Welcome to Occupied 3.0. Some of you may have noticed a lack of episodes recently, and for that unannounced break I apologised. But I’m back and I’m inspired to continue bringing you more regular eps and interviews again! 

A hot topic every April during OT month. Why does no-one know what we do? I want to look deeper into how this became a problem and what can we do to fix it.

Occupational Therapy Practice Framework: Domain and Process (3rd Edition)”. American Journal of Occupational Therapy. 68 (Suppl. 1): S1–S48. March–April 2014. doi:10.5014/ajot.2014.682006

Look after yourself, look after others, and always keep Occupied

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Transcript

0:02  

So many moons ago, I did an episode on occupied about how to talk about occupational therapy. And it remains, to this day, one of the most popular episodes that are out there. There’s been a lot of talk recently, around a similar topic. And it tends to be something that comes up pretty much every April every 18 months, surprisingly, in the States. So I thought I’d revisit this topic and try and delve into a little bit more detail so that we have a better understanding of why it’s important that we do gain a good professional identity, we do gain confidence in what we do, and we are speaking about the profession in a more consistent manner. Why? Or how do we know this is an issue, I only have to look into a number of ot Facebook groups or Instagram accounts, or particularly my favorite meme pages to see that the complaint of no one knows what we do is still prevalent within the profession. There’s been some talk recently about blaming the individual or blaming the profession. And I do want to assure you, I’m not here to blame anyone. But I am here to hopefully get you to see that although it’s not an individual’s fault, or it’s not the professions fault, it is also our responsibility to fix it because no one else is going to fix it for us. So I think it’s important that we have a look back at sort of how we got here. And to do that, because we’re such a young profession, we have to go right back to the very start. So it’s important to know if you don’t already that ot was birthed from a group of people from a number of different professions, there were psychologists, or psychiatrists, nurses, and a lot of other professions, I can’t read all of them off the top of my head, but other professions are weren’t even health related, who all saw this sort of gap in the medical model at the time, there were people slipping through the cracks, and there was things not being done because it didn’t fit within that medical model.

2:47  

The overall sort of consensus was that occupational therapy could be a profession that looked more at the complex interrelation of social, economic, and biological reasons for a person’s dysfunction, rather than just the medical reason. So it was looking outside the medical model to improve health and well being, even if they weren’t exactly the terms used back in the early 1900s. There was early on, and I believe he was one of the founding people of IoT, I can’t remember his name off the top of my head. But they came up with four sort of core points for what would become occupational therapy. And those points were that occupation has a positive effect on health and well being. That occupation creates structure and organizers. I’m that occupation brings meaning to life, culturally, and personally. occupations or individual people value different occupations. The weird thing about that thing, the thing that I actually really like about that, as even though that was written many moons ago, and the profession has through a number of different phases, the phase that we’re coming back to for the last 1520 years. This fits perfectly. I can’t think of a really good sort of occupation based practice or that that doesn’t fit within these four points. But since that was written before or like after that was written, we went through a phase around World War Two, were based on the huge number of injured vets and some criticism From the medical model professions, the medical model health system, OTS adopted more of a reductionist philosophy, we kind of merged, we assimilated more with that medical model. And I think it was more to do with just needing more hands to do what they were doing. OSI at that point in time, very small, a very small percentage. And we’re thinking sort of David and Goliath type sort of odds. But we were essentially it was mob mentality, in a way we, the dominant culture was the medical model culture. And after looking for validation and looking to, I guess, kind of cement our identity, even though we’re still kind of forming our own identity, and didn’t really know what that was, we still are to a degree, we tended to, or the profession itself tended to move into that reductionist philosophy, where a lot of practical skills were adopted, and grown, especially around the areas of physical rehab, and assistive technology, etc. But we tended to drift away from our core philosophy, which was the use of occupation as a therapy. This way, there’s a number in in in different clinical settings, there is still a number of different phases, but the main sort of ones we’re we’re that were started off being very occupation based, we moved into a more reductionist role, a more reductionist framework around the sort of late 40s 50s. And it really wasn’t any really wasn’t until occupational science was coined, and was was formally formed in 1989, and then rolled out through the early 90s, that the profession had a good hard look at itself and started to move back towards its roots. Now, I can’t imagine how big a shift that would have been, and the the time and effort that it would have taken to shift our whole profession, even that, yes, in the 90s, to get the profession would have been much smaller population wise than it was than it is right now.

7:48  

But you’re really trying to steer a huge ship with what essentially was a handful of therapists that we’re driving that movement. So whether you are in care, occupational science or not our ridiculously impressive feat. Either way, the underlying philosophy of at evolve from being more of a diversion from illness, which it kind of had evolved into during that reductionist period, it became more of a diversion or thing as opposed to looking at enablement through the use of occupation. So that’s how we kind of got here, we’re still in that transition phase, we’ve still got therapists that qualified and worked. We’ve still got, like during that reductionists period, yes, there. They may be in the academic roles. They may be retired, they’re still the one thing I’ve learned about OTS is even in retirement, they still seem to they love the professional enough that they still are usually quite involved, which I think is says amazing things about the profession itself, which is, which is wicked. But there’s still that influence. A lot of the theories and the textbooks that we don’t even think twice about using were develops during that reductionist time period. And yes, some of the newer ones may have been developed through the sort of transition period of the 90s. But there’s still that flavor. I’ve talked a lot on occupied about cultural transitions. And I’m thinking and again, completely unrelated to the topic, but the idea of ongoing cultural influence in my episode, interpret and God around the colonization of Australian healthcare system. And yes, in that example, yes, like, I’m not trying to colonize the work that I’m doing. But I’m working in a system that has been influenced for many, many years, quite often without me really putting any thought into the fact that hey, wait a minute, maybe this isn’t working for everyone involved, that the the profession is the same, we are enculturated into the workplace that we go into. And if that workplace is heavily influenced by a well now very old reductionist paradigm, then you’re going to be as a new grad enculturated into that. One of the reasons that I believe that we need to talk about ot more or better is, in order to change this. Now we need to try and complete this transition over to our very occupation based back to our roots, our core assumptions. Back to those four points that I spoke about earlier, that occupation has a positive effect on health and well being it creates structure and organizes time brings meaning to life, culturally and personally. And it’s individual people value different occupations. The reason we need to get back to that we need to complete the transition back to that is at the present, if we pictured on I don’t have the exact numbers, but if we picture that there’s 50% of the profession, and that’s probably a bit overkill, but 50% of the profession working in a very sort of reductionist paradigm still and 50% working from the more widely promoted occupation based paradigm. How are those two kind of diametrically opposing philosophies going to form one single, cohesive, professional identity?

12:23  

You think about the recent US elections, like there was so much turmoil, because there was two parties that had such an opposing view on opposing philosophy on one what it was to be an American, and to the what the system does, pretty much everything wasn’t really on, it was pretty much everything. And that kind of you saw the turmoil, that that created of not being able to form this cohesive i