Highlight: September 2020 -"bOunceT" Occupational Therapy (OT) model of rebound therapy.
Callum MacKinnon (Founder & Occupational Therapy Lead) at bOunceT Innovative Occupational Therapy CIC reflects on his journey from learning about rebound therapy, to setting up a rebound therapy service, then developing this into a specialist occupational therapy service.
Definition
Rebound therapy is not a registered trademark
(CSP, 2016)
"As there is no regulatory body for this intervention, there is no one-single organisation who can deliver training in rebound therapy and there is no membership or license to accredit you to do this"
Advertising Standards Authority, 2016
In the UK ‘rebound therapy’ is a descriptive term which means the therapeutic use of a trampoline (Intellectual Property Office, 2013)… think of this as an intervention that a wide range of people, from various professions, are trained to deliver in their workplace or in the community with the people they support.
It does not define a business and there is no regulatory body for rebound therapy in the UK.
As there is no regulatory body for this intervention, there is no one-single organisation who can deliver training in rebound therapy and there is no membership or license to accredit you to do this (Advertising Standards Authority, 2016).
There are ‘best practice’ guidelines published by various organisations who deliver different models of rebound therapy, such as the Chartered Society of Physiotherapy (CSP) - but naturally you need to take training from a qualified Physiotherapist to follow these guidelines.
See their guidance here for more information about how they define rebound therapy: https://www.csp.org.uk/system/files/safe_practice_in_rebound_therapy_01_10_16_0.pdf
As registered Occupational Therapist's (OT's), our qualified staff are regulated to by the Health Care Professions Council (HCPC) and are professional members of the Royal College of Occupational Therapists (RCOT). Our qualified staff may delegate tasks to assistants with appropriate supervision.
You can check me and my staff out on their register here, and find out more about these governing & professional bodies here:HCPC: https://www.hcpc-uk.org/check-the-register/
RCOT: https://www.rcot.co.uk/about-occupational-therapy/what-is-occupational- therapy
Having had positive conversations with both RCOT & CSP in the past few years, it is accepted that my team and I can refer to - and be influenced by - the CSP guidelines for rebound therapy, in addition to RCOT standards of practice within our clinical reasoning because of our qualifications and registration with the HCPC. However, over time I would like to take this further and work with these professional bodies to publish joint Occupational Therapy & Physiotherapy guidelines/ standards of practice for registered Allied Health Professionals (AHP’s) delivering rebound therapy as an intervention in their clinical practice. This is a real gap that I have identified doing this work.
Back to the start...
I set up the multi award-winning service ‘Forth Valley Rebound Therapy Service CIC’ - now known as ‘bOunceT Innovative Occupational Therapy CIC’ at just 23 years old, from my initial interest and training in rebound therapy. This was from training delivered by Rebound Therapy Ltd who were running a course locally to me at the time. I had no idea what rebound therapy was, or who used it and for what purpose. After attending a two-day rebound therapy workshop with this company that focused on learning the Eddy Anderson Model of rebound therapy, I was full of motivation and ideas about how I could ‘do rebound therapy’ and similar activities within my local community. Being an occupational therapy student at university, I felt anything to do with inclusive activities, movement, play, etc was something I wanted to be a part of! The rebound therapy training course gave me some great ideas about activities, and some creative pointers for what to do with different individuals who may benefit from using the therapeutic use of a trampoline.
During the training course with Rebound Therapy Ltd, they mentioned they were going to 'certify' us as 'rebound therapy approved' trainers, but once I had finished the course there was no type of license/training model moving forward that meant we would be regulated by them. In addition, many services across the UK who had taken this - or another - rebound therapy course seemed to 'do their own thing' in practice (to a certain degree within the boundaries of their abilities) as typical rebound therapy training courses do not teach you to follow specific/ standardised activities, like a medical model. They teach you to be creative in the way you engage individuals with disabilities in inclusive physical activity, centred on and around a trampoline. Furthermore, the training I received was not intended to be for registered healthcare professionals, so naturally a lot of the content we learnt about focused on the need for completing risk assessments with a Physio and/or OT to assess if the suggested activities were actually suitable to do with each person we would be working with (e.g. there will be a significant difference between what you would do with an individual who has autism, compared to a wheelchair user who had spinal surgery).
So, the opportunities for me to use both my knowledge from this training course, and my learning from university, was endless! I soon had the entrepreneurial skills - and occupational therapy qualification - to do good within my local community. I already had some fun ideas about delivering inclusive & meaningful play opportunities to children and adults with disabilities locally (using core occupational therapy skills like activity analysis and bringing in theory about the value of 'occupation') - so to include a trampoline into this meant I would have very engaged and excited service users! With some blind faith, and a whole lot of enthusiasm, I started delivering 'rebound therapy'* sessions locally part-time whilst looking for graduate OT jobs (in the NHS and Council's, etc).
Little did I realise this would end up to be my full time job, and I would employ various occupational therapy, and assistant level, staff to deliver rebound therapy and other interventions!
Clarification - but still confused?...
*To clarify what I mean by 'rebound therapy' here, I mean using a trampoline for therapeutic use - not one specific programme. We wanted to have the trampoline as a key piece of equipment within our therapy room as we have found it is the one thing everyone is automatically drawn to when they visit us.
What better way is there to get (any) child or adult active than having a room full of inclusive play equipment, a bubble tube, music - and a big Olympic sized trampoline!
Taking a typical OT 'top down' approach within our sessions, whilst offering an occupation focused service that integrated assessments and other paperwork from the 'world of occupational therapy', I found that I never seemed to use the knowledge/ guidance taught to me previously. I started to find the outcomes from the Eddy Anderson model of rebound therapy was not going to work in my service - equally nor were half of the assessments/outcomes measures from the world of occupational therapy that were drilled into me for 4 years at university.
At this stage, I felt a little lost and confused......it probably did not help that I was a new graduate with no immediate team to support me - or fellow occupational therapy staff to bounce ideas off, like I would on placement or at University.
However, turning this anxiety into an action, I worked hard to build a small management team around me (Board of Directors & Professional Advisor to Board of Directors) whilst seeking clinical supervision from Elizabeth at Occupational Therapy Scotland (OT Scotland). In addition, I sought professional advice from Anne at the Royal College of Occupational Therapists (RCOT) Professional Practice Enquiries service. This really boosted my confidence and got me 'back onto track' to continue pursuing my dreams of developing this rebound therapy service as a registered Occupational Therapist!
Building a brand
Fast forward to today....
Over the last 3 years since graduating from university, my team and I have developed our “programme” – or “version of rebound therapy” if you like. I used to call this something like the 'Callum MacKinnon model of rebound therapy' or 'Callum MacKinnon model of trampoline therapy' - but I knew that I wanted/needed something that could be standardised out easier in the future. This was not only to reflect our work as occupational therapists better, and to aid our clinical reasoning within practice, but it was to differentiate ourselves away from other services who use rebound therapy.
As the Advertising Standards Authority state, there is not one single organisation who can accredit people to use rebound therapy in their practice in the UK. Therefore, naturally, we want to let these other organisations run their own business' in the best way for them – whilst we run our business in a way that is best for us; as specialist occupational therapists.
For as long as I have been doing this, I have felt it can be a lonely place to work as we have 'no competition' 'no support' / 'no comparisons' / 'no evidence' since we are the 'only ones doing this'. Well, this may be true within the world of OT when we use the term 'rebound therapy' and no one knows what we mean 'clinically' by this - even students can feel a little put-off as this is 'not what other OT's do' so they have worried about being placed in a non-traditional service. However, reflecting on what 'traditional' Peads & Learning Disability services do offer - or have offered previously with more funding within their service / across different parts of the UK (and world!) - then we basically do what they do within 'OT Gym' or 'Motor Gym' sessions.
Furthermore, this same 'loneliness' applies to the business world as this type of work is not done by a lot of companies - so of course it is not a competitive market and there are a lack of people to connect with and/or compare yourself to. As such, there has been confusion within this field regarding the definition and scope of rebound therapy - hence the need for blogs like this.
The importance of change and celebrating 'different'
It is important to note that despite having the relevant qualifications, HCPC registration and previous experience working in the field of learning disabilities, the harshest critiques I have received about setting up bOunceT are from occupational therapist’s themselves; often as they do not understand ‘what we do’. Some have told me that because it is ‘different’ to set up in independent practice ‘so young’ and ‘not have worked in the NHS’ that what I am doing is alien. As a result, some (local) services have deterred families away from accessing bOunceT - even when they do not know what we do - even my name, or the companies real name - just because we are not operating within the walls of NHS. I am still unsure if this is because there would be payment attached onto attending bOunceT, and there is a universal view across healthcare that services should be 'free'. If this is the case, I would stress to these professionals they should research services like mine - or even better, liaise with the services directly - to find out what we actually offer, and how they are delivered.
For those Team Lead's, Service Managers & individuals who have, they have learned as we are a non-profit organisation we deliver fully-funded projects to the majority of our customers, and keep costs as low as possible for families out with these projects (some Occupational Therapy sessions costing only £10 for example).
This is mainly thanks to funding granted from generous organisations like The Robertson Trust, The National Lottery Community Fund Scotland, Corra Foundation, Scottish Government, etc.
This conflict between professionals - and from business to business - needs to change. I am proud to be proof that change within the business world, and OT world, can happen - but there is still a long way to go.
Beyond bOunceT right now...
Finally, planning for the future and our existence as a sustainable business in the future, I fully understand bOunceT needs to invest into researching the effectiveness of what we do & showcase this to both the ‘business world’ and ‘occupational therapy world’. This will allow us to demonstrate the value of using rebound therapy within occupational therapy practice (both from academic and social impact perspectives).
Already, we are in discussions with various individuals from different universities who may be able to work with us at bOunceT to take this forward. In addition, I am enrolled onto the MSc (Post-Registration) Occupational Therapy degree at Queen Margaret University (QMU) - here I hope to complete my Master's research study on something to do with bOunceT.
Thank you all for your time and attention. I hope it has been informative.
I look forward to posting more blogs about our journey as a growing social enterprise and ‘diverse’ third sector occupational therapy service!
Callum MacKinnon
Member of Royal College of Occupational Therapist (MRCOT): BT0252603 Health and Care Professions Council (HCPC) Registered: OT75956
bOunceT Innovative Occupational Therapy is a registered Scottish Company Limited by Guarantee with Community Interest Company status: SC563848.
Additional Information & Links
To clarify some of the points made above, and to further defend our position as an organisation please see below some links to relevant website pages that you are freely available to Google.
ASA upholds CSP complaint over misleading ‘rebound therapy’ ad
ASA Ruling on Rebound Therapy Ltd
Opinion piece - September 2019
‘Defining rebound therapy - and where it fits within Occupational Therapy’
