The British Journal of
Occupational Therapy O F F I C I A L J O U R N A L O F T H E C O L L E G E O F O C C U PAT I O N A L T H E R A P I S T S
Time to Get Political Dikaios Sakellariou,1 Nick Pollard 2 and Frank Kronenberg 3 No occupational therapist can ignore the rapidly changing context of practice. Health policies are informed by many stakeholders, not only from the state sector and professional associations but also from service user organisations, the private sector and non-governmental organisations, among others. Accountability becomes harder to define in such a complex context: to whom are occupational therapists accountable and for what? In 2006, the World Federation of Occupational Therapists published a position statement on human rights. This statement endorsed access to occupation as a human right. If only a portion of people can access meaningful occupation, then this is a call for action for occupational therapy. As professionals who are concerned with facilitating occupational choices, occupational therapists are advocates for the right to meaningful occupation. In recognising and working for the right to do, be, become and belong, occupational therapists have a role in safeguarding equitable access to occupation and ensuring that situations of occupational injustice are brought to the surface. We believe that occupational therapists are primarily accountable to the individuals and communities that they work with towards an equitable access to occupation. Equitable access does not imply similar access: people have different wishes and needs. In addition, some factors that hinder access to occupation are not amenable to change, whereas others, like geographical features, apply to everybody. However, many of the factors that restrict access to occupation are due to preventable causes that go against the needs and desires of individuals or communities. When these occur over a long time, they can have a pervasive impact on the resources and opportunities available, presenting a potential violation of the right to occupation. Problems in access to occupation arise from social restrictions and often result from policy or its failure. Occupational therapists need to get political if they are
to negotiate and deal with these issues in a sustainable and effective way, making sense of power differentials and the interactions between stakeholders that influence access to occupation and enable changes (Pollard et al, in press). A political practice of occupational therapy facilitates an understanding of the interactions between these decision-making forces and the stakeholders involved. It entails developing competencies to deal with this environment. Rather than having a fixed sets of tools, what occupational therapists need are adaptable and transferable skills to help them to navigate an unknown and rapidly changing terrain. Occupational therapists need to develop a dynamic perspective, that is, being engaged in a constant process of refocusing attention and assuming multiple vantage points in order to understand the context of practice. Being political does not mean that we need to change our values or to abandon hard-won knowledge and expertise. On the contrary, a political practice of occupational therapy is about maximising the potential impact of our engagements and ensuring that we are working towards the construction of civil society. If, as Frank and Zemke (in press) argue, the foundations of the profession lie in political engagement and social transformation, it is time to honour our foundations. Frank G, Zemke R (in press) Occupational therapy foundations for political engagement and social transformation. In: N Pollard, D Sakellariou, F Kronenberg, eds. A political practice of occupational therapy. Edinburgh: Elsevier. Pollard N, Sakellariou D, Kronenberg F (in press) A political practice of occupational therapy. Edinburgh: Elsevier. World Federation of Occupational Therapists (2006) Position statement on human rights. Available at: http://www.wfot.org/office_files/Human%20 Rights%20Position%20Statement%20Final.pdf Accessed on 09.10.07. 1Cardiff University. 2 Sheffield Hallam University. 3International Guest Lecturer
in Occupational Therapy, Cape Town, South Africa. Corresponding author: Dikaios Sakellariou, Lecturer, Department of
Occupational Therapy, School of Healthcare Studies, Cardiff University, Ty Dewi Sant, Heath Park Campus, Cardiff CF14 4XN. Email:
[email protected]
British Journal of Occupational Therapy September 2008 71(9)
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