My reflection on this state of affairs led to two conclusions.
Firstly – wow! If we don’t understand and can’t articulate what we’re trying to achieve then of course other people won’t understand us, or give us credence. I realised that primarily, we are responsible for other people’s lack of understanding about our profession.
Secondly – well OK, let’s do something about it. Writing a pair of articles with two amazing colleagues led to a further exploration of the passage and position of our professional identity (Turner and Knight 2015) and an articulation of what we considered were our profession’s core skills (Turner and Alsop 2015 Figure 1). We concluded that there were several elements that can lead to an uncertain identity and proposed what could be done to address this (Turner 2018 Figure 2).
Articulating what we saw as the ‘issue’ with professional identity was cathartic – but I was at the end of my career and had recently retired. However wanting to understand the why further led me to undertake my PhD to explore in more depth our profession’s identity. Using the History of Ideas approach (Lovejoy 1940) I delved more deeply into how Elizabeth Casson’s core concept, the use of meaningful occupation to positively influence health and wellbeing, had been initially executed but then smothered when our need for status and access to people we could help led us to try and further our profession by medicalising our thinking and actions. I discovered that our professional tipping point came with degree level pre and post-registration education together with the development of occupational science and its evidenced articulation of our beliefs and values. I also found that we are in a process of recognising that our philosophy is different but complementary to the one that dominates healthcare systems in many countries, but that it’s perfectly OK to be different. We do, after all, live in a world that is beginning to celebrate difference.
We also inhabit a culture that is beginning to recognise that to maintain and recover our health the application of medicine is a vital stage in the process but other paradigms are often needed too. This current pandemic is a classic example. Our society has recognised, more than ever, how hugely grateful we are to the medical profession for its innovations and advances in treating COVID-19, but it has also recognised that there are wider concepts that have value and efficacy in the restoration and maintenance of health.
So where is our professional identity now? Reading about the many innovative developments initiated by occupational therapists, especially those beyond the realms of conventional health and social care settings, makes me believe that there is resurgence amongst occupational therapists of understanding of our core concept, coupled with the confidence and opportunity to develop practice initiatives based on this belief. However I also read in OT News in May 2020 an occupational therapist’s exasperation that “…it [occupational therapy] is so hard to define because we cover such a vast area as a profession…” (Fennelly page 37). Clearly our diversity is both our strength and an inhibition.
I wonder then where your professional identity sits on this continuum? Honestly the core concept isn’t rocket science is it? However negotiating the systems, expectations and values in which it is embedded can certainly be a huge challenge. But, as a very good occupational therapist friend said to me recently “We are no longer a young profession, no longer adolescent. We’ve got to grow up. It’s time to put on our big pants and just get on with it!”
Casson E (1955) Dr Casson tells: How the Dorset House School of Occupational Therapy came into being Occupational Therapy 18(3) 92-94
Fennelly S (2020) Occupation and isolation OTnews Royal College of Occupational Therapists, London
Quality Assurance Agency for Higher Education (2001) Benchmark statement: Health care programmes: Occupational Therapy Gloucester, Quality Assurance Agency. Available at: www.qaa.ac.uk
Turner (2018) Professional Identity in Occupational Therapy PhD by Published Work, Ulster University (unpublished)
Turner A and Alsop A (2015) Unique core skills: Exploring occupational therapists’ hidden assets British Journal of Occupational Therapy 78 (12) 739-749
Turner A and Knight J (2015) A debate n the professional identity of occupational therapists British Journal of Occupational Therapy 78(11) 664-673
Wilcock A (1993) A theory of the human need for occupation, Journal of Occupational Science 1(1) 17-24