Recognizing Inequity: A Critical Step of Health Literacy for People With Disability

Developing Client Self-Advocacy in Occupational Therapy: Are We Practicing What We Preach?

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.

Float to grow: nurturing the roots of socially inclusive and just practice in occupational therapy students

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.

Disability Studies and Occupational Therapy: Renewing the Call for Change

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.