OTalk

#OTalk 20th April 2021 – Advocacy in Occupational Therapy

This weeks chat will be host by Toks Odutayo @tokunbotweetz

As one who was once described as a ‘mouthy martyr’ (a label I proudly bear), I can confess that I typically do not shy away from offering my tuppence worth on matters that I consider to be unjust, unfair or discriminatory. As an occupational therapist working in the youth justice sector, I have observed issues with occupational deprivation, alienation, imbalance and dysfunction in children and young people within the justice system. Identifying such health, social and educational needs within this marginalised group has highlighted the inextricable link between justice and advocacy in occupational therapy practice (Stover 2016).

The more exposure I have to such issues, the more the subject of advocacy in occupational therapy has been stirring within, quite like a musical earworm. It is worth stating at this point that I by no means approach this subject as an expert. Rather, I come to it as an absolute novice, looking to facilitate conversations and shared learning that would further shape, strengthen and develop our approach to advocacy in practice. 

As occupational therapists, we acknowledge that occupation is a fundamental human right (World Federation of Occupational Therapists 2019), and therefore naturally find ourselves advocating for the clients we serve when their rights are compromised. One reason for this could be related to the fact that we primarily view health from the lens of the social model of disability, as opposed to the medical model (Dhillon et al. 2010). Although advocacy may not be an essential component to our training curriculum, it is inherent to what we do as occupational therapists (Kirsh 2015) and is also identified as one of the six core intervention types of occupational therapy (American Occupational Therapy Association 2020). 

My newly curated curiosity into this subject has also led to the consideration of advocacy in occupational therapy in relation to recent social issues. The past 12 months has seen instrumental campaigns such as Black Lives Matter and women’s public safety, which many of us have been affected by, had a particular interest in, and involvement with. But what have these issues got to do with our occupational therapy practice? Do we simply use our professional platform to lobby for matters that hold meaning and value to us? Or could it be that we acknowledge how these matters impact our practice by not only setting up barriers to us as clinicians, but also account for the lived experiences of our clients (as well as ourselves), and therefore impede on their ability to perform their desired occupations; and/or act as secondary barriers to their engagement with therapeutic interventions and subsequent functioning?

I firmly believe in the latter as experience has shown the significant detriment to our client’s health, wellbeing and quality of life, when their needs are not acknowledged, understood or catered to in our practice. However, I hope this OTalk would open up more conversation that affirms, challenges, and proposes additional considerations to my thinking.

With inclusion and participation being integral to occupational therapy practice, as well as the assumed promise of equality and diversity being core to our practice (Royal College of Occupational Therapists [no date]), I would like to think together about the ways in which we currently engage in advocacy from a professional perspective. I would also like to explore how we could further develop our efforts to ensure that it remains a core facet of our practice to enable our client’s engagement in occupation.  How we do this can vary from voicing individualised matters, all the way to contributing to larger political, legislative and policy changes (Kirsh 2015).  

Having recently re-engaged with my twitter account (for the umpteenth time), I have observed how advocacy is imperative to all areas of occupational therapy practice. There are numerous health, social, cultural, physical, and institutional issues that can impact on the participation of our clients. These can include, but not limited to:

  • Raising awareness about specific and poorly understood conditions, e.g. neurodevelopmental conditions.
  • Outlining the need of specific equipment and/or technologies in practice.
  • Promoting equality and inclusion for marginalised groups, e.g. displaced individuals.
  • Writing business plans for occupational therapy roles in services.
  • Educating on the severity and impact of Long Covid on health, wellbeing and occupational engagement.
  • Highlighting accessibility issues in public and private settings.

In addition to advocating for our clients and enabling their ability to advocate for themselves, we also advocate for ourselves. As an evolving, and continually developing profession, we also find ourselves championing and fending for the specialist skill set within our discipline and advocating for the necessity of our roles within multidisciplinary teams.

All of this leaves me with a million questions about the subject of advocacy in occupational therapy, but I have managed to whittle them down to the following:

Questions

  1. What is your understanding of the meaning of advocacy in occupational therapy? Is it a core function of what we do as occupational therapists? 
  2. Can you share any specific matters related to your current practice that you feel would benefit from advocacy (eg. client groups, condition awareness, practice areas)?
  3. In what ways do we currently engage in advocacy as occupational therapists? Do we have the adequate tools to support us in effectively advocating for matters related to occupational justice?
  4. What are the challenges or barriers faced when advocating for others or ourselves? How might we overcome them?
  5. Can you share any past or present experiences of successfully, or unsuccessfully, advocating for a matter? Or experiences of a current advocacy journey?

References

American Occupational Therapy Association. 2020. Occupational Therapy Practice Framework: Domain and Process- Fourth Edition. The American Journal of Occupational Therapy 74(s2), pp. 1-87.

Dhillon, S.K. et al. 2010. Advocacy in occupational therapy: Exploring clinicians’ reasons and experiences of advocacy. Canadian Journal of Occupational Therapy 77(4), pp.241-248.

Kirsh, B.H. 2015. Transforming values into action: Advocacy as a professional imperative. Canadian Journal of Occupational Therapy 82(4), pp.212-223.

Royal College of Occupational Therapists. [No date]. Available at: https://www.rcot.co.uk/equality-diversity-and-inclusion [Accessed: 11th April 2021].

Stover, A.D. 2016. Client-centered advocacy: Every occupational therapy practitioner’s responsibility to understand medical necessity. American Journal of Occupational Therapy 70(5), pp.1-6.

World Federation of Occupational Therapists. 2019. Occupational therapy and human rights. Available at: https://wfot.org/resources/occupational-therapy-and-human-rights [Accessed: 11th April 2021].

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