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Caotkeynote2010april26ml et-hp-option2


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note I have created two options -the et-hp is essentilly as it was with content for me. the option2 has heading changes ans transition slides - and may work better - see what you think!

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Caotkeynote2010april26ml et-hp-option2

  1. 1. From ‘C’ to ‘C’ to ‘C’: An Ocean of Possibilities Dr. Mary Law Dr. Helene Polatajko Dr. Elizabeth Townsend
  2. 2. ????MOVE
  3. 4. Celebrate Challenge Create
  4. 5. Celebrate Our collective accomplishments
  5. 6. Celebrate: the Past Historic Profession with Great Potential to Grow Background Photo: Jessie Luther en route to St. Anthony. (Courtesy of Brenda Head, Copyright © Jessie Luther Papers.) Jessie Luther working in St. Anthony’s community Workshop, 1908. (Courtesy of Brenda Head. Copyright © Grenfell Historical Society, p. 196). Jessie Luther teaching basketry to a resident who is blind, 1908. (Courtesy of Brenda Head, Copyright © Grenfell Historical Society, p. 184).
  6. 7. Celebrate: our client centred guidelines <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>
  7. 8. Celebrate: our 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>
  8. 9. Celebrate: our 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
  9. 10. Celebrate: our Client-centred occupational focus <ul><li>The occupational imperative </li></ul><ul><li>Regardless of the perspective </li></ul>Client-centred Human Occupation
  10. 11. <ul><li>Occ picture slide here???? </li></ul>
  11. 12. Celebrate: our Canadian Model of Occupational Performance (CMOP) Original Occupational Performance Model (Adapted from Reed and Sanderson, 1980)  Performance components  Areas of occupational performance  Adapted from Reed and Sanderson, 1980 THE INDIVIDUAL spiritual  physical  mental  socio-cultural  SOCIAL ENVIRON-MENT productivity  self care  leisure  ENVIRONMENT (social, physical, cultural) CULTURAL ENVIRON-MENT PHYSICAL ENVIRONMENT
  12. 13. Celebrate: our CMOP CAOT, 1997
  13. 14. Celebrate: our evolving Canadian perspective on occupation <ul><li>From divergence </li></ul>
  14. 15. through therapeutic use …
  15. 16. <ul><li>to enabling occupation … </li></ul><ul><li>At the level of … the individual </li></ul>
  16. 17. Celebrate and Be Proud MOVE?????? <ul><li>Highest Uses of CMOP (1993 Canadian Survey) </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>
  17. 18. Celebrate: our CMOP <ul><li>OCCupation, now used to frame ourselves </li></ul><ul><li>CAOT membership profile </li></ul>
  18. 19. Celebrate and be proud: CMOP Now used to frame our practice <ul><li>Debbie Hebert of the Toronto Rehabilitation Institute writes… </li></ul><ul><li>Prior to the Enabling I publication, our OT documentation reflected a very medical model, impairment based type of assessment process…t here was nothing really occupation based about this form! Other professions such as nursing and physiotherapy might have filled out this assessment form as well as us. </li></ul><ul><li>One day, we were reflecting on how documentation both dictates and reflects practice. Our documentation was dictating something that did not reflect how occupational therapists work with clients </li></ul><ul><li>We renovated the initial assessment document and called it the “Occupational Performance Module”. </li></ul>
  19. 20. Celebrate and be proud: CMOP Now used to frame our practice <ul><li>Debbie Hebert continues… </li></ul><ul><li>This change was transformative … </li></ul><ul><ul><li>with respect to how we were practicing and how our teams regarded our input. </li></ul></ul><ul><li>The Enabling Occupation document gave us the guidance and validation to be the leaders in patient centred goal setting at our hospital </li></ul><ul><li>Now we are mostly considered as an invaluable profession for our knowledge of helping our clients articulate their goals and evaluating how safely our clients perform their needed and desired occupations. </li></ul><ul><li>It is nice to now hear our colleagues say… </li></ul><ul><li>“ I wish I were an OT” rather than “What do OTs do?” </li></ul>
  20. 21. Celebrate and Be proud – CMOP Internationally lauded Your work has such international significance, it has such professional significance and to me it has such personal significance as it gave me the structure to build my science that has always had the focus to improve the lives of those with or threatened with disabling conditions. … it has involved and it has influenced so many therapists, scientists, educators and clients that have been served. Congratulations to all Canadians for your vision, your work and your commitment. Dr. C Baum, 2010 AOTA Past President
  21. 22. Celebrate: our 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>
  22. 23. Celebrate: COPM - Slovenia
  23. 24. Celebrate and Be proud COPM around the world  Countries where the COPM is used
  24. 25. Celebrate and Be Proud <ul><li>Highest Uses of CMOP (1993 Canadian Survey) </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>
  25. 26. Celebrate Our collective accomplishments Be proud
  26. 27. Celebrate -> Be proud Challenge Each other to go further
  27. 28. Challenge the Present: go further <ul><li>Enabling II: Advancing OT vision for health, well-being & justice through occupation </li></ul><ul><li>Occupation-based practice </li></ul><ul><li>Beyond performance </li></ul><ul><li>Beyond disability </li></ul>
  28. 29. Challenge: Canadian Model of Occupational Performance AND Engagement - occupation as our focus
  29. 30. Challenge: our scope and go further <ul><li>Individuals with impairments </li></ul><ul><li>Individuals with occupational performance issues (OPIs) </li></ul><ul><li>Individuals, families, groups, organizations, communities or populations with OPIs or potential OPIs </li></ul><ul><li>The human population </li></ul><ul><li>Impairment reduction </li></ul><ul><li>Adaptation (P, O, E) </li></ul><ul><li>Accommodation (E) </li></ul><ul><li>Skill acquisition (P) </li></ul><ul><li>Social reconstruction (O,E) </li></ul><ul><li>Health and well-being </li></ul><ul><li>Occupational enablement </li></ul>1 2 3 4 7 2 3 1 6 4 5
  30. 31. Challenge: our practice and go further <ul><li>Sunnybrook Health Sciences Centre OT’s journey toward occupation-based practice: </li></ul><ul><li>Initiated in 2003 and kept alive by the professional practice leader – Fran Aiken </li></ul>
  31. 32. Challenge: our practice and go further <ul><li>Sunnybrook Health Sciences Centre OT’s journey toward occupation-based practice: </li></ul><ul><li>Fran Aiken writes… </li></ul><ul><li>I have always felt rooted to occupation as the basis of practice. BUT - I experienced first-hand the move to increasingly ‘disease-oriented’ health care and found that even my OT colleagues devalued activity-oriented interventions. THUS, it was with open arms that I welcomed the 1997 Enabling Occupation guidelines </li></ul>
  32. 33. Challenge: our practice and go further <ul><li>Fran —as the Centre’s Professional Leader—used occupation-based practice as a unifying concept for the newly amalgamated Occupational Therapy service </li></ul><ul><li>Over the years, Fran and her colleagues incorporated a series of knowledge building exercises (through large professional group workshops and retreats), as well as one-on-one individual reflective practice exercises—all related to occupation-based practice . </li></ul><ul><li>And then they studied the effect </li></ul>
  33. 34. Challenge: Be Daring Occupation-based practice <ul><li>The Question : How do OT’s at S&W incorporate an occupational view of health in the context of their clinical practice on a day-to-day basis? </li></ul><ul><li>Our Long-term goal : To contribute to the understanding of occupation and thus develop methods of helping people </li></ul><ul><li>Interesting findings : The meaning GAP </li></ul>
  34. 35. Challenge: Be Daring <ul><li>The meaning GAP </li></ul><ul><li>When there is incongruence between how therapists believe occupational therapy should be practiced in an ideal world and how they actually do practice in the real world, they experience a “ meaning gap. ” </li></ul><ul><li>“ Well, again I think we always struggle with being true to our profession and yet being true to the programme that we work in.  And very often I think it's hard to say that I've been able to balance both in my clinical practice.” </li></ul>
  35. 36. Be Daring: Occupation-based practice <ul><li>The meaning GAP </li></ul><ul><li>The process of resolving the meaning gap between ideal and actual practice is a personal journey . The search for meaning facilitates a personal sense of occupation that guides practice . </li></ul><ul><li>Those who bridge the gap have specific stories about co-creating meaning and how that meaning transforms their practice . </li></ul><ul><li>“ it’s your individual sense of occupation that sort of guides you. ” </li></ul>
  36. 37. Be Daring: Occupation-based practice <ul><li>The meaning GAP </li></ul><ul><li>Therapists who highly value occupation and see the potential for client occupational engagement in their daily roles are enthusiastic therapists, who derive personal meaning and satisfaction within their own occupation, despite other challenges in their work environment. </li></ul><ul><li>it’s your individual sense of occupation that sort of guides you.” </li></ul>
  37. 38. Be daring: Contribute to society <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>
  38. 39. <ul><li>to enabling occupation </li></ul><ul><li>At the level of … the group </li></ul>
  39. 40. to enabling occupation At the level of … society
  40. 41. 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>
  41. 42. 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>
  42. 43. 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>
  43. 44. Be daring – Naming Enablement
  44. 45. 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
  45. 46. 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 &quot;road tested&quot; the Enabling Occupation guidelines over the course of a year.
  46. 47. 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)
  47. 48. Challenge each other to go further Be daring
  48. 49. Celebrate -> Be proud Challenge -> Be daring Create An occupational future for all
  49. 50. Create: An occupational future for all <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>
  50. 51. Create: 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.
  51. 52. <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
  52. 53. 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)
  53. 54. Imagine if……….
  54. 55. <ul><li>&quot;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.&quot; </li></ul><ul><li>- parent of a child with a disability </li></ul>
  55. 56. Imagine if………. <ul><li>Helene </li></ul>
  56. 57. Imagine if………. <ul><li>Helene </li></ul>
  57. 58. Imagine if………. A Visionary Occupational Therapy Council of Canada?
  58. 59. Imagine if………. The assessment of development cannot be divorced from the lives that people can lead and the real freedom they enjoy Sen 2009, p. 346
  59. 60. Celebrate -> Be proud Challenge -> Be daring Create -> Be the difference
  60. 61. Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. Margaret Mead
  61. 62. Thank You Merci