Craig Greber

Increasing the occupational therapy mental health workforce through innovative practice education: A pilot project

AIM This paper describes the evaluation of a pilot trial of two innovative placement models in the area of mental health, namely role emerging and collaborative supervision. The Queensland Occupational Therapy Fieldwork Collaborative conducted this trial in response to workforce shortages in mental health. METHOD Six occupational therapy students and eight practice educators were surveyed pre- and post-placements regarding implementation of these innovative models. RESULTS Students participating in these placements reported that they were highly likely to work in mental health upon graduation, and practice educators were positive about undertaking innovative placements in future. An overview of the placement sites, trials, outcomes and limitations of this pilot trial is provided. CONCLUSION Though limited by its small sample size, this pilot trial has demonstrated the potential of innovative placement models to provide valuable student learning experiences in mental health. The profession needs to develop expertise in the use of innovative placement models if students are to be adequately prepared to work with the mental health issues of the Australian community now and in the future.

Occupation-Focused Practice: Challenges and Choices

Occupational therapy has undergone a paradigm shift from a more mechanistic to an occupation-focused perspective, which has influenced practice as well as the professional education curriculum. However, this shift has not been readily adopted in some practice settings. Anecdotal examples from students, and from practitioner colleagues, have led the authors, as experienced academics and practitioners, to consider what would further assist the profession in moving forward and embracing this change. In keeping with others in the profession, in this opinion piece we would like to support colleagues in practice by suggesting ways of progressing by small ‘nano steps’ along the continuum from medical to occupation-centred practice.

Clinical utility of the four‐quadrant model of facilitated learning: Perspectives of experienced occupational therapists

BACKGROUND/AIMS This study explored perspectives of experienced occupational therapists regarding teaching-learning approaches used during intervention. The aim was to ascertain the clinical utility of the Four-Quadrant Model of Facilitated Learning (4QM) (Greber, Ziviani, & Rodger, 2007a) by understanding how it might enhance clinical competency when applying teaching-learning modalities. METHODS   Mixed methods were used to ascertain the perspectives of two groups of therapists with seven or more years experience in either adult (n=8) or paediatric (n=7) practice. A pre-discussion questionnaire was used to prime participants for an initial focus group centred on understanding how participants used teaching-learning within occupational therapy intervention. Following a brief description of the 4QM, a further session explored the perspectives of participants regarding the 4QM as a means of conceptualising and planning teaching-learning interventions. RESULTS Irrespective of practice area, therapists considered teaching-learning approaches core to their practice, without necessarily identifying a clear process to guide their implementation. Proficiency in teaching-learning was generally seen to be gained through trial and error. Participants identified potential clinical applications for the 4QM as a useful structure to support the application of teaching-learning interventions, speculating that it would be particularly useful for novice clinicians. CONCLUSIONS Participants endorsed the 4QM as a useful integrating framework to support the development of professional competencies related to planning interventions that use a teaching-learning approach.

Re: the dark side of occupation: a concept for consideration.

Dear Editor, Twinley (2013) challenged readers of this journal to reconsider notions of occupation as a positive and lifeaffirming influence. Furthermore, she detailed ways in which the concept of occupation must necessarily include facets of life that are not commensurate with health and wellbeing, as well as those that are antisocial, illegal and/or immoral. The discussion is a critical one as occupational therapy diversifies from the select cultures and caseloads from which many of its theoretical premises were derived. I congratulate the author on a thought-provoking article and I suggest that such a complex consideration of the relationship between occupation and health is pivotal at this point of the profession’s evolution. It is important to test the robustness of these founding notions if we are to expand our theories to include the populations with which we now find ourselves involved. In response to the discussion proffered by Twinley, I offer these further observations:

Pluralism: Signposting a split in occupational therapy?

Bakhtin (1984, cited in Irving & Young, 2002) proposed pluralism as a way of conceptualising the multiple versions of reality experienced by different individuals or groups. In a paradigmatic sense, pluralism is characterised by heterogeneity of core concepts, theoretical frameworks, perspectives and methods (Somers, 2008). Given the multiple practice areas in which philosophies about human occupation are enacted, Mosey (1985) acknowledged that occupational therapy is by nature a pluralistic discipline. With the many and varied versions of occupational therapy practice, building consensus about what occupational therapy is has proven elusive, frustrating the development of a unified professional identity (Brasic Royeen, 2003). Literature that identifies varying degrees of embrace for the contemporary paradigm (e.g. McEneany, McKenna & Summerville, 2002; Wilding & Whiteford, 2007) suggests that diverse responses to transformations in professional paradigms over the years can perhaps be understood from a pluralistic perspective. This article aims to use a pluralist platform to understand variations in the ways occupational therapy is practised. It then proposes issues arising as the extremes of these differences become so pronounced as to reflect different underlying philosophies.

Postmodernism and beyond in occupational therapy

Throughout its history, occupational therapy has been shaped by ideologies characterising the cultures in which it has been practised. The profession has evolved during successive periods of modernist and postmodernist thought and has been influenced substantially by both perspectives. Like all eras, postmodernism will eventually exhaust its influence and occupational therapy will be reformed by a new approaching age. This study describes the current influence of postmodernism on the profession and considers a future beyond the postmodern era that embraces both reductionist and occupation-focused approaches to practice, as well as the area in between.