Disclaimer: The opinions expressed in this blog are entirely our own and not necessarily those of our employer or any other occupational therapist.

Monday, 1 February 2010

A rose by any other name........

I have recently been involved in a brief yet relevant discussion on Facebook with OT colleagues around the world on our title "Occupational Therapist" and whether this reflects our role.

Since I qualified as an occupational therapist in the early 1980's there has been much debate over our title "occupational therapist" Throughout the decades there have been letters and articles within relevant publications each suggesting either a title change or a shift in practice to reflect the title we hold.

In 1983 BJOT received a number of letters in support of a poll for name change - with suggestions of Ergotherapist and Parotherapist being top of the list.

Gilfoyle's Eleanor Clarke Slagle Lecture (1984) clearly states the importance of defining and underpinning the profession with clear, unifying system of values that encompasses both historical and current concepts of the role and if this happened then a name change would not be necessary. At that time the profession was undergoing a paradigm shift - certainly within the UK. Moving from a diploma to degree training programme, the upsurge of models of practice and other evidence-based practices were developing and the title Occupational Therapist became a protected title

In 1997, Greg Kelly looked at the common themes of the BJOT over the previous 6o years, and title change was one of these themes.

In 2000, Catherine Moor in Therapy Weekly suggested a name change for the millenium. Her opinion was based on the fact that our main goal was one of rehabilitation using activity in achieving our client's goals and not "merely occupation" . Following on from the changes of the previous two decades Moor suggested that a name change to Rehab Therapist ( a suggestion first made by Elizabeth Cracknell in 1970 as Rehab Officer) might achieve greater understanding of our role. Letters flooded in over the next few issues, some in support, believing that a name change would stop the need for us to explain and define our role and offering also Ergo therapist, Independence therapist and Activity therapist to name a few. One letter from a Speech and Language Therapist strongly urged us not to change - her experience of their title change (to add the "Language" tag) was "more trouble than it's worth".

The essence of most of the responses was very much about occupational therapists embracing the term "occupational" and that those not addressing the needs of occupational beings should not be calling themselves occupational therapists. "The only way we can hope to be understood is by doing occupational therapy and being occupational therapists" (Matthew Molineaux response July 20th 2000 Therapy Weekly)

In 2001 again BJOT ran an article by Perrin (2001) Don't despise the fluffy bunny: a reflection from practice where she talks about occupational therapists having lost the art of fostering creativity and talks of a new Activity Therapist role at NVQ level to fulfil this need. Letters of response both for and against included the suggestion of Ability Therapists as a title change.

In the past couple of decades, there has been a strong professional shift towards the use of occupation in many areas of the profession - although not all. Many of the UK undergraduate programmes now have this at the core of their programmes and much time is spent defining and analysing how we use occupation within our diverse roles.

So it is interesting that what seems to be beginning is a questioning now of the term "therapist" within our title. Claire started the discussion off and my response was in agreement with her to look at the term "therapist"

Many people we work with here in the UK and our potential future clients (given the push to third sector working) do not see themselves as needing a therapist. Before our final year students go on role emerging placements we have to get them to practice how to explain their role without using words such as "help, better and problem ". Many people they engage with do not see that they need "therapy" or that there is something wrong or dysfunctional that needs therapy to occur. Instead we get the students to think about words such as "facilitate", "quality of life", "engage" "roles" etc.

Bronnie thinks it accurately describes what she does, and that it's a positive way to describe the process of working with someone

Anita Hamilton response is "Let's just keep doing a good job, telling people what occupation is and what amazing therapy it is for the heart, the mind, the should, the body, the spirit, families, communities and whole darn populations... just keep doing it!"

I open the debate to you here - any ideas?


Allie Hafez said...

I've blogged on this theme myself:

The "F-word": function(al)


Splitting More Hairs

Anonymous said...

The problem doesn't lie with the name of our profession but in the process of how to address a person's occupational issues. If the process is truely collaborative and respects that they are the experts about their illness experience then our engagement with them can become therapeutic.

Anonymous said...

I have been doing some work within the OT sector for a couple of years now.

The angst over "Who are we?" seems peculiar.

On one level the question is essentially one of branding - Do people recognise what occupational therapists do? I know that I did not until I worked with them.

But I also fear that there is a question of confidence within the profession also.

I've heard debates about other service providers (cough cough physiotherapists cough) are in some cases being appointed in place of OTs.

I have little doubt that many of the functions carried out by OTs can and are also carried out by other professionals.

I suspect that there is a need for the OT sector to do more to communicate outwardly what they do, what value do they bring to clients' situations and the like. That need will not be satisfied by a name change alone.

Indeed I think that a new title would be a retrogressive step. At least people are familiar with the OT term, even if not fullly aware of what it means. An entirely new moniker would take years, decades even to establish itself.

Anonymous said...

I think possibly the most irritatingly confusing thing is the distinct difference between mental health and physical health occupational therapy. After all, what we do in each of those roles is worlds apart! I remember on one of my practice placements in a CMHT, there was a need for assistive devices to enable function, but the mental health OT couldnt assess for these devices because it wasn't their role apparently...if OT philosophy is to be "holistic"...then what;s holistic about that? Not very in my opinion!

My suggestion would be to seperate both areas at undergratuate level, where students would train to become an Ergotherapist or an Activity therapist/Recovery therapist or something where they could become experts in their area of interest...while still having a core foundation year where core principles of occupational therapy are taught! This is what happens in Nursing education...why can't OT facilitate this? This would seem to fit the way that OT is delivered in the NHS and beyond!

It's a shame that many OTs (including myself) embarassingly fail to have the ability to describe their profession as a whole, and can only see this as being a way to explain properly what we do and help our clients understand too. Laughabley, I've heard OTs refer to themselves as "Physiotherapists that aren't quite physiotherapists"!

Personally, I'm bored of having to explain what it is I do! It gets tedious after the first few times. If OTs cannot even explain what they do, how on earth will our clients and the wider public? My vote goes to the name change 100%!

Jack said...

I don't know what to tell about it. So, I would like to more concentrate on my OT education which I have taken from occupational therapy university.

Thanks !


hkpeck said...

I am an occupational therapy student, currently finishing my last year of my Master’s program. The topic, “what is occupational therapy?” and how we define it is a running theme throughout these last few semesters. A lot of good discussions amongst my classmates and professors have emerged on the topic. The generic response that I hear in class is “When people ask me if I help people get jobs, I take the opportunity to explain what OT is all about.” I have even used the line a time or two, and for the most part it is true. However, I have to admit that the questions about what I go to school for can get tiresome, as my friends, family, and some acquaintances may not understand exactly what I am working so hard for.
Neil’s response brings up an interesting point, he as a professional did not even understand what exactly OT is all about until direct exposure. As a profession we need to increase our exposure to the general public. Neil uses the term “branding,” I completely agree that this is a missing link. I do not feel it is the title “occupational” therapist but it how consumers in the general public link that name to the goods and services we provide. The 2008 presidential address is a great example of linking our profession to providing people the opportunities to “live life to the fullest.”
As professionals, occupational therapists can promote the name of our services by providing consistent and meaningful interventions to our clients. Also professionals need to take the opportunities to promote the profession such as using advertisements from our organization. As students we have the advantage of numbers in a group. It is our responsibility to get the word out with potential consumers of our services and participate in activities that is going to educate our communities about the goods OT has to offer.