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

CelebrateCelebrateChallengChallengee

CreateCreate

Celebrate

Our collective accomplishments

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).

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)

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

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

Celebrate: our Client-centred occupational focus

The occupational imperative

Client-centred

Human Occupation

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

From divergenceFrom divergence

1919 - Wounded soldiers receiving occupational therapy

through therapeutic use …

to enabling to enabling occupationoccupation

……

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

individualindividual

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

Celebrate: our CMOP

CAOT, 1997

Celebrate and be proud: Celebrate and be proud:

CMOPCMOP Now used to frame our Now used to frame our practicepractice

Debbie Hebert, Corporate Professional Leader and Clinical Educator (OT), Toronto Rehabilitation Institute, writes…

Documentation both dictates and reflects practice

Prior to the Enabling I publication, our OT documentation reflected a very medical model, impairment based type of assessment ……. nursing and physiotherapy might easily have filled out this assessment form as well as us.

We renovated our documentation and created the “Occupational Performance Module”.

Celebrate and be proud: Celebrate and be proud: CMOPCMOP to to frame practiceframe practice

Debbie continues….

This change was transformative

Enabling Occupation gave us the guidance to be the leaders in patient centred goal setting

Now we are considered an invaluable profession

Our colleagues now say…

“I wish I were an OT” rather than “What do OTs do?”

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

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

Celebrate: COPM - Slovenia

Celebrate and Be proud COPM around the world

Countries where the COPM is used

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)

Celebrate -> Be proud

ChallengeEach other to go further

Challenge the Present: go Challenge the Present: go furtherfurther

Enabling II: Advancing an Enabling II: Advancing an 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

Challenge our present: Challenge our present: beyond performance beyond performance

Canadian Model of Occupational Performance and Engagement

Challenge our present: Challenge our present: beyondbeyond

Disability/IndividualsImpairment reduction

New York Times: “occupational

therapists have taken their place —

the army that often stands behind

academically successful students.

(February 24,

2010)

(Clark et al)

Challenge: our Challenge: our practice practice to become occupation-to become occupation-basedbasedFran Aiken, professional practice leader,

Sunnybrook Health Sciences Centre writes….

I had always felt rooted to occupation as the basis of practice, but, I experienced ‘disease-oriented’ health care and OT …

I welcomed the 1997 Enabling Occupation guidelines and initiated the gradual shift

to occupation-based practice

Be Daring: Occupation-Be Daring: Occupation-based practicebased practice

Sunnybrook OT’s discovered :Sunnybrook OT’s discovered :

A MEANING GAP: “… I think we always struggle with being true to our profession and yet being true to the program that we work in.”

Resolving the meaning gap is a personal journey

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

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

to enabling to enabling occupationoccupation

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

to enabling occupation

At the level of … society

Be daring – Be daring – Naming Naming EnablementEnablement

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

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.

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

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

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

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

Celebrate -> Be proudChallenge -> Be daring

CreateAn occupational future for

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

‘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

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)

Imagine if……….Imagine if……….

"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

Imagine if……….Imagine if……….

Imagine if……….Imagine if……….

A Visionary Occupational Therapy Council of Canada?

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

Celebrate -> Be proud

Challenge -> Be daring

Create -> Be the difference

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

Thank YouMerci