Revolution or Evolution - what does the occupational therapy profession require?

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 generative.  I will explain.

Rebellion is generally viewed as a byproduct of discontent and focuses on short term goals and grievances.  I am thinking of the Boston Tea Party, or more recently, the January 6 uprising.  Rebellions can develop into revolutions if there is a persistent ideological clarity.  That is definitely not present in the occupational therapy profession.

As example, the occupational therapy profession has progressed through several 'paradigm' shifts - from a founding philosophy of holism and occupation, to reductionism, back to occupation, and then on to social justice and internationalism.  I believe that the initial concept of occupational therapy may have been revolutionary, and then it fell off track into reductionism a little, and then it evolved (not revolved) to a marriage between holism and reductionism in philosophy and theory (Mary Reilly's 'not only but also' thinking), and then in recent years the whole of American culture took clinical professions off of a social justice cliff that is more political rebellion than it was clinical evolution.  I view the OT 'Fourth Paradigm' as a rebellion - definitely a byproduct of discontent and grievance.

Don't get me wrong, there is nothing wrong with discontent or grievance, but when it lacks ideological clarity and when it has not been tested for 'goodness of fit' with its proposed vehicle (i.e. the occupational therapy profession) - problems happen.  This occurred in the recent period of occupational therapy rebellion - disconnected ideas about equity, climate, sustainability, rights, and more all applied oddly to a health care profession that in practice looks like it is trying to help people put on their pants and socks after a stroke.

I over-simplify, but I think the point is valid.

I would prefer that we thought more in terms of evolution as opposed to rebellion and revolution. Let's think about these words a little more deeply:

REVOLUTION comes from the Latin 'revolutio' meaning 'a turn around.'  It was originally applied to planetary motion and then obtained a political connotation in the 17th century.

Currently, revolution refers to dramatic and abrupt change is political or social systems.

EVOLUTION comes from the Latin 'evolutio' meaning 'unfolding.' It was originally used during the Enlightenment and described the progressive unfolding of ideas or processes.  Later, it got applied to Darwinism.

Currently, evolution emphasizes gradual and incremental change and is associated with natural or social progress.

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In the occupational therapy context I think EVOLUTION is a better term.  Again, this does not mean that the ideas people are interesting in revolting or rebelling exist are not valid concerns - just that the occupational therapy vehicle might not be the primary place to solve thorny social and cultural problems.  By misidentifying the vehicle to solve a problem or grievance, we shift attention away from the profession's intended goals - and as I have stated before - that is why academicians are still requiring students to develop 'elevator speeches' about what the profession even does.  We keep confusing the public about what occupational therapy even is - and after 100 years of existence that is unfortunate.

Evolution allows the profession to preserve its core principles - and protects the identity of the profession that is intended to promote participation in meaningful activities within a framework of evidence-based practice.

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I am all for a good revolution now and then.  In context of Shay's REBELLION Thomas Jefferson told us that the tree of liberty has to be refreshed with the blood of patriots and tyrants.  

But do we rebel against social and political systems through the lens of a clinical health care profession? 

Let's think about that a little more.

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