#OTalk 15th September 2020 – Using an asset based approach in Occupational Therapy to promote self-agency and self- management.

This weeks chat will be hosted by Sally Scott-Roberts @sallyroberts.

Antonovsky’s (1996) salutogenic orientation (a focus on the origins of health) was proposed as a shift in the way we think about health. It was not intended to replace the more traditional pathogenic (medical) paradigm, that focuses on risk factor reduction, but to compliment it. Antonovsky suggests that people are viewed as being on a health/dis-ease continuum rather than being viewed as healthy or not. Therefore, rather than focusing on the management of a condition and/or the characteristics of a disability, the factors that keep someone nearer the ‘health’ end of the continuum should be explored and where possible engaged. Simply, he proposed a process that focused on the whole of the person, engaging both the person’s and their communities’ resources to further both their individual and collective health and wellbeing. 

Antonovsky’s (1996) proposition of being asset focused was directed at the field of Health Promotion but it can so easily be seen to align with Occupational Therapy. It affiliates well with the underpinning humanistic philosophy of Occupational Therapy; valuing the uniqueness of each person, whilst supporting them to be active agents in unlocking their occupational potential (Stein & Cutler, 1998). Our occupational therapy operational models promote the exploration of the person in context and identify strengths as well as barriers to participation. In doing so it is possible to establish ‘what has worked well and how,’ when someone requests support because they have moved or wish to avoid moving towards ‘dis-ease.’ 

From practice experience, working mainly with people who consider themselves to be neurodivergent, many have become experts in managing their health, often only entering services at a point of ‘crisis.’ At this point in time, they may have lost sight of, or may not recognise, the assets that help to keep them well. In reframing my focus, I have endeavoured to work with people appreciatively, to identify, develop and then mobilise their personal and community assets, with the aim of empowering them to continue to self-manage their health and well-being. This is particularly important, as this group of people, as adults, often remain hidden from traditional health and care services.  

I was hoping that this topic may be of interest to those Occupational Therapists, working with people who live with life-long conditions or chronic disability but also those working to promote well-being in the wider community. I look forward to the chat. 

Questions to reflect upon for the chat: 

  • Is an asset based way of working new or does it just describe the way in which we already work? 
  • Are there interventions we already utilise that have a basis in salutogenesis e.g. Recovery Through Activity? 
  • When might you choose to use asset based interventions and with whom? 
  • What might be the barriers to working in this way?
  • What skill set do Occupational Therapists need to draw upon to work in this way? 

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