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!

Practicing what we preach

Yesterday I attended a networking/learning day hosted by Coventry university. I had signed up to go as I was intrigued by the blurb, it was local and £35 quid so off I went not sure what to expect.....

Laraine Epstein, lecturer at Coventry University and lead for the COT disability forum introduced the day, and explained the background to the forum, which had been set up to give OTs with disabilities an opportunity to discuss and network. I began to question whether I was an outsider at this event and what I could bring to such a programme.

The day started with a deeply personal and insightful presentation from the ever interesting Jennifer Creek. She discussed the concept of identity, and introduced her theory of "bricolage" to describe how individuals create their own identity. She reflected that we all have a "dark shadow" which may be a physical or emotional limitation, or a character trait we do not like. The challenge of achieving a truly integrated identify which reflects who we really are is then to explore and accept our own shadows. Jennifer contended that trying to "fight" or "conquer" those less desirable or limiting parts of ourselves only serves to prolong our feeling of fragmentation. She then moved on to contemplate the identity of Occupational Therapy as a profession and the struggle that therapists face to explain what we do.

Dr Clare Taylor then gave us a review of the relevant research on the experiences of health professionals with disabilities, and the attitudes towards them of colleagues without disabilities. We then worked in groups to explore the highly complex issues of why, as OTs, we struggle with inclusion when we claim to be experts in this area.

Sarah Lewis, Equality and Diversity Manager at Coventry University talked us through the complex legislation framing these issues.

We then broke for lunch with a building sense of dissatisfaction and unease at the ability of our profession to welcome our colleagues with disabilities and act as the exemplars that we should for the inclusion agenda.

If I was in any doubt as to the depth of frustration, disillusion and at some points despair of many of the OTs with disabilities present I was left with my head pounding after the emotive presentation by Sarah Barratt. Sarah presented us with the following statement:

"People with disabilities are entitled to the same human rights as all other citizens. Occupational therapists attempt to help people with disabilities exercise control over their own lives. They believe that society could be modified to include and accommodate the needs of all persons. Occupational therapists also believe in equal opportunities and access to all of society’s resources for people with disabilities and try to facilitate the individual’s inclusion into all areas of society. They acknowledge that the right not to be discriminated against has to be complemented by the right to benefit from integration into the community. (COT’s Curriculum Framework for Pre-registration Education COT 2004)."

See Patrick Carrolls thread on the BAOT discussion forum and join the debate but a few notable points include the very half hearted and quite patronising language highlighted in bold above.

Colin Jones, one of the BAOT English Board reps reminded us that all BAOT members have the ability to input to these documents and that we should work, through our regional groups, to challenge this wording. For me this made me reflect on why I haven't been involved with BAOT so far and I'm not sure I have any good excuse!

Sarah went on to provide a moving and genuinely shocking account of her (mostly) terrible experiences as a qualified OT with a disability, she was applauded by colleagues who could clearly relate personally to her testimony.

For me the key themes raised by my colleagues were:

• "Rabbit in headlights" syndrome by OT's without a disability - a feeling of knowing they needed to support (not help, therapy or treat) colleagues with a disability but didn't know how
• A lack of recognition by the profession about the depth of the challenges faced
• An overwhelming sense of being let down by a profession that appears not to practice what it preaches
• The importance of acknowledging the unique contribution and perspective OTs with disabilities can bring to the profession
• The urgent need for change, both to support therapists who are currently qualified and to encourage potential students

A part of me wonders (and maybe hopes?) that the OTs who make up the forum may have been particularly motivated by negative experiences to come together, and that there are OTs out there who have a disability, but on the whole feel they have been received positively into the profession?

I wholeheartedly support the members of the forum in bringing this fundamental issue to the attention of all OT's as an urgent issue. However I would also urge them to reflect on the positive experiences they have had and try to draw out what worked well and why so that this can be transfered to other situations.

In conclusion I feel this event has been one of the most thought provoking of my career and the questions it raised cut to the core of the profession I love. To be told by fellow therapists who also have a disability that my profession, which claims to be highly skilled at facilitating inclusion, has made them feel unwelcome and not valued was very hard to hear. So how to do I do something constructive with these extreme emotions? Well reflecting on it and sharing my thoughts through this blog. I will also feed back to the OTs where I work. I also plan to get involved with my regional BAOT group to ensure I have a say when documents such as the on mentioned above are developed.

Conferences, conferences and more conferences!

I've just come back from presenting at RAatE 2008 at Coventry University. I talked about the a unique scheme our team operates to optimise the flow of communication between ourselves (as a specialist tertiary service) and local community OTs. As with all public speaking in was a bit nerve wracking but very worthwhile. It was interesting to learn about similar services in Ireland and the developing AAC/PC access service in East Kent

In September I was fortunate enough to attention the Communication Matters annual symposium. I a newbie in the field of Augmentative and Alternative Communication and it was really useful to gain such up to date ideas and information. CM is a truly personal and friendly event with many AAC users and their families attending.

I'm looking forward to attending the COT/BAOT annual conference next year. I went in 2007 and found it a genuinely inspiring event. I'm sure the same will be true this year and I have the added excitement of hosting a round table session with a colleague looking at the current and potential input of OTs to Augmentative and Alternative Communication.

Also on the agenda for next year is a workshop at the Cheshire Occupational Therapy Conference. Having previously worked for Cheshire County Council it will be a good opportunity to catch up with old work friends. I'm still not sure of the exact focus of the workshop but there is plenty of time to decide! The conference is a great example of collaborative learning where therapists from health and social care from across the county gather.

If you had told me when I was training that in my OT future I would be presenting at conferences to large groups I would have laughed. It goes to show that being excited about OT and pushing yourself to do the things that interest you, but scare you at the same time can be really positive. I find attending conferences a great luxury, taking time out from the day job to indulge myself in learning!