“Occupation, Evidence and Outcomes: the future of our profession.”
Professor Mary Law – Professor, School of rehabilitation Science, McMasters University and lead author of the Canadian Occupational Performance Measure (COPM)
Participation is the raison d’etre of occupational therapy.
According to the World Health Organisation (2011) over 27% of people in the UK have a disability which impedes on everyday life. Add this to the current climate (financial, environmental, and societal) and also the complex lifestyles that we now lead it is recognised that people need occupational therapy now more than ever before.
It is widely acknowledged that physical and mental health is affected by financial and economic status. A lack of participation in activities and occupations of importance and meaningful can lead to a decline in the health and well-being of individuals, eventually leading to occupational deprivation.
Occupational deprivation being defined as:
“a state of percussion from engagement in occupations of necessity and/or meaning due to factors that stand outside the immediate control of the individual.” (Whiteford 2000 p.201)
Participation in activities is also crucial for in life transitions, especially within children and teenagers. For adults and older people participation is associated with feelings of:
· Improved health and wellbeing
· Increasing cognitive behaviours and levels (which can be maintained as well as lengthened through participation in activities.)
It is also important to remember that a person’s diagnosis does not directly affect participation. Elements such as functional ability, personal preferences and environments etc. do. This is where Occupational Therapists are perfectly suited to work with individuals due to their client-centred, holistic and non-medical model focus on assessment and treatment.
OTs open doors to participation and increase individuals participation and involvement in life activities.
Evidence Based Practice as an interlinked concept!
· Occupational science, theories, models of practice, frames of references etc.
· Therapist’s wisdom and training.
· Therapeutic use of self.
Person(s) receiving OT services
· Meaningful occupational goals.
· Person(s) experiences, dreams and needs.
(Both motivation and positive therapy outcomes are increased by these.)
Occupational and individualised goal setting helps people to focus on participation and helps people to see more realistic and fulfilling goals for themselves. This leads to significant improvements in goal achievement and meaningfulness increasing as opposed to when using generic goals/therapy.
Best research evidence
· Occupational focused interventions
· Changing environments
Occupation should be both the means and the end of therapy.
Other key points from the plenary:
· Professionals are defined by the outcomes of the therapy and their effects to their clients.
· Occupation is the focus of therapy and participation should be our cornerstone. Outcome measures should reflect this.
· For ever complex problem there is no simple solution. As OTs we need to draw on all our knowledge and take a holistic approach to each individual client.
Occupational Therapists understand and celebrate complexity.