OT in the Media: In Need of a Better Article!

This blog post is one that I’ve been wanting write for a very long time – the article I’m analyzing was published over a month ago, but I’ve been too busy to get my thoughts down and express them in the way I’d like until now. This post contains my thoughts on an article titled “Healthy Living: Occupational Therapy Takes ‘Wholistic’ Approach” by occupational therapist Jeffrey Sheridan. The article’s target audience is the general public, and its goal is to explain what occupational therapy is, what it is not and who can benefit from it. It is pretty brief, so please give it a quick read before continuing on to my critique!

I would like to state first and foremost that my goal in writing this article critique is not to criticize the writer himself – Mr. Sheridan is doing a great thing in trying to get the word out about our field! However, I think his article as a whole does not provide a very clear, compelling or useful explanation of occupational therapy for the general public. I realize that he was most likely working with a word limit imposed by an editor, and so he couldn’t fit in everything he might have liked to say. Even so, I think that Mr. Sheridan’s article could be a much better – and ironically, a much more “wholistic” – explanation of the field of occupational therapy.

The following is my critique of some of the article’s main points and my suggestions for how Mr. Sheridan and future writers of pieces about occupational therapy can make their writings more compelling, informative and accurate.

First, I would like to address Mr. Sheridan’s definition of occupational therapy as it is summarized in the first two paragraphs. He writes: “OT focuses on a “wholistic” approach to a person, rather than an injury. Treatments are based on functional tasks that the patients need, or want to participate in.   The best way to explain it is that OT helps you with your daily “occupations.” Occupations are anything you do from the moment you wake up until the moment you fall asleep; not just your job. It’s hard to get ready for work if you can’t put your belt or shoes on.”

While he makes a good general statement about occupations as “anything you do” between waking up and falling asleep, I think that this part of the article would have been greatly strengthened if Mr. Sheridan had included any examples of meaningful occupations that therapists help clients continue or return to engaging in. For example, he could have written about how a therapist might help a child learn how to play and socialize, a young man with an intellectual disability dress and toilet himself or an adult woman return to her occupations of sewing and crafting after a stroke. I think that the entire article minimizes the role of OT in occupations other than dressing – putting on a belt and shoes are certainly important, but I would have liked to see examples of other meaningful occupations a therapist might help clients return to so that readers could better understand how valuable an OT’s contribution to treatment truly is.

I also think that this “definitional” part of the article would have been stronger if it discussed the wide variety of populations with which occupational therapists work. If the author had mentioned OT’s role with children, wounded warriors, stroke survivors, amputees, or other groups I think it would have painted a clearer picture of the profession.

Additionally, I think that this early part of the article explaining occupational therapy would have been greatly improved if Mr. Sheridan had explained the difference between how OT’s view and treat clients holistically and how the majority of doctors (for example) primarily use the medical model in treatment. (Any physician readers out there please correct me if I’m wrong!) I realize that using the medical model does not automatically exclude holistic treatment of a person, but there is a distinct difference between how professionals in each field view their clients and thus treat injury and illness.

Unfortunately, I feel that the author failed to give readers a clear, concise definition of what occupational therapy is, why it is important, and who can benefit from it from the start. Of course, this is difficult to do under any circumstances and especially in an article with a tight word limit, but his definition here leaves a lot to be desired.

 

Next, I’ll discuss the main issue I had with this article — the author’s highly inaccurate comparison of occupational therapy and physical therapy. Regarding the distinction between the two fields, he explains: “The main difference between PT and OT is that occupational therapists address primarily arm injuries while physical therapists have a wider range of treatment including arms and legs as well as everything in between. Examples of injuries occupational therapists treat are tendonitis, muscles strains, carpal tunnel, finger fractures, rotator cuff tears, lymphedema issues, strokes and other neurological disorders.”

Because it’s my blog, I’m going to be completely honest here and just say it – I absolutely ABHOR this whole paragraph! I was very frustrated when I first read it, because Mr. Sheridan presents such a grossly oversimplified view of OT compared to PT. Here, he makes it seem like OT’s ONLY treat the arms (10% of the body’s total weight) and PT’s do “arms, legs and everything in between!” Honestly, I find it truly shocking that an occupational therapist would have such a narrow, simplistic view of the work he does and other therapists do.

One of the most important things I learned from my volunteering with my OT mentor Helen is that occupational therapists may not technically “treat all parts of the body” and that there are certainly tasks, movements and skills that are outside her scope of practice as an OT. However, as an occupational therapist her job is to treat the whole person, and that means so much more than just treating “arm injuries”!

She gave me the example of feeding therapy, something she does with many of her young clients. It’s very true that one’s hands and arms are a very important part of feeding, but she also pointed out how important a person’s posture, cognition, and executive function skills – among others – are when he is feeding himself. In addition to being able to lift the utensil and food to his mouth, a person must ensure that he is positioned well for safe, efficient feeding as well as being able to reason and plan how large or small a serving to ingest. Therefore, even an activity like feeding requires the knowledge and expertise of an occupational therapist who understands that this and many other activities require treatment in functional areas beyond physical injury.

Sadly, I think Mr. Sheridan has done a very poor job of explaining the difference between OT’s and PT’s in this article, and I’ll definitely be on the lookout for a better explanation of the differences between the two professions as I continue to read, write and research!

 

Finally, I would like comment on the author’s description of the conditions and issues occupational therapists are able to treat. He lists several examples in the quote above, saying that “… occupational therapists treat tendonitis, muscle strains, carpal tunnel, finger fractures, rotator cuff tears, lymphedema issues, strokes and other neurological disorders.”

While this is a good list of the various conditions and injuries occupational therapists can treat, it fails to include the wide range of non-physical conditions that OT’s also treat. OT’s help clients with visual coordination problems, balance and motor coordination, cognition, social readjustment, job placement, emotional regulation, executive function skills…so much more than the just “arm injuries” that are listed above. In this article, Mr. Sheridan places a very strict limit on what occupational therapists do, and that may simply be a result of his personal experience – I cannot be certain, and I hesitate to assume anything. However, I would like to reiterate what the author has not – that occupational therapists are responsible for treating the whole person, not just a person’s injured hand or limb.

Although I had several issues with the statements Mr. Sheridan previously made about occupational therapy, I think his brief discussion of occupational therapists’ roles as client educators was good: “…one important part of the therapy process is education regarding adaptive equipment or adaptive techniques. These can help individuals…become more independent. Reachers, dressing sticks and shoe horns are just a few of the types of equipment occupational therapists are trained to educate patients on for lower extremity dressing. OT also educates you on adaptive techniques like one-handed shoe tying for after a stroke and joint protection for arthritis patients.”

While I did not enjoy this article as a whole, I think the author’s effort to include occupational therapists’ roles as educators was worthwhile. Therapists are responsible not only for treating clients, but educating them as well. Mr. Sheridan makes note of this when he describes how OT’s can help clients learn adaptive techniques for shoe tying and how to use adaptive equipment. I think that this is one of the better parts of the article, in large part because he provides several examples to support his statement that occupational therapists are educators that help clients become more independent.

In my own experience, I have found that therapists are definitely teachers in addition to being healthcare professionals. During the sessions where parents observed, Helen spent a great deal of time explaining different therapy techniques, home programs, home and routine modifications and adaptive techniques. She also explained many of these same things to her adult clients.

So, although this section about therapists’ roles as client educators still focuses too heavily on dressing and fails to mention other areas of functional activity in which occupational therapy can be helpful, it generally does a good job of explaining another important aspect of OT.

 

In sum, my main issues with this article lie in Mr. Sheridan’s weak and ineffective initial explanation of occupational therapy, his poor differentiation between occupational therapy and physical therapy and his very limitedexplanations of what occupational therapists are capable of doing. In spite of these shortcomings, he did a fair job of mentioning how OT’s are important for client education, which I appreciated.

Ultimately, I don’t think that I would refer any of my friends or family to this article as a way of helping them understand my career choice. In my opinion, this article does not do a great job of defining occupational therapy or explaining how it is different from other healthcare careers – the questions from others that I most often find myself answering. In the future, perhaps I will be fortunate enough to be able to write an article informing people about occupational therapy, and if that ever happens I hope that somebody will critique me and perhaps help me reconsider OT from another perspective! Until then, I’ll just keep reading, writing, blogging and developing my own understanding of occupational therapy and its role in the world.

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