The old buckeye: how do we define what we do as OT's

Thought I would post this here, its my response to the Frederick Road post and ensuing debate about core values/core skills of OT. It seems to follow on from the thoughts on my previous post......

" It's an oldie but a goodie (great students by the way Salford!). Here is the link to Jennifer Creeks "OT as a complex intervention".

My personal feeling is that we apply our core skills (which may in part be generic) to our core belief which is unique (humans as occupational beings, occupation as central to wellbeing).

The thorny issue of how OTs define the profession is inherent in its own exisistance. To understand OT you have to be involved in the occupation of occupational therapy. Lost yet? I was fortunate enough to be at a study day with Jennifer just before Christmas and she made a simple but impactful observation. The only clear way to explain is for someone to try to mimic the work of an OT, or to be the recipient, or to sit alongside the process. In other words to use engaging with the occupation of occupational therapy.

Is that too much to ask? How can pragmatically do that to promote the profession?

Would it be a pushing it so say that many people have a more clear view of say of the profession of medicine and the work of a GP as everyone has seen a GP at some point, they know when they would go and the gist of what will happen. They have sat alongside and been a recipient of that care. They have experienced the occupation of a GP appointment/intervention.

Hope that makes some sense and isn't too garbled - I'm trying to hold a baby on my knee and type at the same time!"

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.