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

Monday, 18 October 2010

Dancing with possibilities.................

As many of you know, we were privileged to have Frank Kronenberg accept our invitation to meet with us here at the university and to run a seminar for students and practitioners. Followers of the blog may remember that Frank recently became an Honorary Professor here at the University of Salford and has  worked with our MSc teaching team on a number of occasions. Sarah and I also met him "for real" (as opposed to being Facebook friends) on our much documented and talked about trip to Chile to the WFOT Congress earlier this year. In fact, those of you that are eagle-eyed will have realised that Sarah and I teased you back in May about the meeting that we had with Frank 

The day overall provided us with much food for thought. An hour of so spent chatting with Frank Kronenberg (a newly appointed Honorary Professor at Salford) has possibly turned much about how we think of our profession on its head - but that´s for another post - we need time to reflect and assimilate before going public with this very radical view! Frank will be vsiting the University in October - watch this space for more details.

Well, now we may be in a position to reveal some of the discussions we had that sent our minds into overdrive.

Frank arrived in Salford on Thursday and was met by Heather Davidson and Chris Kenney, who have been the main instigators and organisers of the successful visit. He was  brought to the university where he briefly met members of the team and then was whisked away to deliver a session in the virtual classroom to our MSc students. The Vice Chancellor had invited the OT team to his house for a drinks reception with Frank as guest of honour - with both of them having lived and worked in Cape Town, S Africa they were old acquaintances and each aware of the energy, philosophy and work of the other.

Most of us arrived within time of each other and then waited for Chris and Frank to arrive, and waited......and waited..........

Now, I'm sure Chris may want to tell her own story - and in fact on hearing it twice now it gets better with the telling and creates a very visual image... but in a nutshell it involves a missing piece of paper with an address on it, a guest of honour in the passenger seat with an unfamiliar mobile phone, a car and an optimistic outlook that could only be described as blind faith!!

That said, eventually everyone was in place and a pleasant evening was had by all in stylish surroundings and with good company of the team and invited guests.

Next day, Frank met with those in the team that were free to meet and we talked about many issues of the profession, how we are moving forwards at Salford and what sense of connectedness we had as a programme to our local communities. The overarching theme could be described as "get naughty...but smartly" brought about by discussions that as a profession we tend to be "good girls" (and as Frank pointed out, even as a nation we tend to be rather tolerant and accepting of injustice and controlling edicts) and often do not speak up for what we believe in or what we can offer. Therefore we should be smarter about how we challenge and should begin to turn disadvantage into advantage within our practices as we do with our clients/service users.

The afternoon saw a lecture theatre full of students, pratitioners and representatives from local organisations and agencies in a seminar delivered by Frank.

He  suggests that occupation integrates the medical and social models. That we cannot discard one or the other, but by the analogy of a pendulum clock with the medical and social models being at the end of each swing left and right and occupation being the clockface or hands of the clock that makes sense of the swing. He suggests that "participation in dignified and meaningful occupations of daily living is as fundamental to all people's experience of health and wellbeing, quality of life as eating, drinking, belonging and loving" (Kronenburg 2004)

His charismatic and inspirational style had us looking at things in a different way and challenging preconceived ideas and assumptions.  For example:
  • what is poverty? there is a tendency  to measure from an economic/income perspective - but we should also be looking at it from a social deprivation perspective
  • Stop looking for problems to solve all the time, instead look how to understand how people live and their connectedness with others in their space/world
  • What is the relevance of occupational therapy? Proportionally only a handful of people worldwide have access to occupational therapists, but if the whole world had access, how relevant would occupational therapy be to their world?
  • that as a profession we may be pre-occupied with existential angst as a result of external pressures of following a scientific agenda and the internal pressures of living up to our full potential. All of this is potentially diminishing the art of occupational therapy.
  • That maybe we should be looking to other areas of the world - for example latin america where there has been a paradigm shift into a more socio-political awareness.

Some of these themes connect with and expand on some of the discussions Sarah and I had with Frank in Chile. We were talking about the 3P Archaeology expained in Frank's new book (‘Occupational Therapies without Borders: Towards an Ecology of Occupation-Based Practices’).   and I replicate some of the reflections on our discussion here, Sarah and I are identified by the black font and Frank's response in blue:

a)         So, it is important that we begin to look at ourselves and our interventions on a much deeper level. To do this we need to be in touch with our personal values and how these impact on our role with others.
b)         There is no such thing as an “occupational therapist” rather there are people who hold personal, professional and political values and use occupational therapies as tools with the people they engage with
This point really interconnects with your previous reflection and is based on one of OT’s beliefs or assumptions ‘every human being is unique’. We invite people to engage in ‘3PArchaeology’ (3PA), an in-depth critical exploration of who they are, where they come from, what matters most to them and what they really stand up for in everyday life. Surely, it is possible to identify common OT characteristics, but that doesn’t make all OT’s the same. Essentially, one’s value add to society isn’t only influenced by one’s culture, often times it also has to be politically negotiated.     
c)         Occupational therapies are tools that enable the phenomena of well being in both giver and receiver.
Personally, I’d prefer to speak of ‘occupations’ (in the broadest sense) as ‘vehicles’ for bringing about meaningful changes. These changes may be therapeutic, but could also have other focuses, learning, development, conflict resolution, etc. Hence, in our new book, we propose OT to essentially constitute a (political) possibilities-based practice, which generates practice-based evidence, to complement evidence-based practices (‘Occupational Therapies without Borders: Towards an Ecology of Occupation-Based Practices’).     
d)         I use occupational therapies to facilitate health and wellbeing using occupation.
I am always  a person first, and OT is merely one of the instruments that I use to play my life’s music.    
e)         The profession is a compromised version of the ideal. Having a profession is preventing us from being contextually driven – the lived experience is what should be driving us – not the profession 
 The ‘gold’ is to be found in the nuance…these reflections here are linked with raising our ‘occupational consciousness’, which Ramugondo (2009) operationally defined as: “An ongoing awareness of the dynamics of hegemony, an appreciation of the role of personal and collective occupations of daily life in perpetuating hegemonic practices, and an appraisal of resultant consequences for individual and collective well-being.”   
f)      Insight is required into self in order to judge whether something is going well for you and for the other person. You should be able to use the 3PArchaeology to look at deeper levels of personal, professional and political and ask yourself
a.       How do I connect with the idea of OT?
Yes, discerning between the profession of OT and the idea(s) that gave birth to OT. As the late great violinist Isaac Stern once said in response to the question what is music all about: “The instrument is not that important, it is only a means to an end. In other words, you don’t use music to play the violin, you use the violin to play music.” ...the profession of OT is the instrument, the idea of OT its music…do you see where I’m hinting at?     
b.      What would I be willing to give up for this?
Here we’re entering the most often narrowly and negatively interpreted realm of ‘politics’ and ‘the political’…but I’d argue that we really can’t afford not being politically conscious and engaged…once we’ve excavated and (re)connect with our personal and professional values, our capacity and power to exercise these in our daily lives and practices relates to the 3rd ‘P’ of 3PA…it’s not firstly about what can you gain from your involvements, but what are you willing to give up for being true to who you are and what you value, personally and professionall  
c.       What am I occupassional about?
In other words, what gets you up in the morning, what keeps you up at night, in terms of what really gives you enthusiasm for life and living, what must you do regardless of whether the world around you says no, you can’t do that’ (?)…but because you’re burning for it you’ll try to do it anyway (!?) We’re talking about internal authentic DRIVE/POWER (of an individual and/or collective) as a resource that can be tapped into more consciously… this question is asked under the first ‘P’ of PERSONAL of the three ‘Ps’…and the second ‘P’ refers to the PROFESSIONAL dimension…exploring the value-add of – in our case – occupational therapy to the society in which we find ourselves… 

 These discussions have provided much food for thought - and I'm not sure that I have truly managed to answer all the questions or managed to excavate enough so far - but I'm sure these will be ongoing discussions within the team for some time to come.

Unfortunately I had to leave before the seminar had ended so I will rely on my colleagues to offer feedback on the rest of the session but on a final note I would like to share one more quote from the seminar

"Each of you is bigger and more beautiful than your professional identity".

We would love to hear from anyone who attended the session to share any impact on your professional development. Also, any who were not able to attend but have something to share about the issues raised please feel free to comment and share.

Friday, 1 October 2010

Final Year Exam Papers ......(1983)

 As we welcome new students to their occupational therapy career and our final year students begin to look towards life away from the institution and into professional practice I thought I might share my  exam papers from my final year of training in 1983! Here in the UK this was, at that time, a diploma course and the exam was set nationally across all occupational therapy schools. What strikes me most is the language/terminology used and the very practical nature of the questions. There was little expectation of using theory to underpin answers or indeed references to support statements!
If you click on the photos you should be able to enlarge them, but to give you a taster here are some of the questions. Could you answer them?, o

Occupational Therapy for Pyschiatric Disorders and Mental Handicap
* Describe the assessment procedure you would use for the selection of patients for a group home. Outline a possible training programme for the selected patients.
* Describe how you would use TWO of the following activities:
      a) music to improve communication skills
      b) pottery to improve task performance skills
      c) art to improve group interaction skills

Occupational Therapy for Patients with Medical and Surgical Disorders:
* How may the community occupational therapist contribute to the management of a young mother who has multiple sclerosis?
* Write short notes on how TWO of the following activities can be used to improve hand function:
            a) stool seating
            b) gardening
            c) wrought iron work (metal craft)

Communication and Management:
* Unnecessary wastage costs money. Where might such a wastage occur in an occupational therapy department? Discuss the methods by which these may be reduced.
* Write a short report for your Head of Department on the possible uses of
                    EITHER: a) a microcomputer
                      OR        b) a video system.