Recent mounting acknowledgement of the Vona du Toit Model of Creative Ability (VdTMoCA) as a unique and beneficial O.T. model of practice has led to it becoming implemented across U.K. forensic mental health settings. The Vona du Toit Model of Creative Ability: Creative Participation Assessment (VdTMoCA:CPA) (Van der Reyden, unpublished) is the VdTMoCA's core assessment recording tool. Although its psychometric properties have been investigated, little additional research has been conducted on its use. With accuracy of assessments being vital for effective treatment planning, this study aimed to understand and explore experiences of O.T's utilising the VdTMoCA:CPA within medium and low secure health services within the U.K.

This qualitative descriptive study, using semi structured web-based call interviews, involved eight O.T's from various U.K. medium and low secure units. Thematic analysis was used to elicit themes from the data. Member checking and peer scrutiny were key strategies applied to ensure rigor and trustworthiness.

Six key themes emerged. Developing an understanding of the patients. Assessing the patient, importance of seeing the patient engaged in activity. Making sense of outcomes from the VdTMoCA:CPA. Communication, and Learning the VdTMoCA and the VdTMoCA:CPA within the current healthcare climate.

VdTMoCA:CPA is a versatile, appropriate and sensitive tool for use within forensic mental health settings. It is effective with patients of various diagnoses and presentations, leading to routine and regular use. Observing patients engagement in a broad range of familiar and unfamiliar activities is consider vital in ensuring VdTMoCA:CPA completion is accurate. This enables clear identification of patient's skills and deficits, and aids treatment needs and priorities to be ascertained. VdTMoCA'a unique handling principles are recognised as attracting O.T's to use this model. Forensic environments are complex and restrictive yet beneficial to VdTMoCA implementation due to their structure and routines, along with lengthy admissions affording O.T's time to conduct thorough assessments, interventions and evaluations. Patients institutionalisations, poor motivation and cooperation are challenges encountered by O.T's when incorporating unfamiliar tasks into practice. VdTMoCA:CPA use has been found to improve O.T's clinical reasoning and treatment planning, along with their communication with patients, the multidisciplinary team and between O.T's.

VdTMoCA, VdTMoCA:CPA and APOM are complimentary tools which together enable the O.T role to be clearly defined, delivered and recognised by others as effective. VdTMoCA:CPA language and  structure are however deemed to be in need of refinement to support ease of application to O.T practice within the currently pressurised healthcare climate. Further research is required ti support these findings including studies to establish psychometric properties of the VdTMoCA:CPA and APOM and effectiveness of the VdTMoCA.