occupation in action

So much of what we read about in our occupational therapy journals has to do with models of medical illness. Disability models are traditional practice for health care professionals. Therapists feel 'comfortable' when working within these systems.

In 1985 I took an undergraduate Community Health course. At that time the concept of community health was in its infancy and we were just seeing the beginnings of a move away from inpatient and institutional care. I recall that the course gave me the idea that one day we would not be in hospitals, developmental centers, and large state institutions for the chronically ill.

We have made some progress since that time, but I often wonder why more OTs are not in private practice or doing more work in the community. OTs still prefer the safety nets of institutions and agencies. Practice is decidedly more community based than when I first graduated: there is a lot more home care - both for infants and adults. More services are provided in Head Start programs and neighborhood schools, and more services are provided in assisted living facilities and day programs.

Still, this is all just what I call 'second generation' community health programming. True community health service delivery meets the identified needs of people in their communities and as the community defines the problem. This kind of programming is rare; this is why stumbling across a real community health program is such a treat.

In last week's OT Practice Laura Schmelzer of the University of Findlay describes a program to promote healthier lifestyle choices for children who need to attain a healthier weight. Her innovative program is deeply embedded in the concept of lifestyle redesign and wellness. More importantly, she describes the program development process that she went through - warts and all. This kind of honesty provides an incredible model for other therapists who might also think of developing community based program initiatives.

Great ideas aren't usually hatched in perfect form - they are born of the hard work that involves thoughtful planning and persistent effort. Throw some genuine caring into the mix too - Laura gets an 'A' across the board in all areas. This is an article that you should not let pass by.

Go read her article. Then read the Healthy People 2010 report. Get inspired, and get into the community!


Schmelzer, L. (2006 September 11). An occupation-based camp for healthier children. OT Practice, 18-23.

U. S. Department of Health and Human Services. (2002). Healthy people 2010: Understanding and improving health. (2nd ed.). Washington, DC: U. S. Government Printing Office.


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