ABC Therapeutics Occupational Therapy Weblog

Several years ago, I wrote about the confusion that arises when occupational therapy conflates charity with social justice  and about the subtle but important shift from the Social Gospel tradition toward a politicized discourse of redistribution and equity   At the time, some dismissed these concerns as overly semantic. But the receipts are there: once you build “social justice” into the profession's  Code of Ethics , you’re no longer talking about voluntary altruism. You’re talking about mandatory redistribution. And now, as discussion emerges on academic listservs about the decline of student volunteerism , some are discovering that not all students are enthusiastic about forced redistribution. So, what’s the next move? You start mandating volunteerism. Think about that for a moment. Mandatory volunteerism. That phrase itself is a contradiction so sharp it should stop us in our tracks. If the goal is charity , it cannot be compelled because coerced charity is ...

For twenty years, I have used this blog to document occupational therapy as it unfolded: its controversies, contradictions, policy shifts, and unfinished arguments. This archive records my evolving perspective as well as the broader struggles of the profession to define itself. It is not tidy, and it was never meant to be. Sometimes sharp, sometimes uncomfortable, occasionally at odds with what the field preferred to hear, but always honest. The blog has received more than 1.7 million pageviews since 2006, with an estimated 200,000 to 250,000 of those representing real human engagements. That is a remarkable footprint in a small profession where many peer-reviewed articles are read only a few hundred times. Spikes in readership came during inflection points such as the doctoral mandate debate, showing that the blog became a gathering point when the profession was most unsettled. Even in quieter years, thousands still returned, treating the archive as a touchstone for reflection and cr...

I came into occupational therapy as a street level clinician. Like many of my generation, I learned Ayres Sensory Integration (ASI) in school. I took additional steps to get certified to administer and interpret the Sensory Integration and Praxis Tests (SIPT) when they were first published, and tried to make sense of what the model promised. Over the years, I watched that test become outdated, all while  waiting for the robust evidence base to emerge. I was told at countless workshops and conferences, " The research is coming. " It never did. In the meantime, neuroscience did not stand still. We now have dynamic systems theory, heterarchical processing models, robotics, and AI-driven neural networks that give us far richer and more precise understandings of how brains actually develop and adapt. These frameworks have left Ayres’ mid-20th century metaphors behind. I say this not as an outsider taking potshots. I am a clinician who has lived with the sensory integration mode...

  Twenty-five years ago, I started ABC Therapeutics at a point in my career when things felt uncertain. At that time, it wasn’t common, and in fact it was really almost unheard of, for occupational therapists to open private practices. But something in me said it was time to try. We didn’t have a template. There was no guidebook. Just a belief that families deserved more, and that we could help fill a gap that was far too wide. We started small—just me, driving to kids’ homes, carrying therapy tools in my trunk, figuring it out one visit at a time. From those beginnings, we secured contracts for early intervention and CPSE services. Eventually, we rented our first space. My grandmother helped us pay for the sign out front. It was a small but deeply symbolic act, and it meant everything. As the practice grew, we reached another milestone: we purchased our own building, where we provided services to families for over 15 years. It became a true home base, not just for our work, but fo...

In February of 2024 I left my prior academic role and wrote about some of the challenges and questions facing occupational therapy (OT) education . What should the next generation of OT programs look like? How do we ensure graduates are prepared for where the profession is headed? What does it mean to build something that contributes meaningfully to both students and the field? Most importantly, how do we rationalize the occupational therapy education market? These weren’t rhetorical questions. Over the past 18 months, I’ve had the opportunity to help shape the answers. Today, I’m proud to share that the Rochester Institute of Technology’s entry-level Doctor of Occupational Therapy (OTD) program is officially live on OTCAS , the centralized application system used by occupational therapy programs nationwide. While some programs have already begun evolving, too much of OT education in the region remains tethered to outdated models. It’s not enough to add more programs. We need to build ...

The World Federation of Occupational Therapists just released a new definition of occupational therapy. It’s short, clean, and stripped of jargon: “Occupational therapy promotes health and wellbeing by supporting participation in meaningful occupations that people want, need, or are expected to do.” Some commenters online have already begun objecting to the phrase “expected to do,” criticizing it as normative, colonial, or culturally prescriptive. What many don’t seem to realize is that the phrase isn’t new. It’s been in the WFOT definition since at least 2010. The 2025 revision didn’t add this language; it chose not to delete it. That’s significant. A Bit of History Occupational therapy once had role theory as an anchor point. That orientation helped the profession identify what people  should be doing, based on their life stage, culture, and social context. In the 1960s through the 1980s, OT was often described as facilitating participation in the roles of self-care, pro...