Dina Vara, a 26-year-old occupational therapist from North West London, started 2016 a smoker, as were many of her clients. She knew that telling them to simply ‘give up’ was easier said than done, and somewhat hypocritical. She decided to do something about that. October 2016 saw her take up the ‘Stoptober challenge’, vlogging all the while. Here, she talks about her journey to becoming a non-smoker to benefit her clients and herself.

“I am often called a people person because I like to talk and enjoy helping others. I studied Health and Social Care at college and had a placement in a residential care home where I saw first-hand how boring it was for the patients; there was no engagement in any activities or meaningful occupation so I started to do activities and engage them more. Without knowing it I was practicing OT. Since that placement I knew Occupational Therapy was the job for me.      

In my current role I work in a mental health rehabilitation service and I have been working in this setting for a year now. I have always been drawn to mental health work due to the creative and challenging nature of the work. My patients’ diagnosis include personality disorders and psychotic conditions.           

My experience to date is that OT is still being neglected due to a fundamental lack of understanding of what we do and how we do it. I promote OT almost on a daily basis and I use my creativity to build new and interesting interventions for my patients to engage in. 

Our trust becoming smoking free was an idea I initially struggled with. I even questioned if it was allowed to happen and you don’t need me to tell you how my patients’ took it when it was relayed back to them. Leading up to the date of my service becoming smoke free we held groups and smoke free sessions to prepare them for the change and make the transition as comfortable as possible. We used the month of October, Stoptober, to really drive this.

I remember I was in the smoke free group and it had just finished, I reached over for my coffee, cigarettes and lighter, and that’s when I started to think about this the smoke free movement slightly differently. We often try to understand and have a sense of empathy towards our patients but this only takes us so far. I realised that as a smoker I can go the extra mile because I have the ‘need’ to smoke too. I often get patients saying “what do you know? You go home at the end of the day and I’m stuck in this place”, or that it’s “us against them”, so this was my way to demonstrate differently and challenge these statements.       

When I said that I was going to participate in the Stoptober challenge, most of my patient’s laughed at me. As the weeks went on and they could tell that I was taking the challenge seriously, raising money, vlogging my journey for the portal and taking tasks (bake a cake) from the patients for the month, their interest sparked. My patients began to ask me questions, “Why I am doing this?” My reply was simple – to see what it is like to stop something you don’t want to.

I think that was a key turning point in the journey as my patients started to take note, monitor my progress, asked me how I was feeling and how I coped over the weekend. Some even offered to buy me chocolate and some were so shocked that I went cold-turkey with no NRT’s that they started talking about the range of products available. I took on my patient’s own coping methods. For example, one patient said that when she feeling down she wore her onesie and has hot chocolate, so I did the same. Patients were also able to see that it was not easy and even I struggled – I was close at one point to failing but I managed to complete it. I received a lot of support from my team and they joined me in making a vlog too. Everyone engaging in the challenge positively impacted the month.          

Stoptober affected me more socially than I had anticipated. I had to change my morning routine as this was the hardest time for me. I also had to assess my social events and friends as to stay away from the ones that smoke so I wasn’t tempted. At work, I had cravings to smoke which meant I had to go and walk it off. I also noted that I needed something in my hands to play with, like a pen. This soon changed into apples and carrots towards the end of Stoptober as my appetite increased.          

My going smoke-free and undergoing this change led to the patients actually listening and instead of the smoke free change being ‘you against us’ it became ‘we’. This resulted in more open discussions with staff and services. Additionally, the idea that occupational therapists are creative was clearly demonstrated during all my tasks. It highlighted to me that we should consider that to our patients we ourselves are almost role models. ‘If you can do you it, I can do it too’ – this was what I began to see towards the end of my challenge. It also challenged the theory of interventions. Interventions do not need to be in 1:1 or group settings for it to support the overall recovery journey. Often disconnected patients commonly feel that they are unable to relate to others, leading them to feel alone or have a sense of hopelessness. Although we do need to maintain our professionalism, we can still highlight that just like in the Stoptober challenge, everyone has struggles but they can be overcome with the right support.

Since Stoptober I have tried to carry on the challenge and I have cut down significantly. I hope to stop in the near future. I am proud of myself for completing the challenge. I feel it has informed my practice and made me connect with my patients in a way that I don’t think I would have been possible without doing this challenge. I can now say to my patients that we really are working together and truly trying to understand the effect on their life psychologically, physically and socially.      

I would 100% do another challenge like this again, in fact I am already looking into my next project!

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