“Working in the Charity Shop has really helped me and has been a good experience” – Service User, Dave.

My name is Louise Jeffries and I am the Lead Occupational Therapist (OT) for the Medium Secure Division, Northampton. I qualified in 1995 and since this time have worked in medium secure services, with 18 years dedicated to St. Andrew’s Healthcare.

I am using this opportunity to share a positive experience of an individual who accessed Workbridge light and heavy industry within William Wake House at St Andrew's and then progressed to work in the Charity Shop at Workbridge.

Vona du Toit Model of Creative Ability

Within my practice, I use the Vona du Toit Model of Creative Ability (VdTMoCA). Vona was an OT who worked in South Africa in the 1960’s and 70’s and was passionate about helping patients recover from mental illness, with a focus on vocational rehabilitation. Vona was an inspiration for the OT profession and inspires me greatly today. The VdTMoCA enables the OT to carefully grade and adapt activities to best suit an individual’s level of ability to make sure they develop skills at the right pace and activities are not too threatening or demanding. It aims to help individuals reach their maximum potential, at the right time and the right pace.

I want to introduce a patient of mine, Dave, who valued the work role and at some point in his future wanted to access voluntary or part time paid work. Dave lacked self-confidence and his self-esteem was low, which made him feel a little uncertain about his skills and abilities to fulfil his goal.

The vocational pathway at Workbridge was ideal for Dave to start his journey albeit with some anxiety and trepidation. It is not as easy as just attending his session in Workbridge light industry, it is far more complex than that and this is what I want to illustrate. I will do so through highlighting the skills required to perform vocational activities and how, as a therapist, I supported Dave to ensure he would succeed at a rate appropriate for him. However, the whole process is too detailed to share so I just want to give a flavour of the process and considerations.

Personal presentation is the initial stage in vocational rehabilitation which includes:

  • - regular attendance,
  • - punctuality,
  • - appearance,
  • - personal attitude,
  • - self-control
  • - and discipline.

These are all challenging skills to acquire if you’re mental health isn’t at its best. I think sometimes healthcare professionals take these skills for granted without considering the enormous effort and skill required to arrive on time and be dressed appropriately for sessions.

Social presentation is also an essential part of vocational rehabilitation including:

  • - interactions with a wider social and professional group,
  • - taking and giving instructions,
  • - delegation
  • - and coping with criticism and praise.

Work competency is highly demanding and includes the ability to:

  • - concentrate,
  • - follow instructions,
  • - recall information,
  • - organise workspace,
  • - accuracy,
  • - neatness,
  • - evaluating work and self,
  • - correcting errors,
  • - decision-making,
  • - perseverance and judgement.

These skills and abilities were introduced gradually over many months taking into consideration the demands of personal presentation, social interactions and task demands. At each stage of accomplishment, I checked with Dave the next step to take. We had contingency plans in place when he accessed new environments or conducted new tasks, to give me the ‘nod’ if he wanted to leave or the task was too challenging. We negotiated together, with each new opportunity, I clearly explained what to expect and what was expected of him to reduce anxieties and increase competency.

In addition, living in a medium secure environment Dave had to demonstrate his responsibility whilst accessing high-risk areas with heavy machinery and tools. These are added pressures that people do not always understand and appreciate how challenging it can be to ‘prove’ oneself worthy of accessing environments outside of medium secure care.

Dave and I experienced every new challenge together during many sessions over many months, carefully grading each step to ensure the end goal was achieved to work in the Workbridge Charity shop. However, this in itself brought new challenges requiring further negotiation, careful management of emotions to ensure developing confidence and continued skill acquisition.

As a therapist, it was an absolute pleasure to work alongside Dave during this journey. A journey, which is currently on hold due to Covid-19 restrictions, however a journey Dave will now continue in low secure services.

I commend Dave for the effort he has put in to this part of his recovery and how this provides the basis for him to grow as an individual and achieve his goals. Without the opportunities Workbridge provides, this would not have been possible.


Louise Jeffries
Lead Occupational Therapist
Medium secure Division, St Andrew's Healthcare