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VanPuymbrouck L, Chun EM, Hesse ED, Ranneklev K, Sanchez C. Developing Client Self-Advocacy in Occupational Therapy: Are We Practicing What We Preach? Occup Ther Int 2024; 2024:1662671. [PMID: 38571573 PMCID: PMC10990644 DOI: 10.1155/2024/1662671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/06/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Background Developing client self-advocacy is in occupational therapy's (OT) scope of practice; however, there is limited understanding of if, or how, occupational therapists learn about self-advocacy interventions as well as implement self-advocacy into clinical practice. Objective This study sought to identify if and how therapists learn about self-advocacy intervention approaches and identify if and how therapists implement self-advocacy into their work with clients. Method A survey was distributed via email to academic and professional listservs in the United States, and data were collected using REDCap survey software. Descriptive statistics were analyzed data using REDCap/SPSS. Comparative statistics, Kruskal-Wallis's tests, Chi-square tests for independence, and Pearson's correlation tests analyzed differences across groups of respondents. Results Practicing and licensed occupational therapists (n = 138) across the United States completed the survey. Findings indicate a majority (59.5%) of occupational therapists not learning strategies for addressing or developing client self-advocacy. Of significance, 21.7% of participants had never been exposed to concepts of client self-advocacy in academic or clinical education. Practitioners who did address self-advocacy did so indirectly through teaching-related skills (76.6%). Conclusion Many clients of OT will need self-advocacy skills in order to address issues of exclusion and discrimination that prohibit full participation in society. Occupational therapists must prioritize incorporating client self-advocacy into curricula and clinical practice.
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Affiliation(s)
- Laura VanPuymbrouck
- Department of Occupational Therapy, Rush University, 600 S. Paulina St., Chicago, IL 60612, USA
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Karp P, Block P. Float to grow: nurturing the roots of socially inclusive and just practice in occupational therapy students. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2022. [DOI: 10.1590/2526-8910.ctore253533122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Models of practice and theoretical frameworks that seek to deemphasize impairment and focus on the implications of societal attitudes, norms, and culture are significant and relevant to the practice of occupational therapy. As an underpinning of client-centered practice, there is a need to highlight and embrace the intersection of impairment-deemphasizing theories and move from conceptual understanding to true application of those theoretical models in practice. This article describes the inclusion of the Salamander Workshop; an experiential learning activity designed to facilitate the development of students’ therapeutic self-awareness and initiate a starting point for incorporating social frameworks into authentic practice. Student reflections conceptualize the discussion about professional growth and development against the backdrop of disability experiences, social change, and empowerment. The article begins with an introduction to how the profession of occupational therapy and disability studies interconnect. This is followed by a description of both the occupational therapy education program where the experiential learning activity took place, and details of the workshop itself. The final two sections of the article articulate and discuss student reflections of the experiential learning exercise and conclude by framing the discussion within the larger context of occupational therapy pedagogy. The Salamander Workshop facilitated an opportunity for students to immerse themselves in the lived experience of others, while enhancing their own self-awareness, which in turn may translate to their growth and development as inclusive practitioners.
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Magasi S, Angell AM, Papadimitriou C, Ramirez RD, Ferlin A, Reis JP, Wilson T. Inside an Occupational Therapy-Disability Community Partnership to Promote Health Management: Ethnography of a Research Collaboration. Am J Occup Ther 2021; 75:7504180050. [PMID: 34780614 PMCID: PMC8369666 DOI: 10.5014/ajot.2021.045468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Disability studies-informed occupational therapy is predicated on full and equal partnerships among occupational therapy practitioners, researchers, and disability communities. Community-based participatory research (CBPR) is an approach to research that aligns with this vision yet is not without challenges. Understanding the tensions that arise from stakeholders' perspectives and priorities is critical for promoting collaboration between occupational therapy professionals and disability community partners. OBJECTIVE To understand the group dynamics and relational processes of a CPBR team in the context of an intervention development study focused on health management for people with disabilities (PWD). DESIGN This 9-mo ethnographic study included semistructured interviews and participant observation. Data were analyzed thematically. SETTING Community-based multiagency collaborative. PARTICIPANTS Nine participants (6 academic team members, 4 of whom were trained as occupational therapists; 2 disability partners; and 1 managed-care organization representative) took part. Three participants self-identified as PWD. FINDINGS CBPR processes, although productive, were fraught with challenges. Team members navigated competing priorities, varying power dynamics, and multifaceted roles and identities. Flexibility was needed to address diverse priorities, respond to unexpected challenges, and facilitate the project's success. CONCLUSIONS AND RELEVANCE Deep commitment to a shared goal of health care justice for PWD and team members' willingness to address tensions promoted successful collaboration. Intentional relationship building is needed for occupational therapy researchers to collaborate with members of disability communities as equal partners. What This Article Adds: Disability studies-informed occupational therapy research demands that team members intentionally nurture equitable relationships through shared governance, clear communication, and recognition of the fluid nature of power dynamics.
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Affiliation(s)
- Susan Magasi
- Susan Magasi, PhD, is Associate Professor, Departments of Occupational Therapy and Disability and Human Development, University of Illinois at Chicago;
| | - Amber M Angell
- Amber M. Angell, PhD, OTR/L, is Assistant Professor, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles. At the time of the study, Angell was Postdoctoral Fellow, Department of Occupational Therapy, University of Illinois at Chicago
| | - Christina Papadimitriou
- Christina Papadimitriou, PhD, is Associate Professor, Department of Interdisciplinary Health Sciences and Department of Sociology, Oakland University, Rochester, MI
| | - Ricardo D Ramirez
- Ricardo D. Ramirez, OTD, OTR/L, is Occupational Therapist, University of Illinois Hospital and Health Systems, Chicago. At the time of the study, Ramirez was Doctoral Student and Research Specialist, Department of Occupational Therapy, University of Illinois at Chicago
| | - Alli Ferlin
- Alli Ferlin, OTD, OTR/L, is Occupational Therapist, Vibra Rehabilitation Hospital of Denver, Denver, CO. At the time of the study, Ferlin was Doctoral Student, Department of Occupational Therapy, University of Illinois at Chicago
| | - Judy Panko Reis
- Judy Panko Reis, MS, MA, is Robert Wood Johnson Community Health Leader, Chicago. At the time of the study, Reis was Health Policy Analyst, Access Living Center for Independent Living, Chicago
| | - Tom Wilson
- Tom Wilson, MS, is Community Activist, Chicago. At the time of the study, Wilson was Community Development Organizer for Health Care, Access Living Center for Independent Living, Chicago
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Sheth AJ, Kish J, VanPuymbrouck LH, Heffron JL, Lee D, Mahaffey L. "A Legitimate Place in the Profession": Author Reflections on the 2005 Disability Studies Special Issue. Am J Occup Ther 2021; 75:12522. [PMID: 34780610 DOI: 10.5014/ajot.2021.045294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE In 2005, the American Journal of Occupational Therapy published a special issue focused on disability studies. Contributing authors challenged readers to reflect on their practices and recommended ways to change the field, yet literature on the current state of the integration of disability studies into occupational therapy is scarce. OBJECTIVE To engage the original authors of the 2005 special issue in an examination of perspectives on how disability studies perspectives have contributed to changes within occupational therapy and what work remains. DESIGN The research team conducted semistructured interviews with 11 authors who published an article in the special issue. Interview transcripts were analyzed using thematic analysis. Triangulation of coders, multiple phases of data analysis, and member checking were used to establish trustworthiness. RESULTS Five themes emerged from the data: (1) exposure to disability and disability studies, (2) impact of the special issue on occupational therapy, (3) changes observed in occupational therapy beyond the special issue, (4) challenges integrating disability studies into occupational therapy, and (5) disability studies-informed recommendations for occupational therapy. CONCLUSIONS AND RELEVANCE Although the original contributing authors acknowledged the transformative impact of disability studies on their own practice and scholarship, the results suggest that disability studies remains outside mainstream occupational therapy scholarship. Exploring the connections and divergence between disability studies and fields such as occupational science could improve understanding of how disability studies concepts are defined and used in theory and practice. What This Article Adds: Since the publication of the original special issue in 2005, the field of disability studies has continued to influence occupational therapy, although more often in individual than in systemic ways. Work is needed to embrace a disability studies-informed critical and intersectional foundation for the profession and explore the ways in which occupational therapy can better partner with populations through a disability studies lens.
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Affiliation(s)
- Alisa Jordan Sheth
- Alisa Jordan Sheth, PhD, OTR/L, is Assistant Professor, School of Occupational Therapy, Pacific University, Hillsboro, Oregon;
| | - Jacqueline Kish
- Jacqueline Kish, MS, OTR/L, is PhD Candidate, Department of Disability and Human Development, University of Illinois at Chicago
| | - Laura H VanPuymbrouck
- Laura H. VanPuymbrouck, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Rush University, Chicago
| | - Jenna L Heffron
- Jenna L. Heffron, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Ithaca College, Ithaca, NY
| | - Danbi Lee
- Danbi Lee, PhD, OTD, OTR/L, is Assistant Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Lisa Mahaffey
- Lisa Mahaffey, PhD, OTR/L, FAOTA, is Professor, Department of Occupational Therapy, Midwestern University, Downers Grove, IL
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Holler R, Chemla I, Maeir A. Disability Orientation of Occupational Therapy Practitioners in Physical Rehabilitation Settings: Tension Between Medical and Social Models in Theory and Practice. Am J Occup Ther 2021; 75:12518. [PMID: 34780606 DOI: 10.5014/ajot.2021.042986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE To date, little is known about the extent to which occupational therapy practitioners have adopted the core insights of disability studies. OBJECTIVE To examine the degree to which occupational therapy practitioners endorse the medical model of disability versus the social model of disability in theory and in practice. DESIGN Cross-sectional study. SETTING Physical rehabilitation facilities, ranging from hospital to community settings. PARTICIPANTS One hundred two Israeli occupational therapy practitioners. Outcomes and Measures: The Orientation toward Disability Scale, constructed for this study, has two dimensions that distinguish between the medical and social models of disability: locus of intervention (the person or environment) and client involvement (extent to which the practitioner fosters the client's autonomy in the rehabilitation process). Each dimension addresses both theoretical and practical endorsements. RESULTS Greater support for the social model of disability was mostly evident in the client involvement dimension, whereas support for the medical model of disability was mostly evident in the locus of intervention dimension. Over both dimensions, the medical model of disability was significantly more endorsed in practice than in theory. Work setting and prior exposure to the social model of disability were found to affect practitioners' disability orientation. CONCLUSIONS AND RELEVANCE Occupational therapy practitioners working in physical rehabilitation are still relatively far from fully adopting the critical insights of the social model of disability. This finding is especially relevant when their actual practice, rather than their theoretical views, is considered and when rehabilitation takes place in out-of-home settings. What This Article Adds: This study offers unique insight into the disability orientation of occupational therapy practitioners, showing a need for more training programs to expose students to the social model of disability. These programs should use critical discussions of the challenges that this model presents to the profession and barriers to implementing it in practice.
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Affiliation(s)
- Roni Holler
- Roni Holler, PhD, is Senior Lecturer, Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel;
| | - Idit Chemla
- Idit Chemla, MScOT, is Graduate Student, School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adina Maeir
- Adina Maeir, PhD, is Associate Professor, School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Harrison EA, Sheth AJ, Kish J, VanPuymbrouck LH, Heffron JL, Lee D, Mahaffey L. Disability Studies and Occupational Therapy: Renewing the Call for Change. Am J Occup Ther 2021; 75:12524. [PMID: 34780612 DOI: 10.5014/ajot.2021.754002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Disability studies (DS) is an interdisciplinary field grounded in a minority studies philosophy that approaches disability as a socially constructed phenomenon. The first special issue of the American Journal of Occupational Therapy on DS was published in 2005. The present issue serves as a follow-up to highlight opportunities for and examples of DS integration into occupational therapy education, research, and practice. Studies in this special issue reflect a DS approach to research that prioritizes lived experiences, critical approaches, and participatory methodologies. Reported interventions focus on changing societal barriers rather than remediating individual impairments and acknowledge instrumental activities of daily living often neglected by traditional research. Studies on educational practices in occupational therapy have found persistent issues around negative attitudes toward disability and many opportunities to better infuse disabilities studies into curricula. Revisiting DS as it applies to occupational therapy has shown that many of the issues and considerations raised in 2005 remain in the field today. Recommendations across articles in this special issue highlight that advocacy and working for broader social change are essential for occupational therapy practitioners, given ongoing occupational injustices for people with disabilities. Infusing DS ideas into occupational therapy can promote greater alignment with priorities of disability communities and spur professional change to dismantle oppressive structures and ideologies.
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Affiliation(s)
- Elizabeth A Harrison
- Elizabeth A. Harrison, OTD, OTR/L, is PhD Candidate, Department of Disability and Human Development, University of Illinois at Chicago
| | - Alisa Jordan Sheth
- Alisa Jordan Sheth, PhD, OTR/L, is Assistant Professor, School of Occupational Therapy, Pacific University, Hillsboro, OR
| | - Jacqueline Kish
- Jacqueline Kish, MS, OTR/L, is PhD Candidate, Department of Disability and Human Development, University of Illinois at Chicago
| | - Laura H VanPuymbrouck
- Laura H. VanPuymbrouck, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Rush University, Chicago, IL
| | - Jenna L Heffron
- Jenna L. Heffron, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, Ithaca College, Ithaca, NY
| | - Danbi Lee
- Danbi Lee, PhD, OTD, OTR/L, is Assistant Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle;
| | - Lisa Mahaffey
- Lisa Mahaffey, PhD, OTR/L, FAOTA, is Professor, Department of Occupational Therapy, Midwestern University, Downers Grove, IL
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McArthur AR, Gill CJ. Building Bridges: Integrating Disability Ethics Into Occupational Therapy Practice. Am J Occup Ther 2021; 75:12516. [PMID: 34780604 DOI: 10.5014/ajot.2021.044164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Throughout the course of their careers, occupational therapy practitioners will encounter many ethical dilemmas as a part of service provision to disabled people. This article illustrates how disability ethics can strengthen the application of the Occupational Therapy Code of Ethics in practice. To maintain the integrity of the occupational therapy profession, it is critical that practitioners integrate concepts of disability ethics into the profession so their practice will promote environments in which disabled people will flourish.
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Affiliation(s)
- Amy Roder McArthur
- Amy Roder McArthur, MS, OTR/L, is PhD Candidate, Department of Disability and Human Development, University of Illinois at Chicago;
| | - Carol J Gill
- Carol J. Gill, PhD, is Professor Emerita, Department of Disability and Human Development, University of Illinois at Chicago
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Williamson HJ, Armin JS, Stakely E, Nasimi B, Joseph DH, Meyers J, Baldwin JA. Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities. ANNALS OF INTERNATIONAL OCCUPATIONAL THERAPY 2021; 4:e158-e165. [PMID: 34676309 PMCID: PMC8528383 DOI: 10.3928/24761222-20201202-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. METHODS This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members identified as Indigenous. RESULTS Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. CONCLUSION The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD.
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VanPuymbrouck L, Friedman C. Relationships between occupational therapy students' understandings of disability and disability attitudes. Scand J Occup Ther 2019; 27:122-132. [PMID: 30946612 DOI: 10.1080/11038128.2019.1596310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Entering occupational therapy (OT) students have established beliefs, informed by sociocultural backgrounds. Understanding how students define and understand disability, and the relationships these understandings have to disability bias, can guide curriculum design decisions to integrate meso and macro level perspectives of disability into clinical reasoning.Aim/Objective: This study's aim was to explore incoming occupational therapy students' (n = 67) understandings of disability and their attitudes towards it.Material and method: An online survey was used to collect data on students' attitudes and definitions of disability. Mixed research methods were used to analyze students' definitions of disability (content analysis) in relation to disability attitudes (Disability Attitudes Implicit Association Test).Results/Finding: Findings reveal students enter curriculums with vast differences in understandings of people with disabilities and these may provide a basis for and contribute to differences in attitudes of disability.Conclusions: OT students have established beliefs of disability as individualized or more socially constructed and these influence disability biases.Significance: Students' education has considerable influence in shaping attitudes and ways of interacting with people with disability. Understanding students' assumptions as they enter a program is a first step to evaluate how curriculum design may influence development of student clinical reasoning strategies.
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Affiliation(s)
| | - Carli Friedman
- CQL
- The Council on Quality and Leadership, Towson, MD, USA
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