When Occupational Therapy Goes Right

In preparation for tonight’s #OTalk entitled “When Occupational Therapy Goes Wrong”, I’ve been reflecting on times when occupational therapy does not live up to its potential.

I have never received occupational therapy services, but I’ve listened to a lot of people who have. Common themes I’ve heard/observed of occupational therapy “going wrong” include:

  • When there is a lack of understanding/respect of the value/unique contribution/purpose of occupational therapy
  • When there is a mismatch between what is important/meaningful to individuals, and what is offered
  • When people are not aware of occupational therapy service or how to access it
  • When occupational therapy services lack a consistent approach, model or pathway

This has led me to think about what times when occupational therapy has “gone right”:

  • When occupational therapists communicate a robust professional identity. I recall times as a student when I asked occupational therapists questions – for example, what set them apart from physiotherapists or psychologists. I remember answers like, “there isn’t really a difference, we just had different basic training” or “physiotherapists deal with lower limbs, we deal with upper limbs”, with no reference to an overarching occupational philosophy or core occupational therapy skills. When I think about occupational therapists I admire, I realise that they are the people who are certain about what occupational therapy is (and isn’t), and are confident that what they’re offering is important and valuable.
  • When occupational therapists are able to communicate theory and evidence in a consistent and accessible way. I remember placements where the occupational therapists used specific practice models (the Model of Human Occupation or Model of Creative Ability) in a consistent way, and were familiar with current evidence. Communicating their underpinning theory and evidence to multidisciplinary team members and clients in ways that made sense enhanced their credibility.  Occasionally, this was formal – for example, in-service training – but more often than not, this communication occurred within the context of team meetings or during the introductions of interventions. In contrast, I’ve seen services where therapists work inconsistently, and do not articulate their clinical reasoning. In these settings, I’ve observed a lack of understanding of the value/contribution of occupational therapy, sometimes resulting in lack of respect for the profession.
  • When occupational therapists are genuinely interested in their work/service users. I’ve encountered occupational therapists who are interested in what they do. I’ve also encountered those who are not, and I know who I’d rather work with!
  • When occupational therapy has a high profile. The most effective occupational therapy I’ve encountered is when professionals and clients are aware of the presence and purpose of occupational therapy. Sometimes, this has been the result of higher-level service development work. However, it has often been the culmination of many individual discussions – such as when occupational therapists introduce themselves to individuals, and regularly participate in team/patient meetings.
  • When occupational therapy services measure/demonstrate their effectiveness. The most effective occupational therapy services I’ve come across are the ones that regularly measure outcomes and evaluate their practice, with the aim of providing a high quality service. They are able to provide evidence to service users, team members, and commissioners of the impact of intervention.

As I look back over this post, I’m sure that I’ve missed a lot. I’m looking forward to discussing this tonight, and learning from other people’s experiences.

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