Exploring professionalism: The professional values of Australian occupational therapists

Research Article

Exploring professionalism: The professional values ofAustralian occupational therapists

Alejandra Aguilar,1 Ieva Stupans,2 Sheila Scutter3 and Sharron King4

1School of Pharmacy and Medical Sciences, Division of Health Sciences, University of South Australia, Adelaide,South Australia, 2School of Science and Technology, Faculty of Arts and Sciences, University of New England, Armidale,New South Wales, 3School of Medicine and Dentistry, Faculty of Medicine, Health and Molecular Sciences, James CookUniversity, Townsville, Queensland, and 4School of Health Sciences, Division of Health Sciences, University of SouthAustralia, Adelaide, South Australia, Australia

Background/aim: There has been limited research into thevalues of the Australian occupational therapy professionand as such, the values have not been made explicit. Expli-cit values provide insight into what professionalism meansto a profession. They can be used by practitioners for self-reflection purposes, shaping the future practice of individ-uals. Clear values can also enable the recognition andmanagement of value conflicts between health professions.This study aimed to make a preliminary identification ofthe values of the profession, by exploring the professionalvalues of 15 Australian occupational therapists.Methods: A naturalistic approach and constructivist para-digm guided this study. Purposive sampling was employedto identify Australian occupational therapists who couldcontribute rich information to the study. Data were collectedthrough semi-structured interviews that were recorded andanalysed using an inductive data analysis method.Results: The professional values identified encompassedthree main areas: the client and the client–therapist part-nership; occupational therapy knowledge, skills and prac-tice; and selfless values. The emerging values guidedeveryday practice, professional relationships and theresponsibilities of being a professional.Conclusion: This study provides insight into the profes-sional values of Australian occupational therapists and

contributes to research orientated towards identifying thevalues of the profession. The results also contribute to theunderstanding of what professionalism means to the Aus-tralian occupational therapy profession.

KEY WORDS professional practice, social values.

Introduction

Professionalism can be defined from both a values and

behavioural perspective. From the behavioural perspec-

tive, professionalism signifies the demonstration of

desired professional behaviours (Cruess, McIlroy, Cru-

ess, Ginsburg & Steinert, 2006; Symons, Swanson,

McGuigan, Orrange & Akl, 2009). However, this defini-

tion has been described as superficial as it does not con-

sider the intrinsic motivators that guide a person’s

professional decisions and actions (Hammer, Berger,

Beardsley & Easton, 2003). Professionalism can also

be defined as upholding and applying the values of a

profession (Ginsburg, Regehr, Stern & Lingard, 2002;

Rowley, Baldwin, Bay & Cannula, 2000). Describing

professionalism from this perspective moves the focus

beyond observable behaviours, providing insight into

the values which guide practice, motivate practitioners

and unite a profession (Duque, 2004; Kanny, 1993).

Hence, from this perspective, the values of a profession

are of critical importance.

A profession’s values have been described as the

‘basic and fundamental beliefs, the unquestioned pre-

mises upon which its (a profession’s) very existence

rests’ (Disney, Basten, Redmon & Ross, 1986, p. 77).

The values of a profession are shaped and influenced

by the surrounding societal, institutional, cultural and

political environments (Martimianakis, Maniate & Hod-

ges, 2009; Watson, 2006). Hence, what is considered a

value in a profession within one environment may not

be identified as relevant in another (Misch, 2002). A

profession’s values are instilled through professional so-

cialisation, which can be described as the process where

Alejandra Aguilar BAppSc OT (Hons); PhD Candidate.Ieva Stupans PhD; Professor. Sheila Scutter PhD; Associ-ate Professor. Sharron King PhD; Senior Lecturer.

Correspondence: Alejandra Aguilar, School of Pharmacyand Medical Sciences, University of South Australia, Play-ford Building P4-47, City East Campus, G.P.O. Box 2471,Adelaide, SA 5001, Australia. Email: [email protected]

Accepted for publication 15 December 2011.

© 2012 TheAuthorsAustralianOccupational Therapy Journal© 2012OccupationalTherapyAustralia

Australian Occupational Therapy Journal (2012) 59, 209–217 doi: 10.1111/j.1440-1630.2012.00996.x

an individual acquires the knowledge, skills, behaviours,

attitudes and values of a particular profession and

develops a professional identity (Ajjawi & Higgs, 2008;

Clark, 1997). The socialisation process extends beyond

university education as the work environment, interac-

tions with colleagues and patients, moral challenges and

dilemmas, shape an individual’s values (Clark, 1997).

The values of a profession should ideally be upheld by

all members of the profession (Kanny, 1993), forming

part of their professional value system.

There is an imperative to making the values of a pro-

fession explicit. Values that are explicit enable profes-

sionals to reflect on how their own values align with

those of the profession (Byng, Cairns & Duchan, 2002),

further enhancing professional awareness and shaping

the future practice of these individuals. Clear values

can also enable the identification of potential value con-

flicts that may occur in practice with other professions

as clearer comparisons can be made between the exist-

ing value systems (Colombo, Bendelow, Fulford & Wil-

liams, 2003; Fulford, 2004). Explicit values also provide

insight into what practitioners aim to uphold and pro-

fess, clarifying what professionalism means to a profes-

sion.

Several international studies have attempted to iden-

tify the values of the occupational therapy profession.

The US Standards and Ethics Commission identified

several occupational therapy values after referring to the

1986 report developed by the American Association of

Colleges of Nursing. These values were initially identi-

fied as altruism, equality, freedom, justice, dignity, truth

and prudence (Kanny, 1993). Peloquin (2007), an Ameri-

can occupational therapy scholar, suggested additional

values including: courage, imagination, resilience, integ-

rity and mindfulness, stating that the additional values

captured the distinct features of the occupational ther-

apy profession. Duque (2004) reviewed British, Ameri-

can and Canadian occupational therapy literature and

summarised the values of the profession as: the value of

the person and human life, occupation as a determinant

of health and a therapeutic agent, and balancing the art

and science of practice in health promotion. As values

are influenced and shaped by their surrounding context,

findings from previous studies may not be directly

transferable to the Australian occupational therapy

profession. The values of the Australian occupational

therapy profession remain unspecified.

This study takes initial steps to determine these val-

ues by identifying the shared professional values of 15

Australian occupational therapists. For the purposes of

this study, a professional value is defined as a principle

or standard that an individual perceives as important to

their professional role. This definition is modified from

the definition of ‘value’, which appears in the Austra-

lian Oxford Dictionary where it is described as ‘one’s

principles or standards’ about ‘what is valuable or

important in life’ (Moore, 1999, p. 1428).

Methods

Design

A naturalistic approach was used to explore the profes-

sional values of occupational therapists. The naturalistic

approach was applicable as there was limited knowl-

edge available on the phenomena under investigation

and the approach aims to develop ‘explanations, princi-

ples, concepts and theories’ (DePoy & Gitlin, 2011,

p. 96). Furthermore, the naturalistic approach is inclu-

sive of environmental influences (Patton, 2002), enabling

the holistic exploration of values.

The study was guided by the constructivist paradigm

as described by Guba and Lincoln (1989). The paradigm

aims to understand phenomena from the perspective of

those who experience it. It also acknowledges the exis-

tence of multiple socially constructed realities, which

are developed by individuals as they make sense of

their experiences. These multiple realities are seen as

equal and no perspective is more ‘true’ or ‘real’ than

others (Guba & Lincoln, 1989; Patton, 2002). This para-

digm was suitable for this study as it aimed to under-

stand participants’ constructions on their professional

values.

Participants

Ethics approval was obtained from the University of

South Australia’s Human Research Ethics Committee.

Purposive sampling was used to identify the partici-

pants who could provide an in-depth understanding

of the phenomenon (DePoy & Gitlin, 2011). Selection

criteria included that participants be employed with

five or more years of experience as an occupational

therapist in Australia. Participants who met the inclu-

sion criteria were identified by two Australian occupa-

tional therapists that had 10 or more years of

experience in the profession. Potential participants

were contacted via email and sent detailed information

on the study. Interested participants returned a signed

consent form to the researcher. They were then attrib-

uted codes to protect their privacy, such as OT2 or

OT7. Participants were recruited until no new informa-

tion emerged during data collection (Lincoln & Guba,

1985).

Fifteen occupational therapists participated in this

study. Thirteen were female and two were male. Five

participants came from South Australia, three from

Queensland, two from both News South Wales and

Victoria and one each from Western Australia, the

Northern Territory and Tasmania. Five participants had

worked for a minimum of five years, three for a mini-

mum of 11 years and three for a minimum of 21 years.

Four participants had worked as an occupational thera-

pist for a minimum of 31 years. The average number

of years that participants had worked was 22. Partici-

pants were employed in a variety of work settings,

© 2012 The AuthorsAustralian Occupational Therapy Journal © 2012 Occupational Therapy Australia

210 A. AGUILAR ET AL.

including private practices, educational institutions,

public hospitals, community rehabilitation and rural

health services.

Data collection

A semi-structured interview schedule was piloted and

then used to guide the interviews, which occurred face

to face or via telephone. They lasted around an hour

and were recorded. As it can be difficult for individuals

to identify professional values (Greenwood, 1993), par-

ticipants were asked open-ended questions about the

values they admired in other therapists, the values they

considered important for their profession and what

made them proud of their profession. They were also

asked to provide clinical examples of where values

were and were not being upheld. Hence, participants

were asked indirectly about their values and the con-

structivist approach was used to explore their construc-

tions.

Data analysis

Data were analysed using an inductive approach and

the processes of unitising, categorising and filling in

patterns (Lincoln & Guba, 1985). This analysis method

has been used in other health-related constructivist

studies (Goodman-Brown & Appleton, 2004; Koch &

Webb, 1996). First, units of information were identified

within each transcript and attributed participant codes

to ensure a data trail. The constant comparison method

was used to bring similar units of information together

to form provisional values, to devise rules that describe

each value and to render the entire value set as inter-

nally consistent. The values were reviewed for lack of

fit and repetition. Relationships between the values

were established based on their content and categories

were formed.

Methods for trustworthiness

To aid credibility, initial interviews were analysed sep-

arately by the researchers. The researchers then com-

pared the results, discussed and addressed any

potential biases and disparities. The principal

researcher (A. A.) also engaged in peer debriefing. Fur-

thermore, throughout the analysis process, the emerg-

ing categories were checked against the recorded

interviews to ensure that they had a strong grounding

in the raw data. To address issues of dependability

and confirmability, the principal researcher kept an

audit trial and thus a record of all decisions made

during the analysis process (Lincoln & Guba, 1985).

The researcher also engaged in reflexivity throughout

the study by keeping a journal and engaging in a ‘pro-

cess of self-examination’ to identify possible cultural,

political, social and ideological influences and biases

(Patton, 2002). Transferability is aided through provid-

ing a rich description of the study’s results (Lincoln &

Guba, 1985).

Results

The emerging professional values formed three main

categories. For a list of categories and their values, see

Table 1.

Category I: The client and the client–therapist partnership

This category contains several values relating to the cli-

ent and the client–therapist partnership.

Working with clients

Participants reported highly valuing the client–therapistpartnership and the approaches they used to work with

clients. The partnership commenced with gaining client

confidence and trust. OT6 commented:

Make sure that they feel safe within the relationship

and that you’re going to treat their information

confidentially and that they can rely on you and

trust you.

TABLE 1: Categories and values that emerged from the

interviews

Categories Values

The client and the

client–therapist

partnership

Working with clients

Empowering clients to lead

Understanding the individual

client

Honouring clients’ priorities

and goals

Client independence

Occupational therapy

knowledge, skills

and practice

Using and updating knowledge

and clinical skills

Occupation

Problem solving

Self-reflection

Working within a health team

Leadership within the workplace

Advocacy

Being a professional

Selfless values Kindness

Warmth

Empathy

Honesty

Fairness

Caring

Thoughtfulness

Humility

Helping clients

Giving hope

Perseverance

Respect


PROFESSIONAL VALUES IN OCCUPATIONAL THERAPY 211

The collaborative approach to working with clients

was particularly valued by five participants. These par-

ticipants used the terms ‘working with’ to describe the

approach, for example, OT6 described it as ‘working

with the person side by side’. OT3 perceived the

approach as ‘working in co-operation with that person

(the client) to find something that is going to work for

them’. The ability to work in this manner was perceived

as essential to being a good occupational therapist.

Empowering clients to lead

Four other participants valued an approach that moved

beyond ‘working with’ clients and instead allowed

clients ‘to lead the way’. OT7 described the approach as

‘more than partnership, the client should be the leader

of what is to occur.’ Similarly, OT1 believed that it was

also important to leave the ‘client in control as much as

possible’. This approach also involved empowering

clients to make their own decisions. OT14 explained:

If we are truly client centred, it is about us empow-

ering the client to make those decisions, rather than

us making them for them.

Understanding the individual client

Throughout the interviews, it became clear that the

majority of participants valued understanding each

individual client including their circumstances, needs,

strengths, abilities and environments, including their

social supports. To best understand each client, partici-

pants believed that it was important to ‘look at the full

picture’ and to have a ‘holistic focus’. Having a holistic

focus involved looking beyond a person’s medical diag-

nosis or injury. OT4 described this succinctly:

Need to hone and focus on the person, who they

are, what drives them, what motivates them, what

are their interests, what are their core values, what

are their roles and their habits and routines, what

can they do, rather than what are their impair-

ments.

Honouring clients’ priorities and goals

Several participants reported valuing clients’ priorities.

For example, OT3 discussed the importance of honour-

ing and respecting ‘where a client was at’ and their pri-

orities at that point in time. She also commented:

Be respectful enough to determine what the needs

of our clients actually are, what their priorities are,

which might actually be different from ours.

These participants also believed that clients’ priorities

should be placed above those of the therapist. For

example, OT6 explained that it was important to remain

‘focused on what your clients’ want and need rather

than what the therapist feels is important’.

Participants also valued working towards meeting cli-

ents’ personal goals. OT13 described her enjoyment of

meeting clients’ goals:

There is nothing better than asking somebody

‘what it is that you really want to be able to do?’

and being able to achieve that with them at the end

of your treatment.

Client independence

Throughout the interviews, participants discussed a

belief in client independence. OT10 explained that she

had a strong focus ‘on maintaining independence, either

through restoring, maintaining or compensating for

decrease in function.’ Interestingly, OT8 perceived the

strong focus on client independence as both a drawback

and strength:

I think within Australia we value autonomy and

independence for our clients. That’s both a strength

for us but can also create some difficulties when

we are working with people who aren’t from the

dominant culture.

Category II: Occupational therapyknowledge, skills and practice.

This category encompasses values relating to clinical

and professional practice.

Using and updating knowledge and clinical skills

Occupational therapy knowledge and clinical skills

were valued by the majority of participants. Partici-

pants also highly regarded the clinical expertise of other

occupational therapists and admired therapists who

had ‘a very clear sense of their training and their core

skill’.

Participants also discussed the importance of updat-

ing their knowledge and skills. OT3 commented that as

a professional, it was her responsibility to maintain her

knowledge and make sure she was ‘up to date with the

latest interventions.’ A therapist who stayed up to date

with current knowledge and skills was perceived as a

good occupational therapist.

The use of knowledge to make and justify clinical

decisions was also valued. The term ‘clinical reasoning’

was used by a few participants to describe this use of

knowledge in practice. OT10 provided an example of

what clinical reasoning involved:

… doing the assessment and then incorporating dif-

ferent knowledge bases and theories of practice

and then incorporating that into the intervention

that you are going to use with the client.



Occupation

Participants clearly valued occupation. They valued rec-

ognising the importance of ‘what people do’ and saw

this focus as unique to occupational therapy. OT14

explained:

Unique to us obviously is the fact that we place

such an importance on people’s ability to do the

things they need to do for a sense of wellbeing.

Participation in occupation was seen as a human right

by OT5. It was also perceived by two participants as

‘giving purpose and meaning to life’ and ‘being essen-

tial for good health’.

Several participants valued the use of occupation as a

therapeutic medium. They talked about ‘having an

occupational focus’ in practice, using activity and occu-

pation as ‘part of treatment’ and keeping occupation

‘core to intervention planning’. OT4 described a good

occupational therapist as someone who used occupation

in practice:

A great occupational therapist knows how to use

occupation as a means and end. Rather than using

a whole bunch of generic skills that other profes-

sions can use, they use occupation as their primary

therapeutic medium.

Problem solving

The ability to problem solve was perceived as crucial to

occupational therapy by several participants. They

talked about admiring therapists who problem solved

‘outside the square’. They also admired therapists who

were ‘visionary’, ‘imaginative, ‘innovative’ and ‘crea-

tive’ in their problem solving. Part of being a good

problem solver involved a willingness to take risks and

this was supported by OT14 in describing a therapist

she respected:

They were quite visionary and thought outside the

box and were very prepared to be creative, try new

things and take risks.

Self-reflection

Personal reflection on skills and limitations was valued

by several participants. These participants also reported

taking steps to address their own limitations, including

seeking out specialist knowledge and support. They

also referred clients onto other professionals if they

were unable to assist.

Several participants also valued reflecting on their

practice. This was very important for OT13, as she sta-

ted that therapists were ‘human beings’ and ‘didn’t

always get it right’. She believed that it was important

for therapists to reflect on what they did in practice, the

reasons behind their actions and how things could be

carried out differently next time.

Working within a health team

Occupational therapy participants gave great impor-

tance to working well with other professionals in the

health team. They valued building good rapport, being

flexible, compromising and communicating effectively

with others in the team. They also appreciated the con-

tributions of other health professionals, OT14 explained:

We also value contributions of others, other health

providers and community agencies, because we can

see how important they can be towards achieving a

functional goal for our client.

OT14 also believed that by working together with

other professionals, clients’ needs could be met in a

greater capacity than just occupational therapy. In

regards to working with the medical profession, four

participants believed that it was possible for the occupa-

tional therapy holistic model to work ‘alongside’ the

medical model. However, they were adamant that occu-

pational therapy should not follow the medical model

and that occupational therapists need to challenge the

model when necessary. OT4 discussed how following

the medical model can negatively impact occupational

therapy values:

Values of the OT profession get lost quite frequently

because we get caught up in the medicalisation of

the systems that we work in and we become focused

on the impairments and fixing the impairments.

Leadership within the workplace

Several participants reported valuing occupational ther-

apy leadership within departments and organisations.

They admired therapists who had leadership skills and

who were in leadership positions. OT11 described a

therapist whom she respected:

The therapist who’s a manager, who’s got an excel-

lent department and runs a really good OT depart-

ment. She’s got really good leadership skills.

Participants believed that a good leader encouraged

colleagues to grow, supported less experienced staff in

their career pathway and inspired others to aim for

excellence in occupational therapy.

Advocacy

Advocacy for clients was valued by participants. OT14

discussed that client advocacy could take place within

the health system or within a client’s family and friend-

ship circles. Occupational therapists who took on this

role were admired:



I think of examples where practitioners have stood

up against other health practitioners in team meet-

ings around clients’ readiness for discharge or cli-

ents’ transfer to nursing home … I see that as

really admirable (OT7).

Similarly, occupational therapists who advocated on

behalf of the profession were held in high esteem. Such

advocates took action on issues that were of concern to

the profession and articulated and spoke of the impor-

tance of occupational therapy.

Being a professional

Participants believed that it was important to always act

in a ‘highly professional’ way. For OT3, this meant not

doing anything that compromised her professionally,

keeping the core principles of the profession ‘in mind’

and demonstrating them constantly. OT6 who worked

in a rural setting, also shared this view:

I guess working in a rural area, you have to have

your values in mind all the time because we see cli-

ents out and about often in town, on the weekends,

or in the supermarket, at the pub, whatever. So you

have to keep your values in mind because you

need to make sure that you’re treating people confi-

dentially and respectfully.

They also discussed the importance of maintaining

professional ‘boundaries’ with clients for the benefit of

the client and the therapist. OT1 explained:

All of us will meet clients like that one day. That

turn all of your emotions upside down … and it’s

coping with that … keeping yourself emotionally

sort of apart from things that could drag you in. I

think you can get too close. So I think it’s to protect

the client. But if you get too involved like that you

will burn out too quickly.

Participants also valued ethical practice, including

abiding by the codes of ethics and work standards.

Category III: Selfless values

Several selfless values emerged that were seen as essen-

tial to occupational therapy practice. Values such as

‘kindness’, ‘warmth’, ‘empathy’, ‘honesty’, ‘fairness’,

‘caring’ and ‘thoughtfulness towards the client’ were

considered important. Two participants in particular

valued ‘humility’. For instance, OT8 admired an occu-

pational therapist that remained humble, despite her

great success as a private practitioner. OT3 believed that

being humble helped therapists to recognise that they

were not the ‘expert’ of the client’s situation and stated:

I think we have to have a lot of humility actually,

to be a good OT. With humility comes that ability

to accept that we don’t have all the answers. That

we don’t know this person’s individual circum-

stances. We actually are there to learn about that

particular person.

Participants also valued ‘helping clients’ and conse-

quently making a difference and contribution to their

lives. Making this contribution gave them a sense of

pride. OT3 explained:

At the end of the day, what we do to people actu-

ally does make a difference and that makes me

very proud.

They also valued ‘giving hope’ to the client. OT9

described this value succinctly:

It really is about supporting belief in someone and

them knowing that someone does believe in their

goals.

‘Perseverance’ was seen as essential to giving hope.

Participants talked about the importance of therapists

not giving up, working through resource limitations,

working with the client until the issues were resolved

and trying a whole range of options with the client until

the most suitable solution was found.

‘Respect’ for clients was also valued and participants

believed it was important to respect emotions, rights,

values, beliefs, culture, language and priorities. OT3

also believed it was important to respect colleagues,

their points of view and their contributions.

Discussion

The purpose of this study was to identify the profes-

sional values of Australian occupational therapists.

The resulting values encompassed three main areas:

the client and the client–therapist partnership; occupa-

tional therapy knowledge, skills and practice; and self-

less values. Previous studies exploring the values of

occupational therapy have mainly focussed on identi-

fying and describing philanthropic values (Duque,

2004; Kanny, 1993; Peloquin, 2007). The results of the

current study indicate that there are also values which

guide daily practice, including client centred practice,

professional relationships and the responsibilities of

being an occupational therapy professional. While the

results cannot be generalised to the wider Australian

occupational therapy profession, they provide insight

into several of the values that are shared amongst a

group of experienced occupational therapists. This is

an initial step towards identifying the values of the

profession and making them explicit and identifying

the values that comprise occupational therapy profes-

sionalism.

Due to differences in their meaning and content, it is

difficult to make direct comparisons between the values



identified in the current study and those that emerged

in previous international studies. Nevertheless, some

similarities can be observed. For example, the Standards

and Ethics Commission in America (Kanny, 1993) iden-

tified the value of ‘dignity’ which incorporated ‘valuing

the uniqueness of each person’, ‘empathy’ and ‘respect’.

These aspects emerged as values in the present study.

Peloquin (2007) identified the value of ‘courage’, which

included ‘advocay’ and ‘giving hope’, which emerged

as two of the values in the current study. The value of

‘occupation’, which emerged in the present study, was

also considered a value by Duque (2004) and perceived

by Kanny (1993) as essential to the values of ‘freedom’

and ‘dignity’ and by Peloquin (2007) to ‘integrity’.

There were also several differences between the val-

ues in the current and previous studies. For example,

the Commission’s value of ‘dignity’ also encompassed

the ‘nurturing of dignity’, ‘competence’ and ‘self-worth’

(Kanny, 1993), which did not emerge in the present

study. Peloquin’s (2007) value of ‘mindfulness’ only

shared the aspect of ‘thoughtful reflection’ with the cur-

rent study and not the aspects of ‘anticipating future

challenges’ and ‘adapting to ongoing change’. In addi-

tion, some values were not shared at all between the

studies. For example, the Commission’s value of ‘pru-

dence’ was not identified in the current study. Duque’s

(2004) value of ‘balancing the art and science of practice

in health promotion’ was also not identified. Several

values also emerged in the present study which did not

appear in the previous studies, including the values of

‘humility’, ‘empowering clients to lead’, ‘working with

clients’, ‘honouring clients’ priorities and goals’, ‘leader-

ship within the workplace’ and ‘working within a

health team’. Hence, several unique values emerged in

the current study. These values are indicative of partici-

pants valuing their working relationships with clients,

their roles within a health care team and workplace set-

ting and the ability to maintain humble with clients and

colleagues. Interestingly, the unique values of ‘empow-

ering clients to lead’ and ‘working with clients’ were

explored as two separate occupational therapy client

centred approaches by Canadian authors Falardeau and

Durand (2002), indicating that participants valued dif-

fering approaches to working with clients. Further

research on these and the additional unique values will

assist with clarifying their relevance within the broader

profession.

The differing and unique values could be due to the

influence of the surrounding contexts on the develop-

ment and socialisation of professional values, as the

previous studies were either based in America or sum-

marised American, Canadian and British literature. This

suggestion is supported by Van De Camp, Vernooij-

Dassen, Grol and Bottema (2004, p. 700), who stated

that ‘depending on the context from which one tries

to conceptualise professionalism, constituent elements

will be different in abstraction level, relevance and

importance’. The differing and unique values highlight

the importance of identifying the values of the profes-

sion within the Australian context.

The similarities between some of the values identified

in the previous and current studies may be explained

through the shared ‘Western culture’ and thus the shar-

ing of several norms, values, beliefs and world views

(Hasan & Ditsa, 1999; Watson, 2006). For example, indi-

vidualism and a firm focus on personal independence,

freedom and choice are strong values of Western culture

(Eckersley, 2006). As a result, Hocking and Whiteford

(1995) ascribed the Australian occupational therapy

value of individuality as a ‘Western notion’. Participants

in the current study also valued the individuality and

independence of clients. This study also identified the

importance of occupation for participants, in line with

the views of Iwama (2004), who believed that the con-

cept of ‘occupation’ was important in Western culture.

This raises the question of how westernised values of

Australian occupational therapists align and interact

with the values of other cultures. This is of particular

concern when occupational therapists work with clients

from cultures who have differing values. For example,

cultures that do not value individuality, but rather col-

lectivism and personal relationships, such as the cultures

of West Africa, the Middle East and the Indigenous peo-

ple of Australia (Eckersley, 2006; Fogarty & White,

1994).

Iwama (2004) has commented that culture and its

influence on occupational therapy practice is easily

taken for granted. This could be due to lack of reflec-

tion amongst occupational therapists on how culture

shapes and moulds their own professional values. This

lack of awareness could lead to ‘values myopia’, which

is a ‘tendency to assume that other people’s values are

the same as our own’ (Fulford, 2004, p. 220). This

places occupational therapists at risk of providing cul-

turally irrelevant practice and failing to meet the occu-

pational needs of their clients. To provide occupational

therapy that is culturally appropriate, occupational ther-

apists need to reflect on how culture influences their

professional values, how their values shape their prac-

tice and how these value may differ to those of their

clients.

Reflection on professional values could also assist

therapists to understand how their values align with

those upheld by other professions. Byng et al. (2002)

explored the values of UK speech pathologists and

found that practitioners experienced disagreement and

conflict with the curative values of the medical profes-

sion. Participants in the current study perceived a divi-

sion between their values and the values of the medical

profession, suggesting potential conflict with some of

the values of the medical profession. Reflection on pro-

fessional values could assist individual occupational

therapists to identify which values come into conflict

with those of the medical profession and could assist



them to manage, negotiate and work within the existing

value conflicts (Fulford, 2004).

However, reflection on professional values is

impeded by their centrality and a framework may be

needed to guide the process. Byng et al. (2002) devel-

oped a value-based framework to guide the reflection of

speech pathologists. The framework enables practitio-

ners to examine the values that underpin different lev-

els of clinical practice. Practitioners are able to reflect on

the values that underpin their ultimate practice goals,

their intermediate goals, specific interventions and their

related social dynamics. There is potential for this

framework to be adapted and used by Australian occu-

pational therapists.

This study has provided insight into the professional

values of 15 Australian occupational therapists. It is an

initial step towards identifying the values of the profes-

sion and making them explicit. The results of the cur-

rent study could be used as a baseline to inform future

explorations. For example, the values could be used as

deductive codes to extract professional values from

Australian occupational therapy literature, documenta-

tion and curricula. They could also be used to guide

future interviews exploring the practical application of

specific values. The results of such studies will assist

with achieving the overall aim of making the values of

the profession explicit.

Having explicit values will enable students and thera-

pists to reflect on how culture shapes and influences

specific values of the profession, centralising culturally

appropriate practice in the profession. Clear values will

also facilitate comparisons with the values of other pro-

fessions, enabling the identification and future manage-

ment of value conflicts. They could also be used to

create awareness amongst other professions of the val-

ues and priorities of occupational therapy, addressing

misunderstandings and enhancing mutual respect and

team work (Fulford, 2004). Explicit values will also

clarify what professionalism means to the Australian

occupational therapy profession and thus providing

insight into the values that guide practice, motivate

practitioners and unite the profession.

This study had a few limitations. Due to its qualita-

tive approach, the results cannot be generalised beyond

the group of individuals who agreed to participate in

this study. However, as previously described, steps

were taken to enhance the credibility and transferability

of the results. Furthermore, it is not possible to know

the extent to which participants upheld the emerging

values. It is also not possible to determine which values

participants perceived as fundamental or peripheral.

Conclusion

This study aimed to explore the professional values of

Australian occupational therapists. It also aimed to con-

tribute to research orientated towards identifying the

values of the profession and in doing so, clarify what

professionalism means to the Australian occupational

therapy profession.

Several professional values emerged that were philan-

thropic in nature, but others emerged which guided the

practice of occupational therapy, professional relation-

ships and the responsibilities of being an occupational

therapy professional. Some of the emerging values had

not been previously identified, highlighting the impor-

tance of identifying the values of the profession within

the Australian context.

To enable culturally appropriate practice and man-

agement of potential value conflicts, occupational thera-

pists need to reflect on how culture influences their

professional values, how their values shape their prac-

tice and how they differ from those of their clients and

other professions.

Acknowledgments

The authors would like to thank the participants who

volunteered in this study.

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