The expanding world of occupational therapy

By Nancy Gowan and Susan Strong

Historically, occupational therapists were found within the clinic providing treatment somewhat removed from the workplaces and homes of the client. This approach has quickly changed. It’s now common to see an occupational therapist with hard hat and work boots in the workplace, facilitating healthy work environments and effective return-to-work programs. This result was due to the pioneering of many therapists who dared to step into the workplace and realize the true connection between disability and productivity.

Occupational therapists have long recognized the potential of an individual and the importance of meaningful occupation to health and well-being. They bring to the workplace an understanding of the importance of personal achievement and the impact of injury and illness on worker roles. Occupational therapy practice and theory have further developed and there is an additional focus on relationships among individuals, occupations and the environments in which individuals engage in occupations. This means that the occupational therapist approaches workplace issues with a unique perspective and the problem solving ability to creatively bring together adjustments in the workplace on many levels; for example, individual worker, work group, organization, systems. The understanding of the Person Environment Occupation Model (worker, workplace and work) has allowed occupational therapists to tread into the workplace with steel-toed boots!

Today we find occupational therapists leading occupational health departments in national corporations, facilitating corporate teams that will develop policy and procedures > for return to work programs, leading chronic pain management groups in industry and educating employers on the cost benefit of protecting their most valuable investment — their employees.

Occupational therapy in the workplace: a natural fit

Educating CEOs about the importance of the individual and how he functions in a productive role can be easily explained by occupational therapists. They understand not only the pathology and prognosis of the injury and illness but they also bring to the decision-making table creative solutions such as adaptations to the workplace, the work and the worker.

Why should employers and insurers contract occupational therapy services?
Providing medical treatment alone is often insufficient to improve an individual’s ability to return to work or sustain work performance. The return-to-work literature demonstrates that the physical disability is the smallest barrier to re-entering the workplace. Once the doctor has provided a return-to-work note, the other barriers remain to be addressed. These may include: coworker relationships, ongoing pain, occupational bond with the employer and physical demands of the job, etc. The occupational therapist brings a unique understanding of these issues to the workplace. The skills and knowledge base of therapists will allow a bridging of the gap between disability and worker roles. The employer requires a professional who not only understands the medical side of the injury or illness but also has the ability to understand the workplace and the impact of the injury on the abilities of the individual in a productive role.

Occupational therapists’ unique understanding of the relationship between individuals, their work and workplace environments allows them to break down the barriers and make return to work successful and sustainable. By understanding the impact of illness and injury on function, occupational therapists can suggest an appropriate job match and develop a realistic return-to-work plan. In particular, their skills in occupational analysis allow for an understanding of the physical, cognitive and emotional demands of the job within the context of the particular workplace environment. Due to the therapists’ recognition of the importance of the person as a whole and the worker role, no barriers are left untouched. These barriers can be addressed on an individual and/or organizational basis.

Individualized approach

Occupational therapists offer a distinctive approach to the worker and the workplace. Occupational therapists uniquely enable the individual worker to become a part of the rehabilitation and return-to-work process. Therapists appreciate the importance of that regaining of independence and the impact that this can have on the bottom line of business. Professional training, directed by ethical, client-centred practice, ensures that the worker comes first in the process and therefore is given the power and control needed to succeed again in the workplace.

Occupational therapists have created improvements in many workplaces through consultation and on-site provision of service. Therapists bring a distinctive perspective, unique approach and broad set of skills. Their negotiation and communication skills allow for a bringing together of the workplace parties. The role of an occupational therapist in the workplace is widely variable but the key to being an occupational therapist lies in the ability to understand that the worker is at the centre of a complex interacting worker-workplace-work relationship. Unions and business managers have recognized that our client-centred approach, when utilized in the workplace, can bring benefits to all the stakeholders.

About the authors

Nancy Gowan, B.H.Sc. (O.T.) O.T. Reg. (Ont.) is a registered occupational therapist with over 15 years of experience in industrial rehabilitation and return-to-work programming. Nancy has assisted employers of all sizes with development of health and disability management strategies, which have added bottom line profits through improved productivity and reduced disability costs. She has implemented health and disability management programs yielding returns on investment ranging from 10% to 600%. Nancy specializes in working in partnership with employers to develop a customized strategy that will bring sustainable savings and improved employee productivity. As one of the lead faculty for the National Institute of Disability Management and Research’s (NIDMAR) disability management certificate program, Nancy has provided employers with the training and skills that allow them to develop state-of-the-art disability management programs for their employees. Email:  gowanhealth@gowanhealth.com  www.gowanhealth.com

Susan Strong, M.Sc., B.Sc., O.T.(C), O.T. Reg. (Ont.) is an Assistant Clinical Professor with the School of Rehabilitation Science and a Research Associate with the Work Function Unit at McMaster University. After graduating from the University of Toronto (1981), she worked in various positions as an occupational therapist in mental health services. She obtained a Master of Science Degree in Clinical Epidemiology & Biostatistics (Design, Measurement & Evaluation Programme), McMaster University (1995) where she studied environmental factors influencing work for individuals with mental illness. Her publications focus on person-environment-occupation relations, and vocational evaluation.

While teaching in the undergraduate occupational therapy programme, Susan has engaged in consultations and research with clinicians, business and industry. She has been a principal investigator for several vocational studies including the Work Place Perspectives Study, Determining Claimant’s Effort Project, and the newly completed study, Assessment of a Person’s Ability to Function at Work. Her latest research project involves developing and evaluating a new participatory method for research dissemination involving joint researcher-user interaction, collective learning, and collaborative change in the area of functional assessment practices and policies.

This article first appeared in the September/ October 2002 issue of Occupational Therapy Now magazine published by the Canadian Association of Occupational Therapists. Reviewed July 2010.