Seeing Disability as a Continuum: Effects on Occupational Therapist's perspectives

Seeing Disability as a Continuum: Effects on Occupational Therapist’s perspectives

            “Care asserts that as difficult and painful as life can be, it is worth something to be in the present, alive, and doing one’s daily bit. ”

— Kathleen Norris, The Quotidian Mysteries

Have you ever had a health care experience where you felt like you were being treated and viewed as a product on an assembly line? Where the doctor, therapist, or nurse didn’t acknowledge your situation you were going through and wanted to focus on fixing the problem rather than listening to your concern when you were going through a difficult time? 

Unfortunately, that is the reality for some patients in the health care system in our world today. It is known that there are barriers that exist in health care settings that negatively impact a patient’s delivery of care and experience. Occupational therapy is one small part in the whole health care system but it is important to examine because of their work with people with disabilities whether it is acquired or congenital, temporary or permanent or chronic or acute. As well, OT’s focus on rehabilitation of a person can fall into a medicalized view of disability, resulting in attitudinal barriers that lead to patient’s being stigmatized and oppressed. Although OTs work with the disabled population, they are still disconnections existing between what OT’s are taught and practice, and principles of disability studies that work to enhance patient’s treatment experience, outcomes and lives. These disconnects create issues of empowerment and equitable access in OT’s practice which negatively impact patient’s seeking care.

One of the Disability Studies tenets is that disability is a continuum that every single person will experience some degree or level of in their lifetime. As well, most of us will experience some form of health care in our lives, if you haven’t already. The issue of attitudinal and systematic barriers affects almost all of us whether it is directly, or indirectly through loved ones. This specific issue is important to care about because health care systems work like machines with wheels (each department) affecting and influencing each other and addressing gaps and barriers can be positively impactful for combating barriers faced by patients. If Occupational Therapy is addressed through a Disability Studies lens and DS tenets are integrated into OT education and practice, there is potential for a snowball affect involving other health care professions adopting DS tenets when addressing barriers in participation and access. Most importantly, addressing these barriers could result in more effective care experiences for patients leading to more positive experience.

 

“You treat a disease: you win, you lose.
You treat a person, I guarantee you win-no matter what the outcome.”

— Patch Adams

 A study was conducted to examine OT’s perceptions of integrating DS principles into clinical learning, training and practice. Resulted are 4 themes that describe the relationship with OTs and DS including intersections and discrepancies between OT and DS, perceptions of disability influencing practice, navigating systemic barriers and incorporation of DS-aligned intervention strategies into practice. These themes can be used to demonstrate the positive impact that a DS perspective can bring to a health care profession’s perception and practice. There are also discrepancies acknowledged in this article that provide insight into how people with disabilities are treated in the health care system specifically in OT settings that result in negative experiences for patients. In comparison, some of the intersections that exist include participants acknowledging the social model of disabilities tenet that environments can be impactful, identifying the client as the expert and recognizing their power, knowledge and autonomy in their own care receiving. Additionally, one participant from the UK noted that her training and education program was aligned with Disability Studies and its principles. 

Following, implications are suggested moving forward to address the gaps and disconnects between OT and Disability Studies. Suggestions included were:

1)    Practitioners can advocate for patients with disabilities by incorporating instinctive communication with patients to establish their needs.

2)    Researchers can recognize interventions that address priorities and societal barriers to participation and critically examine treatments that effectively address patient’s needs and barriers they face.

3)    DS tenets can be integrated into OT education by partnering with community placement sites that tackle obstructions to patient participation and access.

4)    OT programs can offer access to continuing education resources that allow practitioners to educate themselves, their clients and their colleagues.

5)    People with disabilities can hold leadership roles in OT in order for their voice to be heard and recognized.

6)    OT programs can integrate efforts to strengthen disability, inclusion and diversity discussions in education, as well as address what non-discriminative OT practice looks like.

In conclusion, a Disability Studies lens can provide a unique and critical lens that can be extremely useful to apply to health care professional’s roles and practices when attempting to enhance client’s experience, treatment outcome and self-perception. The way DS views a person with a holistic approach and acknowledges their own lived experience can be positively impactful for practitioners to use to make client’s environments more welcoming and supportive and can reduce attitudinal and participation barriers. Disability Studies perspective is applicable to all patient’s that access OT treatment because they all have some type of functioning limitation to address. This is why it is so important to understand the barriers that a patient may already face that is studied in DS, in order to not contribute to barriers and attempt to navigate or eliminate obstacles for the patient so they receive the more positive care experience possible.

“Tell me and I forget.
Teach me and I remember.
Involve me and I learn. ”

— Chinese Proverb