CANADIAN ASSOCIATION OF CANADIAN ASSOCIATION OF OCCUPATIONAL THERAPISTS OCCUPATIONAL THERAPISTS

CONFERENCE 2007CONFERENCE 2007

OCCUPATIONAL THERAPISTS OCCUPATIONAL THERAPISTS IN THE 21IN THE 21STST CENTURY: CENTURY:KNOWING THE WAYKNOWING THE WAYSHOWING THE WAYSHOWING THE WAY

July 11, 2007July 11, 2007

The rules break like a thermometer …The rules break like a thermometer …Quicksilver spills across charted systems.Quicksilver spills across charted systems.We’re out in a country that has no language, We’re out in a country that has no language,

no laws,no laws,Chasing the raven and the wren Chasing the raven and the wren

through gorges unexplored since through gorges unexplored since dawn.dawn.

Whatever we do together is pure invention.Whatever we do together is pure invention.The maps they gave us were out of date The maps they gave us were out of date

by years.by years.

Adrienne Rich,Adrienne Rich, Twenty-one Love PoemsTwenty-one Love Poems

How can we dare Wisdom in How can we dare Wisdom in the mosaic of our the mosaic of our realities?realities?

Inès Maria dell’ Inès Maria dell’ EucaristiaEucaristia

OVERVIEW OF OVERVIEW OF REFLECTIONSREFLECTIONS

Setting the ContextSetting the Context Mosaic of our RealitiesMosaic of our Realities Expectations of CanadiansExpectations of Canadians Occupational Therapists as Occupational Therapists as

LeadersLeaders Readiness for and Response to Readiness for and Response to

Trust Given YouTrust Given You

CHANGES IN WESTERN SOCIETYCHANGES IN WESTERN SOCIETY

Demographic shiftsDemographic shifts Increasing urbanizationIncreasing urbanization Increasing cultural diversityIncreasing cultural diversity Impact of computerizationImpact of computerization Culture of consumerismCulture of consumerism Increasing gap between rich and poorIncreasing gap between rich and poor Role of womenRole of women Realities of violence and povertyRealities of violence and poverty Understanding of health of Understanding of health of

environmentenvironment Expectations of public serviceExpectations of public service Credibility of leadersCredibility of leaders

CHANGING CHANGING UNDERSTANDING UNDERSTANDING

OF HEALTHOF HEALTHHealth is a state of complete Health is a state of complete

physical, emotional, social and physical, emotional, social and spiritual well-being; it is a resource spiritual well-being; it is a resource for everyday living.for everyday living.

Examples of Implications:Examples of Implications: Value of one’s own experiences Value of one’s own experiences Social, psychological and spiritual Social, psychological and spiritual

factors factors Gender as health determinantGender as health determinant Health of person, family, community, Health of person, family, community,

population and earthpopulation and earth

CHANGING CHANGING HEALTH PROFESSIONSHEALTH PROFESSIONS

Advances in science and technologyAdvances in science and technology Growing educational opportunitiesGrowing educational opportunities Changes in law re scope of practice Changes in law re scope of practice

and responsibilitiesand responsibilities Loss of control over working Loss of control over working

conditionsconditions Expansion of guidelines, expectations Expansion of guidelines, expectations

and recommendations from and recommendations from professional associationsprofessional associations

Focus on evidence-informed practiceFocus on evidence-informed practice Shift from profession-centred to Shift from profession-centred to

patient-centred culturepatient-centred culture

CHANGING CHANGING HEALTH PROFESSIONSHEALTH PROFESSIONS

Blurring professional boundariesBlurring professional boundaries Increased expectations of inter-Increased expectations of inter-

professional collaboration in professional collaboration in education and practiceeducation and practice

Increasing demands for Increasing demands for accountability and transparencyaccountability and transparency

InternationalizationInternationalization Move from traditional inward-Move from traditional inward-

looking, reactive culture to outward-looking, reactive culture to outward-looking, proactive culturelooking, proactive culture

CONCERNS OF PEOPLECONCERNS OF PEOPLE

1.1. Staying healthyStaying healthy:: Will I be able to stay as Will I be able to stay as healthy as possible-through education, health healthy as possible-through education, health promotion, preventive services, and early promotion, preventive services, and early detection of disease? detection of disease?

2.2. The basicsThe basics:: Will I have access to needed Will I have access to needed services and will I be treated respectfully and services and will I be treated respectfully and understand what is said to me? understand what is said to me?

3.3. GGetting betteretting better: : If I get sick, will I get better If I get sick, will I get better and regain normal functioning? and regain normal functioning?

4.4. Living with illnessLiving with illness:: If I suffer from a chronic If I suffer from a chronic condition will I be able to maintain the best condition will I be able to maintain the best possible functioning? possible functioning?

5.5. Changing needsChanging needs:: As I face death or disability As I face death or disability in my family, will we be able to cope?in my family, will we be able to cope?

Lansky, Lansky, 19981998

VULNERABLE VULNERABLE POPULATIONSPOPULATIONS

Aboriginal peopleAboriginal people – poor health status, – poor health status, poverty, violence, substance abuse, lower poverty, violence, substance abuse, lower life expectancylife expectancy

Lone parentsLone parents – poverty, financial stress, – poverty, financial stress, food insecurity, violence and emotional food insecurity, violence and emotional abuseabuse

Rural womenRural women – higher mortality rates – higher mortality rates Incarcerated personsIncarcerated persons – exposure to – exposure to

HIV/AIDS, antibiotic-resistant HIV/AIDS, antibiotic-resistant tuberculosis, hepatitis C, sexually tuberculosis, hepatitis C, sexually transmitted diseasestransmitted diseases

Young womenYoung women – most vulnerable to health – most vulnerable to health risks: smoking, alcohol abuse, anorexia, risks: smoking, alcohol abuse, anorexia, violence and emotional abuse, violence and emotional abuse, depression, AIDS/HIVdepression, AIDS/HIV

Women’s Health Surveillance ReportWomen’s Health Surveillance Report (CPHI –CIHI, 2003)(CPHI –CIHI, 2003)

CHILDREN AT RISKCHILDREN AT RISK

Aboriginal children Aboriginal children Children with disabilities Children with disabilities Children living in remote Children living in remote

communitiescommunities Children of single parent familiesChildren of single parent families Children in the welfare system Children in the welfare system Children of recent immigrants and Children of recent immigrants and Refugee childrenRefugee children

WHAT DO WE CITIZENS WHAT DO WE CITIZENS EXPECT?EXPECT?

Rights Rights – – People have a right to health and People have a right to health and health care health care

BalanceBalance – – Care of individual patients is central, Care of individual patients is central, but the health of populations is also our concern but the health of populations is also our concern

ComprehensivenessComprehensiveness – – In addition to treating In addition to treating illness, we have an obligation to ease suffering, illness, we have an obligation to ease suffering, minimize disability, prevent disease, and minimize disability, prevent disease, and promote health promote health

CooperationCooperation – – Health care succeeds only if we Health care succeeds only if we cooperate with those we serve, each other, and cooperate with those we serve, each other, and those in other sectors those in other sectors

ImprovementImprovement – – Improving health care is a Improving health care is a serious and continuing responsibility serious and continuing responsibility

Safety Safety – – Do no harm Do no harm OpennessOpenness – – Being open, honest, and trustworthy Being open, honest, and trustworthy

is vital in health careis vital in health care Tavistock Principles Tavistock Principles

(2001)(2001)

ROLES OF OCCUPATIONAL ROLES OF OCCUPATIONAL THERAPISTS AS LEADERSTHERAPISTS AS LEADERS

Visionary Visionary – musician, artist– musician, artist CatalystCatalyst – prophet, disturber – prophet, disturber

of the peaceof the peace PartnerPartner – one who reaches out, – one who reaches out,

finds gifts in others, finds gifts in others, appreciates diversityappreciates diversity   

Decision-maker Decision-maker – one who – one who makes the decision even if makes the decision even if difficultdifficult

ROLES OF OCCUPATIONAL ROLES OF OCCUPATIONAL THERAPISTS AS LEADERSTHERAPISTS AS LEADERS

Inspirer Inspirer – spirit creator, calling – spirit creator, calling forth the goodforth the good

FacilitatorFacilitator – one who draws forth – one who draws forth the energy, hopes, action of the the energy, hopes, action of the groupgroup   

Implementer Implementer – doer of the often – doer of the often difficult deedsdifficult deeds

Evaluator Evaluator – not just the one who – not just the one who measures but one who celebrates measures but one who celebrates wins, learns from losseswins, learns from losses

OCCUPATIONAL OCCUPATIONAL THERAPISTS AS THERAPISTS AS

THERAPISTSTHERAPISTS Manage diversity within your professionManage diversity within your profession Respond within changing social realitiesRespond within changing social realities Be inclusiveBe inclusive Understand globalization and health Understand globalization and health

care reformcare reform Reintroduce values of flexibility, Reintroduce values of flexibility,

discovery and innovation discovery and innovation Tell storiesTell stories Create environments allowing creativity, Create environments allowing creativity,

questions, riskquestions, risk

OCCUPATIONAL THERAPISTS OCCUPATIONAL THERAPISTS AS AS RESEARCHERSRESEARCHERS

Research Research Interdisciplinary and collaborative Interdisciplinary and collaborative qualitative and quantitative qualitative and quantitative investigative and evaluativeinvestigative and evaluative

Input and participation of therapists at every Input and participation of therapists at every stage of research processstage of research process

Link with wider national and international Link with wider national and international professional communityprofessional community

Research agenda = gender-sensitive and Research agenda = gender-sensitive and inclusiveinclusive

Recognition of diverse communities of Recognition of diverse communities of therapiststherapists

Increased number of OT researchersIncreased number of OT researchers Means of transforming research results into Means of transforming research results into

health policy and practicehealth policy and practice

OCCUPATIONAL THERAPISTS OCCUPATIONAL THERAPISTS AS AS VISIONARIESVISIONARIES

Stretch into new ways of thinkingStretch into new ways of thinking Leave behind what is no longer Leave behind what is no longer

appropriateappropriate Interconnect practice, education, Interconnect practice, education,

administration, and researchadministration, and research Value your networksValue your networks Re-inspire your spiritRe-inspire your spirit

ELEMENTS OF RESPONSEELEMENTS OF RESPONSE

VisionVision ValuesValues RelationshipsRelationships Value of TraditionValue of Tradition Celebration Celebration

VISIONVISION

Had, held, shared, grownHad, held, shared, grown ““Something significant left to Something significant left to

do”do” Vision CommunityVision Community

OCCUPATIONAL THERAPY OCCUPATIONAL THERAPY VISIONVISION

Occupational therapy is a health profession Occupational therapy is a health profession concerned with concerned with promoting health and promoting health and quality of life through occupationquality of life through occupation. The . The primary goal of occupational therapy is to primary goal of occupational therapy is to enable people to participate in the enable people to participate in the activities of everyday lifeactivities of everyday life. Occupational . Occupational therapists work collaboratively with therapists work collaboratively with people of all ages and abilitiespeople of all ages and abilities who who experience challenges or obstacles to experience challenges or obstacles to participation. These obstacles may be participation. These obstacles may be caused from an impairment of body caused from an impairment of body structure, a change in function, or from structure, a change in function, or from barriers in the social and physical barriers in the social and physical environment.environment.

VALUESVALUES

Values are sets of freely Values are sets of freely chosen convictions which chosen convictions which compel action as they are compel action as they are cherished and publicly cherished and publicly affirmed. affirmed.

Charles Charles McCoyMcCoy

Occupational Occupational therapists believetherapists believe

About occupation,About occupation, occupation gives meaning to life occupation gives meaning to life occupation is an important determinant occupation is an important determinant

of health and wellbeing of health and wellbeing occupation organizes behaviour occupation organizes behaviour occupation develops and changes over a occupation develops and changes over a

lifetime lifetime occupation shapes and is shaped by occupation shapes and is shaped by

environments environments occupation has therapeutic occupation has therapeutic

effectivenesseffectiveness

Occupational Occupational therapists believetherapists believe

About the person,About the person, humans are occupational beings humans are occupational beings every person is unique every person is unique every person has intrinsic dignity and worth every person has intrinsic dignity and worth every person can make choices about life every person can make choices about life every person has some capacity for self-every person has some capacity for self-

determination determination every person has some ability to participate every person has some ability to participate

in occupations in occupations every person has some potential to change every person has some potential to change persons are social and spiritual beings persons are social and spiritual beings persons have diverse abilities for persons have diverse abilities for

participating in occupations participating in occupations persons shape and are shaped by persons shape and are shaped by

environmentenvironment

Occupational Occupational therapists believetherapists believe

About the environment,About the environment, environment is a broad term including cultural, environment is a broad term including cultural,

institutional, physical and social components institutional, physical and social components performance, organization, choice and satisfaction performance, organization, choice and satisfaction

in occupations are determined by the relationship in occupations are determined by the relationship between persons and their environment between persons and their environment

About health,About health, health is more than the absence of disease health is more than the absence of disease health is strongly influenced by having choice and health is strongly influenced by having choice and

control in everyday occupations control in everyday occupations health has personal dimensions associated with health has personal dimensions associated with

spiritual meaning and life satisfaction in spiritual meaning and life satisfaction in occupations and social dimensions associated with occupations and social dimensions associated with fairness and equal opportunity in occupations fairness and equal opportunity in occupations

Occupational Occupational therapists believetherapists believe

About client-centred practice,About client-centred practice, clients have experience and clients have experience and

knowledge about their occupations knowledge about their occupations clients are active partners in the clients are active partners in the

occupational therapy process occupational therapy process risk-taking is necessary for positive risk-taking is necessary for positive

change change client-centred practice in client-centred practice in

occupational therapy focuses on occupational therapy focuses on enabling occupationenabling occupation

RELATIONSHIPSRELATIONSHIPS

WholenessWholeness InclusionInclusion InterconnectednessInterconnectedness InterdependenceInterdependence EnculturationEnculturation Appreciation of diversityAppreciation of diversity

I’m sittin’ on my stage-head lookin’ out at I’m sittin’ on my stage-head lookin’ out at where Skipper Joe Irwin’s schooner is where Skipper Joe Irwin’s schooner is ridin’ at her moorin’ … thinkin’ about how ridin’ at her moorin’ … thinkin’ about how weak are the things that try to pull weak are the things that try to pull people apart – differences in colours, people apart – differences in colours, creeds and opinion – weak things like the creeds and opinion – weak things like the ripples tuggin’ at the schooner’s chain. ripples tuggin’ at the schooner’s chain. And thinkin’ about how strong are the And thinkin’ about how strong are the things that hold people together – strong, things that hold people together – strong, like Joe’s anchor, and chain, and the good like Joe’s anchor, and chain, and the good holdin’ ground below.holdin’ ground below.

Ted Russell, Ted Russell, The Holdin’ GroundThe Holdin’ Ground

RESPECTING THE RESPECTING THE TRADITIONTRADITION

Image of the doryImage of the dory Strengths of the pastStrengths of the past

READINESS TO RESPONDREADINESS TO RESPOND

Awareness of complexityAwareness of complexity Skills developmentSkills development Strengths of traditionStrengths of tradition Emotional preparednessEmotional preparedness ReflectionReflection Ceremonies and celebrationCeremonies and celebration SymbolsSymbols Confidence/convictionConfidence/conviction

Beannacht ("Blessing")Beannacht ("Blessing")

May the light of your souls guide you. May the light of your souls guide you. May the light of your souls May the light of your souls

bless the work that you do bless the work that you do with the secret love and warmth of your hearts. with the secret love and warmth of your hearts.

May you see in what you do May you see in what you do the beauty of your own souls. the beauty of your own souls.

May the sacredness of your work May the sacredness of your work bring healing, light and renewal bring healing, light and renewal

to those who work with you to those who work with you and to those who see and receive your work. and to those who see and receive your work.

May your work never weary you. May your work never weary you. May it release within you wellsprings of May it release within you wellsprings of

refreshment, inspiration and excitement.refreshment, inspiration and excitement.

May you be present in what you do. May you be present in what you do. May you never become lost in bland May you never become lost in bland

absences. absences. May the day never burden. May the day never burden.

May dawn find you awake and alert, May dawn find you awake and alert, approaching your new day with dreams, approaching your new day with dreams,

possibilities and promises. possibilities and promises. May evening find you gracious and fulfilled. May evening find you gracious and fulfilled.

May you go into the night May you go into the night

blessed, sheltered and protected. blessed, sheltered and protected. May your souls calm, console and renew May your souls calm, console and renew

you.you.

Adapted fromAdapted from

John O'Donoghue, John O'Donoghue, Anam CaraAnam Cara