Liz We can celebrate and be proud of a century of development that is ongoing today. Long history of working in the community as well as hospitals and other places, and working on many issues to enable participation in occupations e.g., Jessie Luther (Rhode Island OT at Grenfell Mission) engaged in community development to enable healthy & disabled workers engage in productive occupations
Liz I am proud to look back at my good fortune. I was attracted to join the first national 'Guidelines' Task Force in 1979 at the invitation of Hilary Jarvis, then CAOT President from Nova Scotia. At the time, I was enrolled in a Masters of Adult Education program. This privileged position of being an outsider-insider helped me to see the importance for me - and I believe for all occupational therapists and other professionals - to learn to articulate what we do, what we know, how we work, and why societies might benefit from and want to use the knowledge. Thelma Sumsion, the first Task Force Chair and CAOT President, took introduced the nation to national occupational therapy guidelines funded by the Department of National Health & Welfare. Our review of the literature convinced us that what we have been doing for the last century is what Carl Rogers called client-centred practice.
As a profession in Canada, we can be proud to have almost 30 years of national guidelines development. This history of examining, questioning, and articulating what a profession does from a national perspective appears to be a precedent amongst Canadian professional groups, and unique around the world. While practice guidelines are well known in most professions, Canada can be proud of developing generic, conceptual guidelines for any practice. While they are not as directive as many practice guidelines, they have helped us to uncover and describe the foundations that make it possible to practice occupational therapy in so many different ways & places. CAOT formed a Client-Centred Practice Committee that integrated three original1980s Guidelines into a single volume published by CAOT in 1991. The Committee was based in Nova Scotia and included Lori Multari, our CAOT Board Member. These were adventurous times… including working to publication deadlines despite the weather and power outages!
Liz The 1990s were exciting times in Canadian occupational therapy circles as our Canadian perspective evolved from the early 20 th century post-World War I idea of ‘divergent therapy’ to keep wounded soldiers and people with tuberculosis and other diseases ‘occupied’. A physician, Dunton (1919) already recognized the power of occupational engagement to promote health!
Liz Occupational therapy’s evolution from divergent therapy had a fascinating stage in which occupational therapists learned to adapt ‘occupations’ for therapeutic uses for the body, such as using a bicycle saw for exercise, coordination, and work tolerance. A multitude of assistive devices came on the market as aids to daily living. Fred Sammons became a familiar name as an inventor and business man in assistive devices. Muriel Driver, for whom Canada’s premier lectureship is named, wrote in 1968 about occupational therapists’ fascination with technical sciences and the need to understand the profession’s philosophic foundations.
Liz Enabling Occupation emerged as a new framing of client-centred practice. The focus returned to the profession’s origins in addressing occupation beyond technical interests in body parts. At this point, the emphasis was largely on individual occupational performance.
Liz When Enabling Occupation I was published by CAOT in 1997 with the help of Geraldine Moore then Editor of the Canadian Journal of Occupational Therapy
Mary I thought this might be a good way to show how the ‘impact’ of the guidelines has been considered – both in terms of sales and the impact on practice
Mary Suggestion – put the “I just pilled….” quote on the slide and say the other quote Used intermationally
Speak about # translations, # countries, # research articles on COPM
Quote from Sara Crepinsek
Helene ENOTHE view from Europe of the emphasis on working too often only with the individual … when we have much to contribute on the societal level
Liz With occupation being articulated as the domain of concern, Canadian occupational therapists were daring in creating a new model to capture the profession’s implicit, taken-for-granted understanding about HOW occupational therapists actually work. With informal testing to name ‘enablement skills’, we found resonance and support to dare to name 10 enablement skills in an Enablement Continuum in Enabling Occupation II. to name the core competency that distinguishes occupational therapy as ‘enablement’. With this new language, stories have begun to be articulated. For example where occupational therapists have felt restricted by being labelled and locked into a job as the ‘equipment person’, stories are emerging about using enablement skills to educate people about their occupational issues and the potential for them to realize occupational dreams with technical assistance, or to coach them in using particular technologies, and to collaborate with the client – who may be an architect firm to design and actually test the building of inventive technologies that make daily living possible.
Liz International colleagues join us in daring to use the power of ideas, models, and practice process guidelines for enabling occupation. Being able to see what occupational therapy is really about is being examined in different cultures and systems such as Japan
Liz The idea of being daring is catching around the world. An Australian group of occupational therapy researchers and practitioners in various settings has created a Community of Practice to examine what it means for occupational therapists to try enabling occupation in their particular situations. They ‘road tested’ the Enabling Occupation guidelines and dared to raise important critical perspectives about the struggles and the great breakthroughs practitioners reported on their practices, using the latest guidelines for Enabling Occupation II
Liz The Australian project was an important one for daring occupational therapists – some of whom like Lauren felt they were drifting away from the core beliefs and values of occupational therapy – to reassert their interests in enabling occupation
Speak briefly about the impact of occupation on person’s lives and our communities; need to create knowledge to carry our discipline forward; stretch our boundaries beyond health services
Justice with interests in social inclusion Injustice lies in denial or restrictions on the different capabilities that people can actually develop Accommodations need to support the realization of actual potential
Imagine if………………occupational therapists are leaders in the creation of environments that truly support the participation of all persons Imagine if……………..occupational therapists enable occupation at points in transition in person’s lives (e.g. school entry, retirement, first job)
- With a quiet background – e.g. looking off to horizon in future
- With a quiet background – e.g. looking off to horizon in future
Liz Imagine if WE pooled our energies as practitioners, students, and faculty as in the photo of such a group at Dalhousie? Imagine if our pooled energies was focused on changing the cities and towns of Canada, like Halifax and a Newfoundland fishing village in the photos, to make them more inclusive for living a meaningful life Imagine if we were enabling change from the use of technology to health practices to homelessness and social inclusion in schools and workplaces around the world
Liz contemplation on developing awareness and the ability to both describe and critique our profession, our work, and our world
ALL – or Liz briefly as continuity from the last Imagine if? We hope that you’ll be proud, be daring & be the difference in your individual practice, and as a professional community in Canada and the world.
Caot keynote 2010 april 26 ml et
From ‘C’ to ‘C’ to ‘C’: An Ocean of Possibilities Dr. Mary Law Dr. Helene Polatajko Dr. Elizabeth Townsend
Be proud – client centered practice <ul><li>13 Important Ways to Use the Guidelines for the Client-Centred Practice of Occupational Therapy by Thelma Gill </li></ul><ul><li>#1. The guidelines provide </li></ul><ul><li>a clear outline of the process </li></ul><ul><li>of O.T. which can be useful </li></ul><ul><li>in discussions with the </li></ul><ul><li>administrator of your </li></ul><ul><li>facility. ……….… #13. </li></ul><ul><li>From Thelma Sumsion’s 1982 & 1983 Series on “Getting our Act Together and Putting it on the Road … or Handling the Challenge of Change” , NATIONAL, September 1984 , p. 12) </li></ul>
Be proud – client-centred practice <ul><li>“ 8:00 p.m. Meeting </li></ul><ul><li>convened at the home </li></ul><ul><li>of Lori (Multari, NS </li></ul><ul><li>CAOT Board Member, </li></ul><ul><li>using candles in power </li></ul><ul><li>outage] Light beamed </li></ul><ul><li>steadily on the editorial </li></ul><ul><li>work of the 1991 Edition… </li></ul><ul><li>Tea and muffins were </li></ul><ul><li>served” </li></ul><ul><li>Shedding Light on the Work of CAOT (NATIONAL, July 1991, p. 6) </li></ul>
The Evolving Canadian Perspective <ul><li>From divergence </li></ul>
<ul><li>to enabling occupation … </li></ul><ul><li>At the level of … the individual </li></ul>
Be proud – Client-Centred Practice of Enabling Occupation “ What is this important publication and valuable addition to your professional library?” Angela Naugle, Member, CAOT Client-Centred Practice Committee. National, The Newsletter of the Canadian Association of Occupational Therapists, May / June 1997 , 14 (6), p. 1
<ul><li>Original Occupational Performance Model </li></ul>Be Proud: Canadian Model of Occupational Performance (CMOP) Performance components Areas of occupational performance Adapted from Reed and Sanderson, 1980 Figure 1: Interacting Elements of the Individual in a Model of Occupational Performance SOCIAL ENVIRON-MENT THE INDIVIDUAL spiritual physical mental socio-cultural productivity self care leisure ENVIRONMENT (social, physical, cultural) CULTURAL ENVIRON-MENT PHYSICAL ENVIRONMENT
Be Proud: Canadian Model of Occupational Performance (CMOP)
Be Proud - CMOP <ul><li>1993 Canadian Survey </li></ul><ul><li>Highest Uses of CMOP </li></ul><ul><li>Assessing </li></ul><ul><li>Educating others </li></ul><ul><li>Explaining the profession to others </li></ul>Impact Evaluations <ul><li>Sales over 10 years (1999 – Sep. 2009) </li></ul><ul><li>COPM manuals: 11,542 </li></ul><ul><li>Enabling I (1997, 2002): 13,623 (French and English) </li></ul><ul><li>Enabling II (2007): 4186 (French and English) </li></ul>
Be Proud: CMOP <ul><li>OCCupation, now used to frame ourselves </li></ul><ul><li>CAOT membership profile </li></ul>
Be Proud: CMOP <ul><li>Now used to frame our practice </li></ul><ul><li>TRI documentation example </li></ul>
Be proud – CMOP <ul><li>Your work has such international significance …Everything has a temporal order, your groundbreaking work had and has a temporal order of high magnitude- and it has involved and it has influenced so many therapists, scientists, educators and clients that have been served…. </li></ul><ul><li>Carolyn Baum, Former President, American Occupational Therapy Association </li></ul>… I just pulled the guidelines off my shelf- The 83, 86 and 87 guidelines are dog-eared with notes everywhere.
Be Proud - Canadian Occupational Performance Measure (COPM) <ul><li>Enables meaningful participation in the occupational therapy process through: </li></ul><ul><ul><ul><li>identifying occupational performance problems </li></ul></ul></ul><ul><ul><ul><li>evaluating performance and satisfaction in these occupations </li></ul></ul></ul><ul><ul><ul><li>measuring change in perception of occupational performance </li></ul></ul></ul>
Be Proud - COPM Countries where the COPM is used
Challenging the Present, be daring <ul><li>Maybe here we could start with the new guidelines and a practice focused on enabling occupation very specifically </li></ul><ul><li>So replacing the old cover in the next several slides with the new </li></ul>
Be Proud: Canadian Model of Occupational Performance <ul><li>Graphic of the new model </li></ul><ul><li>Maybe we should, add this to the be daring section in terms of expanidng our focus </li></ul>
Be Daring: Reframing your Practice <ul><li>Occupation-based enablement </li></ul><ul><li>For person to population </li></ul>
Be daring <ul><li>The Canadian guidelines for client-centred practice and enabling occupation have had a great impact in Europe because these concepts match very well with the European values like freedom, democracy, equality, human dignity and solidarity and with European Social Policy … clients say : OT works too often only with the individual and this is a pity since they have much to contribute on society level. </li></ul><ul><li>Hanneke van Bruggen, Executive Director, ENOTHE (European Network of Occupational Therapy Educators) re European Values Study (EVS), 2004, & Tuning Project, 2008 </li></ul>
<ul><li>to enabling occupation </li></ul><ul><li>At the level of … the group </li></ul>
to enabling occupation At the level of … society
Be Daring: Enabling Occupation <ul><li>The Sunnybrook story on the meaning GAP </li></ul>
Be Daring: Building New Partnerships for Practice <ul><li>Family Health Teams </li></ul><ul><li>Legal services </li></ul><ul><li>Municipalities </li></ul><ul><li>School Boards </li></ul>
Be Daring: Building Evidence-based Practice in Partnership <ul><li>Occupational therapists from three Vancouver region health districts </li></ul><ul><li>Worked with a knowledge broker and developed strategies to change practice in three areas: </li></ul><ul><ul><ul><li>cognitive screening </li></ul></ul></ul><ul><ul><ul><li>assessment of risk for skin breakdown </li></ul></ul></ul><ul><ul><ul><li>provision of wheeled mobility and seating equipment </li></ul></ul></ul>
Be Daring: Building Evidence in Partnership <ul><li>A resource to assist families in giving, getting, and organizing information about their child/youth with special needs </li></ul>
Be daring: Naming Enablement in Enabling Occupation <ul><li>“ theory in enabling occupation helped me to see what occupational therapy is really about” </li></ul>Photo & quote courtesy of Hiromi Yosikawa, November 2009
Be daring: Enable our own occupation <ul><li>Members came from diverse practice contexts - including in an indigenous community in the central desert, to a youth focussed mental health outreach service in a large city. (G. Whiteford) </li></ul>Australian Practice Scholar Group 2008 by permission G. Whiteford … we created a community of practice scholars who "road tested" the Enabling Occupation guidelines over the course of a year.
Be daring: Enable our own occupation My inclusion in this practice scholars research came at a time I felt I was drifting away from the core beliefs and values of Occupational Therapy. (Lauren, co researcher in the Australian project)
Creating the Future, be the difference <ul><li>“ Occupational therapists are in the business of helping people to transform their lives through enabling them to do and to be. We are part of their process of becoming and we should constantly bear in mind the importance of this task.” </li></ul><ul><li>Wilcock, 1998 </li></ul>
Creating the Future, be the difference ‘ We make our world significant by the courage of our questions and by the depth of our answers’ . . . Sagan, C. (1973). The cosmic connection. New York: Anchor Press, p. 193.
<ul><li>Yet the ability of a civilization to survive and grow lies in its ability to describe itself </li></ul><ul><li>(Saul, 2009, p. 21). </li></ul>John Ralson Saul Pond Inlet, Baffin Island, 2005
Martha Nussbaum American Philosopher “ The capabilities approach … simply specifies some necessary conditions for a decently just society, in the form of a set of fundamental entitlements of all citizens” (2006)
<ul><li>"You spend their young lives trying to get them ready for the world and when the time comes, the world isn't ready for them. So we have to find a way to do it." </li></ul><ul><li>- parent of a child with a disability </li></ul>