, and creative process‘, American Journal of Occupational Therapy, 55, 249–259

Pierce D (2003) Occupation by design: building therapeutic power. Philadelphia, PA: FA Davis Company

Sorlie C, Jones C, Stanley K, Rushton H and Gorry G (2013) Levelling the playing field: developing online communities of practice. Poster presentation at: College of Occupational Therapists Annual Conference. 18th-20th June, Glasgow. Available online at:

Twinley, R (2012) ‘The dark side of occupation: a concept for consideration’, Australian Occupational Therapy Journal, 60, 301-303

Related Blog Posts

Eating Disorders and Occupational Therapy #OTalk

Becoming “a Real OT” – the Rollercoaster Ride blog post

Call for #EDAW15 Volunteers: Eating Disorders and Occupational Therapy Q&A’s

Last year, @pd2ot and I hosted an #OTalk tweetchat about occupational therapy and eating disorders for Eating Disorders Awareness Week (#EDAW14). We had 63 participants, and tweets from the chat made 659,387 impressions.

Eating Disorders Awareness Week is a chance to raise awareness and understanding of eating disorders, challenge stereotypes and stigmas and raise funds for Beat.

This year, Eating Disorders Awareness Week (#EDAW15) will run from Monday 23rd February – Sunday 1st March 2015. To coincide with this, we will be hosting another #OTalk on Tuesday 24th February.

Acknowledging the fast pace of tweetchats and challenge of fitting complex answers into 140 characters, we’re looking for volunteers with eating disorders experience (clinical or personal) to:

  1. Answer questions from last year’s chat, and any leading up to this year’s chat, to be collated on this Storify (submissions can be anomymous), and/or
  2. Be available from 8-9pm GMT on Tuesday 24th February to respond to questions on the #OTalk hashtag

If you’re interested, please leave me a comment below.

If anyone has new questions relating to occupational therapy and eating disorders, please add them in the comments below too.

Here are last year’s questions (you can also find them on the Storify, along with their answers so far):

@GeekyOT how occupation can help, where does ED sit in terms of affective or psychosis disorders (for want of a better word) #OTalk — Rachel (@OT_rach) February 18, 2014

.@GeekyOT I’d like to understand what an occupational approach to working with people with an ED looks like in practice #otalk 1/2 — Kirsty Elf Stanley (@kirstyes) February 18, 2014

It has made me think though, has working in ED changed your thoughts/feelings/perceptions of your own body in a +ve/-ve way? #OTalk — Lucie Greenham (@JeSuisLucie) February 18, 2014

What do you know about eating disorders and occupational therapy?

The week of 24th February – 2nd March 2014 is Eating Disorders Awareness Week. It’s a great time to increase your understanding, especially if your answer to my question was, “not a lot”. Check out the beat (beating eating disorders charity) website for information about eating disorders. For me, the best way to learn about disorders are through the stories of people who have experienced them. Read recovery stories, for example Jonathan or Amy‘s, and look out for how eating disorders affect roles and occupational performance, and the part occupation can play in recovery. The website has a range of information resources including a guide for athletes and information about eating disorders in the workplace.

As a precursor to Eating Disorders Awareness Week, we will be hosting an #OTalk twitter chat about occupational therapy and eating disorders on 18 February 2014 at 8pm GMT (click the link for local time). You don’t need to be an occupational therapist to join in, and we welcome participation from people who have experience of eating disorders in their own lives or the lives of people they care about.  The transcript of the #OTalk chat about eating disorders and occupational therapy can be found at this link.

Occupational Therapy-related resources you may wish to check out:

I hope to be able to get back online again before the chat to update this list. If you have any other occupational therapy/eating disorders resources to recommend, please leave a comment!

“Dear Occupational Therapists” – Responses to #OTalk “When Occupational Therapy Goes Wrong”

Revisiting this blog post as I start my second week as an occupational therapist in an eating disorders service.


Last week, @pd2ot hosted an #OTalk entitled “When Occupational Therapy Goes Wrong” (the transcript of the chat can be found at this link). Following this chat, we invited people to continue the conversation, unrestricted by Twitter’s 140 character limit:

I was pleased to receive two thought-provoking responses: one from Sarah (@carerseyes), who blogs about her experiences  of caring for her partner with borderline personality disorder, and the other from Linda (@lapsangsusie), who has experienced a range of occupational therapy input as a service user.  I’d like to thank both for taking the time and effort to write about their experiences, and welcome further responses from people who have come into contact with occupational therapy services.

Sarah’s Letter

The full text of Sarah’s…

View original post 2,023 more words