Reflections on the 'branding' of occupational therapy

Also file under: Nel mezzo del cammin di nostra vita mi retrovai per una selva oscura, che la diritta via era smarrita. (because when all else fails, read Dante).

With some pain, I have been watching the wheels fall off the branding bus over on the OT Connections site. AOTA kicked off a new branding campaign in the last year - starting with an unveiling during last year's annual conference and recently represented by the release of a rather odd poster that is being alternately described as wonderful or horrible, depending on your individual opinion.

In response to some of the questions and constructive criticism, AOTA President Penny Moyers writes:

When we read the literature about OT, it is not really about simple engagement back into doing. The essence is about meaning, quality of life, satisfaction, health and well being that comes from being able to participate in a life that is full of potential, regardless of the barriers. We no longer confine our intervention to those with obvious disabilities, we also work to prevent occupational problems and to promote health and participation with clients of all ages, who might not at the time of intervention have a current occupational performance issue. If ever the world needed a positive message given this economic decline, now is the time to deliver it! Living life to its Fullest can be achieved each day.

That's nice and all - but I think that it also represents a real problem and disconnect with those practitioners who are expressing a little concern about this 'brand.' In the world of everyday practice, therapists are trying to develop programs that meet the needs of people who have actual disabling conditions. They are working within established and not-so-established systems to find ways to support the continuation of their work. In simple terms, they are struggling with reimbursement and with barriers to service delivery in hospitals, schools, and communities.

Although I appreciate the lofty rhetoric and philosophic intentions of providing 'positive messages in our current economic decline' I am relatively certain that occupational therapy is not properly positioned or suited for addressing our current state of sociocultural and political decay- at least not in any pragmatic sense. I say this with all due respect to Mary Reilly, whose economic arguments I actually understand and appreciate - but please, let us avoid getting our heads lost in the clouds. There may be time for us to develop Utopian societies, but can we figure out how to deliver evidence based and effective services in school systems and nursing homes first?

I suppose that there is some irony in the OT Practice magazine dated 1/19/09 where our new 'brand' is presented for discussion. The cover of the magazine is about Occupational Therapy and Disaster Response. I'm not sure what the point of the article was - perhaps it was some rationale for us taking over FEMA. I'm not sure if it really matters because last time I checked there was no CPT code for disaster response and I don't know if Medicare identifies this as a restorative service. I need to learn more, obviously. Anyway I am thinking that Disaster Response might have been better applied to finding ways to respond to legitimate criticism about our new branding.

I don't believe that our profession is in crisis because everyday thousands and thousands of occupational therapists go to work and help real people with the real problems in their lives. Sometimes those problems are autism and sometimes they are carpal tunnel syndrome. Sometimes they are drug addictions and sometimes they are advanced cancer. Sometimes the solution is provided in the form of a direct therapy and sometimes it is provided in a piece of equipment or a new way for a family member to help accommodate a problem.

I think that our stakeholders know exactly what I am talking about - and they want us to do our jobs even better.

I am not so convinced that our membership leaders know exactly what I am talking about - at least not based on the responses to street-level practitioners concerns about the 'brand.'

I am all for lofty academic pursuits. I like them, actually. They serve a purpose - but right now the connection to practice is lost or hopelessly buried. I suppose we can continue with branding that can't be sold to our own membership. And then we can follow it up with AJOT issues packed full of more pie-in-the-sky conversations about social justice and self-flagellation over health disparities. But will there come a time when we can have some reasonable marriage between our philosophic base and what is actually going on in practice every day?

Memo to AOTA: If you want to know why membership is declining, look at your current 'brand.' Think about the 'A' in AOTA. It is not only supposed to mean 'A'cademic. It is also supposed to represent all the everyday working practitioners. Real life. Real practice. If the literature about OT is NOT including 'simple engagement back into doing' then you are forgetting something that is rather germane to our practice.