ABC Therapeutics Occupational Therapy Weblog

The House-passed Budget Reconciliation Bill—nicknamed the "One Big Beautiful Bill" by its sponsors—has generated swift opposition from AOTA. The association’s article focuses on the very real concern that shifting Medicaid funding to block grants or per-capita caps could jeopardize occupational therapy (OT) services for vulnerable populations. That is correct analysis. But the AOTA messaging on this issue lacks depth and strategy. A pre-written form letter to Congress isn’t a serious response to a structural overhaul of one of OT’s largest funding streams. It’s time for clinicians and educators to stop outsourcing our critical thinking and advocacy. Here’s a deeper, more balanced look at what’s in this bill—and what OTs   need to be doing. The Real Structural Threat: Medicaid Block Grants Let’s start with the most important thing the bill proposes: a fundamental shift in Medicaid funding . Instead of Medicaid functioning as an open-ended federal match for state spending, ...

I just attended a professional development session on ethics, led by a prominent figure involved in ethics discussions within occupational therapy. The session was structured around a "socially responsive ethical decision-making model" that integrated themes of diversity, identity, power, and historical trauma. It was thoughtfully delivered, and the presenter was receptive and open to engagement. Yet by the end, I was left with a gnawing discomfort about the philosophical architecture beneath the model. It is not that I oppose reflection or the thoughtful inclusion of cultural context. Most clinicians I know already approach their work with thoughtfulness and recognize that each patient brings a unique context worthy of consideration. But what I encountered during this session was not a pluralistic ethics framework. It was a carefully constructed worldview that strongly nudges moral reasoning toward alignment with current sociopolitical trends—while still presenting itself as...

Every profession needs a vision. Vision statements chart the future, express values, and signal where a field aspires to go. Occupational therapy has long embraced this idea. Yet visionary language, when untethered from the realities of practice, can obscure more than it clarifies. This tension is increasingly visible in the language of AOTA’s Vision 2030. Vision 2030 declares that occupational therapy "maximizes health, well-being, and quality of life for ALL people, populations, and communities." The capitalization of "ALL" signals more than inclusivity. It implies universality—if not absolutism—shifting the vision from aspirational to morally directive. But does this align with occupational therapy as it exists and has historically been practiced? Consider daily occupational therapy work. Hospital-based therapists arrive at 7 a.m. to help patients regain basic life functions: dressing, sitting up, toileting. In schools, therapists assist students with handwriti...