Reclaiming occupation as means (ROAM) workshop presentation at the Occupational Therapy Australia Queensland division state conference 2014

1. Reclaiming Occupation As Means
Mr Brock Cook
Mr James Naismith
Dr Robert Pereira
Ms Amelia Di Tommaso
Noosa
October 25th 2014
Reference to cite: Cook, B., Naismith, J. & Pereira, R. B. (2014). Reclaiming Occupation As Means (ROAM): Creating communities of occupation-centred
occupational therapists. Paper presented at the 'Queensland Occupational Therapy Conference: Engage, Inspire, Advance’, Noosa , Australia, October 25.

2. Brock Cook
Quality time with GF
Occupational Therapist
Mental Health
practitioner
Gym
Rugby
Powerlifting
Playing with Rusty my
dog
Being Batman
Advancing the profession
James Naismith
Husband
Father to fur-babies
Occupational Therapist
Music enthusiast
Socialising
Gardening
Home Renovator
Advancing the profession
Richmond Tigers supporter
Robert Pereira
Being a Husband
Going to church
Socialising
Racquet Sports
Photography
Travelling
Gardening
Occupational Scientist
Occupational
Therapist
Amelia Di
Tommaso
Family time
Occupational Therapist
Teaching Fellow
Playing Tennis
Playing Hockey
Travelling
Doing a PhD
Doing a PhD
Doing a PhD!

3. ROAM
Reclaiming Occupation As Means

6. ROAM
Reclaiming Occupation As Means
6

7. 12hrs in Ward rounds
6hrs in other ward meetings
10hrs doing admin tasks
3hrs per functional assessment
3hrs running groups
38hrs in a working week
34hrs before ANY interventions
This left me with only 4hrs a week
to do any 1on1 interventions
ROAM
Reclaiming Occupation As Means

8. ROAM
Reclaiming Occupation As Means

9. Operation Occupation
ROAM
Reclaiming Occupation As Means

10. 6hrs in Ward rounds
2hrs in other ward meetings
3hrs doing admin tasks
0hrs per functional assessment
0hrs running groups
38hrs in a working week
Only 11hrs before ANY interventions
This now left me with 27hrs a week
to do tailored 1on1 interventions
ROAM
Reclaiming Occupation As Means

11. ROAM
Reclaiming Occupation As Means
What is Occupational Therapy?

12. "....provides services to individuals and
populations to develop maintain, restore and
optimise health and function throughout the
lifespan. This includes providing services to
people compromised by aging, injury, disease
or environmental factors."
ROAM
Reclaiming Occupation As Means

13. ROAM
Reclaiming Occupation As Means
"....Physiotherapy identifies and maximises
quality of life and movement potential....This
encompasses physical, psychological,
emotional, and social well being.
(Physiotherapists Board of New Zealand)
Physiotherapists Board of New Zealand. (2009).
Annual Report 2008-2009. Wellington: Author

14. Definition "Occupational Therapy"
ROAM
Reclaiming Occupation As Means
Occupational therapy is a client-centred health profession
concerned with promoting health and well being through
occupation.
The primary goal of occupational therapy is to enable people
to participate in the activities of everyday life.
(WFOT 2012)

15. What is
ROAM
Reclaiming Occupation As Means
Occupation

16. Occupation is engagement in activities, tasks,
and roles for the purpose of productive pursuit,
maintaining one’s self in the environment, and
for purposes of relaxation, entertainment,
creativity, and celebration (Christiansen,
Baum, & Bass-Haugen, 2005)
ROAM
Reclaiming Occupation As Means
Occupation is groups of activities and tasks of
everyday life, named, organized, and given value
and meaning by individuals and a culture;
occupation is everything people do to occupy
themselves, including looking after themselves (self-care),
enjoying life (leisure), and contributing to the
social and economic fabric of their communities
(productivity) (Canadian Association of
Occupational Therapists, 1997)
Occupations are the daily living tasks that are part of an individual’s lifestyle (Golledge, 1998).
Occupation provides the mechanism for social interaction and
societal development and growth, forming the foundation of
community, local, and national identity because individuals not
only engage in separate pursuits, they are able to plan and
execute group activity to the extent of national government or to
achieve international goals for individual, mutual, and community
purposes (Wilcock, 2006)
Occupation is the doing of work, play, or
activities of daily living within a temporal,
physical, and sociocultural context that
characterizes much of human life
(Kielhofner, 2008)
Occupation is perceived as “doing” by the individual, is goal-directed, carries
meaning for the individual, and is repeatable. (McLaughlin-Gray, 1997)

18. "...occupation as ends and occupation
as means..."
Gray, J. (1998). Putting occupation into practice: Occupation as ends,
occupation as means. American Journal of Occupational Therapy, 52(5),
354-364
ROAM
Reclaiming Occupation As Means

19. ROAM
Reclaiming Occupation As Means
Occupation as a means is when a specific occupation is
used as a means in therapy to bring about change in a
person's performance.
Occupation as an ends is the goal or the product
of intervention.
Perspectives in Human Occupation: Participation in Life / [edited by]
Paula Kramer, Jim Hinojosa, Charlotte Brasic Royeen. (pg 2)

20. Occupational Therapy’s
Dilemma:
ROAM
Reclaiming Occupation As Means

21. Gradual loss of occupation in
practice
ROAM
Reclaiming Occupation As Means

23. Gap filling
ROAM
Reclaiming Occupation As Means

25. Lack of unifying professional
identity
ROAM
Reclaiming Occupation As Means

26. Inconsistency in
Reclaiming Occupation As Means
understanding what
ROAM
occupational therapists do

27. Discomfort in using
occupational terminology in
practice
ROAM
Reclaiming Occupation As Means

28. Reclaiming Occupation As Means
Current professional
ROAM
development focus is to
address our roles as gap fillers

29. ROAM
Reclaiming Occupation As Means
What do we own in our
professional toolkits that is
occupation specific?

30. 30
Nicholson, E. (2013). Collective action and the transformation of occupational therapy practice.
Unpublished doctoral thesis; Auckland University of Technology, New Zealand.

31. Validation
Acknowledgment that change could not begin
without recognition of the barriers to
occupational practice, and the significant trust,
courage, and resources required to change
practice.
Working with others to construct & critique
knowledge & practice was imperative to
changing practice
31

32. V: Reflective Questions
Thinking about your own practice/practice
context:
-Do you need and/or have permission to change
your practice?
-What are the barriers to occupational practice?
-Who are likely to be your occupational practice
allies?
-What knowledge & pragmatic resources would
support practice change?
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33. Exploration
‘Trying on’ occupational practice by:
-Accessing & critiquing knowledge;
-Using occupational language covertly;
-Managing information carefully;
-Accessing social media.
33

34. E: Reflective Questions
Thinking about your own practice/practice
context:
-Do you have access to the resources you need to
facilitate practice change?
-Where in your practice can you start to use more
occupational language?
-How can you work smarter to access & integrate the
knowledge that you need?
-Are you a member of the 4OT pages on FB?
34

35. Negotiation
Transforming practice through:
-Reframing barriers as opportunities;
-Challenging expectations about the OT
role;
-Using occupational language overtly.
35

36. N: Reflective Questions
Thinking about your own practice/practice
context:
-What are the possibilities and opportunities for a
different kind of practice?*
-How can you (professionally) challenge and change
expectations about your role?
-Where in your practice can you confidently use
occupational language?
36

37. Integration
Increased confidence with language & practice;
Exploiting opportunities to sustain occupational
practice (such as supervising students);
Signalling a change in the philosophy of practice
through recertification, CPD, & supervision.
37

38. I: Reflective Questions
Thinking about your own practice/practice
context:
-What opportunities exist in the immediate and
wider context to sustain occupational practice?
-How will you now describe your competence and
your role?
-What are your ongoing PD needs?
-Is it time to think about a new direction in
supervision…or a new supervisor?
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39. A: Action
Authentic expression of practice as:
-Meaningful;
-Occupational;
-Client/Family centred;
-Culturally responsive.
39

40. A: Reflective Questions
Thinking about your own practice/practice
context:
-Do you experience your practice as ‘meaningful
occupation’? Why? How?
-What strategies do you use to authentically partner
with clients and families at each of the stages in the
CPPF?
-How is your practice culturally safe & responsive?
-Would your clients agree? Have you asked them?
40

41. #whatisROAM
• Increasing the professional development
opportunities that are aimed at strengthening our
occupation focus
• Increase the knowledge sharing and knowledge
translation opportunities about occupation-based
practice
• Promote (both professionally and publicly) the power
and link between occupation and well-being
• Promote occupation-in-practice
ROAM
Reclaiming Occupation As Means

42. #whatisROAM
• Promote greater use of occupational terminology in
everyday clinical practice (i.e. the power of words to
change practice and perception)
• Promote and support Occupational Therapists to be the
change agents that we all know we can be!
ROAM
Reclaiming Occupation As Means

43. o Participatory in nature
o occupation-focused
o Learning how to apply occupation-in-practice
o Journal article and other publication reviews
o Reflective practice opportunities'
o Learning-through-doing opportunities
(participating in meaningful occupations
together)
o Invite different levels of participation – people
will want to engage at different levels and in
different ways, that is fine, not everybody
needs to be core or in leadership position
o Develop public and private spaces – allow for
individual, small group and large scale
interactions.
o Local communities tailored to local needs
ROAM
Reclaiming Occupation As Means
ROAM CoP’s are:
Whiteford, G. (2007). Autonomy, accountability, and professional practice: Contemporary issues
and challenges. New Zealand Journal of Occupational Therapy, 54(1), 11-14

44. Final Thoughts….
• What do Occupational Therapists feel they need to learn about
occupation?
• Is occupation relevant in your practice?
• Are you comfortable being gap fillers?
• Are you comfortable that your profession lacks a strong
professional identity, unity, presence, and relevance?
• What’s at risk if we don’t ROAM?
o Professionally
o For the people who we work with
o For the future of our profession
o For occupational science and occupational therapy research
o For our relevance to society
ROAM
Reclaiming Occupation As Means

45. Thank You
Brock Cook
@brockcookOT
brockcook.com
James Naismith
@jimmynai
Robert Pereira
robertbpereira@gmail.com
Amelia Di Tommaso
amelia.DiTommaso@canberra.edu.au