Recently, I met with a friend of the family who was thinking about a career change and wanted to know more about occupational therapy. It was during our conversation that I was reminded how challenging it is to explain occupational therapy and what the profession is all about. We talked for over an hour about the many career trajectories an occupational therapist could follow. In the first 30 minutes I explained human occupation and how it can be interrupted with illness, injury, or the environment and how occupational therapists address this problem in medical or community-based service delivery models. This included an explanation of the occupational therapist’s role in acute, subacute, rehabilitation, long-term care, and home care. Then, after 30 minutes of explanation with additional descriptions of inpatient and outpatient services, I added, “Of course, then there is occupational therapy service for children in medical and school-based settings, for people who have mental illness, and for people who are at risk for illness because of occupational imbalance!” I needed an entire hour to explain the kind of work an occupational therapist could do! I’m not sure how well I was able synthesize it as an explanation for one profession.
If describing occupational therapy seems complex to me, an occupational therapist for more than 35 years, imagine how confusing it could be for someone unfamiliar with the profession. We teach our students to create “elevator speeches” about occupational therapy. In other words if someone asks, “What is occupational therapy?” and the answer can only be 1 to 2 minutes (or the length of a ride on the elevator), what would they say? These elevator speeches are helpful in describing the occupational therapy focus on meaningful occupation, but less helpful when someone wants to know what occupational therapists actually do every day or what is meant by the term occupation. An example of this confusion occurred last month when one of the manuscripts I reviewed for this journal was about research with industrial workers and human resources. The author must have seen the word occupation in the journal title and assumed it was about employment-related research.
I am highlighting the complexity of occupational therapy because this issue illustrates that complexity. First, the research in this issue is global, with authors representing five different countries. Second, the scope of the research is across the lifespan, childhood to older adults. Finally, the research addresses person factors (tactile and kinesthetic perception, the mirror neuron system, and pain), activity limitations (from obesity), and participation restrictions (due to difficulty managing difficult behaviors of children or from neighborhood characteristics). What binds this broad collection of occupational therapy research together?
The glue that binds this global research is the International Classification of Functioning, Disability and Health (ICF), developed by the World Health Organization (2001). I find myself using the ICF framework as a way to organize my thinking when describing occupational therapy scope of practice to people who are unfamiliar with our profession, especially if they are from another country or culture. One of the aims of ICF was to establish a common language for describing health and health-related states for improved communication between different users (p. 6).
The scope of occupational therapy practice fits nicely within the framework provided by the ICF and is understood globally. Put succinctly, occupational therapy helps people engage in meaningful occupations and participate fully in their lives (activities and participation) and addresses the environmental (contextual factors) or person-factor (body functions and structures) components that may interfere with that engagement. Understanding the ICF framework helps clarify why an occupational therapist may research the influence of the mirror neuron system (body functions) and its implication for human occupation (activities and participation) or why occupational therapists study the influence of neighborhood characteristics (contextual factors) related to participation.
It makes perfect sense to me. Now I need to challenge myself to have a good elevator speech ready to recite when needed, and a more articulate 30-minute description about occupational therapy practice and research when the discussion occurs over a cup of coffee with someone who is really interested.
Kathleen Matuska, PhD, OTR/L, FAOTA
- World Health Organization. (2001). ICF: International classification of functioning, disability and health (short version). Geneva: Author.