This week I’ve been at the NOI Conference 2012 – a real blast! A week of neuroscience-backed biopsychosocial practice, and nerdy passions. My brain is nourished, in fact, it’s replete. And now to digest.
Why the headline?
Well, throughout the conference, over and over again I heard about physiotherapy and psychology – and nary a murmer about occupational therapy’s contribution (from the profession’s inception) to the biopsychosocial model of practice. It’s like the profession simply does not exist.
One very brave young occupational therapist voiced her concern that there is a disconnect between the occupational therapy profession and the consciousness of other clinicians. In a profession that has always worked from a biopsychosocial model, how is it that there is so little mention of it in a conference where this is at the heart of an enormous change in practice? Lorimer Moseley’s response was to say that occupational therapists must research more and publish in non-occupational therapy journals. I have to agree.
I know there will be a chorus of “yes but…” from people, and I recognise the challenges. As a profession we struggle with our epistemological and ontological orientation because we argue that our interventions are so tailored to individual needs that we can’t measure their outcomes. That every individual has unique needs so we can’t measure outcomes empirically. And after all, individuals say they like and need what we offer. We can’t do large-scale research because we don’t get research funding, or we’re clinicians not researchers, or if we do a good research study we can’t publish because major journals won’t accept our publications – all yes but’s!
Before I get torn limb from limb, I haven’t published – yet. And as a clinician I know how difficult it can be to pull a research proposal together, particularly without good support from health administrators. I know this – and yet, Lorimer has a very good point.
Occupational therapists need to become far more visible but the way to do this is not by claiming “oh but we do X” – or Y or Z.
The profession simply must begin collaborating with people who have leverage – like Lorimer Moseley and his collaborators.
The profession must begin to critically appraise what it does, how it does it, and then begin to do therapy better.
The profession needs to train both clinicians and researchers and clinician-researchers. A scientist-practitioner model is not out of the question – in fact, I think it must happen or the little respect we are afforded will be lost, and the profession will be absorbed into other disciplines.
What are the interesting hypotheses that need to be explored in occupational therapy practice? How can we contribute to the greater awareness of the “person-in-context” that other professions have right now? How can we answer our own questions about whether we are effective, or simply “nice people” who help others through nonspecific effects rather than specific occupational therapy?
These, and other curious questions, must be explored and publicised.
As Dr Fiona Wood said at NOI 2012 – Blinkers off, game on!
For more info on NOI 2012 – go here for 80 pages of transcript via Twitter. A powerful medium.