Tracy Fortune

Occupational Therapists: Is Our Therapy Truly Occupational or are We Merely Filling Gaps?

This article is concerned with role identity and its relationship to the professional thinking and action of occupational therapists. In this informed viewpoint, the notion that occupational therapists could be perceived as gap fillers is explored, based on empirical data that focused on the roles adopted and the guiding philosophies enacted by occupational therapists working in child and adolescent mental health. Following the presentation of interview data from four occupational therapists, two cogent issues are presented and discussed. The first issue posits that a failure to ground practice in occupational philosophies contributes to perpetuating an incoherent role identity. The second issue discusses whether the recovery of an occupational paradigm in practice can liberate occupational therapists from role incoherence and enable them to reclaim their identity as therapists of occupation.

Perspectives of occupational therapists working in primary health promotion

BACKGROUND/AIM Given a global reorientation of health services towards upstream, or primary health promotion, there is a need to explore the role of occupational therapy in this area of practice. This study aimed to explore and describe the primary health promotion practice of community health workers with an occupational therapy background. The study highlights their practice working at a community or population (macro) level, rather than at the client service (micro) level, and explores related enablers and barriers to this practice. METHODS The study utilised the qualitative methodology of narrative enquiry. Five workers with an occupational therapy background were recruited from community health services within Victoria. Data were gathered via in-depth interviews. Individual participant interview data were ordered to form a narrative detailing each participants experience. These narratives were then analysed to generate themes representing important aspects of participants experiences. RESULTS Although some practitioners with an occupational therapy background perform primary health promotion, the findings indicate that a number of barriers deter occupational therapists from engaging in this type of practice, including lack of funding, preparation and limited understanding of the role of occupational therapy in health promotion. Enablers to engagement included undertaking further education, gaining clinical experience and establishing a professional identity. CONCLUSION This study provides insights into the experiences of occupational therapists who work at a macro rather than micro-level of practice, and emphasises some of the barriers and enablers to embracing the sorts of roles that are emerging as part of a changing health system.

The challenge of interdisciplinary collaboration in acute psychiatry: Impacts on the occupational milieu

This paper, based on a larger ethnographic exploration of the acute inpatient environment for older people with mental illness, describes and provides interpretations of staff perceptions and actions in order to highlight tensions between professional groups which adversely affect opportunities for patients to engage in meaningful occupations. Fieldwork conducted in 1999-2000, supplemented by 20 in-depth interviews with a range of mental health professionals, provides the foundation for suggesting that the extent and nature of occupational engagement is significantly impacted by interdisciplinary relations. The skill of occupational therapists to collaborate with their nursing colleagues in a socially complex environment, and the importance of personal leadership skills among our new graduates are discussed.

Should higher education curriculum develop political acumen among students

Around 20 years ago, I was afforded a wonderful opportunity to create, within my own master of science degree, a module of study on any subject that I could demonstrate had some relevance to my overall major of study. That major was occupational therapy, and the module I chose to create saw me enrolling across a number of subjects spanning cultural origins and biological anthropology. I proposed that by studying ‘humans’ in terms of biological and cultural origins, I could add to the body of knowledge about humans as ‘occupational beings’. I recollect this almost forgotten cross-discipline journey due to a current concern I have about the preparation of graduates for strategic and effective employment and, more specifically, the role that political acumen plays in surviving what Barnett (2011) refers to as the ‘supercomplex’ world of professional practice. The point I wish to make in this piece relates to how graduate attributes can really speak to the heart of the social and political landscape that graduates find themselves in today. It’s a landscape akin to a minefield. As workers in universities, we surely know what the consequences of stepping on mines can look like – for example, failure to gain promotion, ill health, limited autonomy over the balance of research and teaching and pressure to deliver better, more quality experiences for our students in a context of limited resources. One of the most interesting ideas I was exposed to during my anthropological sojourn was the notion of ‘Machiavellian intelligence’ put forward in Byrne and Whiten’s (1988) classic Machiavellian intelligence: Social expertise and the evolution of intellect in monkeys, apes and humans. The text drew together a range of contributions all geared toward exploring how highly social animals, in particular primates, engaged in sophisticated tactics involving deception, cooperation and competition in order to secure needed resources. The thesis is that intelligence may have evolved as an adaptation to living in socially complex environments. Of particular interest was a chapter drawn from Franz de Waal’s (1982) Chimpanzee politics, which outlines a fascinating and compelling set of observational notes, one of which is entitled ‘Luit’s new policy’. The notes detail how one adult male (Luit) in the colony challenges another dominant male, Yeroen. While Yeroen initially has the support of many of the females in the colony, Luit has the support of another male, Nikkie. As Yeroen’s support from the females reduces over time due to increasing punishments from Yeroen’s rivals, Luit becomes the alpha male. Not only was Luit’s physical appearance

Bridging Identity "Chasms": Occupational Therapy Academics' Reflections on the Journey towards Scholarship.

ABSTRACT The performative context of higher education demands that practice-oriented academics shift their priorities from preparing practitioners for the profession, towards ‘productive’ scholarship. We present narratives from occupational therapy academics at the end of a year-long journey through an action research project focussed on academic identity and scholarly growth. Our analysis captures subtle and striking shifts in being and becoming, doing and belonging. The findings, re-presented as an adapted Hero’s Journey, also reveal the powerful impacts on identity and practice that are enabled when academics have the opportunity to create spaces for scholarship that are experienced as caring, collaborative and collegial.

Supporting scholarly identity and practice: Narratives of occupational therapy academics:

Introduction Internationally, an increasing number of occupational therapists are making the transition from clinical practice to academia. Many make this transition with strong practitioner identities, limited academic skills, and inadequate preparation for a competitive academic environment. A group of 13 Australian occupational therapy academics participated in blogs as part of a 12-month action research project, with the aim of being and becoming more scholarly academics. Method Throughout an action research project titled Growing Scholarship, co-participants/researchers participated in a closed blog for sharing experiences of being and becoming more scholarly academics. In the present study, qualitative data from the blogs were analysed through an iterative and inductive process and themes generated by the research team. Findings Constructing and reconstructing identity emerged as a key theme during analysis of the blogs, with the sub-themes striving to reach one’s potential and growing through collaboration and support emphasising the significance of individual and macro factors in shaping academic identity formation. Conclusion This study demonstrated how the occupation of blogging can be used to support the scholarly identity and practice of occupational therapy academics. Other professionals facing change and uncertainty in the workplace could consider a similar approach to support the process of identity reconstruction.

Mental health care for our ageing Australian population

Objective: In the context of the National Strategy for an Ageing Australia, the aim of this paper was to highlight some of the challenges for aged mental health services as our population ages. Conclusions: The demand for greater consumer participation in treatment planning and provision, and the increasing complexity of managing medical and psychiatric comorbidity in our ‘old-old’ population will be major drivers for improving our models of clinical practice and forging stronger partnerships between the public and private sectors.

A profile of inpatient admissions to an aged psychiatry service in Victoria

Objective: The study aimed to characterize the demographics, diagnostic makeup and aspects of patient management for the inpatient population of a large aged psychiatry service. Method: Sociodemographic and clinical variables were retrospectively collated from inpatient files and discharge summaries over a 3-year period. Age, gender, country of birth, diagnostic group, length of stay, involuntary care status and number of admissions were described and analysed. A total of 604 patients were included in the study, with complete data available for 516. Results: Approximately half of the patients were aged 65–75 years and 59.3% were female. More than half had been born outside of Australia. The primary diagnosis was an affective disorder in 39.0% of admissions, dementia in 27.5% and psychotic illnesses in 25.8%. The median length of stay was 28 days; 60.8% had a period of involuntary care and 79.8% had only one admission. Conclusion: In the near future, aged psychiatry services will face increased numbers of patients and rising expectations. To best respond to these challenges, we need to have an understanding of current patient and service profiles. The findings of this study illustrate a range of patient, diagnostic and management variables in aged psychiatry practice. This information can be used for comparison with other services and in planning for future development of services.

Returning history to the educational formation of health professionals in Australia

ABSTRACT History has practically vanished from allied health professional education. We ask, what kind of problem does a ‘history of the professions’ pose for health sciences curriculum? What are the implications of graduates being unschooled in the history of their profession? Literature on knowledge in the curriculum, is used to interrogate how historical knowledge has come to be constituted in professional education fields. We develop a sketch of two particular health professions – occupational therapy and physiotherapy – and ask why it might be difficult to include a history of the profession in these curricula. Our view is that by helping students to cultivate an historical imagination, they can see how their experiences are framed by a fascinating collision of ideas, politics and practices. Furthermore, attention to history can help students better situate their own uncertainties about transitioning to practice enabling them to tackle professional quandaries with hindsight, foresight and insight.

Global Citizenship and Higher Education: A Scoping Review of the Empirical Evidence

Student attainment of capabilities associated with global citizenship remains a priority for higher education institutions. We report on a scoping review of empirical studies to explore how global citizenship is understood and enacted in higher education. The 29 included studies span the arts, psychology and social sciences, professional degrees, purpose-designed global citizenship courses, and community development, service, and educational travel programs. Notwithstanding considerable diversity in study aims, methodology, and how global citizenship was described, we were able to discern an overarching framework to describe the theoretical contributions to global citizenship education. Our findings contribute to building conceptual clarity both for educators charged with developing curricula and for higher education researchers seeking to explore and evaluate the outcomes of global citizenship education.