How was I an OT today?

This is a new set of blogs as I make my way into practice after more than thirty years as an academic. It is also a way of understanding my philosophy of OT. By tracking how occupational therapy happens in my everyday life, I hope that I can articulate the deep ways this ways of work happens in a life.


I made a summary of the cases that I have worked on over the last couple of months. Of course I felt completely inadequate. There is a feeling of helping, but the need continues. This was clarified to me by Eleanor who says – they will always be there. They may duck out for awhile, but the problems don’t go away and the need that occupational therapy meets is still there.

I learn that the research assistant employed by the practice is not going to continue after the merger. This is a thread that I had hoped to continue and so it is also a disappointment. I imagined that there could have been a collaboration with the university where the clinical needs were picked up and worked with. The examples that I saw when I was here included the ‘dignity and equipment’ arguments. This is about the need for evidence about the provision of equipment that enables dignity. For example, a teenager who is undressed in her bedroom and moved into the bathroom. There were be more dignity in enabling the whole change to happen in the bathroom, but this required a hoist.

It is hard to leave this wonderful practice, which has given me a glimpse of what a ‘no blame’ culture can look like. It’s clearly a practice for people who are able to work very hard and to be self-determining. Some of them are working at 1.5FTE, and being on casual contracts this allows them a lot of freedom to come and go as they please. Others cannot get this pace going and they are very quickly moved along.

I visited YouthInc and met the wonderful Jen Vonic-Joyce. She is general manager of the place that calls itself a school, but it much more like a transition into life. The work of creating a genius is always about relationship in a one-to-one way. The school system cannot do this – and I believe the school system is an abomination in terms of what it does to our children. Fred Heidt who started the school went and visited the schools around the world who are doing this work, for example at the KaosPilot in Denmark. The “Making A Difference” program at Capable in the Otago Polytechnic was also modelled on this way of working. There is a philosophy of KaosPilot about being “overprepared and understructured”. This may be helpful in understanding the kind of confidence that I would like to support young people to have. The occupational therapist will always do this work of knowing a million options, and then help to guide through the ‘just right’ challenge.

Jen talked about how the school is based on restorative justice and positive psychology. The latter has had a bad press lately, with toxic positivity. However, it is a reminder to go back to ‘flow’ and Csikszentmihalyi. This is another place where occupational therapy has made a starting place. The focus on restorative justice resonates with me from the quaker roots. In schools it’s about not using punishment as a modality, and Jen has drunk deep at this well from her time as a policewoman. The restorative justice focus also seems to be about ensuring that the school is not stocked with teachers who are bullies. Jen was clear about how quickly she identified the blocks and the bullies in the team, and these have been cleared away.

There is something like project based learning at the heart of a process where young people can have the kind of education that Hannah Arendt had. She had a mother (Martha) who was prepared to completely dedicate herself to a learning journey, and did not insist on schooling. There were clearly very bright people that she had access to, and by 13 she had decided that she was going to be a philosopher or ‘die’. By 18 she had that relationship with Heidegger that became so important to her, both as a defining and as a rejection of all he stood for. This is real aristocratic learning, the kind of space described by Hoel that was created for gentlemen of leisure.

I hit on this kind of parenting back when I read “Far from the Tree” by Andrew Solomon. This was about situations where parents found ways to be there for children who are dramatically different to them. It is really a story of genius parenting, where they are prepared to go beyond the mile for their children. Those children could be a genius in some way, or have a mental health problem. In each case they found ways not to abandon them. Parents are criticised these days for helicoptor parenting, but there is a need to give everything that we have got to this process of guiding. This is especially the case where society is giving so few cues to our children.

Parents are desperate for real support with children who are not able to fit the mould, because the mould is so gruesome. Sarah Ruddick talked about this in “maternal practice”. She described out we need to help children to survive, thrive and ‘fit’, but the last one ‘fitting’ has always been the problem. When she wrote her ethnographic and philosophic exploration of parenting, children were being ‘fitted’ for the Vietnam war. Now they are being “fitted” for a university system which does not provide deep relationships with teachers; to be endebted; and to work in ways that alienate them from themselves.

Keywords: restorative justice; positive psychology;