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From ‘C’ to ‘C’ to ‘C’:An Ocean of Possibilities
Dr. Mary LawDr. Mary Law
Dr. Helene PolatajkoDr. Helene Polatajko
Dr. Elizabeth TownsendDr. Elizabeth Townsend
CCelebrateelebrateCChallenghallengee
CCreatereate
Celebrate
Our collective accomplishments
Celebrate: The past
Historic Profession with Great Potential to Grow
All photos courtesy of Brenda Head, Copyright © Jessie Luther Papers
Jessie Luther working in St. Anthony’s community Workshop, 1908.
Jessie Luther teaching basketry to a resident who is blind, 1908.
Jessie Luther en route to St. Anthony
Celebrate: Our client- centred guidelines13 Important Ways to Use the Guidelines for the Client-Centred Practice of Occupational Therapy by Thelma Gill
#1. The guidelines providea clear outline of the processof O.T. which can be usefulin discussions with theadministrator of yourfacility. #13.
From Thelma Sumsion’s 1982 & 1983 Series on From Thelma Sumsion’s 1982 & 1983 Series on “Getting our Act Together and “Getting our Act Together and Putting it on the Road … or Handling the Challenge of Change” Putting it on the Road … or Handling the Challenge of Change” , , NATIONAL, NATIONAL, September 1984September 1984, p. 12., p. 12.
Celebrate: Our client-centred practice
Celebrate: Our client-centred practice of enabling occupation
“What is this important publication and valuable addition to your professional library?”
Angela Naugle, Member, CAOTClient-Centred Practice Committee.
National, The Newsletter of theCanadian Association ofOccupational Therapists, May / June 1997, 14(6), p. 1
Celebrate: Our client-centred occupational focus
Our practice imperative
Client-centred
enablement
Human Occupation
Celebrate: Our evolving Canadian perspective on occupation
From divergence…
1919 - Wounded soldiers receiving occupational therapy
through therapeutic use …
to enabling occupation…
Celebrate: Our Canadian models of occupational performance
THE INDIVIDUAL
spiritual physical
mental
socio-cultural
SOCIALENVIRON-MENT
productivity
self care
leisure
ENVIRONMENT(social, physical, cultural)
CULTURALENVIRON-MENT
PHYSICAL ENVIRONMENT
Original Occupational Performance Model(Adapted from Reed and Sanderson, 1980)
Performance components Areas of occupational performance Adapted from Reed and Sanderson, 1980
Celebrate: The Canadian Model of Occupational Performance (CMOP)
CAOT, 1997
Celebrate and be proud: CMOP now frames practice
Debbie Hebert, Corporate Professional Leader and Clinical Educator (OT), Toronto Rehabilitation Institute, writes…
Documentation both dictates and reflects practice
Prior to the Enabling I publication, our OT documentation reflected a very medical model, impairment-based type of assessment ……. nursing and physiotherapy might easily have filled this assessment form out as well as OT.
Now we’ve renovated our documentation to create an “Occupational Performance Module”.
Celebrate and be proud: CMOP now frames practice
Debbie continues….
This change was transformative
Enabling Occupation gave us the guidance to be the leaders in patient-centred goal setting
Now we are considered an invaluable profession
Our colleagues now say…
“I wish I were an OT” rather than “What do OTs do?”
Celebrate and be proud: CMOP internationally lauded
Your work has such international significance, it has such professional significance and to me it has such personal significance as it gave me the structure to build my science that has always had the focus to improve the lives of those with or threatened with disabling conditions. … it has involved and it has influenced so many therapists, scientists, educators and clients that have been served.
Congratulations to all Canadians for your vision, your work and your commitment. Dr. C. Baum, 2010
AOTA Past President
Celebrate and be proud: Our COPM enables partnershipEnables meaningful participation in
the occupational therapy process through:
identifying occupational performance problems
evaluating performance and satisfaction in these occupations
measuring change in perception of occupational performance
Celebrate and be proud: Our COPM in Slovenia
Celebrate and be proud: Our COPM around the world
Countries where the COPM is used
Celebrate and be proud
Highest Uses of CMOP (1993 Canadian Survey) Assessing Educating others Explaining the profession to others
Sales over 10 years (1999 – Sep. 2009) COPM manuals: 11,542 Enabling I (1997, 2002): 13,623 (French and English) Enabling II (2007): 4186 (French and English)
Celebrate -> Be proud
ChallengeEach other to go further
Challenge: Our present
Go further …Enabling II: Advancing an
OT vision for health, well-being & justice through occupation
Occupation-based practice …
Beyond performance Beyond disability
Challenge our present: Challenge our present: Beyond performance
Canadian Model of Occupational Performance and Engagement
Challenge our present: Challenge our present: beyond …beyond …
Impairment reduction
New York Times: “occupational
therapists have taken their place —
the army that often stands behind
academically successful students.
(February 24,
2010) (Clark et al)
Challenge our practice:Challenge our practice:
Be daringBe daring Therapists at (what once was) Sunnybrook and Women’s challenged each other to move to occupation-based practice
Fran Aiken, professional practice leader, writes….
I had always felt rooted to occupation as the basis of practice, but, I experienced ‘disease-oriented’ health care and OT
We welcomed the 1997 Enabling Occupation guidelines as a way to initiate our journey
Challenge and be Challenge and be daring: Be occupation-daring: Be occupation-based based
They studied the effect and discovered…They studied the effect and discovered…
A MEANING GAP: I think we always struggle with being true to our
profession and being true to the program that we work in.
Resolving the meaning gap is a personal journey
Therapists who highly value occupation and see the potential for client occupational engagement in their daily
roles are enthusiastic therapists, who derive personal meaning and satisfaction within their own occupation, despite other challenges in their work environment.
Challenge and be daring: enable occupationenable occupation
At the level of …
the group
Challenge and be daring: enable enable occupationoccupation
At the level of …
society
Challenge and be daring: Contribute to societyThe Canadian guidelines for client-centred practice and enabling occupation have had a great impact in Europe because these concepts match very well with the European values like freedom, democracy, equality, human dignity and solidarity and with European Social Policy … clients say: OT works too often only with the individual and this is a pity since they have much to contribute on society level.
Hanneke van Bruggen, Executive Director, ENOTHE (European Hanneke van Bruggen, Executive Director, ENOTHE (European Network of Occupational Therapy Educators) re European Values Network of Occupational Therapy Educators) re European Values Study (EVS), 2004, & Tuning Project, 2008Study (EVS), 2004, & Tuning Project, 2008
Challenge and be daring: Naming Enablement
Challenge and be daring: Naming Enablement in Enabling Occupation
“theory in enabling occupation helped
me to see what occupational
therapy is really about”
Photo & quote courtesy of Hiromi Yosikawa, November 2009
Challenge and be daring: Enable our own occupation
“… we created a community of practice
scholars who "road tested" the Enabling Occupation
guidelines over the course of a year.”
Australian Practice Scholar Group (2008)Members came from diverse practice contexts - including in an indigenous community in the central desert, to a youth focussed mental health outreach service in a large city. with permission G. Whiteford(G. Whiteford)
“My inclusion in this practice scholars research came at a time I felt I was
drifting away from the core beliefs and values of Occupational Therapy. “
(Lauren, co researcher inthe Australian project)
Challenge and be daring: Enable our own occupation
Challenge and be daring: Building new partnerships for practice
Family Health TeamsFamily Health Teams Legal servicesLegal services MunicipalitiesMunicipalities School Boards School Boards
Challenge and be daring: Building evidence-based practice in partnership
Occupational therapists from three Vancouver region health districts
Worked with a knowledge broker and developed strategies to change practice in three areas:
cognitive screeningassessment of risk for skin
breakdownprovision of wheeled mobility and
seating equipment
Challenge and be daring: Building Evidence in
Partnership
A resource to assist families in giving, getting, and organizing information about their child/youth with special needs
Celebrate -> Be proudChallenge -> Be daring
CreateAn occupational future for
all
Create: An occupational future for all
“Occupational therapists are in the business of helping people to transform their lives through enabling them to do and to be. We are part of their process of becoming and we should constantly bear in mind the importance of this task.”
Wilcock, 1998
“We make our world significant by the courage of our questions and by the depth of our answers . . .”
Sagan, C. (1973). The cosmic connection. New York: AnchorPress, p. 193.
Create an occupational future for all: Be the difference
Martha NussbaumAmerican
Philosopher
“The capabilities approach … simply specifies some necessary conditions for a decently just society, in the form of a set of fundamental entitlements of all citizens” (2006)
Create: Be the difference
Imagine if……….
… be the difference
Imagine if …
"You spend their young lives trying to get them ready for the world and when the time comes, the world isn't ready for them. So we have to find a way to do it."
- parent of a child with a disability
… be the difference
Imagine if……….
… be the difference
Imagine if……….Imagine if……….
The assessment of development cannot be divorced from the lives that people can lead and the real freedom they enjoy
(Sen 2009, p. 346)
Imagine if……….
A Visionary Occupational Therapy Council of Canada?
… be the difference
Celebrate -> Be proud
Challenge -> Be daring
Create -> Be the difference
From ‘C’ to ‘C’ to ‘C’
Never doubt that a small group of
thoughtful, committed citizens can change
the world. Indeed, it is the only thing that
ever has.
Margaret Mead
Thank You
Merci