Multigenerational Panel on Delayed Exposure to OS and its Impact on Their OT Practice

Free Occupational Science 101 Guidebook
https://beacon.by/evolved-living/occupational-science-101-guide-podcast
OS Empowered OT Facebook Group
https://www.facebook.com/groups/1569824073462362/

This panel interview (a sample from the Foundations of Occupational Science for US-Based OTP's Capstone Course) explores the perspectives of 4 Occupational Therapists from different Generations (Baby Boomer, Generation X, Millennial, and Generation Z) on getting exposed to Occupational Science in the middle of their careers (or before entering the field) and how it has benefited their practice in the field and future aspirations as OTs.

Dr. Susan Burwash (Baby Boomer Panelist)
Linkedin: linkedin.com/in/susanburwash
Website: sburwash.wordpress.com (Portfolio)
Twitter: subu_ot

Dr. Karen Dwire (Generation X Panelist)
Linked in: https://www.linkedin.com/in/karendwireotr/

Anna Braunizer, Reg. OT (BC),  (late Millennial/Gen Z Panelist)
Linked in: linkedin.com/in/anna-braunizer

Supplementary Learning: 

• Link to Dr. Susan Burwash's Dissertation: Doing occupation: A narrative inquiry into occupational therapists’ stories of occupation-based practice
• Link to Dr. Karen Dwire's Capstone Presentation Pets Alleviating Loneliness in Seniors (PALS) An Adjunct Occupational Therapy Program to Impact Loneliness in Isolated Older Adults
• Article Referenced by Anna on Sanctioned Occupations: (Available through Researchgate)
  • Kiepek, Niki & Beagan, Brenda & Laliberte Rudman, Deborah & Phelan, Shanon. (2018). Silences around occupations framed as unhealthy, illegal, and deviant. Journal of Occupational Science. 26. 1-13. 10.1080/14427591.2018.1499123. 

Link to full Podcast Disclaimer

Evolved Living Network Instragram @EvolvedLivingNetwork
Free Occupational Science 101 Guidebook
https://swiy.co/OS101GuidePodcast
OS Empowered OT Facebook Group
https://www.facebook.com/groups/1569824073462362/
Link to Full Podcast Disclaimer
https://docs.google.com/document/d/13DI0RVawzWrsY-Gmj7qOLk5A6tH-V9150xETzAdd6MQ/edit

Transcript

Intergenerational_Interview_Cut

[00:00:00] Josie: Hello, welcome to this panel discussion. I'm so excited to share this discussion with you. So one of the interesting things about occupational science internationally and specifically in the United States is due to its recent contributions to the fields of academia, that means that there's a lot of variation in how.

[00:00:25] Josie: Based occupational therapists get exposed to it, and most of us are gonna be the position where we're gonna start getting exposed to it. Later in our career, after we've been practicing at OTs there are some OTs out there that are coming into the field with programs that have really robust foundation and occupational science and.

[00:00:46] Josie: We'll have an example of one of a clinician that's been practicing since 2018 that had the opportunity to begin her practice with a very rich exposure to [00:01:00] occupational science. But for most of us practicing in the field, in the United States, That's not really the case. And a lot of us have rich decades, longs of practical field experience.

[00:01:10] Josie: I'm with it being maybe a while since we've set foot in formal academics. But the goal of this course is to help occupational science feel like a welcome subject to everyone. And from that, we're really gonna start off this first module with a really open dialogue about what it's like to get.

[00:01:30] Josie: Expos to occupational science at different points intergenerationally. And so in this discussion, we have included Dr. Susan Burk. So Dr. Susan Burk, she's been a practicing OT since 1979. So she is our represen representative of really getting exposed to OS as it was developing in the late eighties and early nineties.

[00:01:55] Josie: And she's gonna discuss with us what kind of it felt like [00:02:00] to enter the field with a very practical. Education that didn't really have much in terms of having a theory driven practice or kind of a operationalized understanding of occupation and how searching for that really drove her to occupational science and even developing a tradition for occupational research through the lens of narrative inquiry.

[00:02:24] Josie: So she really has gotten to contribute to this field as a clinician and as a scholar. Having really late and mid-career exposure to occupational science. We also have included in this panel discussion, Dr. Karen Dwyer, who is our generational ex panelist. She's a practitioner occupational therapist here in the United States where she's been practicing since 2001.

[00:02:50] Josie: She entered the field at the bachelor's level. Posed in the timeline of our developing international conflicts within the US as well as the major changes [00:03:00] to Medicare's pps SY system that really impacted a lot of our Generation X therapists out in the field. She's worked in a variety ver widely varied range of practice settings, working in travel therapy just like me but also doing a lot.

[00:03:14] Josie: Powerfully focused, worked with veterans through the Veterans Administration, and is now developing emerging practice really after 18 years of practicing in the field in a variety of settings. She hadn't really heard of occupational science before until we were both in a class together in 2019 at the post Professional doctorate program at the University of Utah.

[00:03:37] Josie: She's gonna talk to us about how this was something she was really resistant to at the beginning. Especially the concept of occupational justice. However, through this resistance grew a persistence and it ended up being the focus of her doctoral work. And now she sees occupational science as a lens that in bolds not just her upcoming immersing work, but also how she can better understand her past work and how [00:04:00] she's always been working around the occupational alienation and justice issues relating to our clients.

[00:04:06] Josie: She's a great example of how like exposure to occupational science through engaging with these concepts and having and navigating a disorienting dilemma, ended up really changing her worldview. Entering this conversation as a bachelor's level ot, it's now a very empowering part of her life.

[00:04:23] Josie: I'm gonna be the discussion facilitator, but I will be the requisite millennial representative. And really, I had some exposure to occupational science in my master's degree program and just Karen, Dr. Dwyer, I didn't really get as much of an in-depth exposure until I. Those to it in the post professional doctorate program.

[00:04:45] Josie: From there, it really was what I needed to feel more empowered about the future of OT and seeing the international programs that were developing in other countries and how starved we are for that United States. I now feel super motivated to help bring this [00:05:00] wisdom and open the conversational table on occupational science for other clinicians, because I really do think that we need this lens and this mindset to practice here in the us.

[00:05:10] Josie: Lastly, as our generational Z representative, we have Anna Zi, a master's level OT practicing in Canada. She graduated from Dalhousie with a, from a program that really invested in occupational science as its solid foundation. This has allowed her to enter the. Field with an active occupational science lens where she is able to actively theorize with her clients in community based settings and use occupational science as a lens to help clients collaboratively find ways to make meaning of their experience and to collaboratively problem solve in the context of their naturalistic environment.

[00:05:47] Josie: She feels empowered to develop new theories and to understand occupational experiences through the lens of occupational science, and it's allowing her to rapidly. Develop innovative programs with a solid foundation [00:06:00] and utilizing the language of occupational science in her documentation is even helping her with various stakeholders and payers in her community.

[00:06:08] Josie: And she utilizes occupational science, not just as an occupational therapist, but just in her own life as an occupational being in her occupation as an activist and community builder and exploring diverse. Interests and research and she really has some great inspiration to help us brainstorm how we can start practically applying at OS lids in our practice.

[00:06:28] Josie: Starting tomorrow. One of the things I loved about this conversation is that even though we are practicing OTs from all different generations, there ended up being overlap. In all of our different areas of practice, even across the Canadian border, we were able to connect on shared interests and get inspired by the different lenses of problem solving and how we're all part of the growing occupational narrative of occupational therapy and occupational science.

[00:06:58] Josie: Across borders. It [00:07:00] truly was an inspiring conversation and I look forward to you joining in and hopefully feeling empowered through some pure examples in how we can start engaging with occupational science and applying it to our practice and to our personal lives no matter where we inhabit. What practice setting we're in, what our educational background was, or what our goals are.

[00:07:20] Josie: We really can collaborate and support each other across intergenerational lines and have so much to learn from each other in our different experiences as occupational therapists in emerging occupational sciences. So thank you so much for joining this conversation, and I'm so excited to share it with you.

[00:07:38] Josie: Hello. Welcome everyone. I'm so excited to host this intergenerational dialogue. We are all clinicians, just like you we got exposed 

[00:07:48] Josie: to occupational science at different times and I chose a good sample. So we can talk about some of the challenges of taking on occupational science and the, benefits and value [00:08:00] that we've had from going on this disorienting dilemma journey.

[00:08:03] Josie: Along with you guys, I want you to know that you're not alone. We're all traveling on this journey together, and we're all on different timelines and we all have different perspectives that can really fill in the gaps and we wanna create a culture of supporting each other on this journey. So that's what I'm inviting you in and I'm bringing some of my good allies and cohorts that have been a great model of how we.

[00:08:29] Josie: Collaborate as intergenerational OTs. I wanna invite them to introduce themselves, and they're also going to let us know what their background is as an OT and how they found themselves embraced by occupational science. Can we start with you Dr. Susan Burk. 

[00:08:46] Susan: Hi. Yeah I'm happy to be the, oh, the Boomer representative on this panel.

[00:08:54] Susan: Late Boomer still a boomer. So I am Canadian. I graduated from the University of Alberta [00:09:00] with a diploma in occupational therapy in 1979. And immediately began working in the field of, psychiatry in a psychiatric evening hospital, which was specifically designed so that people could continue to do what they needed to do during the day.

[00:09:18] Susan: So go to school, work, parent, but had. Then, had therapy in the evening and, it was a group psychodynamic program. Very different from anything I'd really been prepared for, but also really fascinating. So I've worked in psychiatry in a variety of settings in Edmonton, in Calgary Alberta, and in Vancouver.

[00:09:47] Susan: In Vancouver, I worked again, mostly with Folks who were community dwelling. I did some inpatient work and I first [00:10:00] connected with people who were connected to OS in the mid eighties because I worked with Melinda Suto, who would later become one of my colleagues at ubc. And she was someone who finished doing an MA at USC with Gaia Frank.

[00:10:19] Susan: And so I started to hear just about anthropological approaches to looking at disability. And so that was the very first glimmers. And then I 

[00:10:34] Josie: I was just curious too, do you mind I'm curious, what was your what were some of the main features of OT education at that time? Did you graduate?

[00:10:45] Josie: Was that at also like bachelor's level or what were some of the main influences of OT education? At 

[00:10:53] Susan: that point, it was pretty much, more focused on skills. [00:11:00] That diploma was three years. I could have gone on to do a second bachelor's degree, but I already had one. So, it was largely a theoretical, There was a beginning of certainly we, learned about some theory, humanistic psychology, some of those pieces the, actual environment at that point, which much was much more behavioral and that.

[00:11:26] Susan: I, I, that wasn't something I was up for. 

[00:11:29] Josie: Like occupational behavior theory, more of the Mary Riley work was maybe somewhat influential or 

[00:11:36] Susan: even I suppose early in my career maybe there was some Mary Riley work, but it was even before that. So I was practicing a theoretically and not, bound by anything that I would call ot other than the skills and my interest and science of, directing [00:12:00] participation.

[00:12:01] Susan: I think that's one of the old definitions of ot. So, my problem was early on is that I didn't feel like I had that occupational core. So really all the things that I've done since then have been to find that occupational core to try and help students. Find an occupational core. 

[00:12:22] Josie: Did you feel that void?

[00:12:23] Josie: There was like a void and you're trying to, Huh? I need to feel and satisfy where this feels more solid. 

[00:12:30] Susan: And then I think the other piece of my puzzle, I mean there are there's, links to os all the way through mainly through a variety of people. Sue, Farwell and, Melin were my colleagues when I was at UBC as a faculty member, meeting Gail Whiteford and, talking with a friend who was very good friends with Ann Wilcock.

[00:12:54] Susan: It's, these people whose work I started to follow the OT Without Borders folks, and then [00:13:00] much later and, I suppose I should say that my, my background is mostly mental health, but also work rehabilitation, which has a huge psychosocial component to it because mostly people are having a hard time going back to work because they're going back to a toxic environment or they're traumatized by their injury.

[00:13:19] Susan: So, after that clinical practice, then I started a, variety of academic experiences at UBC in Texas at University of Alberta where I did my master's. And then my PhD and then at Eastern Washington where I met Josie. So, all the way along there's been this, thread of os and this interest in, os and for me it's mostly and, this interest in social justice because a lot of my work in those programs was actually supervising students who were going out into inner [00:14:00] city missions, to women's shelters, to centers that work with people with addiction and having to out of the thin air of not having anyone else there.

[00:14:14] Susan: Okay, that complexity, understand how to support people in their occupation. So, there's always been that really strong community focus for me and that sense of how do we, practice as occupation focused and occupation based practitioners. So, bringing that, and then the other thread for me is always a narrative.

[00:14:36] Susan: I've been so lucky to have been starting with my master's where I did quite a bit of study related to qualitative research in general with some of the early proponents of that in our, in the field of ot and then in my PhD where I got the unbelievable experience of getting to work directly with Jean Clan in and who.

[00:14:58] Susan: I consider the[00:15:00] the epitome of narrative inquiry development. I, feel like I've always been making those connections between OT and OS and the ideas of o os and the. That core of occupation. And then I think bringing my own interests as a, as an artist and a musician and all those other things that I consider my meaningful occupations into practice in whatever way I can.

[00:15:28] Susan: So that's, the very short version of 40 years. That's 

[00:15:31] Josie: sounding I'm seeing as you're expressing that sort of like the, driftwood and the river bank of how there's maybe these. Threads along your, Cowell River, that has been a, it ended up being resourcing in some way. And I was just a quick question and I'll pass on to Karen and give some of some context on your journey towards OS as well.

[00:15:55] Josie: I was curious in relation TOT and education in [00:16:00] the sixties and seventies, was there any conversation of that social justice lens or was that somewhat of a divergence that the OS perspective brought in after? 

[00:16:11] Susan: I think there was, one of the things that happened in Canada was the, it started with the guidelines for client-centered practice, which one of the people who was super involved with that was Sharon Brinell at ve.

[00:16:23] Susan: And so I, the guidelines for client centered practice I think started that conversation 

[00:16:30] Josie: about, Disability rights and things, because certainly the disability rights movement was pretty active in the sixties and seventies at that time. And that's actually, I think, a great segue too in into Dr. Dwyer's work because that what we've, I, what I imagine you've noticed as well, Dr.

[00:16:49] Josie: Dwyer being us clinicians, is this notion of having. A social justice mind practice actually has a long tradition of resistance in the United States in that we still have a [00:17:00] sense of OT practice being apolitical or something that needs to exist outside of the context of politics. And so that's one of the things that seems to inspire some resistance to an os.

[00:17:13] Josie: In some sectors of OT education, but I know that the focus of your doctoral capstone looked at an occupational justice lens. So it makes me really curious about your, journey as, I think also a bachelor's level OT went, through OT education, United States. H How did your journey go and did you experience any like disorienting dilemma moments in terms of that exposure to OS and things that we'll talk as a community too, but would love to lay the foundation of your journey in this.

[00:17:46] Karen: I think it's funny the, reason why I'm laughing is because the two things coming in 15 years after my getting my initial bachelor's is when I went into the doctorate [00:18:00] program and then. Myself and, one other student that I started with. So we went through the whole track together.

[00:18:07] Karen: The, two things we were most resistant and initially defying was occupational science and occupational justice. And I was just like, whatever, Like fluff, like you, obviously, And that's the two things that ended up being the most present and are, moving me forward into the next phase of, my career and my, occupational world I guess.

[00:18:31] Karen: It's, amazing how that comes back, but seem like 

[00:18:34] Josie: rhetoric at the time when you first got exposed to it didn't just seem like jarbo, like this is just words that sound. Good on paper, but they don't really mean anything kind of thing. 

[00:18:46] Karen: Yes, it was initially and I'm, a very occupational based person since birth.

[00:18:52] Karen: Basically I was always say I was born to do OT and that the day I discovered it was the day I [00:19:00] said yes, and I focused from the time I was like 14 years old on getting into the right OT school. And, I had very specific I came of age during the I'm a Gen X representative, so I came of age during the nineties when things like the ada the ADA passed when I was what, in eighth grade.

[00:19:19] Karen: That kind of became a huge thing that I was super interested is accessibility advocacy and I've, maintained that for my entire career. But also I had a lot of personal experience from the time. Five years old. I was diagnosed with leukemia and spent many months, years actually with Children's Hospital interacting with that world there.

[00:19:41] Karen: I always said I was gonna become a doctor. And then I was like, Ooh, too much school. And then the nurses had to deal with vomit and poop and I too much. And I, although I deal with vomit and poop more than I ever thought I would as an ot, but that another story, . But so then it was like, then I, learned about physical therapy and some of the other allied health and I was just like, those kind [00:20:00] of, I was like, that's interesting.

[00:20:02] Karen: But then when I got exposed to ot, and it was actually through an equine like through Hippotherapy and this amazing OT that was at my church as my youth group leader, but she was also, she had this, whole. This whole program for equine assisted therapy and I started volunteering there, and that just became a very super I'm like, Sign me up.

[00:20:30] Karen: So I went in, I got ex as a bachelor's, it was a pre OT program for the first two years, and then you had to apply for your second two years. I didn't get in the first time because they were going almost heavily on academics and there was like 500 people applying. And this was at Colorado State and there was like 500 people applying for 50 slots every year.

[00:20:51] Karen: And and I, whereas I was we, know that the, Brainiest or the the, book [00:21:00] Smart people don't always make the, best ot. So I was like I was hanging in there with a low three point something, but So luckily that year they, decided to change it, to make it a little bit more well rounded as far as the in the lottery system.

[00:21:15] Karen: That, as far as you met these pretty, So I actually, I took a year, I switched my major to like human development, family studies. I applied the, following year and then I was able to get into the program. So I was a year delayed, but it was actually it was great. So I, graduated in, technically in 2002, but I did my internships for that.

[00:21:38] Karen: So it was 2001. Had a really lot of really interesting experience. Because 2001, of course, September 11th I, flew out to my first internship in Hawaii in behavioral health and mental health September 10th. And I was started the, a couple weeks after September 11th happened. So that was a really interesting time.

[00:21:58] Karen: So it was like these [00:22:00] big issues these big worldwide issues that then led to the more some, other 

[00:22:08] Josie: lingering in the background. Yeah. And it was like 

[00:22:11] Karen: then it was like, then we went into a war for 20 years and and all this, other kind of stuff that happened.

[00:22:17] Karen: So I I, pretty much, I graduated and I, pretty much went straight into clinical practice into a skilled nursing. That wasn't my, that wasn't my original attention. But I graduated in 2002 and it was right after I went in, 1996 into the pre-program, and then they were like, You can just walk out and get a job anywhere.

[00:22:38] Karen: It's just fabulous. Everybody loves it and then they they ushered in PPS and like the, in that died for a few years, but then it was like, it was kinda like, good luck and I was. Bar I finally found a job and a skilled nursing an hour away, and I I took what would be barely over minimum wage these days like I [00:23:00] just was like, I just was desperate to get into the field.

[00:23:03] Karen: You mind if I 

[00:23:04] Josie: asked you like, what were some of the core, like how would you say your bachelor's level OT education, what would you say those dominant influences might have been and, how the OT education was structured? I know, like Dr. Burk mentioned hers was very practical focused. Were there, What were the major like fields of thought for your OT education, would you 

[00:23:24] Karen: say?

[00:23:25] Karen: It was it was an interesting time because like you said, a lot of stuff started happening in the nineties and some shifting started to happen. We got that practical side of things, but then it was mixed in with, they were starting to really develop a lot of the frameworks, a lot of the models of practice.

[00:23:43] Karen: And then this whole concept of evidence based practice was just they had to really define what it was. And I even noticed the definition that I was given in 1999 was very different from the definition [00:24:00] and, going through the evidence based practice courses in 2020 So it's it, shifted a whole lot.

[00:24:08] Karen: So there was definitely like, here's how you, And of course we didn't have like where you could just go onto the online library. So there was like, here's how you can go look up studies, but there's not much. So a lot of borrowed research, a lot of like it was very much in its infancy.

[00:24:25] Karen: And I, like I've said before, I never, no, I never heard of occupational science in 17 years of practice and going through school. I never heard, not 

[00:24:37] Josie: even the notion of the word. Can I make some guesses about that time? I'm just from I, would imagined that maybe Jane Heir's work was starting to get some traction in the field.

[00:24:50] Josie: This would've been before the practice framework was implemented in the field. You would've graduated before that got introduced to [00:25:00] the clinician audience and then it probably was a strong biomedical. And biomechanical focus with where Medicare was out at that time and how many prosperous, seemingly prosperous opportunities there were in post acute care.

[00:25:14] Josie: So I'm imagining that had a strong influence on your OT 

[00:25:17] Karen: education. Yeah yeah, cuz then I that was just where I was gonna start out and, then skilled nursing ended up being when I did, because then I started as a traveler and that was a vessel. It paid the best and I could, that's where the jobs were all over.

[00:25:32] Karen: I've worked all over the country for mostly in skilled nursing, some others, but that's, that was where the money was. And the, and then there was a glory days of that too when, they figured out how to effectively use PPPs instead of just being like, Oh my gosh, this is gonna So they started, there was a real hiring uptick and, a lot of demand since then until they, until.

[00:25:57] Karen: Just said, Okay, you guys until the fraud [00:26:00] and the, abuse started coming into it. But I had probably my first five years it was very much go eval, then we're gonna have a meeting, and then you look at, you tell us what they need and give them only what they need and we can ramp 'em up and the rug levels and everything.

[00:26:15] Karen: It was great. And we were like groups and it was 

[00:26:20] Josie: model of human application or any kil hoofers work come up while you were in school? Yeah. Oh, okay. 

[00:26:26] Karen: Very good. Yeah. Yes Kil Ner was very big. When I time, Yes. 

[00:26:33] Josie: Nineties. Perfect. And do you mind if we segue and then we'll have kind of a group open discussion on some of these other things too.

[00:26:40] Josie: Anna, I'm you're, more like Kristen, your OT education, did you, am I thinking right that you graduated OT school in 2019? 2018, but very 

[00:26:52] Anna: 18. Ok, perfect. Very close. Yeah. So I'm Anna and I'm occupational therapist on V Island in [00:27:00] British Columbia, Canada. I, on the, currently on the territories, the song he's Hung Peoples and s Yeah, Song.

[00:27:08] Anna: He's of Columbia Peoples and I practice in the community. So I'm in my car, I just saw someone . I basically meet people wherever they feel most comfortable and whatever makes most sense for them to work on their goals. So I, we have a clinic, we have offices there that we can use, but I tend to meet people in coffee shops at their home grocery stores.

[00:27:30] Anna: Wherever. And I graduated from Dalhousie in 2018 and I was really fortunate because OS Haw was the director of the school at the time and she's very into os so she brought a lot of OS into the program for like goals and we were there when she was getting to the program. So she brought in a lot around work and understanding occupations from an OS perspective.

[00:27:53] Anna: And then I was also really fortunate to do my research project and to learn with Dr. [00:28:00] Nikki Eck. So Nikki looks at substance use and the sanction of occupations like sex work, making money on the streets, lots of different occupations that are typically. Hidden from view in the broader OT world and literature than not often things that get talked about.

[00:28:17] Anna: But because I got to learn from Nikki, he was like, Okay, what's this process of sanctioning? And just looking at non sanctioned occupations and looking at it across context, looking at substance use and like looking at, okay, why is it more acceptable in this profession but less acceptable for these people to do it?

[00:28:35] Anna: Like kinda grouping people and who's acceptable for two successes, who's not? And having those open discuss. And yeah, so it's what I introduced os I entered practice in 2018. I actually started in a hospital in acute elective ortho and I'm very much a mental health ot. I learned . I was, that was just, it was not the right fit for me.

[00:28:58] Anna: It's like lots of people are really great at that [00:29:00] role, but for me I was just like this exactly incongruent with like why I became an ot. So then I took four months off from practice and my family, my grandparents had just passed away. So a bit of personal health, like family situation and my family members in really struggling.

[00:29:17] Anna: So I'm gonna go to Austria because then I can kinda. Support my family who are struggling with mental health stuff and I can figure out my life, , figure out what I wanna do. So then I went into community ot, and so I'm in private practice here, which so you might be more familiar with is just, I work a lot of people injured in work, injuring car accidents.

[00:29:37] Anna: I work a lot with veterans, currently serving members in the Canadian forces through d and people who have long term stability insurance. And I'm hoping that we'll get to start seeing people with short term disability insurance because some plans are starting to add it, but just right now it's if you don't have money, you can't pay.

[00:29:56] Anna: Or if you're not funded by any of the other services, then it's not [00:30:00] publicly available. But most of my work is with veterans and that's what I was talking about at the conference where I met Josie because it's that transition and the occupational disruption as veterans go from military. To civilian life.

[00:30:15] Anna: There's many different factors there. So os really gave me a lens to exploring this of veterans and looking at, okay, how, what's your individual experience with these factors? It's going from doing collective occupations together as a unit. How that their routines were much commanded then living alone and being entirely responsible for routine.

[00:30:35] Anna: Having a loss of meaning of the occupation, of working out. Cause before for a lot of veterans, it was to be a good soldier. And then in civilian life they're like I'm not a soldier anymore. So I know it's healthy for me. I know it like helps me think more clearly. I know it helps my mental health, I know it helps my physical health, but that's not enough to motivate me to do it.

[00:30:55] Anna: I need to find something meaningful there. I've had veterans where we worked with kinda looking [00:31:00] against sanction of occupations, sanctioning of gender and gender expression. So in the military there're how for them, they couldn't felt, they couldn't express themselves. And while the referral. A lot of fashions referred to me for adjusting to civilian life.

[00:31:15] Anna: It was kinda like, how can we look at civilian life? What is civilian life even like? What does that even mean? Like specifics to Victoria dc So bringing that OS lens has really helped me to bridge that with fashion so we can look at it together and figure, okay, what roles do I wanna have in civilian life?

[00:31:31] Anna: Who do I wanna be in civilian life and what do I wanna do? I don't always use the OS terms. I like, This reminds me of something we study in OS and this is like what it means. Some veterans are very philosophical and they're like, What's that called? And then, we'll, I'll actually use the OS terms, but it's adapting it to each person I meet.

[00:31:51] Anna: So yeah, one person if they want to explore their gender, so we want, they need had some PTSD and had a trauma response in crowds. So we went, [00:32:00] one of their exposure sessions was we went to a shopping. And went shopping for clothes that were gender affirming. So really looking at okay, bringing us understanding context.

[00:32:11] Anna: And then I also use it as no t as like a critically reflective lens. Look at my own practice and as a clinical team lead, I'm like, how are we doing occupational therapy? How is this supporting people and actually getting back? And how are we putting up barriers? How are we maybe sanctioning occupations within our own space?

[00:32:28] Josie: I've been heavily influenced by sanctioning occupations. It's totally one I'm most 

[00:32:32] Anna: familiar with, but like how are we sanctioning occupations own space and relationships, contacts? How are we sharing with people? Is the way that we're sharing people even sanctioning them? Or can we just open way of just 

[00:32:44] Josie: noticing?

[00:32:45] Josie: Do you mind elucidating that concept a little bit? I actually haven't heard of it before. The sanctioning occupations. 

[00:32:52] Anna: Yeah. So sanctioning occupation, So basically occupations that are sanctioned are viewed as a legal or [00:33:00] deviant, socially unacceptable. 

[00:33:02] Josie: There's a great 

[00:33:03] Anna: paper by s likes on it. Who else, Other authors are, but it's from 2020, I wanna say.

[00:33:11] Anna: And it's about the sanctioning of occupations. They actually brought in examples of jazz music in the states. Ok. And how that 

[00:33:19] Josie: wasn't viewed as like socially 

[00:33:20] Anna: acceptable. During context and then with time changes, then okay, now it is. So it's like the process of things becoming more or less like socially acceptable with non sanctioned occupations being not socially acceptable, illegal deviant like bad.

[00:33:37] Anna: That kind of thing. 

[00:33:38] Josie: Kinda what I'm hearing from you too is that maybe you came from a school where OS was really infused in the OT education and the curriculum and maybe there was a really strong focus on occupation centered and occupation based practice, which if I'm not too presumptuous, Dr. Burk I think has previously felt comfortable with me [00:34:00] se sharing her dissertation with this cohort that are going through this.

[00:34:05] Josie: So there's a really great exploration in how the challenges we navigate or that you found from your narrative inquiry. Dr. Bur wash and I'm clinicians often feeling challenged to be occupation based in practice settings. And it sounds like maybe you had some challenges in more of the elective orthopedic setting and utilizing that lens and that, and then in the community based practice there became a lot of open avenues to really operationalize some of these os.

[00:34:33] Josie: Things in practice and seeing a really tangible impact with these populations and if you're comfortable with it, I would love to correlate the work that you're doing here and, compare and contrast it to, with Karen maybe getting to flesh out some of more of your journey. Cause I know we were going through where it, in the nineties, you were part of that gold rush of a postacute rehab and then there was I imagine, a.

[00:34:59] Josie: I had [00:35:00] experience almost like a group trauma for many of the therapists that went through PPS of having OT mean one thing and then totally pendulum swing. And it seems like I, I still feel like I'm stewarding some of my Gen X therapists through that disruption, that occupational disruption of that experience, and that it seems like that has created almost like a scarcity mindset or some of the stigma around occupation based practice because there's a fear of having Medicare punish.

[00:35:29] Josie: OTs again for being very generous with an occupational lens. But you may not know this Anna, but Dr. Dwyer also has a rich pass of working with veterans in the context of the United States and the Veterans Administration and has also prior to you coming on the call doing some reflections about the challenges of navigating community based practice in the home health sector in the us.

[00:35:53] Josie: So there's actually an interesting correlation in your current work and a correlation in the timelines of exposure [00:36:00] to OS because I think hearing you got much more of a whole holistic OS education, your post professional degree, where we're colleagues together, I think we went through that same course together, perhaps with Dr.

[00:36:13] Josie: Poll price. I'm curious hearing about Anna's work. And how your work evolved after getting exposed to OS later. Do you see similarities in the work that Anna is being able to implement now in field? And do you think that work would've been possible for you prior to getting exposed to OS or how has OS really expanded your understanding of what's possible even in the us?

[00:36:38] Karen: Yeah, it's, that's an interesting question. I was really fascinated to hear more and how that's things that might be, I was like sitting here going, I need to contact her more about this later. But I started out when I transitioned to military and then VA after that, there was actually in Italy working in an overseas [00:37:00] environment and a US army based for traumatic brain injury recovery.

[00:37:04] Karen: I saw both veterans that were working like civilian jobs in their, in, in different capacities there. And then active duty who had just jumped out of the plane or they had been deployed guys have all been deployed a bunch of times, blast exposures, all that kind of stuff. So I got to experience, So it was under the, it was a TBI unit, but then what, ended up occurring.

[00:37:31] Karen: Was that this is always co-occurring to ptsd, to other types of trauma, to even like military, sexual trauma. A lot of people dealing with that. So there was just this kind of, this influx and there was also, there's such a stigma and this is such a small base and there's such a stigma on behavioral health that they could come to the rehab department and see someone about their tbi and then all this other stuff came filling out.

[00:37:57] Karen: So there became a [00:38:00] pretty like I had this sort of cookie cutter version of what they wanted me to accomplish within my role as an ot. There was a lot of cognitive and all that kind of stuff and I was like I really, that's when I really had to dig deep. But I, my experience the previous 14 years at the time was, really got.

[00:38:22] Karen: Not very far because when you go from a like a 90 year old who you're trying to help, have a most independent and quality of life, highest quality of life for his remainder of time on Earth, to a 20 year old who needs to be able to pay attention through a meeting and then go shoot a range qual of that, keeps it acceptable into and they're, full and their active duty and all this kinda stuff.

[00:38:49] Karen: Then there's all these troubles at home because like she was saying, you shut off. They just, they just expect you to shut one aspect off and then go and become [00:39:00] father of the year when you're just trained to kill other people. That's what the military, a lot of killer be killed.

[00:39:06] Karen: That's what we're doing and then there wasn't a lot of support and they did have the transitional TSP transitional, so soldier program. I went to them many times and I said, Hey, I think I would be valuable in helping. But they just they, didn't, they had no idea, and so I saw a huge opportunity for OT because there was, there had been, OT was very, cuz it was contractor based PT was even more into like active duty type of com commission officers that were also they were active duty, but they were also working in these, certain roles.

[00:39:47] Karen: But OT had not really, they're starting to move into the actual active duty roles. More OTs are becoming present, and Baylor started an OTD program for active duty [00:40:00] basically. So anyways, so it became it became obvious that, and that's part of why I moved back, part of why I, started into a doctorate because I was creating programs that were having those effective outcomes that we were talking about.

[00:40:14] Karen: Whether it was going into the virtual gun fighter gym or to doing like a scavenger hunt throughout base that you gotta go to the grocery store and you have to make a list on any list and, use this app for that. And then you have to go set reminders to go pick up the laundry before you go home.

[00:40:33] Karen: And how, here's how to have a conversation with your wife about something that's been bothering you rather than so it was just, it was this wonderful kind of, Do you 

[00:40:41] Josie: think that like having, in some ways it sounds like you were doing very occupational work and you were doing some things that are probably like pretty similar to what Anna's doing now.

[00:40:52] Josie: Do you think that it's helpful to have some of the terminology and making some of the terminology explicit in a way that, [00:41:00] I'm wondering if that's something that I, if you guys resonate with this idea. That os gives us some permission to be really explicit. Yeah. About where the impact of our practice is happening in context.

[00:41:17] Josie: Because there's this notion that I hear in the states over and over again of that's what they do in Canada. That's what they do in Australia, that's what they do in the uk. It's just a different system here. We can't do it. Os is something for academia. It's not something for our clinicians. But what you were describing, Anna, in, in the context that you're working in, can you see Dr.

[00:41:42] Josie: Dwyer where we functionally can probably do the exact. Same things with the permission that OS can give us through home health, through the VA , Like as long as you have the words to describe it, there are the opportunities. Wouldn't you say [00:42:00] in the US to implement these practices? Cause you're, saying that you were doing these even before going to DR School, you just maybe didn't have the words to describe them.

[00:42:09] Karen: Yes, and that's, exactly the, that's exactly it because and, the VA is growing in some interesting ways where they have now OTs are in the homeless program the HUD VASH program, they're in the caregiver support. They're growing into those roles as well. And so the VA is our best example of a more.

[00:42:32] Karen: Standard, like a, more subsidized healthcare system. Like what, our socialized healthcare system. Like 

[00:42:38] Josie: what, And we already have a socialized healthcare system right. In the United States through the ba. We just maybe don't, that word isn't as welcome or embraced. And really it seems to me that even in the US a lot of OTs have found their home in traditional practice settings through publicly subsidized and regulated services infrastructure.

[00:42:59] Josie: In a way, [00:43:00] I think that's a total myth that like the US doesn't have the opportunities to use a public health lens on 

[00:43:07] Karen: occupational. It is super interesting too, because like that, was still when I first started into regular, private entities or whatever, is that there was this minimal medical necessity, do the most that you need to get the person to where they need to be.

[00:43:25] Karen: And that has shifted in all, not just ot, but that has shifted into where you're not really. Making those decisions. Like the surgery was the last resort, now it's one of the first and the medication was only if diet and lifestyle changes didn't, take hold. And now it's the first thing. And then we're trying to, 

[00:43:48] Josie: more opportunities for OT in the us perhaps would you credit OS literacy to seeing new niches, Niche niches, niche of [00:44:00] opportunity for occupation focused, occupation centered, occupation based practice in the US context?

[00:44:06] Josie: I'd be curious what you guys think too from a Canadian context or what dr. Burk being somebody that's been a culture broker across the borders. 

[00:44:15] Karen: Yeah, I'll, I don't know. I'll just quickly, I do, I think there's, I think there's a ton of opportunity for, to, for o OT practitioners to go out on their own in a similar fashion to what Anne is doing to do, nothing but straight up.

[00:44:34] Karen: Occupation focus, like taking, like you said, taking someone's whole day and just figuring out and it's even just, I I've, got, I've niche off of that a couple of different ways, like with the PTSD service dogs and I. I have my own and I'm now wor working on a process to help other people self train their own and, under you have to understand the ADA too and, what they say about service dogs.

[00:44:59] Karen: And there's a lot of [00:45:00] misconceptions even with OT world. So there's, an infinite and I've worked a little bit with the sex trafficking survivors and those other kind of things too. It almost 

[00:45:10] Josie: seems os gives us some containers to better contextualize that work, which I wonder, Dr.

[00:45:16] Josie: Burk, are you starting to see through the evolutions of contemporary practice and more os literacy across so many different countries, are you starting to see evidence of that framework that you were craving for in your bachelor's degree? Now, do you think, have you gotten a chance to see this tree of Os grow?

[00:45:38] Josie: And are you also has, how has os. Given you, has os enriched your future vision from OT after getting exposed to it? I'm wondering Dr. Burk? Yeah, 

[00:45:52] Susan: I definitely, I mean I, most of the exciting stuff for me now as a retired [00:46:00] academic and, I live on Pender Island, so we're really close and we'll have to get together sometime cause I talk to you about your work.

[00:46:08] Susan: I actually did some supervision of students working at a place called Vet's Garage in, in Spokane, which is like a men's shed kind of movement. A a, garage with all sorts of cool tools and things to make and working with vets with ptsd sorry side, stepped.

[00:46:28] Susan: So, yeah I think everything that I find exciting about OT is now, can now be described using. The constructs of Os. So that was 

[00:46:46] Josie: just like, Karen, you were maybe doing some of this work before too. Like it was stuff that was on your mind and what you were doing, but there was a loss of the language to describe it, [00:47:00] or the guidance or a framework in how to utilize it in a bureaucratic or a policy st.

[00:47:07] Josie: Did you feel like that was missing in a way? I, might be projecting my own experience. Yes. But I feel like that there's, I'm wondering like, through this being more visible are, you also validated Dr. Boash too and some of your previous work that you were doing, but now you have some language to utilize Sorry if Yeah.

[00:47:28] Josie: Yeah. 

[00:47:28] Susan: Absolutely. I some of, when I was doing my master's degree, I was supervising students who were out in these role emerging settings, and I didn't at that point necessarily have the language to talk about the fact that we were trying to work with occupational apartheid, et cetera, et cetera, et cetera.

[00:47:50] Susan: And having that language now helps me. Frame what I'm doing. And I think language, as you said, Josie, is really, [00:48:00] important. Being able to articulate that 

[00:48:04] Josie: it's visible in a way, or even much more ability to be celebrated in the system. It's unfortunately, I think in both the cultural context that we're in.

[00:48:14] Josie: Words carry a lot of weight. And, in a way that is a lot of, at least in my context as an occupational therapist lately, it's the documentation, right? It's what's reimbursed, how we put to words and how we contextualize our work scientifically is where a lot of the policy leverage can be in wherever you're navigating these nuances of practice and how we try to wield this power that we have with the most responsibility, with the highest ethical standards and hopefully with offering a constructive, transformative experience.

[00:48:49] Josie: That's my angle as continuing to carry the title as an occupational therapist in the United States, and hopefully an applied occupational scientist. [00:49:00] This is creating these terms and being part of this lineage here. Having the words to describe it is, A way that we can hopefully move forward in an empowered fashion in the systems that we work in.

[00:49:16] Josie: But it in no way negates. I think that a lot of the power of the work that OT has offered for over a century now, and that people from all over the world have offered as occupational beings or even words that we can't understand often. This work is not describable, it's wordless, and it emerges in a wordless fashion.

[00:49:40] Josie: And that, I think, has been a systemic disadvantage to ot. And the qualitative demand is, it resists being described particularly in a left brain way, . And it, the qualitative domain is tricky. It shifts, it can change on a dime, and it's [00:50:00] rapidly evolving. So to be part of a field that acknowledges the power of that, it comes with a paradox that it resists being nailed down described.

[00:50:11] Josie: And I think that's been a challenge that OT has had throughout its progression and a variety of different systems. Yeah. To me os makes that explicit and describes that we are deciding to wrestle with the indescribable and we are asserting that it has a measurable and functional difference when we wield it with intention.

[00:50:35] Josie: And so I think that, yeah. I was 

[00:50:39] Karen: just gonna add to that the ambiguity of o OT and, os and whatever for forever. It's I mean we had this whole semester learning how to tell people what we do it's that was the crux of the class was just defining it for ourselves and defining, so I think when I start and then it's like skills for the [00:51:00] job of living and it's like you expect to know what people what you mean by that. And and so I think when I was going through what I was learning about occupational science, much into my career. And then I was, at first I was like, Okay, this is a little bit woo But but then when occupational justice and when that really like occupational deprivation, that was what really anchored it in for me was that because that has, that is what I centered my whole first part of my career, working in the nursing homes, occupational deprivation apartheid, all that kind of stuff, was very, 

[00:51:41] Josie: oh my gosh, what were, seeing.

[00:51:42] Josie: It was what you were experiencing, just cuz you didn't have the word for it, didn't mean it wasn't there or it wasn't what you were doing as a clinician in that space or attempting to address, yeah. 

[00:51:53] Karen: And then you take something like a pandemic and that just further puts a big spotlight [00:52:00] on what was already a problem.

[00:52:02] Karen: It was already a major problem. How we were depriving and isolating and whatever beforehand, but to have. And, the work that we were all doing without maybe knowing it. But then I think really OT came into. Kind of its own through this whole thing. I've just seen some amazing stuff. I've done some amazing stuff that I was like, I think you're starting an 

[00:52:24] Josie: invitation.

[00:52:25] Josie: I think there's an invitation that we can bravely, One of the narratives I got to share with Dr. Burk is I think that occupational therapy as a discipline has always been transformed and shaped by overly daring and undereducated women. There's been in particular, and really we need to also broaden that definition and there's a current invitation, especially from OS for us to.

[00:52:50] Josie: Broadened who is included in our science, in our profession, and that is part of the a o T 2025 vision is it needs to be more than just [00:53:00] in the US It's about 80% now ed, women of resource privilege and education that happen to be Caucasian and of like settler descent in the places that we practice. So that is an invitation that we have to broaden our science.

[00:53:14] Josie: I, think I, I'm I employed to say that I think what I love about occupational science personally is that we, it's not new for us that we, that there's ambiguity around what OT is and what OT does. I think when you truly embrace the invitation that occupational science offers is it lets us understand that ambiguity is actually where our power is in the scientific context.

[00:53:41] Josie: To declare a false sense of certainty about something that is constantly evolving and that you are co-creating with your clients, which is what I've heard from your work, Anna. It's like you're inviting your clients in to decide also what these words mean for themselves and maybe even to have other ways that [00:54:00] they're contextualizing their experience.

[00:54:02] Josie: Os makes explicit that there is a therapeutic power in that and OT makes that, that there's a therapeutic power in being able to have an active relationship and evolving your reality through occupation. So I, wanna, I'm hoping that this course and letting more people know what these words are and to start playing with them and maybe even developing their own words, and to realize that you as an ot, whether you're an OTA or a bachelor's level ot or even just a perspective OT student taking this course because you were an occupational being, and maybe even other words that better will elucidate what that is.

[00:54:42] Josie: You are actually actively, already have been engaging in occupational science and these things and then it's, gonna be an actively evolving conversation. It's not gonna be a fixed, rigid, declarative statement about what something is and, that this is [00:55:00] actually, I think, sorry, I'm just babbling at this point, but we are part of OS gives us an opportunity for this to be an evolving conversation rather than a fixed and rigid conversation.

[00:55:10] Josie: And that's actually what makes the potential transformative and therapeutic. We're not pretending to be certain about something that we don't even know yet. Does that make sense? Yeah. 

[00:55:21] Anna: And I think echoing your point what, I try to do with clients, like I'm trained in acceptance and commitment therapy and I really use that as a bridge to bring in the OS concepts and we look at them together as as occupational scientists.

[00:55:35] Anna: There's this podcast I quake U on OT and chill with Michael Si and anyone can be an occupational scientist. Everybody to be, 

[00:55:44] Josie: Cause other ways we don't know the qualitative domain. You, have to, that's where the data is, with folks that are untrained. You can't be trained in it. You actually have to untrain yourself to be open to this work.

[00:55:57] Anna: Yeah. So we look at it so with [00:56:00] client, oh look at it together. Like one client, like this is my model of occupations. He's I have my passions, fitness, food, fashion projects. And there's two more I can't remember right now, but that was what he wanted. His like balance between in his life. Not like self care, like self us kinda old conversations now, but like that.

[00:56:20] Anna: This is what I want my model of occupations in my life to look like and making it together and co-constructing that and like bringing in occupational beings like os it helps us to really label what's happening in the context. And it also helps us describe that to funders. So it allows us to all to connect as occupational beings.

[00:56:40] Anna: There's human beings. Cause I comment on your report, This person's experiencing this, I'll actually use some OS language. And they're like, this makes so much sense. Like the other day I got a call from a funder. She's Anna, I love your report. I could see exactly what's going on to this person. And like I basically used OS language.

[00:56:57] Anna: I had used the C O P M as my main [00:57:00] standardized tool, but the whole clinical entry, like this is what's going on. This person, this is what we call occupational deprivation, what we call occupational, like these are the transitions that are happening. This is like these grief factors influencing this, her mental health.

[00:57:14] Anna: This is what we need to. So gives us that language. 

[00:57:18] Josie: Stakeholders. I love that you bring in like a very tangible, practical element of the funders, because I would say in the US that I'm gonna again I, am assuming, I think that there is a collective trauma from this PPS that happened in the nineties that.

[00:57:37] Josie: Gotten this automatic like fear and apprehension around funders and the sense of doing occupation based practice. There's a sense of it being stigmatized in the us and we're fearful that it's gonna be all taken away. The rig rug underneath you. And I, think almost in that way, having that framing around what happened in the past is preventing us from [00:58:00] seeing current and future opportunities.

[00:58:02] Josie: I remember my mind being blown when Dr. Burk invited Gil Whiteford to come speak to us as master students at Eastern Washington University. And I believe it was around a time where she was initially proposing her occupational justice framework and she had just published one of the new. Books and it was really looking at working with, I think their parliamentary system at the time and at the end she mentioned that it was coming from the context of I think of a 25 million grant she got.

[00:58:35] Josie: In terms of facilitating like a lot of aboriginal reconciliation work through an occupational justice lens. And that to me, Broke all of the mis, all the conceptions that I had in the US that you can't ever get paid to do work this transformative. And now it's been about [00:59:00] eight, eight or nine years since I had that experience with Dr.

[00:59:04] Josie: Burk facilitating that. And we're starting to see those grants come to the US through community social determinants of health, increased funding in public health financing, looking at diversity, equity, justice, inclusion. These are actually becoming finance conversations and research here in the us. But I think we still have blinders on.

[00:59:29] Josie: That we think we're not allowed to receive financial opportunities in this way or to build businesses from this foundation. So I, guess I'm wanting to share that os has expanded my ability to see practically what's possible and financially what's possible. And also making policy visible. Because that's one of the myths that I hate so much, is that OT doesn't have anything to do with policy.

[00:59:52] Josie: And we're apolitical while we spend all of our day talking to the insurance companies interpreting Medicare and special [01:00:00] education law and navigating the financial disparities. And it's just mind blowing. So I love that os gives me permission to acknowledge this reality. And I 

[01:00:09] Karen: think we need to start claiming it a little bit more.

[01:00:14] Karen: That's a I feel like my generation and, maybe previous too, like we. We got to happily for the first half of my, I just happily got to do what I felt was best and, yeah, there was always demand. And I, think the collective trauma is more how people corrupted the PPPs system cuz it was actually, Medicare's always pretty much done us a solid since they initiated that.

[01:00:41] Karen: There's lots of areas that are reimbursed and, but they, just, they took that system and they, just corrupted it to the point where they, saw the money and then when you go from a 70% productivity to a a 95% productivity expectation in [01:01:00] the span of 10 years, it's just it's ridiculous.

[01:01:03] Karen: And on top of that, it's very stamped out. Keep 'em a hundred days that that's, what got to be the it's just, you lost the individualization and then, and it's no longer, it got no longer celebrated. When I can help. A 92 year old, they bake her five dozen cookies again without totally guessing herself out for the rest of the day because of her C O P D and whatnot.

[01:01:24] Karen: That's how come we stopped, like highlighting that, but yet OT teach or PT teachers are how to get into the car and they're like, we're champions of the year. 

[01:01:35] Josie: That's part of where I would say having the loss of an o. Formed education, OT education system in the us. So some of the context that maybe you, Anna and Susan are aware of the W F O T, the World Federation of OT actually requires occupational science to be included in OT education across the different credentialing accreditation [01:02:00] boards.

[01:02:00] Josie: However, the US has been for some reason somewhat resistant to the inclusion of occupational science embedded in OT education. And what I feel after being like exposed to OS post OT career I got a little bit cuz of professors like Dr. Burk that was really mindful incorporating it throughout some of our, especially our mental health based programs and qualitative methodologies.

[01:02:30] Josie: But overall, I would say it was maybe less than 10% of my OT education at the time. However, getting to be exposed to it in my post professional doctorate. What I love about OS and acknowledging the policy domain in the context of occupation, in the context of occupational therapy services, that really gives you more permission as an OT to use more of a policy lens and to check down where the incentives are and where the actual documented evidence [01:03:00] actually is I like what you said, Karen, about some of this seems to be misinformation and how the system has been corrupted.

[01:03:07] Josie: Because if you go straight to Medicare and read those requirements, it's very different than how they're getting interpreted . And I feel like if We're able to translate an OS lens to clinicians on the field and give them the tools to figure out where the incentives are to do grounded theory to follow the money, quote unquote, and see where it's getting diverted from our core attention.

[01:03:29] Josie: And to have that framework like Dr. Burk brought up, like now we have the words to contextualize what we're doing in the context of the policies and the systems we're navigating in, I think we will be less easily swayed and potentially manipulated away from our core identity. Yeah. As a profession and a lot of our ethical and professional commitments to really play a role that can actually help constructively transform these systems around us, rather than potentially being [01:04:00] used in these systems in ways that could propagate harm.

[01:04:04] Susan: One thing that I think about is in terms of languages, using the language of os, we're never going to be mistaken for PTs. It's a completely different language. It's a completely different focus. It lands on the ears of different people too than using a biomedical lang languages does. And some of those people particularly thinking about covid and, public health they, are using very similar types of language.

[01:04:37] Susan: So who, your discourse draws in I think is also another interesting thing to look, at and capitalize on 

[01:04:48] Josie: to get your perspective. Dr. Burk was like as a, oh, sorry. One second to, I will divert right back to Anna on this because I think you both could comment on this. I'm curious about being trained in [01:05:00] a qualitative tradition now that it's trendy to look at social determinants of health and a public health mindset or qualitative.

[01:05:09] Josie: I was wondering if you could speak to the gift that OS has brought us about taking qualitative inquiries seriously for the past 30 years and how I think in a way there you're seeing a lot more of the biomedical model now, like paying somewhat like lip service to the qualitative domain.

[01:05:27] Josie: And I think it's such an asset that os gives us 30 years of taking qualitative inquiry seriously. And then I wanna divert to Anna, please say what you want and we can go back to that point later on if you want. , 

[01:05:39] Anna: I wanted to say that bringing like also clients like. Along someone lines, what Susan was saying, it can be really validating and and help them process like from a mental health perspective, like what their experience.

[01:05:54] Anna: So in my presentation, which Josie shared with you, so last summer, this is a client who's [01:06:00] more philosophical and wanted to know what's this being, what's that? And that kinda thing. And he's occupational disruption, if that's a thing. If the university is studying, a lot of people must be experiencing it.

[01:06:11] Anna: So then I'm not alone in experience. So having that like compassion, self compassion for where he's at, os can also bring in that way. 

[01:06:20] Josie: So I think that the, Sorry, let's see. I think that's, so I guess that's maybe I wanna invite you guys to come on this and maybe it's just something I'm enthusiastic to embrace is just, I love that OS takes the qualitative seriously and it validates.

[01:06:38] Josie: The lived experience of our clients and how they feel inclined to frame it without being dismissive of it, because it doesn't fit one of the preordained boxes. And so I do I am curious because I, you, Dr. Burk, you've dedicated a good portion of your career at this point [01:07:00] in becoming a skilled practitioner of narrative inquiry, which is something that I'm hoping to invite others to pursue looking at.

[01:07:09] Josie: But do you, can you comment a little bit about, Cuz because in the US we have such a stigma on the qualitative. Domain, How has that changed for you, like being able to use a qualitative lens through your OT practice and as a scholar? 

[01:07:25] Susan: Yeah. I, my, my master's degree, which was in the late eighties my supervisor was an epidemiologist and, but one of our instructors was Laura Crafting, who was one of the very first people OTs to PR to publish on qualitative methods.

[01:07:48] Susan: She'd done a double PhD at Arizona in rehab science in anthropology. So she was coming at this with an anthropology and a disability studies lens. [01:08:00] So it was a very challenging thing to do to try and incorporate some qualitative elements into my master's thesis. It was, Quite challenging because there wasn't really knowledge or support for it.

[01:08:19] Susan: By the time I did my PhD and I graduated with my PhD the day after I turned 60, there was much more acceptance of qualitative approaches, but there was very little knowledge of narrative inquiry as one of those, and so again, I was doing something that was very new. My, my actual, my PhD supervisor was very supportive, but she.

[01:08:50] Susan: Lived in another part of the qualitative research landscape than I wanted to operate in. So I was very, lucky to have Jean Cland in and come in [01:09:00] and, co-supervise me informally, because otherwise I would've had a really hard time. Did that 

[01:09:07] Josie: shift then over your career trajectory of starting it sounds like you're really a trailblazer in a way, in helping OT and os like really explore a narrative in Corey lens now, in our, I think there's six different classes of clinical reasoning that are embraced and one of them is narrative reasoning.

[01:09:27] Josie: Has that been a new development since you started that work? That 

[01:09:31] Susan: was, that started with Mattingly and flaming, so again, an anthropologist and an OT working together and their pioneering work on study, very well funded study for the time on looking at how OTs think. And so that again, has been a, thread that.

[01:09:49] Susan: Started in the, I'm guessing in the mid eighties as well, and 

[01:09:57] Josie: now as a clinician, I'm appealing [01:10:00] to your work and OSS embrace of the qualitative domain. Even if when I was working in something we have in common, Anna is doing TIC orthopedic surgeries, which I fully embraced as more of a mental health OT because it's incredibly terrifying to go under for a major life transformative procedure.

[01:10:21] Josie: And I found that having a sensory lens and helping with the emotional regulation and the transformation, I had zero issues differentiating my services from pt. It's actually one of the most symbiotic collaborations I've had working with physical therapy in, an or. Context because honestly everyone gets joint replacements.

[01:10:41] Josie: I worked with a lot of people with cerebral palsy, autism in that regard, so I got to bring that whole lens. So I, maybe I'm just wanting to owe a debt of gratitude to you, Dr. Burk, for investing in that work because I think caring in this notion that qualitative work has its own rigor and its own [01:11:00] sensitivities and its own need to have a regulated.

[01:11:04] Josie: Modulation of, I think that's gonna give OT a strategic advantage going into these next waves of development, of social infrastructure across the globe. I'm just so grateful to everyone involved in OS and OT that dared to take qualitative inquiry and parts of understanding humans seriously for so long.

[01:11:26] Josie: Really quickly, I know Dr. Dwyer really quickly, but you, I think you, you experimented too with the qualitative domain in your capstone work that looked at occupational justice and sort of the COC occupation of pet ownership for older adults. Yeah, it was it was 

[01:11:43] Karen: more so I did an occupation based, I was, I called it the PALS program, which is Pet's, Alleviating Loneliness and Seniors.

[01:11:52] Karen: And this came about very, organically during the lockdown phase when I was and even [01:12:00] into the following year because I, had to switch from what I had planned to do for my capstone work. And then I, started by noticing that people they might have been afraid of other people or not going outta their house.

[01:12:12] Karen: And I, noticed, I live in a very where there's a lot of older adults, so I started noticing that. And, doing more research on it. Animal anything has almost a hundred percent buy in by any given population. And there and then as that developed where I started looking at seniors who are living alone experiencing loneliness.

[01:12:34] Karen: And so social isolation as a co the results of the UCLA loneliness scale. And then actually having little treatment sessions where I would bring my dog over, they would feed him treats. We made dog treats. We had all this, it just expanded past anything I could have ever imagined.

[01:12:54] Karen: And then the whole thing went under an occupational justice framework, which there's not been a lot [01:13:00] of, of, the OJ done on not much applied 

[01:13:05] Josie: research on that. You're a 

[01:13:06] Karen: trailblazer. I older adults on social isolation, on lonely, on any of that. And then here it was put into the spotlight as a gaping hole of because a lot of people just were so marginalized by different lockdown measures.

[01:13:25] Karen: And so it, it was, and it was, I had tremendous results. And even we're looking forward to, and concepts that I better understand because of occupational science, because I, I had one that her dog had died the previous year, and she was like thinking she didn't wanna get another dog, but then she was like maybe I could be a pet sitter.

[01:13:44] Karen: Maybe I could watch Oscar when you're away, or like whatever the case may be. And then and then another person was like and they got to relive memories about when they had pets and they just maybe even walking someone else's dog [01:14:00] for them or walking with them while they're walking the dog.

[01:14:03] Karen: They went on dog walks with me and it was just like, all this stuff I had never even thought of. I was thinking, Oh, they could feed treats like a bathing him like just different kind of stuff like that. And so it was, or just even looking at him holding reminiscing this, all this wonderful stuff came out and I had tremendous results with my pre and post loneliness scale.

[01:14:23] Josie: Do you mind if I just bring up for the group here? You and I just took one class on occupational science. Neither one of, We were both, I have a master's degree in occupational therapy. And you had a bachelor's degree in occupational therapy. We both took one semester online course, like one sort of discussion post a week.

[01:14:46] Josie: Yep. And now here we are, like a year or two later, just feeling really empowered to imagine these different roles that we can take our practice. Neither you and I we didn't go to usc, we didn't go to [01:15:00] Western. We didn't go and follow somebody in Australia. We have permission to do this work. Now Anna, too.

[01:15:11] Josie: You're not thinking, Oh, I gotta wait and go get this degree and go do this before I can do it. We're all, and we're also acknowledging, we've always done this 

[01:15:20] Karen: work too. It was also very empowering too. Cause I did a focus group with OTs and most of the, that worked with older adults or in animal assisted therapy.

[01:15:28] Karen: And most all of them had, were more experienced, mostly boom or age. They had never heard of it either. They had never heard of occupational justice, occupational science. They, some of them didn't even know we had a code ethics or an ot p 

[01:15:41] Josie: f. Now you just need to hear a bit and now everybody on this journey hopefully, and here you now, hopefully everybody that's taking this course, you got four allies that's cheerleading you on to just learn this language.

[01:15:53] Josie: Like to know that you've actually have been applying these concepts without the words for it, maybe for decades. [01:16:00] And 

[01:16:00] Karen: look around take a, look around at what you're just in your current practice, in your daily life. That was my neighbors. I just, from my OT perspective and then my OTD work with, OS and, other aspects of my OTD work, I was able to identify a gaping need and apply a kind of a innovative way to.

[01:16:26] Karen: To solve an issue 

[01:16:28] Josie: you didn't even really need to get fully published or funding to do it. You made, So that's my goal is I want all of us, like Dr. Dwyer and I, we just took one OS course. You guys all are about to take one OS course. You just gotta need to get an idea of what the words are.

[01:16:46] Josie: And by the way, these words are rapidly still evolving as we get to know more, especially about the qualitative domain. Part of my intention and what I hoped us all as sort of role models for you guys and peer mentors that we're going through this together, were [01:17:00] clinicians just like you and, by the way, this is gonna evolve beyond our understanding of.

[01:17:05] Josie: In the years to come. This is a conversation. This is a table that you get to be a part of as a human being, as an occupational being, but certainly as a practitioner, as an ota, an OT student, and a bachelor's level ot, your master's level ot, you just need, you get to know the words, get to join this conversation and this dance, and be a part of evolving this rapidly evolving world that we're a part of.

[01:17:30] Josie: This is nothing special just because we got to be in a course, in a fancy building and hear from these people. You're just as capable of learning these words and translating them in the context that you've already been living, and you very much could be the thing that offers a new concept that could really totally transform how we understand occupation in a way of feeling this.

[01:17:55] Josie: So I, I just wanted to take the opportunity before, I know you had to step off soon. Dr. [01:18:00] Dwyer, just to contextualize, you started as like bachelor's level OT post nineties. Yep. And not thinking, you said I'm the most resistant to OS and occupational justice did not really, These did not, they just sounded like abstract terms and like propaganda and social justice woke rhetoric.

[01:18:19] Josie: I don't need to say if that could have been something. But then you just danced with them a little bit, even of a couple months and it ended up now just totally making. Texturizing your work in a different way. And 

[01:18:32] Karen: yeah. And also just putting it into a framework or a model of practice and finding those different theories and, really delving into that.

[01:18:41] Karen: That was something that was just coming out. And then once you get into real world getting, through your day and you have this pro, you have this patient list and you have it's like that's something that kind of happens on the on your spare time where you might read a study, but you don't even know how to look for studies or look for [01:19:00] other people.

[01:19:00] Karen: This world is in 

[01:19:02] Josie: sense it's a lens. You can do it while you're there. You can be like, what is this policy and where did it stand? And that person's an occupational being, maybe they're getting maybe they're feeling burned out because they had a major occupational disruption and now is like this field research that you can do all the time just by having this lens of looking at your own context that way.

[01:19:22] Josie: And I realized 

[01:19:23] Karen: I had been doing it all along I had been doing it all along without having the official academia, like the and the discipline of knowing how to fully develop and flush out these kind of things. So that's the real power of something like this. And, when you're if, you're looking around seeing something and it's but nobody's ever done that, or No we other people don't know much about it, that's your opportunity.

[01:19:50] Karen: Like even something small just if you see something, you're looking at it from your, [01:20:00] Occupational lens and that is something we need people to break from this sort of, this mainstream plan of care stamped out, railroaded sort of treatment and clinical practice that I see happening.

[01:20:15] Karen: We so lucky. 

[01:20:16] Josie: I feel like we're so lucky that we have os that gives us this little hack that this whole time we have a, spark of being somewhat critical of the over standardization of the human experience. Yes. I've seen that as being a defiant little strain of all OTs and os academics this whole time is but what if it's a nonstandard path?

[01:20:41] Josie: Like what, if you don't fit in these boxes? What are we going to do? Yeah. Exactly. You can answer that. Is there anything else you'd like to say, Dr. Dwyer, before you need to step off? 

[01:20:53] Karen: No. I really appreciate being a part of this conversation, and I think just, I hope, hopefully that [01:21:00] this has empowered anyone who's watching it to feel emboldened and you keep 

[01:21:06] Josie: going.

[01:21:06] Josie: It's not gonna end the conversation. Yeah. Just 

[01:21:09] Karen: because you may not be getting a lot of we're the unsung heroes in, a lot of. In almost every situation I've been a part of as an ot. And so I think that's really having a few more tools in your toolbox to better define and guide is just, is really 

[01:21:26] Josie: awesome.

[01:21:26] Josie: Making our work visible to ourselves and we get to have sort of our own conversation about what this looks like and that we already have colleagues internationally that have developed this for decades at this point. Thank you to everyone that's been a part of this conversation and if you need to step off Dr.

[01:21:42] Josie: Dwyer, feel free and I would like to invite the other two to also share any reflection that they feel inspired to impart to the students that are just getting this I think lush opportunity to get exposed to OS concepts for the first time. Thank you so much too for you guys's patience and [01:22:00] investment in this conversation so far.

[01:22:02] Josie: I think I Dr. Burk, I wanna honor just how much you've been a trail raiser in the relation to narrative inquiry and carving that road for OTs to go down this pathway here. And, I think you're, already just showing us what's possible through the demonstration of doing, of applying these concept.

[01:22:21] Josie: In a practice model and even sometimes not waiting to get permission . I guess that's the thing that I feel like OS gives me permission to provide OT explicitly. And just from that, I'm curious if you guys have any thoughts that you wanna share what your sort of wishes are for OTs that have never been exposed to os, What do you hope awaits for them or what have you found to be really meaningful and how is it like, if you also wanna comment on how outside of systems and clients, how has it transformed your understanding of yourself and your own life trajectory too?

[01:22:56] Josie: I think that's a richness of OS that hasn't been fully fleshed out in this [01:23:00] conversation at least. But, sorry, it's too much. I'm so bad at doing just the declarative, convers. 

[01:23:05] Susan: I just wanna say that I, really hope that people taking this course really do feel both supported in what they're already doing and embolden to do more and to, say more because again, you don't know who's listening.

[01:23:25] Susan: And if you use a language that resonates, say with an economist or a public health person, or people outside of the traditional environments that we tend to operate in, you never know what responses you're getting. So, I would say boldly go forward knowing that you have an academic foundation that has your back in occupational science 

[01:23:55] Josie: years of development.

[01:23:56] Josie: I'm, a little bit defensive lately of people saying [01:24:00] that OS is in its infancy. Which I, just contest to that depending on what the definitions are that are being appealed to, but even in its most al state, it's undergone 30 years of active and practical development, especially internationally. It is a perspective to take seriously in a variety of different contexts, especially theoretically.

[01:24:26] Josie: Sorry to dismiss that one, but Jess, I wanna affirm not only do you have a science that has your backing as an OTP in the US and beyond, it's one with three rich decades of robust development now internationally. So don't let anybody dismiss this. Just because it's more theoretical and sometimes abstract or qualitative doesn't mean that it's not just as serious.

[01:24:48] Josie: Sorry to cut you off, Dr. 

[01:24:50] Anna: Susan, did you wanna say anything else? No, I'm good. Okay. Yeah, I think reflecting on the question, I have a couple things to say, but fucking first on the question [01:25:00] of how us is gonna change my view on like me as an occupational being and like where I go it's, 

[01:25:06] Josie: I 

[01:25:06] Anna: came into OT with a bit of a, kinda like I, I was kinda felt like I was like born to be an ot, didn't discover what OT was until my fourth year of my undergrad.

[01:25:16] Anna: But when I learned what it was like that is like the definition is my dream career. That is what it is. I came in af 10 i a book by disability rights activist came called of nature as a summer camp leader at the time is about ableism and a whole bunch of really balanced stuff that happened at summer camp.

[01:25:36] Anna: Kinda fictional, a little semi autobiographical. So that was what led me towards the path of what can I do to work people so that everyone in our world, we can do things that matter to us and that fill our souls can connect in community. And since. Learning about os also encouraged me to look more at say like [01:26:00] critical race studies and like Johnson Valley's paper, like I a Canadian, I have American ancestors, but I hadn't I didn't learn much about racism in America until that paper.

[01:26:13] Anna: So I knew stuff about racism in America, but I learned a lot more of the history of it in that paper. So it's okay, I need to go look into more into this. Or I, is a paper, Okay, I need to go look into more, into this from say disability justice say from like, postcolonial feminism.

[01:26:30] Anna: Like just getting more connection in different communities and just learning, this is an academia, but then stepping out of academia and connecting in community. And just I guess becoming more of an activist . 

[01:26:45] Josie: So you find I'm curious though, I tracking some of the conversations, especially in the US.

[01:26:51] Josie: Often those thinkers and that gets side, it's really perplexing to me. It gets side as being [01:27:00] more abstract and philosophical. But what I'm taking from what you're saying is it's actually incredibly pragmatic, I think, and I, acknowledge I use a very large vocabulary, which is gonna be something I struggle with in this course too.

[01:27:15] Josie: Cause it might not be the most accessible. So this is probably just the first iteration of this course will make it more accessible over time. But from what I'm hearing from you is that you're hearing it and you're getting visibility around ways that systems haven't been designed to support everyone in their occupational wellbeing.

[01:27:31] Josie: You're able to take that information in a public's ivy, leave ivory tower somewhere, , Yeah. But then to contemplate it and reflect on it and think about what, that means for you and the concepts that you're in. And then, broadening that lens and looking at your clients and imagining their occupational realities and maybe imagining new possibilities that this, maybe was a system or these are the tendencies in the past, but maybe we can be [01:28:00] critical of these systems, or maybe we can imagine new systems and maybe we can build communities to change the experience of these systems so that they actually have a little bit more equitable empowerment, maybe more occupational wellbeing.

[01:28:14] Josie: Like I, I'm, you're going from like an Ivy League tower published article to actually a process that's pretty grounded and pretty practically 

[01:28:23] Anna: applicable. I'd say it's more even outside my OT work, it's just more connecting with people in community and be like, What could this world be look, like? So it's more of us experience belonging.

[01:28:33] Anna: What could it be more like, So more of us are connecting and doing together? What? What could that look like? I say beyond, yeah, Dancing 

[01:28:41] Josie: with the unknown and letting there be new possibilities in some ways. And that's to go back to that other point, which I hope can reverberate is the opportunity that comes from claiming ambiguity.

[01:28:55] Josie: Like we're so used to framing ambiguity and not having definitive [01:29:00] terms in OT os as a weakness, as a fundamental flaw in the context of OT and os. Yet I think when you really dance with these concepts, I think it's possibly our most strategic strength and in a, I think positions os in an academic context as one of the more honest sciences.

[01:29:25] Josie: In my mind and that, just might be my own personal framing. But where I was trained, in the hard sciences and undergrad prior to becoming an ot. And so OT in a way has been a way for me to get more epistemic balance in my initial education in honoring the qualitative and seeing how these two parts of the universe connect with each other.

[01:29:51] Josie: But I guess what I wanna express with that is sometimes I, when I was trained in the hard sciences, even in the hardest [01:30:00] of sciences that I got trained in, science and certainty don't really go hand in hand. If you're following an integrity in a scientific process, in a peer reductionist and deductive framework, it will maybe give you something predictable that can be reliable in a controlled.

[01:30:18] Josie: Context over rhythmic time, but it's still just resists falsification. It never really will grant you a certain, the declarative stance about how the universe functions and works. It can just be your best. Yes. From that training, I've always had a lot of cognitive dissonance around this notion that science is supposed to give you a certain black and white.

[01:30:42] Josie: This is the truth answer, and what I love about OS is it's honest that it's not gonna ever really give you. A solid declarative answer both in the physical world and in the qualitative world. And I think we may be [01:31:00] one of the only social sciences and hard sciences discipline that is actually honest about that to this day personally.

[01:31:08] Josie: And maybe I'm overly gloating about os, but I think it's a beautiful thing to know that there are things that are currently unknown. Yeah, I think 

[01:31:19] Anna: it really, that's what OS points out to me is it shows me, oh, this is another thing I dunno about. Like this is another thing I don't know about. And I will have a little bit of a cautions, like with the community connection part that I don't do my OT role.

[01:31:31] Anna: It's just like OS is just oh point, okay. Like how can I be better given my communities? There are some communities space I, shouldn't enter as a white woman. Cause then doing that would be harmful. So also respecting those. Is also important. The other piece I wanted to bring forward is as a clinician, I come from background where I'm, My family's pretty linguistic.

[01:31:51] Anna: I'm pretty good at learning words and understanding what they need, that kinda thing. But a lot of clinicians like I don't understand this at all. What is this? And [01:32:00] what I found really helpful is if I email the first author of the paper, like we can start these conversations and just like it builds that connection, which can help learning and learning for everyone in that conversation.

[01:32:13] Anna: So it's okay not know we're all humans. We're all humans. Just reach out and connect. And sometimes people won't respond. That's that's sometimes you will. And it starts with like beautiful relationships and just like learning, shared learning. 

[01:32:29] Josie: And then everybody that goes through this course, there's a community element.

[01:32:33] Josie: So even if you're not connecting with the authors, but you find other people that are inspired by these concepts or you wanna explore other concepts, that is one of the beautiful things about os. And I wanted to also harken back to Susan's point about interdisciplinary, which is a, really amazing gift that OS offers us.

[01:32:51] Josie: The notion of OS being a basic science, and we'll go over this in future modules, means that you're also allowed to think about and explore these [01:33:00] concepts totally separate from practice. You get to do a work life balance. Separation at times with OS doesn't mean you always have to have your OT cap on and you don't always have to be thinking about the bureaucratic barriers and how things are divided at your practice between physical therapy, social work, and ot with os.

[01:33:21] Josie: You just get to dive into a nice little fun theory pool and contemplate about what these things mean on your own terms. And wait, do we have either of you gotten to delve into OS in that way? Separated, Yeah. From OT entirely? Yeah, 

[01:33:38] Anna: totally. Like I think about the world and what again, I, it does happen in the civilian, like my profession looking at civilian contexts.

[01:33:45] Anna: But I also need to know what does a civilian, like what does life look like in Victoria? How are these different forces operating, like kind pairing, looking at OS concepts and how does that play out in life here? How does it relate? Does it fit, does it not fit? [01:34:00] Just having, maybe you 

[01:34:01] Josie: get to do this as a lifelong learner too, outside of academia.

[01:34:06] Josie: Yeah. In a way. Yeah, totally. 

[01:34:09] Anna: I see like a PhD in my future, but I'm also like, I don't wanna go do that until I'm 50, 55, 60, because I really love clinical work. But until then I'm gonna be kinda off the side looking and reading and like thinking and what am I really interested in? What do I wanna focus on and what like in relation to my community and the communities I'm part of 

[01:34:32] Josie: and connected with.

[01:34:33] Josie: What I'm imagining for some folks that maybe take this course is maybe it's been a long time, maybe it's been 12 years since they were anything close in an academic setting, or maybe they didn't get an opportunity to engage with these questions, or there's classically this notion of I don't want theory, I hate theory, I just wanna focus on practice.

[01:34:54] Josie: Theory. Or maybe it was just never something they got invited into. [01:35:00] I would love like Dr. Bro's. Thoughts on this, because you were bringing up that your OT education didn't really cover many theoretical parts of it, and it was something that you ended up exploring as a clinician and as a post grad, and somehow you found your way into these conversations as a potentially humble, newish grad

[01:35:22] Josie: You said you graduated in 79, so some of these threads you picked up on in even the mid eighties. So before os even developed what, guidance would you have for field clinicians where it's been a long time since they've been in, or maybe they don't see themselves having any relation to theory at all?

[01:35:42] Josie: How how has it created richness into your life and how, could, how can we create a sense where they know that? This is something they're allowed to do. It is an open, warm pool for them to swim in. I don't know how to frame the conversation, but I know you are a great exemplar of a lifelong learner and somebody that [01:36:00] dared to be involved in these conversations before you were appropriately credentialed.

[01:36:04] Josie: Yeah 

[01:36:05] Susan: I, think one of the ways this happens is you do have some kind of disorienting dilemma in practice. And I think a way to start pulling your knowledge about OS through is, to find something that really bothers you in practice and then think about it using NOS lens. And I think that's the way you start to learn the language and that's the way you start to think about what might some of the solutions be outside of perhaps your typical practice.

[01:36:47] Susan: So I, was the person who got to teach theory in most of the places that I've taught. And it was often first semester and, I knew that people were sitting there with their eyes glazing over, but I also knew that they came back a few [01:37:00] years later and said that was really helpful. And I wish I'd paid more attention.

[01:37:05] Susan: But I think it, it comes down to, as OTs, were very, as you said, very pragmatic. And so find something that really bothers you and try and pull in some of the os 

[01:37:19] Josie: You'll learn hopefully from this course you'll get some jumping off points of these constructs with the qualifier that will go over that.

[01:37:30] Josie: I'll define some of these terms, but that doesn't mean that those are the only definition of those terms, which is frustrating, but also maybe amazing. Sorry to cut for. That's true. So that's that, is that kind of how you got pulled into some of the wanting hungering for more, You almost hungering more for theory after you were in the field then it's almost like we get it backwards.

[01:37:56] Josie: We teach theory at the beginning and it's almost like we need to circle back [01:38:00] to it at the end too. Yeah. I think we need 

[01:38:02] Susan: to do it at both ends and I think it's important to have that beginning of. Personal identity as an OT from the beginning, but then really come back and say, Okay, now that you've had a bit more experience, how are you seeing this?

[01:38:17] Susan: And what else do you need to know? And what else will help you in your 

[01:38:22] Josie: practice? Maybe what you have to offer, the future development of the field with these insights now that you've been I will explore later in a module that to me os has been very akin an OT to field biology compared to theoretical biology.

[01:38:38] Josie: And that those of us were always working in a field context and have unique insights in that regard. I wanna be really respectful for your time on a Saturday and just, I hope you can feel my gratitude for being open to. Be that role model of showing that other clinicians that at this is something we're all connected [01:39:00] to across the generations and that we have shared in, in many ways.

[01:39:05] Josie: I think when we explore, we have shared goals for OT and whether it's the OT we wanna receive, the OT that we wanna offer, or just the general world that we wanna live in as occupational beings or as great stewards of privilege that even just being on this computer right now or holding this phone in your hands, you have so much opportunity to contribute to a new evolution of this occupational world that we live in.

[01:39:31] Josie: When you're invited to be a part of this conversation, hopefully an empower, empowered, and accountable way. That we can bring more visible visibility to what was previously invisible. And even though it's hard and disorienting and a struggle most of us Dr. Burish you brought up having something that really bugs you In practice, I found that these conversations are often painful.

[01:39:56] Josie: They are really confronting and [01:40:00] they can be disrupt. To your personal life and to your practice life. They're, challenging to reconcile. And part of that, and with the invitation of this course is that you're not alone. And you get to do this in community. And I hope that you can find people that you feel some solace with and some validation of the reality that you're navigating as a clinician today.

[01:40:22] Josie: Cuz this is not easy work. Just because it's theoretical doesn't mean it's not practical. I, in a way I, hope that having this lens can help you see that the challenges that you're facing are real and that we are going to need to change how we understand practice based resource, resources, and care. And that's why we need more people a part of the conversation.

[01:40:49] Josie: And we don't want, I don't want you to be alone in this, so I want you to know this language so that we can start building community, not just in academia and in some of these like annual [01:41:00] conferences that happened in far away places. We as clinicians can start imagining and building what we need now in the field to help these seeds take root in a way that it's not, that it's therapeutic and resourcing to you as a clinician and not something that's dismissive to your practice.

[01:41:18] Josie: So I think all three of these speakers that we've had today has shown that even if it was a little bit different learning about occupational science for the first time, it ultimately became something that was really resourcing and nourishing and permissive to the practice that they wanna do.