ABC Therapeutics Occupational Therapy Weblog

This post represents continuing analysis of the process to change the entry level educational requirements for practicing occupational therapy from the masters level to the doctoral level.  The analysis is offered as a public critique of the occupational therapy profession's methodology for enacting such a change. The 45 day comment period on a new rule that will authorize the conferral in New York State of the degree of Doctor of Occupational Therapy (O.T.D.) will come to a close at the end of next week. The American Occupational Therapy Association reports : In June 2015 AOTA staff also surveyed the 152 accredited master’s-degree-level programs, with 131 (86%) responding to the survey. Of the 131 programs that responded, 106 (81%) indicated that they had started working on a transition to the doctorate and planned to have this completed within 10 years (86 within 5 years).  As I stated recently , "In my opinion the American Occupational Therapy Association Board o...

Ten years ago I posted this first entry: Welcome! Hi everyone... This is the ABC Therapeutics weblog. We are occupational therapists in Western New York. More coming soon... +++ Well it has been ten years! Sometimes the entries were patient stories.  Sometimes they were opinions on professional matters.  Sometimes they were analyses and criticisms of the systems we work in.  Sometimes the entries were pithy and academic and sometimes they were pedantic and boring. No matter what it all has been, I hope that I have been faithful to my mission of creating an ongoing experiment in a mostly open-source exploration of occupational therapy.  No ads.  No bias other than 'just me - '  straight shooting commentary from the hip of a street level practitioner.  Sometimes that resonated and sometimes it created enmity - but it is all dialogue and that is something that we all need a lot more of. No matter what, it seems appropriate to take the ...

The New York Department of State's Division of Administrative Rules (DAR) publishes the weekly State Register.  This document contains newly proposed amendments to state agency rules and provides interested parties an opportunity to comment on actions before an agency adopts each rule. The July 1, 2015 Register contains a new rule that will authorize the conferral in New York State of the degree of Doctor of Occupational Therapy (O.T.D.).  There is a 45 day comment period that will soon come to a close. The Register states that  The purpose of the proposed amendment is to authorize the conferral in New York State of the degree, Doctor of Occupational Therapy (O.T.D.). The proposed amendment arose from a request to confer this degree by one of the institutions of higher education in New York.  The O.T.D. degree is recognized by the Accreditation Council for Occupational Therapy Education (ACOTE) and is an authorized degree in 26 states, which include Californ...

Different people are interested in the things that I do each day, and they are interested in them for different reasons. The people who come to me asking for help with a problem are interested in whether or not I will be able to summon the requisite knowledge to address their concern (Competency Test A).  They are also interested in whether or not I am a 'nice guy who cares' while engaging in that process (Competency Test B).  As an example, this morning a mom wanted my opinion on how to solve a problem with the positioning of her child's head and neck, because of being tilted over to one side.  I have seen hundreds of cases of torticollis, but none of them are "routine" to me.  Every one of them is treated with as much seriousness and concern and diligence that I can muster. If I treated them as 'routine' then I probably wouldn't take the time to meet the parent's Competency Test B (the 'nice guy who cares' test).  Fortunately I was...

Laws, like sausages, cease to inspire respect in proportion as we know how they are made.   (John Godfrey Saxe) The occupational therapy profession is considering a change to requiring a doctoral degree for entry level practice despite the overwhelming opposition to the concept by most practicing occupational therapists.  The current requirement for practice in NY State includes training at the Masters level.  Academic programs can't begin offering an entry level doctoral degree until they receive approval from the State.  Because the OTD is a new degree, Sections 3.47 and 3.50 of the Rules of the NY Board of Regents related to Title VIII of the Education Law that lists approved degrees will need to be amended. There is a lot of confusion and misinformation about this process.  This blog post attempts to explain what is happening at both the surface level as well as 'behind the scenes.'  The purpose of discussing the process is educational and repres...

I went to an IEP meeting with a parent the other day and was greeted with hesitance by the occupational therapist on the educational team. "Why are you here?" asked the therapist.  "Are you here because you are actually treating the child or are you here as an advocate?" Neither characterization seemed correct.  I paused and thought for a few seconds as I was not sure why it mattered.  I also was not sure if I was free to divulge the information.  I ran for the safest middle ground I could find and responded, "I know the child and I am helping the family."  Both were true. I know that the word "advocate" is often perceived negatively by school based practitioners.  I have been attending IEP meetings as an 'outside' therapist for over 20 years and I tend to avoid the term 'advocate' because it engenders a lot of negativity.  I see a lot of reactivity in educational teams when an 'advocate' is involved. Bruce and Ch...

The New York State Occupational Therapy Association is planning to make significant changes to its bylaws and governance in the very near future.  Since so little information has been available on these changes I took the initiative to gather data so that occupational therapists in NY would have more information to assess these proposals. I will begin my analysis with an apology, because it is my longstanding belief that to be an appropriate critic one needs to be a member of the group that is being held to scrutiny.  For purposes of transparency I will divulge that I ceased my NYSOTA membership approximately ten years ago in protest of inappropriate accounting practices.  However, I remained in close contact with many therapists around the State who continued their participation with the membership association.  Many of these members are currently upset about the proposed changes to governance.  Some don't want to make their protest public and have given me c...

After a multi-year debate there was some small capitulation regarding the social justice language in the AOTA Code of Ethics.  The previous section labeled 'Principle 4: Social Justice' was removed and replaced with a more generic section on 'Justice' that focuses on procedural aspects of the Justice construct.  A passing reference to a social justice construct was included in the Preamble. It is difficult to know if it is even fair to say 'capitulation' because we have not had precise commentary from the Ethics Commission on those changes.  What we have are the comments of the EC Chair Dr. Lea Brandt who stated It is correct that in the section on Core Values there is still terminology referring to social injustice.   This reflects the membership feedback which called for inclusion of the concept of social justice while tempering that perspective with a group of members who requested to have the term removed.  The term “Social Justice” was removed from the...

If you ask 100 occupational therapists what they do you will get 100 different answers, because the nature of the profession is to help people do the things that are important to them.  Every patient has their own priorities, and that makes all the stories different. Instead of focusing on the 'what' I like to focus on the 'why.'  When I need to be reminded 'why' I do what I do I like to drag this story out. I knew a young family and they were unable to conceive.  After spending many thousands of dollars they made some arrangement with a young teenage mom so that they could adopt her baby (just about to be born). So they go to get the baby and sign all the papers and get on the plane.  The baby was only a couple days old. On the way back home the baby goes into cardiac arrest and the new mom (a trained health care professional) gives this new baby rescue breathing and chest compressions. They are admitted directly into the intensive care unit when they get...

An interesting quote was attributed today to Amy Lamb, the President-Elect of the American Occupational Therapy Association.  Here is the quote as it appeared on Twitter: I initially consider that the timing of such a statement that "No means not now" could possibly be related to the recent decision by the US Senate to refuse to support the Cardin-Vitter amendment that would repeal the Medicare outpatient therapy cap.  Therapy leaders have been trying for many years to get the cap repealed and it was a stinging defeat . I asked for additional context and clarity about the quote and was informed that it was generally stated as an important leadership principle. The reason why this caught my attention is because of my own experience with the way that the occupational therapy profession deals with divergent opinions. In 2013 I attempted to reach out to a former Ethics Commission Chair to discuss ongoing concerns with the Social Justice construct.  That Chair...

In the Open Journal of Occupational Therapy this month there is an opinion paper written by Barbara Hemphill entitled Social Justice as a Moral Imperative .  The position presented is that Social Justice belongs in the AOTA Code of Ethics, that it is embedded in the tradition of the OT profession, and that it is not a political matter. There continues to be confusion and conflation between the concepts of Christian charity and Social Justice.  The author states that Social Justice is not political, but this is refuted by literature review.  The originators of this movement in the OT profession have overtly stated that social justice is political (Wilcock, 1998; Townsend, 1993).  This is an inarguable fact.   I have already written rather extensively on the topic of whether or not Social Justice was a Core Value of the occupational therapy profession .  I don't have too much to add to that original essay and would point to it as my response to the a...

We want one man to be always thinking, and another to be always working, and we call one a gentleman, and the other an operative; whereas the workman ought often to be thinking, and the thinker often to be working, and both should be gentlemen, in the best sense. As it is, we make both ungentle, the one envying, the other despising, his brother; and the mass of society is made up of morbid thinkers and miserable workers. Now it is only by labour that thought can be made healthy, and only by thought that labour can be made happy, and the two cannot be separated with impunity.   - John Ruskin, The Stones of Venice. 3D printing technology is a new fad that is capturing the attention of occupational therapists.  The technology is disruptive, primarily because of cost factors, but as is often the case there are important considerations lying underneath the alluring new technology. During the Industrial Revolution society developed technological solutions that made mass-prod...