Guest Blogger - "How can you save the world when its ideal path to salvation is different from yours? "

Jouyin Teoh is a occupational therapy student in Malaysia and one of my Facebook friends. She is an outstanding advocate of occupational therapy: dynamic, passionate, not to mention great fun! Here is her post on the importance of evaluating the impact of cultural differences in our approach as occupational therapists:

"Recently I had the privilege of being part of a team of student occupational therapists organizing a community-based rehabilitation (CBR) programme in a predominantly Malay Muslim kampung. It was a one-day event, aiming to educate the community about the opportunities available in Malaysia for people with disabilities (PWDs), indirectly setting the local PWDs and their carers on the path to empowering themselves and leading purposeful, meaningful lives in line with World Health Organisation objectives:

“… To ensure that PWDs are empowered to maximize their physical and mental disabilities, have access to regular services and opportunities, and become active, contributing members of their communities and societies.”

Unfortunately what I saw transpiring on the day itself was a picture of pure disengagement: disappointingly low participant attendance, organizers and participants eating lunch in separate, distinct groups … What was going wrong?

It wasn’t until the post-mortem that I realized that we were actually facing blatant outright disregard and opposition from the community – My colleagues reported cases of kampung residents responding when approached on the morning of the event, “Oh yes, I know about that health rehab thing. I’m not going.” And they shut their doors on us without further explanation. To them, we were an intrusion: They knew of our existence, and we weren’t welcome. To us, this was incomprehensible: What could possibly be wrong with an activity which seeks to empower the community to empower individuals to empower themselves?

The answer came to me via discussion with Japanese occupational therapist Michael K. Iwama on cultural contexts and occupational therapy which took on a form parallel to my CBR experience. We were both of East Asian origin and shared a similar fusion of Confucian/Buddhist values together with the Westernised philosophies that defined our profession, yet we operate in vastly different environments. He talked about the difficulties of transplanting occupational therapy identity in a meaningful way to the people of his native racially/religiously/lingu

istically homogenous Japan whereas I had my own problems articulating the core construct of occupational therapy to suit the diverse cultural contexts which sum up Malaysia.

As occupational therapists, we are importing a foreign set of beliefs in the form of occupational therapy and CBR into our respective homelands. Should we be successful in deconstructing these “alien”, Western concepts and adapting them to our local realities, it would be possible to upgrade the health & wellness sectors in our respective countries to a whole new level altogether with emphasis on better quality of life which no longer discriminates and labels patients as “sick” or “disabled” but which views them as individuals with their own right to be active participants in the great circle of life. Occupational therapy does not aim to “treat the disease”. Rather, it “enables the person”.

However, the danger of this sort of intercultural exchange can best be summed up by Michael Iwama in his essay Situated Meaning: An Issue of Culture (Occupational therapy without borders, 2005). “There is always the danger of importing our own culture and thereby standards of behaviour and meanings that can disrupt people’s way of life … In this way (health & wellness interventions) can oppress rather than empower, encumber rather than emancipate, and disable rather than restore.”

How can you save the world when its ideal path to salvation is different from yours? How can you save the world when its idea of salvation differs from yours? Only by making culture a primary concern and allowing target client groups to understand and dictate the terms by which these foreign ideals should be introduced, then only will cross-cultural, international cooperation reap benefits for all."

Diffidence, geekery, occupational therapy and me

Earlier today I *almost* tweeted that I had just been reading my shiny new copy of The British Journal of Occupational Therapy in the bath and thinking how interesting the articles were this month (OK I would have to have condensed it down a bit but you get the idea!). But then I stopped. "Cant tweet that!" I thought, "I'll sound like a right geek!".

But its true I am a geek, or so I keep telling people. What is a geek anyway?

"a peculiar or otherwise odd person, especially one who is perceived to be overly obsessed with one or more things including those of intellectuality, electronics, etc."^[1]

Hmmm, not sure I like that, so my do I keep saying it?

Well I do love my job, and I'm passionate about occupational therapy, and freely admit I spend lots of my free time doing work related stuff. But given that OT is about facilitating other people to achieve optimum well being I should be proud, right?

All this got me to thinking about a presentation I went to from Jennifer Creek at the Cheshire Occupational Therapy Conference. She was talking about celebrating achievement in occupational therapy and pointing out that, on the whole, occupational therapists aren't too hot at blowing their own trumpet. She gave a great quote from Dr. Thelma Cardwell, former CAOT president, and reflected though we have made much progress, we are still a bit backward in coming forward as a profession.

dif·fi·dent

adj.

1. Lacking or marked by a lack of self-confidence; shy and timid. See Synonyms at shy¹.

2. Reserved in manner.

Now I'm not sure I'm diffident as such. I'm highly likely to be the person in the room to put my hand in the air and give and occupational therapy slant on a discussion, to volunteer for a project which I believe will further the profession, and to try my hardest to find innovative ways to develop OT services.

So why do I term myself a geek? Maybe despite all my gusto I'm still not as confident in myself as I am in my profession. Being the outwardly confident person I describe above doesn't always come easily to me, but if something scares me I'm compelled to try it. Maybe it's a grown up extension of risk taking behaviors in my earlier life? Who knows, but I think what I will take from this reflection is that its OK to be true to my Gemini starsign and be at once unconfident and self doubting if this propels me to action, but at the same time a vocal advocate of my profession.

Some people might say it's a bit of a risk posting this on a publicly accessible blog but I'm quite an open person, and fine with talking about my flaws. In fact I think some of the most interesting blog posts come when people reflect with honesty on a situation. What are your thoughts, how confident are you in promoting OT? Would you critique yourself in a similar way in a public forums?

P.S. I'll do another post about the great articles in BJOT!

Occupational Blog Carnival #2 - Call for submissions

This months the carnival is hosted by Bronnie Thompson over at Health Skills Weblog

The topic is ‘clinical reasoning and occupational therapy’

The closing date for posts is the 3rd April so get going now!
The carnival will be published on the 6th April.

Click here to submit a post

Don't for get to subscribe to the carnival visit its permanent home here.

Please publicize the carnival on your own blog or through other channels such as Twitter, Facebook etc.

Blogging as a voice for the therapists "gut"

This post reflects my thought process following the hotly debated thread on the use of models on the Salford Road blog.

I was rambling on to my husband about how exciting it is to be engaged in a debate about OT with some of the most prominent and influential therapists in the world through web based media. I'll be honest with you - it can be a bit intimidating! This in turn got me thinking about some of the barriers that people have to blogging or engaging in these type of debates. Some of this anxiety may be related to a lack of confidence about articulating ones opinion in such a public way. Making your professional thoughts and opinions known on the web constitutes a type of risk taking in opening you up to critique and comment.

Practicing therapists often feel a gulf between critically appraised, peer review research or theoretical tomes. I then started thinking about how this online debate compares to writing or reading an article in a journal concluded that blogging and online debate offers such an exciting voice for the anecdotal, experimental "gut" professional opinion of practitioners. It provides such a responsive and engaging way to capture and communicate these types of thoughts and opinions.

So for me the internet offers a potential solution to the transmission of that knowledge which falls between practice and research.

As I tetter on the deg of confirming my MSc funding I feel these posts have been a "spa for the mind" and have both refreshed and really inspired me. This reflection galvanizes me in promoting the benefits of web based communication for therapists!

Let me know what you think!

Cheshire Occupational Therapy Conference

I had a great time at the conference today which looked at celebrating the achievements in the past ten years, and considering how OT services can be modernised in times to come.

I really enjoyed giving a presentation on "E"nabling and talked about the ways in which web2.0 can be useful to occupational therapists and our service users.

I will post a more thorough summary and reflection on the day but as part of the talk I urged people to "dip their toe in" and have a look at one of the resources I mentioned. As such I wanted to put a quick post up and invite any of the people who were at the presentation today who might stop by the blog to just leave a quick comment.

At the bottom of this post just click "comments" and fire away. I would really welcome your feedback - and feel free to be honest (you can leave anonymous posts!)

Occupational Therapy Blog Carnival Edition #1!

Welcome to the March 9, 2009 edition of occupational therapy. This is the inaugural edition so it's very exciting! Thanks so much to the contributors and those people who have offered to host upcoming editions.

I was a bit worried about not specifying a topic for this first edition but I didn't want to scare people off submitting a post. I'm really pleased to say that we have a great series of posts which capture the exciting range and diversity of the profession.

Theory

Angela Hook presents Core Values or Core Skills ?........... You decide posted at Salford University Occupational Therapy Education Blog. Not only was it a fascinating post tackling a central issue for OTs, but created lots of discussion, both on the blog and on Facebook. Defining what we do, our skills and beliefs has always been one of the great challenges for our profession. On Twitter @HeatherOT and I wondered about asking OT twitters to define OT in a tweetable 140 characters. Heather came up with

"PTs will teach you to walk, OTs will teach you to dance. We focus on higher level functioning to be able to perform all ADL"

Building on this theme Adiemusfree (Bronnie Thompson) presented Talking about roles in pain management posted at HealthSkills Weblog, saying, "Thanks for starting this carnival!" Bronnie highlights the importance of balancing core skills with the ability to share skills as part of a cohesive team. Interdependence, as opposed to independence as a strength in a team approach.

Frontiers of practice
Andy Levy presents The best book I never read posted at Gosh, that's neat! which he describes as "A pseudo-review of Occupational Therapy Without Borders: Learning from the Spirit of Survivors" The book he describes is written by Frank Kronenburg, the daddy of looking outside the OT box. As Andy underlines, his inspirational view of OT serves as a call for all OTs to "go forth and occupy"!


Alece Kaplan is someone who seems to have taken Frank's advice and writes for the OT Advocacy blog. She presents the Death With Dignity Act Implemented on March 4th All OTs working with people facing terminally illness should be aware of the legal and political drivers in their country of practice, as well as their own feelings, prejudices and anxieties around the complex area of suicide/euthanasia.

Alvaro Fernandez presents Centre for Brain Fitness at Baycrest: Interview with Dr. William Reichman posted at SharpBrains: Your Window into the Brain Fitness Revolution, saying, "we have an opportunity to make major progress in Brain Health in the XXI century, similar to what happened with Cardiovascular Health in the XX, and technology will play a crucial role". OTs are have excellent skills in using technology to meet our clients goals and we should consider the expanding role we may be able to play in the area of "brain fitness". OTs are already engaging well with the concept of Wiihabilitation and the benefits it can play in a range of practice areas.



Learning in Practice

Margaret Rice presents 10 Things They Don't Teach You In School - Learning on the job as a school based therapist posted at Your Therapy Source. Although Margaret has a background in Physical Therapy her practical advise is great for all therapists and therapy students starting work in an educational setting.

And another thing......

I thought it might be good to also feature a news article related to OT which caught my eye. Take a look at this dutch study which showed the effectiveness of OT interventions for people with Alzheimers.

"The Dutch folks found, first, the OT treatment program was considered a substantial success about one-third of the time. Next, they found the average cost of care of the group that had the OT program was about $2,600 less than the regular treatment group."

I think that OT's (in the UK at least!) often worry a lot about marketing and evidencing their service. This encouraging research demonstrates that good quality therapy can also be cost effective. We shouldn't be afraid to "describe by the dollar", in fact we must to ensure the future of OT in an increasingly financially pressured world.

That concludes this edition. Submit your blog article to the next edition of occupational therapy using our carnival submission form. Past posts and future hosts can be found on our blog carnival index page.

The next edition of the carnival will be hosted by Bronnie Thompson at the Healthskills Weblog.
The closing date for submission is 3rd April and the carnival will be published on 6th April.

Subscribe to the carnival at it's permanent home here

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