Constructing positive messages about disability through occupational therapy practice

1. Constructing positive messages about disability through occupational therapy practice Zofia Kumas-Tan, OT(C) CAOT Conference, Ottawa June 4, 2009

2. Introduction • OTs believe in an inclusive society that values people with disabilities as they are • Yet some of OT practice is geared at helping clients become less disabled, more able-bodied • This presentation explores • the tension between valuing and devaluing disability in OT practice • ways to do OT that value disability and promote social inclusion

3. Setting the stage… • People with disabilities experience social and economic marginalization • The belief that disability is ‘bad’ contributes to this marginalization • We may unknowingly convey this belief to clients and others in day-to-day practice

4. People with disabilities experience social and economic marginalization 2008 CCPHO • In 2005, the overall poverty rate in Canada was 11% • Among work-limited individuals, the poverty rate reached 21% 2006 PALS • In 2006, 44% of working-age people with disabilities were out of the labour force – not working or seeking work – compared to 20% of non-disabled people • 10% of people with disabilities in the labour force were unemployed, compared to 7% of non-disabled people

5. People with disabilities experience social and economic marginalization 1990 NHIS • Disabled people living in the community are twice as likely to live alone as those without disabilities (19.6 vs. 8.4%) • Disabled people are twice as likely as non-disabled people to socialize with friends, relatives or neighbors less than once a week (30 vs. 14%) • Disabled people are twice as likely not to have gone out to a movie in the past year (58 vs. 29%)

6. The belief that disability is ‘bad’ contributes to this marginalization Going out in public so often takes courage . . . It is not only physical limitations that restrict us to our homes and those whom we know. It is the knowledge that each entry into the public world will be dominated by stares, by condescension, by pity. - Jenny Morris, 1993

7. The belief that disability is ‘bad’ contributes to this marginalization All the talk about cure just confirmed for me what I already knew: that there was something terribly, horribly wrong with me. I just could not remain the way I was . . . I was just no good that way. Nobody wanted me to be the way I was. - Nadina LaSpina, 1998

8. We may unknowingly convey this belief to clients and others in our practice • Not because we want to be hurtful • Because we’ve been socialized (by family, friends, education, media) to believe that disability is ‘bad’

9. We may unknowingly convey this belief to clients and others in our practice • “We’ll fix you up” = “There’s something wrong with you that needs to be fixed” • “You look much better now that you’re sitting up straight” = “Normal (able-bodied) looks better, different (disabled) looks unattractive”

10. The promise of OT Partnering with clients and families • To find ways of participating in occupations, safely, effectively, efficiently • To identify areas where help is needed and sources of assistance • To nurture within the client a sense of belonging, self-acceptance, pride

11. The promise of OT

12. The promise of OT • “We’ll fix you up” => “We’ll help you get back to doing the things you love” • “You look much better now that you’re sitting up straight” => “Sitting straight makes it safer for you to swallow without choking”

13. The promise of OT • May seem like small, insignificant changes • But small changes can make a big differences • Changes in how we think, speak and act have a ripple effect – can change how society views and treats disability • See Anthony Giddens, Structuration Theory

14. The promise of OT:Reflexive practice • Reflecting on what you said & didn’t say, what you did & didn’t do • Reflecting on the implications of your words, silences, actions & inactions • Words like ‘good’ or ‘better’ • What you & client are working towards and why • Reflecting on how new insights might shape future interactions

15. Promoting social inclusion • Examine current practices for negative messages about disability • Make a conscious effort to convey positive messages about disability • Maintain a focus on occupation rather than able-bodiedness and independence • Foster social support systems for clients and families • Facilitate connections between people with disabilities

16. Thank you! Please e-mail with questions or comments: zkumas@yahoo.ca