Occupational Therapy: Political Engagement and Social Transformation

Occupational Therapy: Political Engagement and Social Transformation An international occupational therapy movement that embraces political engagement and social transformation has been forming (Frank & Zemke, 2009). There has been a shift away from the medical model in the last 30 years (Frank et al, 2009). The political factors and societal factors that play a role in this shift strongly stem from the human rights movement (Andrews, 2013). Andrews (2013) categorizes the human rights movement in three categories: 1) proliferations of human rights, 2) growing human rights culture, and 3) human rights violations by nations and private sector. Andrews (2013) outlines defining historical events that contributed to the human rights movement as the aftermath of WWII, the end of the Cold War, the 1993 Vienna Declaration of Human Rights that defined woman’s rights, the terrorist attacks on September 11, 2001, and the recent global economic crisis. The world has developed a growing negative attitude towards those who discriminate against race, gender, religion, sexual orientation, and disability. According to Lang (2001), the social transformation model arouse out of critique of the medical model that focuses on the individuals’ physiological and functional abilities. This is now a shift towards a focus on society’s ability to integrate individuals successfully. Incompatible physical environment and negative social attitudes toward disabled people result in systematic oppression (Lang, 2001). Disability is manifested through a wider, external lens and not the consequence of the individual’s deficits. An international occupational therapy movement emerged at the 20004 World Federation of Occupational Therapy meeting and a position statement on human rights followed (Frank et al., 2012). Frank et al., (2012) discuss individual change versus environmental change. While both of these are important, I feel that we should start with environmental change. Social change has a significant impact on occupational choices by creating a greater opportunity to minimize disability. “Occupational therapy directed towards social transformation may have a greater impact and more pervasive effects on individuals’ occupational choices than interventions focused exclusively on individual change” ( Frank et al., 2012, p. 130). Drake, Kinner, Bond, & Goldman (2009) argue that by providing supported employment and mental health services it is possible to reduce growing rates of disability, make a positive contribution to the workforce, save the government money, and help people support their own well-being. If I were awarded a six million dollar grant to meet a societal and occupational need, I would expand the American DanceWheels Program. According to Melinda Kremer (2012) “Dancing is about the heart, not the legs.” However, people who use a wheelchair do not realize that they can dance. There feel excluded from this meaningful activity. This population is an example of what Opacich, Lizer, and Goetsch (2012) define as an ‘invisible populations’; people who are not counted by conventional strategies. According to Murcia, Kreutz, Clift, and Bongard (2009), the benefits of dancing are related to the emotional, physical, social and spiritual dimensions. This missed opportunity was brought to my attention when a disabled friend pointed out that even though public building may be wheel chair accessible, the dance floor within in is not. That is because no one expects that someone who uses a wheelchair for mobility would be dancing. Individuals with disabilities rarely have the opportunity to engage in social dancing. The ballroom dance style has the power to bring the able bodied and disabled worlds together. A six million dollar grant would used to educate instructors and students, because both partners need to learn the material. The money would also be used to remove barriers to dance floors or build an accessible one in the community. The program would include hosting dance competitions that included seated partners and provide funding for participation in an international competition. Furthermore, I would allocate money to expand Dr. Hong’s research project “So You Think You Can’t Dance?”. This study investigated the therapeutic effects of veterans living with spinal cord injuries (VA Palo Alto Health Care System Annual Report, 2012). This project is in line with AOTA Societal Statement on Combat-Related Posttraumatic Stress (2009). Sakellariou and Pollard (2012) point out that human interaction with the greater social, political, and economic environment is often overlooked by those who credit themselves as using a holistic approach. The truth is that there are significant environmental factors that influence an individual’s capacity to successfully engage in occupational choices. Galheigo (2011) presented a very powerful message in the article, “What needs to be done? Occupational Therapy responsibilities and challenges regarding human rights”. I was really struck by the parable of the fisherman who went in search of the reason that people were drowning instead of rescuing each person as it happened. There are times when we need to address the dehumanized institution and serve as an instrument of change. Galheigo (2011) then applies this concept to juveniles in the Brazilian institutions and describes when she addressed the root of a problem that affected development and quality of life. An international occupational therapy movement that embraces political engagement and social transformation is upon us (Frank et al., 2009). There has been a shift away from the medical model to a focus on social change to improve occupational engagement for all people. As occupational therapists we have an opportunity to serve as an instrument of change during this movement.

References
Andrews, P., (2013). Sixty Years On: The International Human Rights Movement Today. Maryland Journal of International Law. Volume 24 Issue 1 47-55 Retrieved February 16, 2014 from htttp://digitalcommons.law.umaryland.edu/cgi/viewcontent.cgi?article=1493& context=mjil
American Dance Wheels Foundation Retrieved February 16, 2014 http://www.americandancewheels.org/
American Occupational Therapy Association. (2009). AOTA’s societal statement on combat- related posttraumatic stress. American Journal of Occupational Therapy, 63, 845-846.
Drake, R. E., Kinner, J. S., Bond, G. R, & Goldman, H. H. (2009). Social Security and Mental Illness: Reducing Disability with Supported Employment. Health Affairs. Retrieved on February 15, 2014 from http://content.healthaffairs.org/content/28/3/761.full Frank, G. & Zemke, R. (2009). Occupational therapy foundations for political engagement and social transformation. In N. Pollard, D. Sakellariou, & F. Kronenberg (Ed). A Political Practice of Occupational Therapy (pp, 111-135). New York: Elsevier.
Galheigo, S. (2011). What needs to be done? Occupational therapy responsibilities and challenges regarding human rights. Australian Occupational Therapy Journal 58, 60-66.
Kremer, M. (2012). Dancing from the Heart. Retrieved February 16,214 from http://www.mossrehab.com/living-beyond-disabilities-podcast/podcast-dancing-from- the-heart.html
Lang, R. (2001). The Development and Critique of the Social Model of Disability. Retrieved February 13, 2014 from http://www.ucl.ac.uk/lc-ccr/lccstaff/raymond- lang/DEVELOPMMENT_AND_CRITIQUE_OF_THE_SOCIAL_MODEL_OF_D.pdfM
Opacich, K. J., Lizer, S., & Goetsch, P. (2012). Forging partnerships to address health-related needs: targeting embedded rural communities in the horseracing industry. In N. Pollard, D. Sakellariou, & F. Kronenberg (Ed). A Political Practice of Occupational Therapy (pp, 207- 216). New York: Elsevier.
Marcia, C. Q., Kreutz, G. Clift, S. & Bongard, S. (2010). Shall we dance? An exploration of the perceived benefits of dancing on well-being. Arts & Health (2), 149–163. Retrieved February 16, 2016, from http://ces.frostburg.edu/pdf/Shall%20We%20Dance%20Study. pdf
Sakellariou, D., & Pollard, N. (2012). Political challenges of holism: heteroglossia and the (im) possibility of holism. In N. Pollard, D. Sakellariou, & F. Kronenberg (Ed). A Political Practice of Occupational Therapy (pp, 91-105). New York: Elsevier.
VA Palo Alto Health Care System Annual Report. (2012). Retrieved February 16, 2014, from

http://www.paloalto.va.gov/docs/VAPAHCS_AR2012_508.pdf