The Politics of Practice: Strategies to Secure Our Occupational Claim and to Address Occupational Injustice

Article excerpt

Hello, Bonjour, Kia Ora! Te-na- koutou katoa! Miigwetch. Like so much of what I write about, this talk, metamorphosed and evolved into something different over the months preceding this conference. When I was asked to do today's talk, I really didn't have an appreciation of what I would speak about, but I knew that if I was patient, what I needed to talk about would eventually come. It actually came in bits and pieces. Part of my motivation for speaking to this issue of the politics of practice came from a call for papers from the Canadian Journal of Occupational Therapy while I was in the midst of writing comprehensive exams. This call for papers initially caught my interest by stating, strategies for changing policies to enable occupation and promote occupational justice. Part of my motivation and interest in politics came from a policy practicum I did last autumn/winter with our regional health authority. Also, my interest has evolved from my ongoing hunch that politics in Northeastern Ontario (NEO) has something to do with limited access to competitive employment for persons with serious mental illness (SMI). Serendipity, being what it is, it just so happened that the New Zealand Association of Occupational Therapists was stepping across the political threshold regarding two-tiered health benefits based upon origin of disability. I thought politics would be a timely topic. In the end, my examination of politics required me to reflect about the political nature of my own practice, much of which I had long forgotten and which I hadn't necessarily thought of as being political, although it was.

With those thoughts in mind my goals for this keynote address are:

1. To suggest that occupational therapy is more political than we might think;

2. To suggest that part of our occupational culture must include the politics of practice and so we must become proficient in politics to successfully do our work;

3. To suggest that how we define ourselves and our role in the health care arena is political and directly relevant to our occupational claim;

4. To suggest that securing our jurisdiction in the arena of occupation will depend upon us becoming more political; and,

5. To share collaborative strategies for becoming politically energized!

Dispelling the myth that being political is not professional or therapeutic

Let us begin by understanding what politics is and what it is not. To do that we need to dispel the myth that being political is not therapy, or therapeutic or even very professional at all. Politics are important to occupational therapy for two reasons: First, politics are pervasive throughout health care practice (Hofrichter, 2003) and being a health care profession occupational therapy needs to know about politics. Second, occupational therapy practice is replete with ideas, ideologies and interests that are important to society and healthcare policy and practices are significantly influenced by ideas, ideologies and interests. Therefore, I suggest that we need to get our ideas about occupation out into the political arena so that our ideas can and do influence policy. The challenge will be to clearly express and articulate our ideas and political interests so that others understand them. We also need to establish an organized platform for both promoting occupational therapy ideas, and for defending them in hotly contested arenas, such as healthcare. To meet these challenges, we will need to abandon old notions that being political is not therapy or therapeutic or indeed very professional and acknowledge the undeniable reality of politics to our practice.

Second, it is important for us to dispel the myth that politics only occur at government levels. I found a variety of definitions for politics, including this one which states, "politics is the process by which groups make decisions" (Wikipedia.org, 2008). Although the term is generally applied to behaviour within governments, politics is observed in all human group interactions, for example, in corporate, academic, religious institutions, and professional associations such as the New Zealand Association of Occupational Therapists. …