Introduction
First, let's discuss the centennial vision. In 2017, the occupational therapy (OT) community will be celebrating one hundred years as a profession. In 2003, the American Occupational Therapy Association (AOTA) board of directors decided to develop a strategic plan to develop the centennial vision (see Figure 1) so that we could outline what is our profession going to look like and to commemorate the hundred year anniversary. It is the goal of the association to make sure that the whole profession is promoted in all areas of practice. The vision actually says that we envision that OT is a powerful, widely recognized, science-driven, and evidence based profession with globally connected diverse workforce meeting society and occupational needs. It is a big mouthful but I think that we do need to be focused on science-driven an evidence based practice.
Figure 1. Centennial vision.
They included the global vision piece because global unification instills us to learn from each other to see more unique ways to use therapy in our everyday practice. For example, if you look at what some of our fellow therapists in Australia and Canada are doing, they have some very interesting ways that they are promoting the profession.
Leading Change in OT
There are several factors that are driving change in the OT profession (see Figure 2).
Figure 2. Drivers of change.
Some of the relevant drivers of change in our profession would be aging and longevity. We are seeing more and more elderly and healthcare is being provided to larger amounts of senior citizens. Also, there are a lot of changes in health care and reimbursement with the Affordable Care Act and other changes. At the time of any change in healthcare, some people tend to think that it is going to be bad for the profession, but with every change we have always been able to overcome obstacles. Preventive medicine is part of the new healthcare changes. Preventative care is a great avenue for occupational therapists to be able to look at more of the preventive side of medicine.
Assistive technology is huge. With the changes that we are seeing in assistive technology, tele-health and electronic documentation have become more prevalent. We can use assistive technology in the schools to work with kids on things that we could not do before. There is a large amount of tele-health monitoring and intervention going on with students that are in remote school districts where they do not have access to therapists. There are a lot of great changes that also bring in a lot of great opportunities.Our lifestyles and values are impacting the health of our children. We are seeing a larger amount of childhood diabetes. We are also seeing more obesity. Stress and depression gives an opportunity to work with people in the health care or the mental health industry. Information access can be beneficial and/or detrimental. There is so much out there on the internet and you can research just about anything. It is one of those changes that can also give people information that is actually incorrect.
Figure 3. Obstacles.
There are several obstacles to change (see Figure 3). Some of the obstacles to change are that a lot of us do not like change. We have that rigid adherence to the status quo. We want to do things like we have always done it. I remember when I was working in a school system quite a few years ago and at that time we were still pulling children out of the classroom, taking them down to the gym, swinging them on the swing, doing scooter boards, and therapy was just so much fun. Then the law came that we had to provide least restrictive environment. Which meant we could not be pulling kids out of the classroom anymore, we had to start implementing our services in the classroom.
That was difficult for a lot of therapists to adjust to as we wanted to stay with that same status. We wanted to do what we had done before. However, out of that change we came up with many great ways to implement services in the classroom and we started having the other children participate in the activities. It was really good on how we were able to go away from our rigidity and start doing something a little bit more creative.
Fear is big for every obstacle. You might be one of those people who are thinking about maybe starting your own business or you want to start a new program but fear creeps in and you think, "What if I fail? What if I can't do it? I don't know how to do it." You come up with all that doubt. Fear is part of change and so is failure. You have to get through the fear because there is not any change in the world that someone has not failed at. I am sure that Steve Jobs failed several times before he actually made an Apple computer that was worth buying. Fear is an obstacle.
You see complacency all the time with people who are burnout. They do not want to change. They do not want to do anything different. For example, they may think "I do not want to learn anything else. Why do we have to do that?" Complacency comes from people who are not growing. I believe the minute that you start feeling burnout and complacent or the feelings of "I don't care and I have no passion left for my job" is when you need to start reading. Take a class, change jobs, do something different because you are going to continue to be complacent unless you are growing and stretching yourself.
Everyone has fatigue at some point in their life. Millions of people are working two jobs to make ends meet. If you have kids then you are busy running them places, or you might be taking care of elderly parents or a disabled spouse. We have a lot of things on our plate that we are doing and so thinking about making changes when you are tired is difficult.
Short term thinking can be an obstacle. Only thinking about what do I need to get done this week? Not thinking about, "Wow, here's what I want to do in two years or five years and what do I need to do to get there?" When you only think about what you are going to be doing today or in this week, you do not have a vision. You do not really have anything to look forward to.
