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    • In Praise of Diversity

      This is a shortened version of the first Hanneke van Bruggen lecture, presented by the author at the 17th Annual Meeting of ENOTHE in Ghent, Belgium (2011). Introduction As an enthusiastic traveller, I observe that occupational therapy is recognisably the same profession in every country I have visited, but it also differs in the ways that it is taught and practised, reflecting diverse cultural norms and expectations. Through discussions with colleagues around the world, I have learned to appreciate just how flexible and adaptable occupational therapy can be, when we have the skills and confidence to set goals and deliver our services in ways that are culturally and socially relevant to diverse settings. What is diversity? Diversity means difference, variety and being unlike each other (Shorter Oxford English Dictionary 2002). For example, the term biological diversity, or biodiversity, means 'the variability among living organisms from all sources… and the ecological complexes of which they are part; this includes diversity within species, between species and of ecosystems’ (UN 1992). We know that biodiversity is essential to life on earth because: It is the combination of life forms and their interactions with each other and with the rest of the environment that has made Earth a uniquely habitable place for humans. Biodiversity provides a large number of goods and services that sustain our lives. (Secretariat of the Convention on Biodiversity 2000) Homosapiens is itself a diverse species, with people differing from each other along a huge number of dimensions: gender, race, age, height, intelligence, religious beliefs, emotional resilience, sociability, creativity, ambition, energy, physical fitness, pain tolerance, health, longevity, style of dress and culture, to name just a few. The commonalities we share with others contribute to the fulfilment of a deep need for belonging and community, but it is the differences between people that give us our sense of personal identity and agency. Each of us needs to know that we can make a unique and valuable contribution to the development and wellbeing of our communities (Nixon 2012). Diversity is essential to human survival and wellbeing, because it is not the similarities between people that drive development, innovation and adaptation, but the differences. The Universal Declaration on Cultural Diversity states: As a source of exchange, innovation and creativity, cultural diversity is as necessary for humankind as biodiversity is for nature. In this sense, it is the common heritage of humanity and should be recognized and affirmed for the benefit of present and future generations. (UNESCO 2001) How this paper is organised This paper addresses the issue of diversity in occupational therapy. It argues that the profession started with a predisposition to acknowledge and accommodate diversity, that has not been fully realised in practice. The role of the human rights discourse in promoting diversity is considered, highlighting that recognising a person’s rights is not the same thing as valuing their individuality. The paper then addresses three challenges the profession faces in moving towards greater diversity: the composition of the workforce; access to occupational therapy services, and professional education. The paper finishes with a summary of why diversity is an important issue for occupational therapy. Diversity and occupational therapy When the profession of occupational therapy was founded, at the beginning of the 20th century, the concept of diversity did not appear in the literature, although an implicit acceptance of human differences can be inferred from the writings of the first practitioners. For example, a paper on occupational therapy, delivered at the Glasgow Royal Mental Hospital in 1924, suggested that ‘instead of thinking in groups, we must develop a more individual touch than has ever previously characterized mental hospital organization’ (Henderson 1925, p. 64). Elizabeth Casson, who started the first school of occupational therapy in the UK, in 1930 (Paterson 2010), wrote that ‘even in cases of physical illness [occupational therapy] is primarily psychological’ (Casson and Foulds 1955, p. 113) and, as such, ‘must be applied to each patient as an individual’ (p. 123). A practice that is tailored to the needs of the individual is able to accommodate diversity. Despite this positive beginning, by the early 21st century it was found that ‘despite the occupational therapy profession’s declared allegiance to client-centredness, there has been little effort to enable the perspectives of diverse client groups to infiltrate theories of occupation’ (Hammell 2009, p. 11). Today, throughout the world, some occupational therapists employ the same theories, models, processes and techniques with all clients, without critical evaluation of their social, cultural and personal relevance. An example of this is shown in Box 1. BOX 1: Using a universal approach An occupational therapy service manager in the UK decided to introduce her chosen model for practice across the whole service, rather than encouraging staff to find appropriate ways of working with diverse needs and preferences. The impetus… to choose a service-wide model was in part driven by the need for the profession to establish its identity and clarify its contribution in the current healthcare marketplace… advances in the profession sometimes require a more collective or corporate approach, in which professional members come to use a shared language, along with a common toolbox of structured assessment tools and intervention resources. (Wimpenny et al 2009, p. 514) The manager quoted in Box 1 uses the language of business to justify the adoption of a single model for practice: marketplace, corporate approach, common toolbox. Yet, a Nobel prize winning economist has argued for greater diversity of models: 'We need a variety of alternative forms of economic organisation. We… have focussed too long on one particular model.' (Stiglitz 2010, p. 46) In 2020, the death of a young, black man being forcefully restrained by police in the USA led to widespread protests under the banner of ‘Black lives matter’. The World Federation of Occupational Therapists (WFOT) published a statement of support for the movement, stating that ‘systemic racism needs to be addressed as a global priority’ (WFOT 2020). It will be interesting to see what actions the profession takes in support of this priority during the next few years. As stated in the introduction, diversity is not an option in the modern world but is essential to drive development, innovation and adaptation, whether in economics or healthcare. However, this perspective was not prominent in the human rights discourse of the second half of the 20th century. Human rights The publication of the United Nations’ Universal Declaration of Human Rights in 1948 acknowledged the need to recognise and appreciate diversity. Article 2 of the Declaration states that: Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty. (UN1948) This means that diversity in any characteristic should not exclude a person from enjoying the same rights and freedoms as everyone else in the world. Many governments have enshrined the principles of the Universal Declaration of Human Rights in law so that there is not only recognition but also protection of the rights of vulnerable groups, such as women, children and disabled people. Over the past 70 years, the language of human rights has permeated society, including the education, health and social care systems of many countries. Health and social care personnel are expected to work within a human rights framework that includes respect for all persons. For example, the WFOT Code of Ethics requires that: Occupational therapists approach all persons receiving their services with respect and have regard for their unique situations. They will not discriminate against people on the basis of race, colour, impairment, disability, national origin, age, gender, sexual preference, religion, political beliefs or status in society.’ (WFOT 2016) In 2010, the WFOT published a position paper on diversity and culture, which stated ‘that every person is unique in the way they combine the dynamic interplay between cultural, social, psychological, biological, financial, political and spiritual elements in their personal occupational performance and participation in society’. To state that every person is unique ‘implies that we acknowledge that a diversity of people represents a diversity in values [and suggests] a deep responsibility at the heart of occupational therapy, which entails the practice of respect for people’s differences’ (Kronenberg et al 2011, p. 2). The United Nations and WFOT positions on human differences emphasise the right of all people to full participation in society rather than stressing the vital necessity of maintaining and fostering diversity. We tend to think that inclusivity is to the benefit of disadvantaged people without necessarily recognising that it benefits all of us equally. As occupational therapists, we have a responsibility to ‘incorporate diversity and culture in [our] daily practices… educational programmes, occupational therapy research and the WFOT’ (Kinebanian and Stompf 2009, p. 18), but do we understand that diversity is not optional but necessary, as stated by UNESCO (2001). Diversity is not a problem to be solved, or even a right to be upheld, but is an essential component of human survival and wellbeing. Challenges for occupational therapy The Brazilian occupational therapist, Sandra Galheigo (2011, p. 62), spoke of ‘the risk of producing conformity, instead of emancipation’. Perhaps the greatest risk to occupational therapy at the present time is that we become so conformist we lose the capacity to adapt to rapidly changing social, political and economic conditions. In many countries throughout the world, the practice of occupational therapy is already falling short of what it could be and there is a danger that we will not survive as a profession unless we remain true to our values. At its best, occupational therapy practice reflects a humanistic, person-centred, non-discriminatory ethos that grew from our founding philosophies and continues to absorb new influences, including a human rights perspective. This has enabled the profession, for over 100 years, to match services to the needs of the populations we serve. But, if we are to continue to thrive, more effort must be made to increase the diversity of the occupational therapy workforce, the people who access our services and our professional education. The occupational therapy workforce How diverse are occupational therapists? The first practitioners were young, educated, white women from relatively affluent families (Paterson 2010), not representative of most of the populations they served. Does the present composition of the profession better reflect local demographic profiles, or do we select students to be as much like ourselves as possible: mostly young, educated, predominantly white, mainly female and relatively affluent? In the United States, the Sullivan Commission (2003) on minorities in the health professions identified five principles for increasing diversity in the healthcare workforce: Diversity is critical to increasing cultural competence and thereby improving health care delivery Increasing diversity in the workforce improves patient satisfaction Under-represented minority providers tend to practice in underserved areas, thus improving access for the most vulnerable There are valuable economic benefits Social justice is served However, a European occupational therapy academic pointed out that: Students of different migrant or ethnic minority backgrounds often feel excluded by teachers and fellow students and not attracted to occupational therapy programmes. Furthermore, there is a high dropout rate… It is quite difficult to find good practice about successfully implemented diversity policy in occupational therapy practice and education (van Bruggen 2009, p. xv). If we are to accommodate a wider range of client needs, the profile of the occupational therapy workforce should better represent the ethnicity and gender of the populations with whom we work, their social, cultural and linguistic backgrounds, their contexts and their interests. Access to occupational therapy services Occupational therapists claim to work with anyone who has occupational needs (Creek 2003) but, in reality, we discriminate against certain groups of people, often without being aware that this is what we are doing. Discrimination occurs when services set criteria for who is eligible to receive them without thinking through the consequences for those who are excluded. What might make someone ineligible for occupational therapy? We may exclude some people from access to our services as a defence against the anxiety of working with those we fear we cannot help, because we judge that they are too ill or otherwise unsuitable. A South African occupational therapist argued that ‘the culture of an institution, which can inform the policy and procedures of that institution and influence its primary task, may be established as a defence against the primitive unconscious anxieties that arise from the workers’ direct contact with clients’ (Nicholls 2007, p. 72). The rhetoric of occupational therapy says that we are concerned with ‘the meaning and purpose that clients place on activities and occupations and with the impact of illness or disability on their ability to carry them out’ (Creek 2003, p. 31). Yet, hearing how our clients feel about the impact of illness or disability on their lives can be anxiety-provoking and we may look for ways to protect ourselves. A Canadian psychiatrist (Kirmayer 2001) identified that some truths, as defined by the dominant medical discourse, protect the clinician but damage the patient. For example, every psychiatrist has a checklist in his head when he listens to a patient: this checklist contains the information that he needs to make his diagnosis. Every time the patient says something that matches an item on the checklist, the psychiatrist makes a mental tick: ‘I wake up very early in the morning and can’t get back to sleep’ – tick; ‘My clothes are getting loose because I’m not interested in food’ – tick; ‘I think my family would be better off without me’ – tick. Anything the patient says that is not relevant to the checklist is ignored or simply not heard, becoming a lost narrative. Occupational therapists may have a different checklist in our heads but much of the client’s narrative is still lost because the therapist is looking for specific information rather than trying to hear her or his real concerns. We think that we want to hear what the client has to say but, in reality, we fear that we will not be able understand or cope with a diversity of needs. It is safer to carry out a procedure or fill in a checklist than to confront our own inadequacy in the face of another’s distress; safer to follow prescriptions than to acknowledge that we have choices (Freire 1972). Those occupational therapists who seek certainty in their work cling to models of practice, tools and procedures that they hope will reveal the facts of their clients’ problems and lead to the right intervention. Graeme Smith identified this need in his Casson Memorial Lecture: If we allow our professional narratives to be constrained by tests and formal procedures, we will not be able to get close to our clients. Some practitioners feel safer keeping the professional boundaries intact: they may choose to go into areas of work where they are protected by badges, uniforms and technical expertise (Smith 2006, p. 305)… Practitioners fear uncertainty, which feels unsafe and aspire to certainty, which gives the illusion of safety, of knowing where we are going (op cit, p. 306). The desire for certainty shows not only in the models and procedures followed by many practitioners, but also in how occupational therapy is taught. Occupational therapy education The Brazilian educationalist, Paulo Freire, described a ‘“banking” concept of education’ (Freire 1972, p. 46), in which the teacher’s task is ‘to “fill” the students by making deposits of information which he considers constitute true knowledge’ (op cit, p.49). Banking education imposes a passive role on students, discourages critical thinking, minimises creativity and encourages learners to adapt to the world as it is, rather than seeking to transform it. An occupational therapy programme that employs the banking model of education presents theories, models and approaches to practice as though they are both true and universally applicable. Tutors may claim to teach critical appraisal but they discourage any real challenge to their professional authority. When we teach occupational therapy students, we not only deposit knowledge but also transmit the profession’s beliefs, values, principles and ways of doing things. If students are treated as passive recipients of knowledge, they learn to treat their clients as passive recipients of the occupational therapist’s expertise. When students are taught to follow models and processes, rather than thinking through the complexity of each client’s situation, they become therapists who conform and who expect their clients to comply. The professional rhetoric of occupational therapy proclaims that each intervention is ‘a partnership between the client and the therapist, in which both participate actively, thus increasing the client’s responsibility, choice, autonomy and control’ (Creek 2003, p. 30). If this is what we believe, then occupational therapy education should not follow the banking approach, but strive to create a partnership between teacher and student in which both participate actively, thus increasing the student’s responsibility, choice, autonomy and control. Freire (1972, p. 19) described this approach as ‘a dialogical and problem-posing education’, in which the teacher and students learn in dialogue with each other and are jointly responsible for the process. The teacher ‘does not regard [knowledge] as his private property, but as the object of reflection by himself and the students’ (op cit, p. 54). An occupational therapy educator who espouses the problem-posing model of education presents real problems ‘to the students for their consideration, and re-examines his earlier considerations as the students express their own’ (op cit, p. 54). She or he is driven by curiosity, enjoys exploring and challenging received knowledge and promotes critical exploration in the students. Problem-posing educators trust in their students’ ability to think independently, to know what they want and to understand the world for themselves (Freire 1972). By inviting their students to bring their own knowledge and expertise into the learning situation, and to share it so that all can learn from each other, these educators are modelling a way of doing occupational therapy that engages the client as an active partner in the process of intervention. Summary and conclusion The argument presented here is that diversity among people is not simply a human rights issue but a necessary condition for the survival of the human race. Just as biodiversity provides mutually sustaining habitats for different species, so cultural diversity can be seen as ‘an adaptive process… guaranteeing the survival of humanity’ (UNESCO 2001). Occupational therapists claim to respect people’s differences but this does not go far enough. We need to value human diversity as an essential characteristic of a thriving profession, that is fit for purpose in the modern world. Occupational therapists need to confront three challenges, as a matter of urgency: increasing the diversity of the occupational therapy workforce; making our services accessible to a wider range of people, and incorporating a greater diversity of ideas into our professional curriculum. We can choose to cling to the illusion of certainty produced by conforming to the dominant structuralist discourse, or we can choose to embrace a diversity of cultures, ideas, approaches, education and research, that will allow us to envision and create our future. References Casson, E. and Foulds, E. (1955) Modern trends in occupational therapy as applied to psychiatric illness. Occupational Therapy. 18(3): 113-123. Creek, J. (2003) Occupational therapy defined as a complex intervention. London: College of Occupational Therapists. Freire, P. (1972) Pedagogy of the oppressed. London: Penguin. Galheigo, S.M. (2011) What needs to be done? Occupational therapy responsibilities and challenges regarding human rights. Australian Occupational Therapy Journal. 58: 60-66. Henderson, D.K. (1925) Occupational therapy. Journal of Medical Science. 59-66. Kinebanian, A. and Stomph, M. (2009) Guiding principles on diversity and culture. World Federation of Occupational Therapists. Available at www.wfot.org. Kirmayer, L. (2001) Locating the narratives of psychiatry. Paper presented at Narrative based medicine: an interdisciplinary conference. Cambridge. 3-4 September 2001. Nicholls, L. (2007) A psychoanalytic discourse in occupational therapy. In: J Creek, A Lawson-Porter (eds) Contemporary issues in occupational therapy: reasoning and reflection. Chichester: Wiley. 55-85. Nixon, J. (2012) The ethics of academic practice: grasping what ethics is. In: F Su, B McGettrick (eds) Professional Ethics: Education for Humane Society. 10-24. Newcastle upon Tyne: Cambridge Scholars Press. Paterson, C.F. (2010) Opportunities not prescriptions: the development of occupational therapy in Scotland 1900-1960. Aberdeen: Aberdeen History of Medicine Publications. Secretariat of the Convention on Biodiversity (2000) Sustaining life on earth: How the Convention on Biological Diversity promotes nature and human well-being. Switzerland: UNEP. www.cbd.int/convention/guide/ [Accessed 03/08/2020] Smith, G. (2006) The Casson Memorial Lecture 2006: Telling tales - how stories and narratives co-create change. British Journal of Occupational Therapy 69(7): 304-311. Stiglitz, J. (2010) In praise of pluralism. In: D Ransom, V Baird (eds) People first economics. Oxford: New Internationalist Publications. 37-46. Sullivan Commission (2003) Missing persons: Minorities in the health professions. A report of the Sullivan Commission on diversity in the healthcare workforce. https://campaignforaction.org/wp-content/uploads/2016/04/SullivanReport-Diversity-in-Healthcare-Workforce1.pdf [Accessed 03/08/2020] UNESCO (2001) Universal Declaration on Cultural Diversity: Article 1. http://www.unesco.org/new/fileadmin/MULTIMEDIA/HQ/CLT/pdf/5_Cultural_Diversity_EN.pdf [Accessed 03/08/2020] United Nations (1948) The Universal Declaration of Human Rights. www.un.org [Accessed 03/08/2020] United Nations (1992) Convention on biological diversity: Article 2. www.cbd.int/convention/articles/?a=cbd-02 [Accessed 03/08/2020] Van Bruggen, H. (2009) Foreword. In: N Pollard, D Sakellariou, F Kronenberg (eds) A political practice of occupational therapy. Edinburgh: Churchill Livingstone Elsevier. xiii-xv. Wimpenny, K., Forsyth, K., Jones, C., Matheson, L. and Colley, J. (2009) Implementing the Model of Human Occupation across a mental health occupational therapy service: communities of practice and a participatory change process. British Journal of Occupational Therapy 73(11): 507-516. World Federation of Occupational Therapists (2010) Position paper on diversity and culture. www.wfot.org [Accessed 03/08/2020] World Federation of Occupational Therapists (2016) Code of ethics. https://www.ilota.org/assets/WFOT%20Code%20of%20Ethics%20revised%20CM2016%201.pdf [Accessed 03/08/2020] World Federation of Occupational Therapists (2020) WFOT Statement on Systemic Racism. https://wfot.org/wfot-statement-on-systemic-racism#:~:text=The%20World%20Federation%20of%20Occupational%20Therapists%20%28WFOT%29%20condemns,and%20actions%20need%20to%20be%20louder%20than%20words. [Accessed 20/08/2020]

    • In Praise of Diversity

      This is a shortened version of the first Hanneke van Bruggen lecture, presented by the author at the 17th Annual Meeting of ENOTHE in Ghent, Belgium (2011). Introduction As an enthusiastic traveller, I observe that occupational therapy is recognisably the same profession in every country I have visited, but it also differs in the ways that it is taught and practised, reflecting diverse cultural norms and expectations. Through discussions with colleagues around the world, I have learned to appreciate just how flexible and adaptable occupational therapy can be, when we have the skills and confidence to set goals and deliver our services in ways that are culturally and socially relevant to diverse settings. What is diversity? Diversity means difference, variety and being unlike each other (Shorter Oxford English Dictionary 2002). For example, the term biological diversity, or biodiversity, means 'the variability among living organisms from all sources… and the ecological complexes of which they are part; this includes diversity within species, between species and of ecosystems’ (UN 1992). We know that biodiversity is essential to life on earth because: It is the combination of life forms and their interactions with each other and with the rest of the environment that has made Earth a uniquely habitable place for humans. Biodiversity provides a large number of goods and services that sustain our lives. (Secretariat of the Convention on Biodiversity 2000) Homosapiens is itself a diverse species, with people differing from each other along a huge number of dimensions: gender, race, age, height, intelligence, religious beliefs, emotional resilience, sociability, creativity, ambition, energy, physical fitness, pain tolerance, health, longevity, style of dress and culture, to name just a few. The commonalities we share with others contribute to the fulfilment of a deep need for belonging and community, but it is the differences between people that give us our sense of personal identity and agency. Each of us needs to know that we can make a unique and valuable contribution to the development and wellbeing of our communities (Nixon 2012). Diversity is essential to human survival and wellbeing, because it is not the similarities between people that drive development, innovation and adaptation, but the differences. The Universal Declaration on Cultural Diversity states: As a source of exchange, innovation and creativity, cultural diversity is as necessary for humankind as biodiversity is for nature. In this sense, it is the common heritage of humanity and should be recognized and affirmed for the benefit of present and future generations. (UNESCO 2001) How this paper is organised This paper addresses the issue of diversity in occupational therapy. It argues that the profession started with a predisposition to acknowledge and accommodate diversity, that has not been fully realised in practice. The role of the human rights discourse in promoting diversity is considered, highlighting that recognising a person’s rights is not the same thing as valuing their individuality. The paper then addresses three challenges the profession faces in moving towards greater diversity: the composition of the workforce; access to occupational therapy services, and professional education. The paper finishes with a summary of why diversity is an important issue for occupational therapy. Diversity and occupational therapy When the profession of occupational therapy was founded, at the beginning of the 20th century, the concept of diversity did not appear in the literature, although an implicit acceptance of human differences can be inferred from the writings of the first practitioners. For example, a paper on occupational therapy, delivered at the Glasgow Royal Mental Hospital in 1924, suggested that ‘instead of thinking in groups, we must develop a more individual touch than has ever previously characterized mental hospital organization’ (Henderson 1925, p. 64). Elizabeth Casson, who started the first school of occupational therapy in the UK, in 1930 (Paterson 2010), wrote that ‘even in cases of physical illness [occupational therapy] is primarily psychological’ (Casson and Foulds 1955, p. 113) and, as such, ‘must be applied to each patient as an individual’ (p. 123). A practice that is tailored to the needs of the individual is able to accommodate diversity. Despite this positive beginning, by the early 21st century it was found that ‘despite the occupational therapy profession’s declared allegiance to client-centredness, there has been little effort to enable the perspectives of diverse client groups to infiltrate theories of occupation’ (Hammell 2009, p. 11). Today, throughout the world, some occupational therapists employ the same theories, models, processes and techniques with all clients, without critical evaluation of their social, cultural and personal relevance. An example of this is shown in Box 1. BOX 1: Using a universal approach An occupational therapy service manager in the UK decided to introduce her chosen model for practice across the whole service, rather than encouraging staff to find appropriate ways of working with diverse needs and preferences. The impetus… to choose a service-wide model was in part driven by the need for the profession to establish its identity and clarify its contribution in the current healthcare marketplace… advances in the profession sometimes require a more collective or corporate approach, in which professional members come to use a shared language, along with a common toolbox of structured assessment tools and intervention resources. (Wimpenny et al 2009, p. 514) The manager quoted in Box 1 uses the language of business to justify the adoption of a single model for practice: marketplace, corporate approach, common toolbox. Yet, a Nobel prize winning economist has argued for greater diversity of models: 'We need a variety of alternative forms of economic organisation. We… have focussed too long on one particular model.' (Stiglitz 2010, p. 46) In 2020, the death of a young, black man being forcefully restrained by police in the USA led to widespread protests under the banner of ‘Black lives matter’. The World Federation of Occupational Therapists (WFOT) published a statement of support for the movement, stating that ‘systemic racism needs to be addressed as a global priority’ (WFOT 2020). It will be interesting to see what actions the profession takes in support of this priority during the next few years. As stated in the introduction, diversity is not an option in the modern world but is essential to drive development, innovation and adaptation, whether in economics or healthcare. However, this perspective was not prominent in the human rights discourse of the second half of the 20th century. Human rights The publication of the United Nations’ Universal Declaration of Human Rights in 1948 acknowledged the need to recognise and appreciate diversity. Article 2 of the Declaration states that: Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty. (UN1948) This means that diversity in any characteristic should not exclude a person from enjoying the same rights and freedoms as everyone else in the world. Many governments have enshrined the principles of the Universal Declaration of Human Rights in law so that there is not only recognition but also protection of the rights of vulnerable groups, such as women, children and disabled people. Over the past 70 years, the language of human rights has permeated society, including the education, health and social care systems of many countries. Health and social care personnel are expected to work within a human rights framework that includes respect for all persons. For example, the WFOT Code of Ethics requires that: Occupational therapists approach all persons receiving their services with respect and have regard for their unique situations. They will not discriminate against people on the basis of race, colour, impairment, disability, national origin, age, gender, sexual preference, religion, political beliefs or status in society.’ (WFOT 2016) In 2010, the WFOT published a position paper on diversity and culture, which stated ‘that every person is unique in the way they combine the dynamic interplay between cultural, social, psychological, biological, financial, political and spiritual elements in their personal occupational performance and participation in society’. To state that every person is unique ‘implies that we acknowledge that a diversity of people represents a diversity in values [and suggests] a deep responsibility at the heart of occupational therapy, which entails the practice of respect for people’s differences’ (Kronenberg et al 2011, p. 2). The United Nations and WFOT positions on human differences emphasise the right of all people to full participation in society rather than stressing the vital necessity of maintaining and fostering diversity. We tend to think that inclusivity is to the benefit of disadvantaged people without necessarily recognising that it benefits all of us equally. As occupational therapists, we have a responsibility to ‘incorporate diversity and culture in [our] daily practices… educational programmes, occupational therapy research and the WFOT’ (Kinebanian and Stompf 2009, p. 18), but do we understand that diversity is not optional but necessary, as stated by UNESCO (2001). Diversity is not a problem to be solved, or even a right to be upheld, but is an essential component of human survival and wellbeing. Challenges for occupational therapy The Brazilian occupational therapist, Sandra Galheigo (2011, p. 62), spoke of ‘the risk of producing conformity, instead of emancipation’. Perhaps the greatest risk to occupational therapy at the present time is that we become so conformist we lose the capacity to adapt to rapidly changing social, political and economic conditions. In many countries throughout the world, the practice of occupational therapy is already falling short of what it could be and there is a danger that we will not survive as a profession unless we remain true to our values. At its best, occupational therapy practice reflects a humanistic, person-centred, non-discriminatory ethos that grew from our founding philosophies and continues to absorb new influences, including a human rights perspective. This has enabled the profession, for over 100 years, to match services to the needs of the populations we serve. But, if we are to continue to thrive, more effort must be made to increase the diversity of the occupational therapy workforce, the people who access our services and our professional education. The occupational therapy workforce How diverse are occupational therapists? The first practitioners were young, educated, white women from relatively affluent families (Paterson 2010), not representative of most of the populations they served. Does the present composition of the profession better reflect local demographic profiles, or do we select students to be as much like ourselves as possible: mostly young, educated, predominantly white, mainly female and relatively affluent? In the United States, the Sullivan Commission (2003) on minorities in the health professions identified five principles for increasing diversity in the healthcare workforce: Diversity is critical to increasing cultural competence and thereby improving health care delivery Increasing diversity in the workforce improves patient satisfaction Under-represented minority providers tend to practice in underserved areas, thus improving access for the most vulnerable There are valuable economic benefits Social justice is served However, a European occupational therapy academic pointed out that: Students of different migrant or ethnic minority backgrounds often feel excluded by teachers and fellow students and not attracted to occupational therapy programmes. Furthermore, there is a high dropout rate… It is quite difficult to find good practice about successfully implemented diversity policy in occupational therapy practice and education (van Bruggen 2009, p. xv). If we are to accommodate a wider range of client needs, the profile of the occupational therapy workforce should better represent the ethnicity and gender of the populations with whom we work, their social, cultural and linguistic backgrounds, their contexts and their interests. Access to occupational therapy services Occupational therapists claim to work with anyone who has occupational needs (Creek 2003) but, in reality, we discriminate against certain groups of people, often without being aware that this is what we are doing. Discrimination occurs when services set criteria for who is eligible to receive them without thinking through the consequences for those who are excluded. What might make someone ineligible for occupational therapy? We may exclude some people from access to our services as a defence against the anxiety of working with those we fear we cannot help, because we judge that they are too ill or otherwise unsuitable. A South African occupational therapist argued that ‘the culture of an institution, which can inform the policy and procedures of that institution and influence its primary task, may be established as a defence against the primitive unconscious anxieties that arise from the workers’ direct contact with clients’ (Nicholls 2007, p. 72). The rhetoric of occupational therapy says that we are concerned with ‘the meaning and purpose that clients place on activities and occupations and with the impact of illness or disability on their ability to carry them out’ (Creek 2003, p. 31). Yet, hearing how our clients feel about the impact of illness or disability on their lives can be anxiety-provoking and we may look for ways to protect ourselves. A Canadian psychiatrist (Kirmayer 2001) identified that some truths, as defined by the dominant medical discourse, protect the clinician but damage the patient. For example, every psychiatrist has a checklist in his head when he listens to a patient: this checklist contains the information that he needs to make his diagnosis. Every time the patient says something that matches an item on the checklist, the psychiatrist makes a mental tick: ‘I wake up very early in the morning and can’t get back to sleep’ – tick; ‘My clothes are getting loose because I’m not interested in food’ – tick; ‘I think my family would be better off without me’ – tick. Anything the patient says that is not relevant to the checklist is ignored or simply not heard, becoming a lost narrative. Occupational therapists may have a different checklist in our heads but much of the client’s narrative is still lost because the therapist is looking for specific information rather than trying to hear her or his real concerns. We think that we want to hear what the client has to say but, in reality, we fear that we will not be able understand or cope with a diversity of needs. It is safer to carry out a procedure or fill in a checklist than to confront our own inadequacy in the face of another’s distress; safer to follow prescriptions than to acknowledge that we have choices (Freire 1972). Those occupational therapists who seek certainty in their work cling to models of practice, tools and procedures that they hope will reveal the facts of their clients’ problems and lead to the right intervention. Graeme Smith identified this need in his Casson Memorial Lecture: If we allow our professional narratives to be constrained by tests and formal procedures, we will not be able to get close to our clients. Some practitioners feel safer keeping the professional boundaries intact: they may choose to go into areas of work where they are protected by badges, uniforms and technical expertise (Smith 2006, p. 305)… Practitioners fear uncertainty, which feels unsafe and aspire to certainty, which gives the illusion of safety, of knowing where we are going (op cit, p. 306). The desire for certainty shows not only in the models and procedures followed by many practitioners, but also in how occupational therapy is taught. Occupational therapy education The Brazilian educationalist, Paulo Freire, described a ‘“banking” concept of education’ (Freire 1972, p. 46), in which the teacher’s task is ‘to “fill” the students by making deposits of information which he considers constitute true knowledge’ (op cit, p.49). Banking education imposes a passive role on students, discourages critical thinking, minimises creativity and encourages learners to adapt to the world as it is, rather than seeking to transform it. An occupational therapy programme that employs the banking model of education presents theories, models and approaches to practice as though they are both true and universally applicable. Tutors may claim to teach critical appraisal but they discourage any real challenge to their professional authority. When we teach occupational therapy students, we not only deposit knowledge but also transmit the profession’s beliefs, values, principles and ways of doing things. If students are treated as passive recipients of knowledge, they learn to treat their clients as passive recipients of the occupational therapist’s expertise. When students are taught to follow models and processes, rather than thinking through the complexity of each client’s situation, they become therapists who conform and who expect their clients to comply. The professional rhetoric of occupational therapy proclaims that each intervention is ‘a partnership between the client and the therapist, in which both participate actively, thus increasing the client’s responsibility, choice, autonomy and control’ (Creek 2003, p. 30). If this is what we believe, then occupational therapy education should not follow the banking approach, but strive to create a partnership between teacher and student in which both participate actively, thus increasing the student’s responsibility, choice, autonomy and control. Freire (1972, p. 19) described this approach as ‘a dialogical and problem-posing education’, in which the teacher and students learn in dialogue with each other and are jointly responsible for the process. The teacher ‘does not regard [knowledge] as his private property, but as the object of reflection by himself and the students’ (op cit, p. 54). An occupational therapy educator who espouses the problem-posing model of education presents real problems ‘to the students for their consideration, and re-examines his earlier considerations as the students express their own’ (op cit, p. 54). She or he is driven by curiosity, enjoys exploring and challenging received knowledge and promotes critical exploration in the students. Problem-posing educators trust in their students’ ability to think independently, to know what they want and to understand the world for themselves (Freire 1972). By inviting their students to bring their own knowledge and expertise into the learning situation, and to share it so that all can learn from each other, these educators are modelling a way of doing occupational therapy that engages the client as an active partner in the process of intervention. Summary and conclusion The argument presented here is that diversity among people is not simply a human rights issue but a necessary condition for the survival of the human race. Just as biodiversity provides mutually sustaining habitats for different species, so cultural diversity can be seen as ‘an adaptive process… guaranteeing the survival of humanity’ (UNESCO 2001). Occupational therapists claim to respect people’s differences but this does not go far enough. We need to value human diversity as an essential characteristic of a thriving profession, that is fit for purpose in the modern world. Occupational therapists need to confront three challenges, as a matter of urgency: increasing the diversity of the occupational therapy workforce; making our services accessible to a wider range of people, and incorporating a greater diversity of ideas into our professional curriculum. We can choose to cling to the illusion of certainty produced by conforming to the dominant structuralist discourse, or we can choose to embrace a diversity of cultures, ideas, approaches, education and research, that will allow us to envision and create our future. References Casson, E. and Foulds, E. (1955) Modern trends in occupational therapy as applied to psychiatric illness. Occupational Therapy. 18(3): 113-123. Creek, J. (2003) Occupational therapy defined as a complex intervention. London: College of Occupational Therapists. Freire, P. (1972) Pedagogy of the oppressed. London: Penguin. Galheigo, S.M. (2011) What needs to be done? Occupational therapy responsibilities and challenges regarding human rights. Australian Occupational Therapy Journal. 58: 60-66. Henderson, D.K. (1925) Occupational therapy. Journal of Medical Science. 59-66. Kinebanian, A. and Stomph, M. (2009) Guiding principles on diversity and culture. World Federation of Occupational Therapists. Available at www.wfot.org. Kirmayer, L. (2001) Locating the narratives of psychiatry. Paper presented at Narrative based medicine: an interdisciplinary conference. Cambridge. 3-4 September 2001. Nicholls, L. (2007) A psychoanalytic discourse in occupational therapy. In: J Creek, A Lawson-Porter (eds) Contemporary issues in occupational therapy: reasoning and reflection. Chichester: Wiley. 55-85. Nixon, J. (2012) The ethics of academic practice: grasping what ethics is. In: F Su, B McGettrick (eds) Professional Ethics: Education for Humane Society. 10-24. Newcastle upon Tyne: Cambridge Scholars Press. Paterson, C.F. (2010) Opportunities not prescriptions: the development of occupational therapy in Scotland 1900-1960. Aberdeen: Aberdeen History of Medicine Publications. Secretariat of the Convention on Biodiversity (2000) Sustaining life on earth: How the Convention on Biological Diversity promotes nature and human well-being. Switzerland: UNEP. www.cbd.int/convention/guide/ [Accessed 03/08/2020] Smith, G. (2006) The Casson Memorial Lecture 2006: Telling tales - how stories and narratives co-create change. British Journal of Occupational Therapy 69(7): 304-311. Stiglitz, J. (2010) In praise of pluralism. In: D Ransom, V Baird (eds) People first economics. Oxford: New Internationalist Publications. 37-46. Sullivan Commission (2003) Missing persons: Minorities in the health professions. A report of the Sullivan Commission on diversity in the healthcare workforce. https://campaignforaction.org/wp-content/uploads/2016/04/SullivanReport-Diversity-in-Healthcare-Workforce1.pdf [Accessed 03/08/2020] UNESCO (2001) Universal Declaration on Cultural Diversity: Article 1. http://www.unesco.org/new/fileadmin/MULTIMEDIA/HQ/CLT/pdf/5_Cultural_Diversity_EN.pdf [Accessed 03/08/2020] United Nations (1948) The Universal Declaration of Human Rights. www.un.org [Accessed 03/08/2020] United Nations (1992) Convention on biological diversity: Article 2. www.cbd.int/convention/articles/?a=cbd-02 [Accessed 03/08/2020] Van Bruggen, H. (2009) Foreword. In: N Pollard, D Sakellariou, F Kronenberg (eds) A political practice of occupational therapy. Edinburgh: Churchill Livingstone Elsevier. xiii-xv. Wimpenny, K., Forsyth, K., Jones, C., Matheson, L. and Colley, J. (2009) Implementing the Model of Human Occupation across a mental health occupational therapy service: communities of practice and a participatory change process. British Journal of Occupational Therapy 73(11): 507-516. World Federation of Occupational Therapists (2010) Position paper on diversity and culture. www.wfot.org [Accessed 03/08/2020] World Federation of Occupational Therapists (2016) Code of ethics. https://www.ilota.org/assets/WFOT%20Code%20of%20Ethics%20revised%20CM2016%201.pdf [Accessed 03/08/2020] World Federation of Occupational Therapists (2020) WFOT Statement on Systemic Racism. https://wfot.org/wfot-statement-on-systemic-racism#:~:text=The%20World%20Federation%20of%20Occupational%20Therapists%20%28WFOT%29%20condemns,and%20actions%20need%20to%20be%20louder%20than%20words. [Accessed 20/08/2020]

    • What is a Mental Health Practitioner?

      This is a question that I come across a lot in work. As Occupational Therapists (OTs) have expanded their role across different settings, there is still misunderst goanding of the benefit of OTs in a generic mental health role. Subquently, I have taken some time to reflect on my role within the team. As a mental health practitioner working in the mental health nursing team I am well placed to bring a variety of different skills and viewpoints to the role. As an OT, I draw on the social model to inform my practice. While the traditional medical model may prioritise diagnosis and medication treatment plan, I am to take a holistic view and explore other options for recovery. OTs explore the impact of the person, the environment and their valued occupations on health and well-being. The research supports the role of developing positive occupations and coping strategies through enhancing life skills, meaningful roles and valued relationships. As an example, I have supported a client to explore the benefits of relaxation, through using sensory oils, hand massage and everyday self-care (bath, shower), in order to promote mental well-being. As an OT, I have expertise and knowledge in promoting skills development and supporting people to engage in meaningful occupations, through adaptation and equipment. For example, by tailoring a cooking task to meet the client’s needs, such as using a recipe plan, visual imagery and sequencing. I also actively promote the use of self-management of mental health symptoms, by managing anxiety through mindfulness apps, meaningful activity or journaling. In addition, I am aware that equipment can also be used to help people manage basic activities of daily living and retain some level of functioning. During cooking, a perching stool can support those with reduced standing tolerance; with personal care an electronic stand aid can promote independence and reduce loss of skills (e.g. core strength and stability). The reason that I see this as important is to promote independence and choice in everyday living, thus supporting health and mental well-being. Through reflective practice, I have engaged in healthy discussion with fellow colleague Rebecca, to explore the value of meaningful occupations for health and well-being. My professional experience enabled me to see a different perspective, promoting choices and responsibilities around our human right to engage in valued occupation. Occupational injustice can occur when a person is denied, excluded from or deprived of opportunity to pursue meaningful occupations; thus limiting independence and life satisfaction. These occupational concepts are aligned closely with social justice and the Human Rights legislation. Occupational beings have the basic human right and need to participate in meaningful occupations for health benefits. As a service, we can often feel the need to protect people with a learning disability, to the extent that they avoid consequences such as prison. However, in order to avoid discrimination, we must recognise the responsibilities that come with individual rights and choices. We concluded that, as health professionals, we do not have the right or legal framework to deny someone opportunity to engage in sexual activity, despite the risks associated with the client's understanding around sex. This learning opportunity has helped me to redefine my contribution and role within the scope of my professional practice. My service users will benefit from my knowledge and expertise in promoting occupational rights, in the context of health and well-being management. I would encourage anyone to take on a generic mental health role, to embrace the challenge and promote the value of OT in a variety of different settings and roles.

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    • Home | The Occupational Therapy Hub

      Welcome to your global occupational therapy community What's new? Join us, free Created by occupational therapists Supporting clinicians, students, patients and clients ​ 10,800+ Members 174 countries Hub News 06/09/20 Free The OT Journal Club: Walking as a meaningful occupation analysis and add your critique, to Study results emphasise physical, mental and emotional benefits, whilst recognising the challenges of activity engagement, if not matched to individual ability or needs. Read contribute towards your CPD this September/October. The OT Journal Club 05/09/20 Plus+ New to OT Downloads: Burnout Journal Journaling provides a conscious way to step back and evaluate effects of the occupational phenomenon of 'burnout'. These self-reflective questions are designed to get you in touch and in sync with your mind, body and soul! Now available to download, exclusively for (low-cost upgrade). Plus+ Members OT Downloads (Plus+) 01/08/20 The Occupational Therapy Hub turns 3! Launched on 1st August 2017, today the Hub celebrates 3 years of connecting occupational therapy and its worldwide community. A big to Hub Members, collaborators, writers, researchers and hosts of podcasts, forums and Journal Clubs. thank you Our Mission OT Circles latest Groups are loading Therapy Articles latest Community Forum latest Ellie Dixon Sep 5 September - October 2020: Walking as a meaningful occupation Stacey Vieyra-Braendle Jun 26 Seeking Current School-Based OTPractitioner's in the USA for Survey Research About the School-to-Prison Pipeline Carolyn Connage Jul 20 Setting up new multidisciplinary team "Thank you for being such a great resource for my continuing professional development and daily practice." ​ Dora (email, 2020)

    • Mission | The Occupational Therapy Hub

      Mission Established 2017 The Occupational Therapy Hub ​ Passionately supporting clinicians, students, patients and clients. ​ Via a worldwide , information-sharing community platform . Inclusive to everyone. Our Team What we do The Needs ​ To openly share ideas and resources across the international community To provide a community of practice, to reduce geographic and professional isolation To be a more widely recognised profession, by the wider public The Aim To better and more inclusively support clinicians, students, patients and clients The Goals Led by our two core passions: A GLOBALLY COLLABORATIVE HUB ​ To share the latest occupational therapy-linked news and stories * To facilitate questions and debate * in a safe, professional environment To provide free collaborative professional development * opportunities To showcase podcasts * and videos * from around the world, all in one place To signpost * and to healthcare staff and the public resources, services research * To host live and pre-recorded webinars * - hosted by experienced occupational therapists To provide online group workspaces *, that Members can assign public or private access to To share inspirational and educative articles * - including discussion topics and case studies To offer affordable * - information sheets, checklists and consideration documents downloadable tools To provide , benefitting both clinicians and health/social care organisations dynamic marketing opportunities ​ ENHANCED AWARENESS ​ - access an occupational therapist For individuals - information about occupational therapy, its scope and services For the public and service users - occupational therapy opportunities and career pathways For those considering or developing a career ​ * These portals are accessible to Hub Members. Free and Plus+ Memberships available . here VISION 2020 Prioritising Member engagement Championing the evidence base Greater global representation Growth of Membership Plus+ Get involved Join The Occupational Therapy Hub The occupational therapy information platform and global community. Made by occupational therapists. Shaped by its Membership. The Occupational Therapy Hub is managed by The OT Hub Ltd. Registered in England and Wales. Company number: 11084421.

    • Access OT | The Occupational Therapy Hub

      Access Occupational Therapists Connecting the public to occupational therapists, worldwide. Are you an occupational therapist wanting to be visible to the wider community? We want the public to easily reach you, to benefit from your specialist support. ​ This is an ever-expanding directory. Suggestions from our community are not definitive. Get in touch Canada United States Spain United Kingdom England Scotland Wales More countries soon Show More Enable Therapy Services Promoting the use of rehabilitation and early intervention. Our services are delivered by our UK-wide network of over 120 highly qualified Occupational Therapists, working together with our dedicated office based clinical coordinators – providing rehabilitation and vocational case management. All ETS Occupational Therapists have the knowledge and experience to provide a wide range of rehabilitation reports, assessments and rehabilitation case management. Our wide range of rehabilitation services provide our referrers with one point of contact to ensure continuity of the rehabilitation process; from early intervention until clients reach their optimal recovery, in activities of daily living, social, leisure and return to work. Our comprehensive vocational rehabilitation services are dovetailed with each client’s rehabilitation programme, so that they are supported with advice and guidance throughout their return to work. [LEEDS-BASED; SERVICES AVAILABLE NATIONWIDE] Access From the Harp From the Harp delivers therapeutic activity using the harp as the occupational based intervention, and playing as occupation. Alice is an Occupational Therapist, harp therapist and sound therapist and does harp therapy sessions for groups and individuals in care homes and for health groups. Harp therapy can be beneficial for all client groups and all ages. The harps are very adaptable and can be played on the floor, on tables, in wheelchairs and in bed. Clients can engage with the harps in any way that is meaningful to them. Some like to play them, others will sing, tap, sway, observe, reminisce about their musical experiences or place their hand on the harps to feel the vibrations. Research has shown that live interactive harp music can reduce pain and anxiety and helps to stabilise heart and breathing rates. Making music on the harps has both physical and cognitive benefits and is great for group cohesion and increasing self esteem. [PORTSMOUTH, HAMPSHIRE-BASED; SERVICES PROVIDED ON SOUTH COAST] Access OTCoach OTCoach inspiring and supporting OTs to develop creative and courageous OT practice. OTCoach has been working with individual OTs, OT services and educators since 2005, during which time we have seen the amazing power of a “coach approach.” Interest in coaching in occupational therapy continues to grow, as both professions aim to help people live their lives with balance and purpose. We “coach” OTs themselves and also help OTs develop a coaching approach to their work. ​ | Twitter | Facebook [BRISTOL/SW ENGLAND-BASED; COACHING NATIONWIDE] LinkedIn Access Seirrah Occupational Therapy Based in our clinic in Cardiff, Seirrah OT is a private provider of occupational therapy services for individuals aged 0 to 25 years of age with developmental challenges in their movement, play, learning, and behaviour. As part of our wider services we also work across the UK in homes, schools, and community settings to provide assessment, advice, treatment, and training. Each individual we work with receives a tailored programme according to his or her needs with our treatment programmes being fun and engaging. Our team enable each individual person overcome difficulties they are experiencing by increasing their motivation and adopting a “there’s no limits” approach. ​ [SOUTH WALES-BASED; UK-WIDE] Access GLK Occupational Therapy With a BSc (Hons) in Occupational Therapy (2014) and a diagnosis of Fibromyalgia and Chronic Fatigue Syndrome (2015), I have the knowledge and understanding of what it is like to live with chronic pain, fatigue, depression and anxiety. I believe in a holistic approach to health. I offer independent living advice and general health and wellbeing coaching. We can work together to achieve realistic, achievable goals to increase quality of life and occupational performance in all areas of daily living. I also offer pain management advice and interventions including hire and treatment of the Alpha-Stim - a micro-current and cranial electrotherapy stimulation hand-held device. I'm also a wellness advocate, offering advice on essential oils for health and wellbeing and how to incorporate them into a toxic free lifestyle. DoTerra Mrs Gemma Kempsell GLK Occupational Therapy Independent Occupational Therapist (HCPC registered) [SERVICES AVAILABLE IN BEDFORD, UK] Access Heal-OT Welcome, I’m Sarah Doyle, a qualified Specialist Occupational Therapist (OT). I have an Occupational Therapy BSC Hons degree from Coventry University, (2010). Experienced in; Specialist Surgery, General Medicine, Renal, Respiratory, Elderly Medicine, Trauma & Orthopaedics and Palliative Care. This has enabled me to develop my career, knowledge and clinical skills. Having specialised within Vascular and Thoracic for the last four years. I have gained invaluable experience within Wheelchair Services. 2018 qualified Post Graduate training in Hippotherapy (using the equine for therapy) and Equine-assisted learning (EAL). This was provided by the Association of Chartered Physiotherapists in Therapeutic Riding and Hippotherapy. Have you considered Hippotherapy? Hippotherapy is a therapy that uses the horse's movements sitting on the horse at the pace of walk, by using three-dimensional movements, the horse can stimulate pelvic, gross and fine motor skills. Improves head, trunk control, strength, coordination, and balance. It motivates a child/adults physical, sensory, cognitive and emotional systems. Which then enables improvement in occupational performance. We can learn so much, by interacting with the horse. In EAL the therapist uses the horse as an educational tool, encompassing a range of non-riding-based activities, all which improve the physical and psychological performance of individuals. Which can then be transferrable to daily living activities. Registered with the Royal College of Occupational Therapy (RCOT) & Health and Care Professions Council (HCPC). An associate member of Chartered Physiotherapists in Therapeutic Riding and Hippotherapy (CPTRH). Enhanced DBS check completed. ​ [NORTH WARWICKSHIRE-BASED; SERVICES PROVIDED WITHIN WEST MIDLANDS] Access Healthy & Independent We are specialists in minor and major adaptations, manual handling people and mindfulness in social care. Teaching the correct handling techniques are essential, in order to minimise any risk of accident and to increase safety and dignity. We offer clinical support and workshops online and in situ. [SERVICES AVAILABLE IN SPAIN AND THE UK] Access Millennial OT Aim: To make positive mental health behaviour appealing. ​ Occupational Therapist Grant Mitchell uses this website to provide resources and content to promote positive mental health, such as Youtube videos and handouts. Grant is an occupational therapist working with young adults in inpatient mental health. Content is related to healthy living and positive mental health, through topics such as mindfulness, coping skills and the areas of occupation. ​ [FLORIDA-BASED] Access My Therapy Services Empowering individuals to rebuild their lives by improving function, maintaining skills and reducing risks. Rebuilding lives through Occupational Therapy. We are dual trained in both physical health and mental health. We look at the individual holistically, not just in a ‘work’ capacity as some people assume due to the word “occupation’. This means putting the person right at the centre and acknowledging that they have many facets in life that will have an impact on one another. The service is run by Manisha who has 17 years of clinical experience as an Occupational Therapist within the NHS. This has involved working within a variety of environments including hospitals, schools, care homes and people’s own homes. Interested in a free consultation? Get in touch and we will help assess your situation and discuss what we can do for you. [UK: NOTTINGHAM. Able to travel within East/West Midlands] Access NHS 24 The national provider of digital and telephone based health and care services for Scotland. We provide people with access to information, care and advice through multiple channels including telephone, web and online. We work in collaboration with partners, the public and our people to co-design services using technology and a digital first approach to sustainable service development and delivery. ​ ​ [SCOTLAND] Access OT360 Professional Supervision Royal College of Occupational Therapists, the Health and Care Professions Council and the Care Quality Commission and all agree: expert supervision is essential for all registered care providers. So if you chose to have supervision how will we work together? That is largely up to you. I have years of experience of supervising OTs, building great working relationships and working hard to tackle your issues, dilemmas or problems. I understand the need to be flexible, so we will work together to find a pattern of meetings that works for you. And, of course, after every session you will receive a summary and action plan, as well as evidence of each HCPC standard, so you are always ready for the HCPC audit. How often we meet is up to you. Most people find that one or two hours a month works well. We can meet monthly, bimonthly or whatever works. Simply email me and suggest dates and times, and we can make arrangements. And of course we can talk in person or on the phone. Have a look at my website, read about who I already work with, and what they say about my work. ​ Margaret Spencer MA Consultant Occupational Therapist and Senior Lecturer ​ [UK-BASED] Access Occupational Therapy Glasgow Independent Occupational Therapist offering Functional Assessments with a client’s home environment to identify areas of functional difficulty in day to day life, helping individuals live in their own home independently and safely for as long as possible. Occupational Therapy assessments can also be undertaken on behalf of charities, benevolent funds and housing associations to assess an individual’s functional need in relation to either specific equipment such as stairlifts or riser-recliner chairs, or larger home adaptations/rehousing. Similarly, assessments can be carried out to support applications or appeals by individuals. Access Solutions for Living - Entwistle Power Occupational Therapy Solutions for Living works proactively and compassionately with disabled and injured people to help them improve their functional independence in important life roles. At home, work, in the community or during leisure pursuits, our Mission is to provide people with disabilities solutions for living. In this way, they can have hope for a better future, are empowered towards independence, and succeed in pursuing functional goals. Our Vision is that occupational therapy becomes recognised for all that it is and all that it can offer as a comprehensive and cost-effective health care solution. Further, our firm, driven by caring, passion and integrity, will lead in the delivery of these services across Ontario. ​ [ONTARIO-BASED] Access The OT Practice The OT Practice has the largest team of independent occupational therapists in the UK, specialising in providing high quality services nationwide to private, statutory and business clients. Our practice is based on our reputation for building trusted relationships with our clients, and we are always looking for talented individuals to join our team. ​ Whether you are thinking about taking the first steps into private practice or are an experienced private practitioner, working with us could be just the answer. If you aren’t sure where to start, we can guide you through the process and provide tools to help manage your workload. Our office-based client management team help find, allocate and administer cases, leaving you time to focus on providing clients with the highest level of care. ​ [HAMPSHIRE-BASED; SERVICES NATIONWIDE] Access

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    Forum Posts (878)
    • Occupational Therapy and Coronavirus

      A Community Forum for sharing practice experiences, advice and support, in a time of change and occupational adjustment... As the global community reacts to the COVID-19 pandemic, clinicians, service users and the public are having to adjust to new ways of living and working. In an uncertain climate, occupational balance, engagement and participation will be inevitably affected. Whilst fundamental to slowing the spread of the virus, social distancing and isolation are also likely to impact on physical and mental health and well-being... Occupational Therapy Response to the COVID-19 Pandemic - WFOT Public Statement: 'The COVID-19 pandemic is having a profound impact on the lives, health and wellbeing of individuals, families and communities worldwide... As a profession, we recognise the consequences and changes that are occurring in how people access and undertake their occupations as a result of the COVID-19 pandemic. These include, but are not limited to: accessing resources, activities of daily living, communication, mobility, social isolation, displacement, mental health and wellbeing. Occupational therapists understand the vital need to access and use infection control measures, combined with the need to sustain good psychological, mental health and stamina in order to stay safe and healthy. Occupational therapists will be working with people to develop strategies to facilitate continued access to their occupations. These will include, but will not be limited to: individual, family, community, social and environmental adaptation, mental health, assistive technology and telehealth.' > Read more from the World Federation of Occupational Therapists In the spirit of care and collaboration, The Occupational Therapy Hub offers you this dedicated space for open dialogue, on themes such as (but not limited to): Adapting occupational therapy practice Adapting occupational therapy education and studies Supporting specific client groups Coping strategies, to offer fellow colleagues or those you support We invite you to engage below, in discussions that have the potential to support you and others, worldwide. All the best, The Occupational Therapy Hub Team hubteam@theOThub.com

    • OT clinician yoga practice

      Hi Everyone! I don't know if this is the place to post this, but I am a yoga instructor as well as an occupational therapist. I have been teaching online yoga during quarantine and I am thinking of trying to create a pay what you can zoom yoga class for practitioners. Would anyone be interested in that as a way to disconnect and engage in self care?

    • Sleeping in Riser Recliner chairs

      I have a question with regards to older people (65+) sleeping in their riser recliners (RR). I have a service user who sleeps in his RR out of choice. He has a perfectly good bed which he can get in and out of very well. But choses to sleep in his chair, he says he sleeps well and is happy with it. What are the most common issues/concerns about sleeping in a RR? I was thinking pressures needs & postural concerns.....What can you share with me?

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