A Student’s perspective: ‘Exploring the use of theoretical application in practice’

A guest Post by Michelle Perryman, a 2nd year MSc Occupational Therapy Student (Accelerated Route) from the UK

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Over the past two years, i have asked Occupational Therapist’s (OT’s) which theory underpins their practice? I was told the 100% of theoretical consideration I seek would only contribute to around 30% of my reasoning’s in the ‘real world’. Furthermore, at times evidence-based practice will not be mentioned.  As a result, I observed. So what did I find? Although, the professionals did not verbally link theory, this however, was projected by their practice, I found the OT’s employing Frames of references  (FORs) such as the client centered approach to the behavioral FOR (and more). So I questioned? Why is the expression of evidence based practice important if its already being used?

Evidence based practice governs safe valuable interventions (Creek, 2010) for each individual client. I fear without the application of our valued underpinnings as OT’s our philosophy for practice is challenged preventing a holistic service. As a result, allowing our practice to be governed under service provision without relevance to our unique skills (Sound familiar?). So how does this impact clients health and wellbeing? Nelsons’ (Nelson and Thomas, 2003) ‘conceptual framework highlights clients engage within therapy sessions only after encountering forms that are meaningful and purposeful. This agrees with Kielhofner (2008) and his theory of ‘volition’ specifying the use of purposeful occupations will increase motivation and reduce adherence. Ultimately, will the client still engage with the profession if we are not proving a service individual to them? So what can we do? In one word?  I speculate ‘Advocacy’.

Unsurprisingly, the Casson lecture for the past two years (Turner, 2011, Ballinger, 2012) has expressed the effectiveness and the professional concerns of occupational therapy in its current economic climate. In April 2013 ‘The Health and Social Care Bill’ (DOH, 2012) aims to challenge our national health service and ultimately the profession of occupational therapy considerably, whereby, our services are in need to express the effectiveness in order to become commissioned (DOH,2012) . Thus, highlighting, the sheer importance of evidence based practice expression in a crisis of professional identity utlising such FORs (Law and Mcdermid, 2008) as occupational science providing the underpinning evidence base which we require to remain strong in our role. I personally find occupational science takes into account our philosophy whilst remaining true to our original identity and greatest source of enhancing wellbeing ‘Occupation’.

So what have I learnt? This has allowed me to reckon with provisional standards of larger organisation’s and the impact of the current economic state on my professional reasoning’s. As I am yet to go into practice I am now weary of normalizing my role to orgnisational cultural (Cole, 2012) demands and I aim to maintain my forever, theoretical exploration I currently seek. I aim to do this through conversing with my cohort and maintain my OT links with other professionals’ using social media such as MH4OT, OTALK, OTALK2US, OCCHAT to do so. I have found over the past year thanks to an inspirational colleague introducing me to the social media world. I have learnt so much more than I would have done in my self directed MSc course. I thank the professionals and their determination of advocacy in the OT profession showing me the way forward by guiding me into safe relevant practice.

References

Ballinger, C. (2012) ‘The Elizabeth Casson Memorial Lecture 2012: The effectiveness, impact and legacy of occupational therapy’. British Journal of Occupational Therapy 75(8)

Cole, F. (2012) ‘Lecture Presentation’ UoC

Creek, J. (2010) The Core Concepts of Occupational Therapy: A Dynamic Framework for Practice. Jessica Kingsley Publishers

Department of Health (2012) ‘Health and Social Care Bill’ Available at: http://healthandcare.dh.gov.uk/category/health-and-social-care-bill/

Kielhofner, G. (2008), Model of human occupation. (4th Ed) Philadelphia: Lippincott Williams & Wilkins

Law M. Mcdermid J. (2008)  ‘Evidence-based rehabilitation thorofare, NJ: Slack incorporated, P63-94

Nelson, D. and Thomas, J. (2003) Occupational Form, Occupational performance and a conceptual framework for therapeutic Occupation. Kramer, P.Hunojosa, and Royenn, C. (Eds) Perspectives in human occupation: Participation in life P 87-155 Philadelphia: Lippincott Williams and Wilkins

Turner, A. (2011) ‘The Elizabeth Casson Memorial Lecture 2011: occupational therapy- a profession in adolescence’. British Journal of Occupational Therapy 74 (7)

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