Caotkeynote2010april27 all

56
From ‘C’ to ‘C’ to From ‘C’ to ‘C’ to ‘C’: ‘C’: An Ocean of An Ocean of Possibilities Possibilities Dr. Mary Law Dr. Mary Law Dr. Helene Polatajko Dr. Helene Polatajko Dr. Elizabeth Townsend Dr. Elizabeth Townsend

description

Slides after our discussion today

Transcript of Caotkeynote2010april27 all

Page 1: Caotkeynote2010april27 all

From ‘C’ to ‘C’ to ‘C’:From ‘C’ to ‘C’ to ‘C’:An Ocean of An Ocean of PossibilitiesPossibilities

Dr. Mary LawDr. Mary Law

Dr. Helene PolatajkoDr. Helene Polatajko

Dr. Elizabeth TownsendDr. Elizabeth Townsend

Page 2: Caotkeynote2010april27 all
Page 3: Caotkeynote2010april27 all

CelebrateCelebrateChallengChallengee

CreateCreate

Page 4: Caotkeynote2010april27 all

Celebrate

Our collective accomplishments

Page 5: Caotkeynote2010april27 all

Celebrate: the Past Celebrate: the Past

Historic Profession with Great Potential to GrowBackground 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).

Page 6: Caotkeynote2010april27 all

Celebrate: our client centred Celebrate: our client centred guidelinesguidelines

13 Important Ways to Use the Guidelines for 13 Important Ways to Use the Guidelines for the Client-Centred Practice of Occupational the Client-Centred Practice of Occupational Therapy Therapy by Thelma Gillby Thelma Gill

#1. The guidelines provide#1. The guidelines providea clear outline of the processa clear outline of the processof O.T. which can be usefulof O.T. which can be usefulin discussions with thein discussions with theadministrator of youradministrator of yourfacility. ……….… #13.facility. ……….… #13.

From Thelma Sumsion’s 1982 & 1983 Series on From Thelma Sumsion’s 1982 & 1983 Series on “Getting our Act Together and Putting it on the “Getting our Act Together and Putting it on the Road … or Handling the Challenge of Change” Road … or Handling the Challenge of Change” , , NATIONAL, September 1984NATIONAL, September 1984, p. 12), p. 12)

Page 7: Caotkeynote2010april27 all

Celebrate: our client-centred Celebrate: our client-centred practicepractice

Page 8: Caotkeynote2010april27 all

Celebrate: our Client-Centred Celebrate: our Client-Centred Practice of Enabling OccupationPractice of Enabling Occupation

“What is this important publication and valuable addition to your professional library?”

Angela Naugle, Member, CAOTClient-Centred Practice Committee.

National, The Newsletter of theCanadian Association ofOccupational Therapists, May / June 1997, 14(6), p. 1

Page 9: Caotkeynote2010april27 all

Celebrate: our Client-centred occupational focus The occupational imperative Regardless of the perspective

Client-centred

Human Occupation

Page 10: Caotkeynote2010april27 all
Page 11: Caotkeynote2010april27 all

Celebrate: our Canadian Model of Occupational Performance (CMOP)

THE INDIVIDUAL

spiritual physical

mental

socio-cultural

SOCIALENVIRON-MENT

productivity

self care

leisure

ENVIRONMENT(social, physical, cultural)

CULTURALENVIRON-MENT

PHYSICAL ENVIRONMENT

Original Occupational Performance Model

(Adapted from Reed and Sanderson, 1980)

Performance components Areas of occupational performance Adapted from Reed and Sanderson, 1980

Page 12: Caotkeynote2010april27 all

Celebrate: our CMOP

CAOT, 1997

Page 13: Caotkeynote2010april27 all

Celebrate: our evolving Celebrate: our evolving Canadian perspective on Canadian perspective on occupationoccupation

From divergenceFrom divergence

Page 14: Caotkeynote2010april27 all

through therapeutic use …

Page 15: Caotkeynote2010april27 all

to enabling to enabling occupationoccupation

……

At the level of At the level of … the … the

individualindividual

Page 16: Caotkeynote2010april27 all

Celebrate and be proud: Celebrate and be proud:

CMOPCMOP Now used to frame our Now used to frame our practicepracticeDebbie Hebert of the Toronto Rehabilitation Institute Debbie Hebert of the Toronto Rehabilitation Institute

writes…writes…

Prior to the Enabling I publication, our OT Prior to the Enabling I publication, our OT documentation reflected a very medical model, documentation reflected a very medical model, impairment based type of assessment process…timpairment based type of assessment process…there 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.

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

We renovated the initial assessment document and called it the “Occupational Performance Module”.

Page 17: Caotkeynote2010april27 all

Celebrate and be proud: Celebrate and be proud: CMOPCMOP Now used to frame our Now used to frame our practicepracticeDebbie Hebert continues…Debbie Hebert continues…

This change was transformative …with respect to how we were practicing and how our teams

regarded our input.

The Enabling Occupation document gave us the guidance and validation to be the leaders in patient centred goal setting at our hospital

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.

It is nice to now hear our colleagues say… “I wish I were an OT” rather than “What do OTs do?”

Page 18: Caotkeynote2010april27 all

Celebrate and Be proud – Celebrate and Be proud – CMOPCMOPInternationally laudedInternationally 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

Page 19: Caotkeynote2010april27 all

Celebrate: our Canadian Occupational Performance Measure (COPM)

Enables meaningful participation in the occupational therapy process through:

identifying occupational performance problems

evaluating performance and satisfaction in these occupations

measuring change in perception of occupational performance

Page 20: Caotkeynote2010april27 all

Celebrate: COPM - Slovenia

Page 21: Caotkeynote2010april27 all

Celebrate and Be proud COPM around the world

Countries where the COPM is used

Page 22: Caotkeynote2010april27 all

Celebrate and Be Proud Celebrate and Be Proud

Highest Uses of CMOP (1993 Canadian Survey)

Assessing Educating others Explaining the profession to others

Sales over 10 years (1999 – Sep. 2009)

COPM manuals: 11,542 Enabling I (1997, 2002): 13,623 (French and English) Enabling II (2007): 4186  (French and English)

Page 23: Caotkeynote2010april27 all

Celebrate -> Be proud

ChallengeEach other to go further

Page 24: Caotkeynote2010april27 all

Challenge the Present: go Challenge the Present: go furtherfurther

Enabling II: Advancing Enabling II: Advancing OT vision for health, OT vision for health, well-being & justice well-being & justice through occupationthrough occupation

Occupation-based Occupation-based practicepractice

Beyond performanceBeyond performance Beyond disability Beyond disability

Page 25: Caotkeynote2010april27 all

Challenge: Challenge: Canadian Model of Canadian Model of Occupational Performance AND Occupational Performance AND Engagement - occupation as our Engagement - occupation as our focusfocus

Page 26: Caotkeynote2010april27 all

Challenge: our scope Challenge: our scope and go furtherand go further

1. Individuals with impairments

2. Individuals with occupational performance issues (OPIs)

3. Individuals, families, groups, organizations, communities or populations with OPIs or potential OPIs

4. The human population

1. Impairment reduction2. Adaptation (P, O, E)3. Accommodation (E) 4. Skill acquisition (P) 5. Social reconstruction (O,E)6. Health and well-being7. Occupational enablement

1 2 3 4

7

2

3

1

6

4 5

Page 27: Caotkeynote2010april27 all

Challenge: our Challenge: our practicepractice and go furtherand go further

Sunnybrook Health Sciences Sunnybrook Health Sciences Centre OT’s journey toward Centre OT’s journey toward occupation-based practice:occupation-based practice:

Initiated in 2003 and kept alive by Initiated in 2003 and kept alive by the professional practice leader – the professional practice leader – Fran Aiken Fran Aiken

Page 28: Caotkeynote2010april27 all

Challenge: our practice Challenge: our practice and go further and go furtherSunnybrook Health Sciences Centre Sunnybrook Health Sciences Centre

OT’s journey toward occupation-OT’s journey toward occupation-based practice:based practice:

Fran Aiken writes…Fran Aiken writes… I have always felt rooted to occupation as I have always felt rooted to occupation as

the basis of practice. BUT - I experienced the basis of practice. BUT - I experienced first-hand the move to increasingly first-hand the move to increasingly ‘disease-oriented’ health care and found ‘disease-oriented’ health care and found that even my OT colleagues devalued that even my OT colleagues devalued activity-oriented interventions. THUS, it activity-oriented interventions. THUS, it was with open arms that I welcomed the was with open arms that I welcomed the 1997 Enabling Occupation guidelines1997 Enabling Occupation guidelines

Page 29: Caotkeynote2010april27 all

Challenge: our practice Challenge: our practice and go furtherand go furtherFran —as the Centre’s Professional Leader—

used occupation-based practice as a unifying concept for the newly amalgamated Occupational Therapy service

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.

And then they studied the effectAnd then they studied the effect

Page 30: Caotkeynote2010april27 all

Challenge: Be Daring Challenge: Be Daring Occupation-based Occupation-based practicepracticeThe QuestionThe Question: How do OT’s at S&W : How do OT’s at S&W

incorporate an occupational view of incorporate an occupational view of health in the context of their clinical health in the context of their clinical practice on a day-to-day basis?practice on a day-to-day basis?

Our Long-term goalOur Long-term goal: To contribute to the : To contribute to the understanding of occupation and thus understanding of occupation and thus develop methods of helping peopledevelop methods of helping people

Interesting findingsInteresting findings:: The meaning GAP

Page 31: Caotkeynote2010april27 all

Challenge: Be DaringChallenge: Be Daring

The meaning GAPThe meaning GAP

When there is incongruence between how When there is incongruence between how therapists believe occupational therapy should therapists believe occupational therapy should be practiced in an ideal world and how they be practiced in an ideal world and how they actually do practice in the real world, they actually do practice in the real world, they experience a “experience a “meaning gap.meaning gap.””

“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.”

Page 32: Caotkeynote2010april27 all

Be Daring: Occupation-Be Daring: Occupation-based practicebased practiceThe meaning GAPThe meaning GAP

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.

Those who bridge the gap have specific stories about co-creating meaning and how that meaning transforms their practice.

“it’s your individual sense of occupation that sort of guides you.”

Page 33: Caotkeynote2010april27 all

Be Daring: Occupation-Be Daring: Occupation-based practicebased practiceThe meaning GAPThe meaning GAP

Therapists who highly value occupation and Therapists who highly value occupation and see the potential for client occupational see the potential for client occupational engagement in their daily roles are engagement in their daily roles are enthusiastic therapists, who derive personal enthusiastic therapists, who derive personal meaning and satisfaction within their own meaning and satisfaction within their own occupation, despite other challenges in their occupation, despite other challenges in their work environment.work environment.

it’s your individual sense of occupation that sort of guides you.”

Page 34: Caotkeynote2010april27 all

Be daring: Contribute to Be daring: Contribute to societysociety

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.

Hanneke van Bruggen, Executive Director, ENOTHE (European Network of Hanneke van Bruggen, Executive Director, ENOTHE (European Network of Occupational Therapy Educators) re European Values Study (EVS), 2004, & Tuning Occupational Therapy Educators) re European Values Study (EVS), 2004, & Tuning Project, 2008 Project, 2008

Page 35: Caotkeynote2010april27 all

to enabling to enabling occupationoccupation

At the level of At the level of … the group… the group

Page 36: Caotkeynote2010april27 all

to enabling occupation

At the level of … society

Page 37: Caotkeynote2010april27 all

Be daring – Be daring – Naming Naming EnablementEnablement

Page 38: Caotkeynote2010april27 all

Be daring: Naming Enablement in Be daring: Naming Enablement in Enabling OccupationEnabling Occupation

““theory in theory in enabling enabling occupation helped occupation helped me to see what me to see what occupational occupational therapy is really therapy is really about”about”

Photo & quote courtesy of Hiromi Yosikawa, November 2009

Page 39: Caotkeynote2010april27 all

Be daring: Enable our own Be daring: Enable our own occupationoccupation

Members came from Members came from diverse practice contexts - diverse practice contexts - including in an indigenous including in an indigenous community in the central community in the central desert, to a youth desert, to a youth focussed mental health focussed mental health outreach service in a outreach service in a large city. (G. Whiteford)large city. (G. Whiteford)

Australian Practice Scholar Group 2008

by permission G. Whiteford… we created a community of practice

scholars who "road tested" the Enabling Occupation guidelines over the course of a

year.

Page 40: Caotkeynote2010april27 all

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 inthe Australian project)

Be daring: Enable our own Be daring: Enable our own occupationoccupation

Page 41: Caotkeynote2010april27 all

Be Daring: Building Be Daring: Building New Partnerships for New Partnerships for PracticePractice

Family Health TeamsFamily Health Teams Legal servicesLegal services MunicipalitiesMunicipalities School Boards School Boards

Page 42: Caotkeynote2010april27 all

Be Daring: Building Be Daring: Building Evidence-based Practice in Evidence-based Practice in PartnershipPartnership Occupational therapists from three Occupational therapists from three

Vancouver region health districtsVancouver region health districts Worked with a knowledge broker Worked with a knowledge broker

and developed strategies to and developed strategies to change practice in three areas:change practice in three areas:

cognitive screeningcognitive screening assessment of risk for skin breakdownassessment of risk for skin breakdown provision of wheeled mobility and seating provision of wheeled mobility and seating

equipmentequipment

Page 43: Caotkeynote2010april27 all

Be Daring: Building Be Daring: Building Evidence in PartnershipEvidence in Partnership

A resource to assist families in giving, getting, and organizing information about their child/youth with special needs

Page 44: Caotkeynote2010april27 all

Celebrate -> Be proudChallenge -> Be daring

CreateAn occupational future for

all

Page 45: Caotkeynote2010april27 all

Create: An occupational future for all

“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.”

Wilcock, 1998

Page 46: Caotkeynote2010april27 all

‘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: AnchorPress, p. 193.

Create: Be the differenceCreate: Be the difference

Page 47: Caotkeynote2010april27 all

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)

Page 48: Caotkeynote2010april27 all

Imagine if……….Imagine if……….

Page 49: Caotkeynote2010april27 all

"You spend their young lives trying to "You spend their young lives trying to get them ready for the world and get them ready for the world and when the time comes, the world when the time comes, the world isn't ready for them. So we have to isn't ready for them. So we have to find a way to do it."find a way to do it."

- parent of a child with a - parent of a child with a disability disability

Page 50: Caotkeynote2010april27 all

Imagine if……….Imagine if……….

HeleneHelene

Page 51: Caotkeynote2010april27 all

Imagine if……….Imagine if……….

HeleneHelene

Page 52: Caotkeynote2010april27 all

Imagine if……….Imagine if……….

A Visionary Occupational Therapy Council of Canada?

Page 53: Caotkeynote2010april27 all

Imagine if……….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

Page 54: Caotkeynote2010april27 all

Celebrate -> Be proud

Challenge -> Be daring

Create -> Be the difference

Page 55: Caotkeynote2010april27 all

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

Page 56: Caotkeynote2010april27 all

Thank YouMerci