Hello All:

Recently Biraj pointed out that I:

> always   championed   and   advocated,  very  strongly I  might  add,
> occupation-based   practice  but  now  it  seems  [I  am]  extremely
> disappointed of anything the term has to do with in the OT profession.

Biraj is correct about my past vocalizations but today I don't feel that
I  am  disappointed  about  occupation.  I  still  feel  the  same about
occupation  but  I  think  that  I  am becoming a bit jaded at trying to
integrate  occupation  into  my private practice. You see, occupation is
important,  it's  important  to  ALL of us, but what I am discovering is
that  treating  occupational  deficits does not fit well with my clients
because  clients don't consider occupational deficits to be the problem.
Here's  a  non-OT  story  to  make my point.

Recently,  someone  I  know  was diagnosed with cataracts. The cataracts
affected his vision to the point that modifications were needed to read,
work  and  play.  Now, what do you think this person saw as the problem;
cataracts  or  occupations.  Obviously,  the impact on his occupation is
what  brought the cataracts to the forefront and motivated him to seek a
lens  replacement,  but  cataracts  are  the  problem,  not  the loss of
occupation. So, the person received a lens replacement and everything is
getting better. Well, how does this 'story' apply to OT.

Simple,  our  clients  are  seeking answers to problems. They want these
problems  fixed.  But  the problems are not occupation, the problems are
things  like weakness, loss of balance, developmental delay, depression,
etc. Clients see these 'components' as the problem and this is what they
expect  their  therapist to address. This is the way the entire world of
medicine works and for OT to be any different just doesn't work.

What  I  think needs to be done is for our patients to recognize loss of
occupation  as the primary problem. Then, they recognize the need for an
occupational therapist. And as far as I can tell, the ONLY way that this
is  going  to  happen  on  a  large  scale is for AOTA to put together a
NATIONAL  ad  campaign directed at educating people about occupation and
thus occupational therapy.

Finally, there are settings were occupation is the concern but about the
only  one  that  I  know  of  is long-term mental health. And given that
therapeutic  occupation  is  rooted in mental health, this makes perfect
sense.  But  for  the  majority  of OT's working in the US, I think that
trying  to  integrate  occupation as our main form and outcome is a lost
battle,   unless   patients   are  EDUCATED,  INTEGRATE  and  EXPERIENCE
occupation-based therapy.

Ron




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