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On Ideological Shifts in Occupational Therapy Education: Reflections on DEI and the Presidential Executive Order

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The Accreditation Council for Occupational Therapy Education (ACOTE) Standards have evolved over time, with the 2023 updates reflecting a continuation of a broader ideological trend in the profession. Specifically, these updates prioritize Diversity, Equity, and Inclusion (DEI) in ways that raise fundamental questions about the balance between professional accreditation requirements and academic freedom.  The 2018 Standards recognized diversity as an important foundation for occupational therapy education. While encouraging awareness of diversity issues, these standards avoided prescribing specific ideological frameworks. This approach respected the autonomy of educational institutions, allowing them to incorporate diversity as they deemed appropriate while maintaining space for academic freedom and intellectual diversity. In contrast, the 2023 Standards explicitly embed DEI principles, including equity and justice, as requirements for occupational therapy programs. Faculty are now...
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Should ACOTE have a global focus?

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I read the ACOTE Director's Update - January 2025 with interest as it reported new Vision, Mission, and Values statements for ACOTE as follows: VISION : Lead, innovate, and advance occupational therapy education in a global environment. MISSION : Support quality, inclusion, and innovation to advance entry-level occupational therapy education. VALUES : Quality; Innovation; Collaboration; Inclusion; Integrity. For reference, the previous ACOTE statements were: VISION : Committed to the establishment, promotion, and evaluation of standards of quality in occupational therapy education. To this end, ACOTE will lead in the development of effective collaborative partnerships with the communities of interest, both internal and external to the profession of occupational therapy, which are affected by its activities. MISSION : Ensures quality occupational therapy education by developing accreditation standards and verifying implementation to support the preparation of competent occupational...
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Revolution or Evolution - what does the occupational therapy profession require?

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I saw several re-posts today of someone's meme that occupational therapy was a "quiet rebellion against the reductionistic view of health..." etc.  Is the idea of holism in health care a rebellion?  In concept I agree that the occupational therapy profession has historically positioned itself in a 'holistic' light, although I don't know how well it does to practice what it preaches.  This tension between reductionistic and holistic practice probably contributes to discontent among young occupational therapy practitioners because the health care system does not comport with the holistic platitudes that are sold in many university training programs. That is an unfortunate and sad reality. Occupational therapy talks a good game about holism.  Talks. That got me thinking a little - does the occupational therapy profession represent any kind of rebellion in real terms?  I am not convinced that it does - and to any degree that it does, it has not always been generat...
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Sniff and Scurry Navigate the Red Queen's Race: Occupational Therapy Private Practice in 2024

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I've struggled to find models that help me understand the challenges facing my private practice. I have never really been strongly interested in pop-thought conceptual non-fiction books because they tend to be overly simplistic and repetitive. 'Who Moved My Cheese' is a classic example, even if it did resonate with a lot of people in its time. Anyway, I have been thinking about change and adaptation because I have been trying to pump figurative bullets into our private practice for a couple years now and it just won't die. A global pandemic didn't kill our private practice - we were propped up by a generous governmental solution to keep our employees.  Then there was an increasing demand for therapy since the pandemic created a whole new generation of developmental and mental health problems for the pediatric population. Selling the office building didn't kill the private practice either - demand for in home and community services took the place of the outpatien...
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Sustainability in occupational therapy: A focus on human performance and well-being

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In this blog and in my textbook I have expressed some concerns about application of occupational therapy theory into distal contexts that are only marginally related to the profession.  Specifically, I have stated that although concerns about topics including the climate and social justice are fine areas for people to be interested in, we are obligated to consider whether or not application of these concepts to the occupational therapy process is generative or distracting. It is my opinion that these topics are frequently distracting, and that they confuse our stakeholders. I revisited this topic just last year when prompted by a colleague who was wondering if I ' revisited my thinking ' on the topic.  At that time, I doubled down on my criticism. One of my favorite quotes is from Konrad Lorenz, the renowned (and infamous, I suppose) ethologist, "It is a good morning exercise for a research scientist to discard a pet hypothesis every day before breakfast: it keeps him you...
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On compassion and reward

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  I know that sometimes I start stories and they don't always get finished.  Sometimes that happens because there is no ending - or at least there is not an ending to be found with the framing I was using. That was always the nature of my private practice - and my hesitancy in discharging children and their families. Who is to say that any person's needs are completely addressed? Or that as a therapist I was able to generate a perfect and complete answer that would persist over time? Sometimes the stories I think about finished themselves and were easy to write even if it hurt.  Sometimes the stories needed some kind of ending punctuation -  a final act from the therapist. I keep thinking about one story that did not seem to have an ending, so I thought I would visit with it again. I might have found an ending. +++ I wrote, "I guess now we will see what happens next." Xinren never came back. I never heard from the family again.  I don't actually know what happ...
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Occupational therapy education: How to navigate in a Perfect Storm

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Please click on and read all of the links - they include critical information that is required for this analysis.   A little over four years ago I stated that there are too many occupational therapy educational programs in New York State .  At the NYSOTA conference legislative information session in 2023 I stood up and suggested that we should all stop taking jobs at these institutions that were seeking to develop new programs.  I thought that if we did not take those jobs that the problem would be solved.  That was not realistic or correct, even if the intention was good. Well karma tends to strike when you make public pronouncements, so I thought I should expand on my perspectives on this topic. At current count there are still ~22 occupational therapy programs and ~11 occupational therapy assistant programs in NY.  Most of the programs are delivered at the master's level.  There are a very small number of entry level doctoral programs, but some of t...
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