Any OT student or practitioner has undoubtedly had the experience of trying to explain succinctly and clearly what we do. No, we are not “kind of like [insert other profession – nursing, PT, social work]”, nor do we just work on the upper body or find people jobs. However our work can vary tremendously depending on the setting and the client population, so explaining our work can be a bit of a challenge. Interestingly, I once read that Eleanor Clark Slagle, one of the founder of OT in the US, did not particularly like the name “occupational therapy” for the profession as she felt it was unclear and would be confusing to others.
So what is the domain of OT? It the broadest sense, it is defined in the Occupational Therapy Framework: Domain and Practice (AOTA 2008) as “supporting health and participation in life through engagement in occupation” (p. 626). While we understand what those words mean, I am not sure it helps explain to others what it is we actually do!
To be a little more specific, our domain is further defined by the areas we uniquely address:
- Activities of daily living – basic activities such as self-care, instrumental activities such as home management and driving, but also work, play leisure, education, and social participation
- Client factors – values and beliefs of our clients, but also body structures and function
- Performance skills – motor and praxis skills, cognitive skills, sensory processing skills, communication and social skills
- Performance patterns – roles, habits, routines, and rituals
- Context (our post from yesterday!) and environment – physical, social, cultural, personal, temporal, and virtual
- Activity demands – objects used, activity requirements, sequencing, timing, body structures and functions required to complete the activity
Of course, when working with a client, these things are not addressed in a linear approach as we recognize that these functions and systems are at work simultaneously and cannot be considered independent of the others. On one hand, this is an exciting delineation as we begin to see the unique contribution of OT and how no other professions addresses these aspects of engagement in participation. However, it is still quite a litany of information to provide to someone who is learning about OT!
When explaining our domain to others, I have found that using the word occupation early in the process really makes a difference. If a client, or family, or person sitting next to me on an airplane begins to understand to what we are referring to when we say “occupation,” their understanding is greatly supported. So I usually say something to this effect:
Think of all the things you need and want to do during the day – you get up, get dressed, complete your grooming, prepare your meal and feed yourself, go to work or school, interact with others, socialize with friends and family, participate in a hobby – these are all occupations. If a person has difficulty performing their daily occupations due to an injury, illness, or a developmental condition, he or she greatly benefits from occupational therapy. Occupational therapists – or OTs – address a person’s ability to participate as fully as possible in their daily activities. Sometimes this is achieved through the use of activity, or sometimes the underlying cause that is limiting their participation – such as decreased strength, endurance, cognition, or sensory processing abilities – is addressed. But the goal of any OT is to support a person’s occupational performance.
So how do you explain the domain of OT to those who are not familiar with our profession? What words do you consistently use in your definition?
If you are not an OT, do these explanations give you a clear picture of what it is OTs do?