OTs In Pelvic Health

Receptivity, Validation, and Asking Mindful Questions: The Art of Occupational Science

• Season 1 • Episode 31

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Today's episode is called Receptivity, Validation and asking very Mindful questions. The Art of Occupational Science. My guest joining me is Josie Jarvis. She's been a generalist practicing in traditional settings throughout Washington State, including acute care, post-acute memory care, school based practice and outpatient Pedes, feeling discouraged by challenges in the field and wanting to get ahead of professional burnout. In 2019, she decided to go back to school for her post professional doctorate in O.T.. She then got an in-depth introduction to the field of occupational science and found that it was that key to resolving her disillusionment within the field of O.T. practice. Once she had the language and understanding of occupational science, she finally found the grounding she needed to feel confident about the future of the field. Unfortunately, Josie feels that most USC based occupational therapy practitioners have not been exposed to occupational science, even though it is now formally incorporated into our practice framework and a code of ethics with Aota. To address this problem, Josie has developed an accessible online course on the Foundation of Occupational Science is releasing a podcast called Engaging Occupational Science to help bring all field clinicians up to speed on our secret and powerful science of human occupation that has the potential to radically transform practice, world view and confidence as an occupational therapy practitioner. Josie, I am thrilled to have you on the podcast. There's a myriad of topics that I'm dying to dive into with you today. But I want to start with a very simple one, which is this. When we're practicing as an O.T. through the occupational lens. What does that mean? What does that look like? 


Josie Wonderful question. And you know what? What I have discovered through, I guess now several years of studying of different perspectives within the realm of what can be called occupational science, is that there's actually infinite perspectives and lenses on what it means to engage with the construct of occupation. And what we're learning, particularly internationally, is that we have to make space and be open for lenses and perspectives that actually can't even be conceived with the notion of what occupation is, because in some ways it is engaging with. Aspects of the unknown. There is a potential with adapting. 


Josie To. 


Josie Barriers in circumstances that is creating something new and creating a new territory and engaging with the unknown. And within that process of engaging with occupational science. We have to be open to maybe adopting a lens that has never existed yet before and that, you know, we have potentially limitations for fully adopting another person's or group of people subjective experience. So part of adopting an occupational lens and an occupational science perspective is being open to receiving and very mindfully listening and trusting, even if you can't fully measure it, even if you can't. 


Josie Fully. 


Josie Define it in a way that's stable in our ever evolving, you know, connection to kind of our outer environment and the broader universe, even if you can't define it in a stable way, there's a level of trust that if somebody is sharing their perspective, their experience with you, just maybe it exists, it's meaningful to them and it has a causal relationship to how they show up in their environment and their community. And that even your subjective experience and how is mediating with the outer physical world? That's having an impact in how you are evolving as a human being and how you are connected to your community, to your environment. So in answering your question, I think adopting an occupational lens is almost more so surrendering to the potential of. There are being infinite shifts in. What I'm speaking to too is also it is expressed by other occupational scientists I know resemble. She has a noted notion of viewing occupation as a kaleidoscope that every time that you turn a kaleidoscope in a different, you know, a different context, it has almost infinite variations based on where it is in time, where it is in space. And the lens of who's viewing it. So it's being open, radically open to diverse perspectives and what you can learn for them. And really, a true scientist always starts with receptivity, observation and asking very mindful questions. And I think really part of engaging with an occupational lens as an occupational therapist is letting that be the foundation in the core of your practice. And that's really what I've been hearing from some of your work, Lindsay and some of your guests lately is starting with that mindful listening and adopting and validating the perspectives of our clients and how they are making sense of their life in context. 


Lindsey Vestal So you mentioned occupational science and. Some of us on this podcast, including myself, probably need a refresher on what exactly occupational science is. Josie, can you can you explain that to us? 


Josie Wonderful. Well, I just also want to express some gratitude to you, Lindsay. I just as you probably reference in the introduction, I'm in the last stages of completing my clinical doctorate at the University of Utah. And there I was very fortunate to also as a clinician, I'm going, I think, into my sixth or seventh year of practice at this point. I graduated with my master's in 2015. And I was starting to feel pretty cynical. I was so in love with OT from my How OT is sort of talked about in OT school, there's kind of this stark reality of transitioning into practice, and I was starting to cycle into some cynicism and doubt about the profession, and I needed to revive that spark and to find some hope for sort of I've invested so much of my life in this career and I really wanted meaning and satisfaction through it. So that brought me back to school. And there I was very fortunate to get connected to two occupational scientists that incorporated occupational science as part of their post professional clinical curriculum. And what I really discovered is I deeply needed to reconnect to some of those foundational questions and theoretical questions related to the field of occupational therapy. So you're not alone. I also had to get reintroduced to occupational science, and for a significantly high percentage of OTPs in the United States. They haven't ever been exposed to occupational science, haven't been empowered in that conversation. It really didn't get, you know, officially sort of christened with a formal title until about 1989. And it started pretty rapid development throughout the 90s and particularly took off in other particularly Western nations to start such as Canada, you know, United Kingdom and Australia and essentially branched off and have had has had development other countries with very diverse occupational science. It's not a monolith. So it's it's difficult to defining describe. And so when you ask defining what occupational science is and how to relate to it, it is just like the scientific method. It's more of a process than it is a definitive statement about what's true. It's a way of engaging with questions about understanding, especially in the West, what occupation is, how it has an impact on human beings in general, not just the treatment population. Initially here in the United States and in Los Angeles, the initial thinkers around occupational science, they really wanted to explore what occupation, what impact occupation has on human beings in general as more of a basic science. So basic science is sort of like anatomy, and physiology is a way of understanding how the human body functions without connecting it necessarily to pathology right away. And occupational science from these scholars, they really wanted it to be the way of understanding occupation and sort of its raw form separated from a treatment population. And many of them talked about occupational therapy actually being an applied expression of occupational science. So they still saw a connection of frontline clinicians and our clients as part of the scientific process and discovering knowledge about how occupation impacts human beings in the context that they live in and in other school of thought around occupational science that developed within. Wilcock. And particular you got Gill White for that is a continuum of her legacy. And Claire Hocking in particular, they conceived of occupational science as a lens in perspective for understanding public health and how engagement and meaningful activity is. Actually, it's a social justice issue when we have systemic barriers somewhat from like a social model of disability that impede the quality of life of all humans, of developing meaningful and purposeful activity in the context of their community with belonging. So occupational science is a really open question and sort of a playground to engage with what occupation can mean. In various contexts. And we're actually at a point in occupational science history where the conversation is more inclusive than ever. We're starting to see much more of development of inviting not just clinicians into the conversation, but also seeing our clients as being the most principal scholars that we can learn from in active partnership and somewhat in solidarity, where we're putting sort of the community that we're serving at the center of our questions rather than having our academic development start in sort of these ivory towers that are detached from the reality that we're serving, coming up with ideas and then somewhat imposing them on a community. We're actually revisiting the true roots of occupational therapy, which has been always responding to social justice issues in our communities and partnering with our clients in a way that we can transform their lives to be more meaningfully connected to their communities in a very empowering way that is culturally mindful and putting those questions at the center of our practice. So it's sort of that I think a lot of the conversations around occupational science talk a lot about how occupational therapy and its absorption in the medical model has sort of lost touch with our values and our connection to the people that we want to serve. Often when we utilize the medical model, which is often trying to understand scientific questions that are divorced of context, where you're trying to design an experiment where you remove everything from it except for two variables and the relationship of those variables across millions and millions of people. In a robust controlled design, you may get some information about those two variables and how they relate while missing really the forest for the trees and kind of sterilizing the rich, meaning that if you use a more holistic mindset and you wow for mixed method inquiry and mindful listening to the people that we want to support in their everyday lives, it is a different way of relating to scientific inquiry and it's something that is so much more aligned with the founding of our profession and its continued contemporary evolution. 


Lindsey Vestal Josie, you started off our conversation today kind of talking about like, you know, the disenchantment that you started to experience after just being out of school a couple of years and through your explanation of what occupational science is, I can I can really sense how engaging it is for you. And especially when an I really start to light up when you start talking about this idea that we're partnering with our clients, you know that our clients are our best teachers. And when we lean on them in that really sort of facilitator way versus this fixing mentality, you can really accomplish great things. So I love hearing from you how much that is a part of occupational science, and it leads me to my next question, which I'm not sure, maybe a bit controversial, but, you know, many times I think we can think of OTS and academics working in silos, working separately from from one another, even though in many ways they have the same objective in mind. You know, a lot of times we're not relying on each other very much. We're not interacting, we're not gleaning, gleaning each other's wisdom. Is that happening between occupational therapy practitioners and occupational scientists? 


Josie You know, I think that's very much what I hope will become an active part of my life's work, where I think even in myself as an occupational being and my own relationship to academia, part of my choice to go back to school was reconciling some internal contradictions and divisions even within myself, about, I think that the lens of occupational science has actually helped me with this question that you're that you're expressing here in that, you know, some of my disenchantment as an occupational therapist and as a as a student in relation academia is part of my occupational history is I actually went to about gosh, I think it was like 13 different schools from K through 12. And then I have two degrees from an interdisciplinary school that's kind of a nontraditional learning environment called the Evergreen State College. And part of where I think I'm a compatible human with occupational science is that I got a Bachelors of Arts and Social Sciences and a Bachelors of Arts and Evolutionary Biology, which was more of a hard science focus. And at the school that I was at, which was intentionally interdisciplinary and about communicating across difference, I find myself constantly having to reconcile the, the, the kind of the paradoxes between the humanities and the hard sciences and kind of an individualistic paradigm and a collectivist paradigm and how it really is a wrestle between these different modes. And what I started to notice early in my relationship with academia that has scaled up to the point that I'm almost done with my doctorate is I think there's a mirrored tension in OT, where industry has had an influence in how we practice, right? We are having to adapt. O.T. is often like a square peg in a round hole, and that sense of getting divorced from values often comes through having to commercialize our profession and having to adapt to these systems. And what I've learned from academia is that they're also subject to those same forces. And I think we are mirrored and also being frustrated about being disconnected from our sense of purpose and our aim while being torn in this really high riptide current towards what is viewed as commercially viable, what's viewed as prestigious, what often we're kind of serving those other masters and we're sort of losing ourselves and we're losing touch with that deeper mission of why we maybe went into academia in the first place or what we were hoping to get out of working as a therapist. And I think there are so many correlations, so many similarities between what what forces academics are having to adapt to. And like, for example, in academia there's this notion of publish or perish. And right now there's about five different companies that own, I think is about 80% of the formally published academic journals. And in order to get on what's called like a tenure track where you can have sort of freedom of thought in a secure salary position within a school, you have to publish as many journal articles as you can, as high status journals as possible. In order to be considered for the hiring committees in those universities, which is somewhat analogous to what a lot of us based clinicians face of this pressure for productivity. And in that a lot of these journals that are very prestigious and will have carry weight with faculty hiring considerations, those tend to be the most exclusive publications to even having a readership review. Viewership not just among clinicians, but often what's being critically talked about by the disability rights movement, for example, is that many people with disabilities can't even consume the literature that's about them or the communities. And so I guess in trying to access your question, there is a division between academia and practice, and there is a historic legacy of academia being the most exclusive community possible. And those structures have preserved to this day. And I think we have to give ourselves permissions as clinicians, as academics and in partnership with clients, as we talked earlier about making visible what these barriers are and trying to build partnership and break down barriers. So that's why I'm interested in bringing these conversations outside of academia, explicitly sharing this language and hopefully empowering everybody on the front line to be an active part of the conversations in developing what the science base of our field can look like in a way that's generally helpful, not just to clinicians, but transformative for our clients. We need to start thinking differently about what science is, and it needs to be a conversation that can exist in an empowered way outside of academia. Which isn't to say, to throw the baby out with the bathwater. But I think as OTs, an occupational scientist, we can start with that natural first space if we're going to help our clients face the barriers that they're facing that are limiting their well-being and performance of connection their values. Where better for us to start than in our own worlds and showing that we can break down some of these barriers and create some movement where previously there was maybe some rigidity and a lack of understanding. 


Lindsey Vestal It's incredible. You have opened up my eyes to. 


Lindsey Vestal So many things. 


Lindsey Vestal I am. I'm learning so much. So I know we're still in the middle of our conversation, but I wanted to stop and thank you for for all of this expertise and wisdom and background that you're really bringing to the table, which is very novel for me. So I'm grateful for this. I want to talk a little bit now about something that you and I have discussed in the past, and that is sort of the benefits of transitioning from a medical model setting or a we could call it a mechanistic paradigm to something I'm very passionate about, which is a more occupation based lens or occupation based paradigm to you, to you, Josie, what are some of the benefits of this transition? 


Josie Definitely. And I honestly think in some ways, even though it's framed as a contemporary paradigm, in some cases we're actually in reconnecting to this question going back to our roots. And so if you are open to it, I thought maybe I could express a little bit of what I understand some of the history of occupational therapy, at least in the United States context and somewhat with other Western countries, really occupational therapy. It started with what was called the moral treatment movement, and that was, I guess, distinctly a phenomena that we know about in Western Europe, where most of us, you know, maybe you've watched Game of Thrones or you've seen things like the medieval period was not known to be a nice and friendly time to just about any human being unless, you know, even the royals at that time didn't seem like they were having the highest quality of life. But the moral treatment movement started in that context of the 1700s and whatnot, of the spark of people that were disabled or having mental health issues that maybe it made sense to approach their needs in a way that was moral and ethical rather than cruel and punishing. So that part of Europe, you know, previously had a very punishing approach towards difference, kind of similar to like, you know, a culture of incarceration with, you know, some of the people that we worked with. And so at its foundation before occupational therapy existed, it was a continuum of this idea of treating humans well if they are happening to need to be in more of an institutionalized setting. Fast forward to, you know, the turn of the century that we're all familiar with. One of the continuations of that effort was the arts and crafts movement and looking at how we can develop health care, you know, sanatoriums or places for displacement, those there was a sense of how do we optimize quality of life. And it was very intuitive at that time to look at the impacts that industrialization was happing on, the quality of life on a group of people that, you know, just previously had an active relationship with the land and were very active at every point of time use in their lives was used towards. Benefiting their community or benefiting themselves some way through cooking food, through growing plants. And when you had a transition to industrialization, there was this idea of what's called a buy in. Wilcock Occupational alienation, which is where meaning gets extract from the activities that you're doing and you don't have a of over how you're co-creating your activity and the environments that you're in. So that was something that was at the core of occupational therapy practice in its beginning and its connection to the arts and crafts movement was that through industrialization we were losing some of our humanness and that was somehow connected to our health and our quality of life. Fast forward to the contemporary paradigm that you're talking about today and many of the developments of occupational science and the conversations about how occupational therapy is evolving, especially internationally. There's this strong thread towards looking at how forces of industrialization have impacted quality of life. Those are very meaningful conversations today as we look at the impacts of the pandemic, the great resignation, the quiet quitting era, looking at how labor rights are being treated internationally, how our interconnected economy. Another thing that was a big factor at the turn of the century was World War one and the Spanish flu pandemic. Right. And it was very intuitive back then to connect to what we can describe in the West as an occupational core. And it's sort of screaming at us, I think, today in the Canary program that there's a need for filling in that gap of meaning and connection and community and how do we make our work life balance something that supports our long term well-being in the context that we inhabit and from, you know, the activism lens? Like right now in the United States, we have a tremendous domestic refugee crisis. And many of the occupational scientists that have been doing really profound work throughout the globe have been looking at the quality of life of refugees and how we build systems of mindful inclusion, empowerment and connecting people back to meaningful activity. It's really a human rights and a social justice crisis, including in the United States, that we have so many humans that are disconnected to that meaningful activity and connection to our environment that can fuel our health and meaning and satisfaction, not just from one couple of your slice period of our life, but just thinking of our overall quality of life and continuum. It really impacts our health, how disconnected we are, not just from meeting activity but to our broader community and taking on perspectives of those that are disenfranchized and marginalized in our system. It ends up impacting the health and well-being of all of us. So it's something, particularly for those of us that are working in the medical model and working with very pathologize and Medicalised clients. They're experiencing occupational disruptions and deprivation just by virtue of being somebody that has to mediate their needs in the Western health care system. So us occupational therapists giving us permission to engage with this lens, not only can we better underscore, understand ourselves and some of the burnout that we're experiencing and understand the forces of the systems that we're working with, but we can be a point of connection of humanity and hope and empowerment for our clients that might be experiencing that occupational alienation by being swept up in a system that prioritizes profit and their pain more than their salvation. So I think having this and, you know, just seeing more of that sounded so self-righteous, but more, you know, I think we can be a lifeline as occupational therapists for our clients that are often so disconnected from those activities and those the occupational meaningfulness that they're striving for. So I'm so excited to see this conversation become more mainstream and I think more occupational therapists. I've already been doing this. Work, but they often don't have the words to classify it or the sense of having formal permission. That's changing more and more every day, especially with the publication of the recent practice framework. We now have sort of formal permission in the United States to relate to occupational therapy in this way, not just in thinking about our past, but our current challenges that really align with that mission and vision of occupational therapy from the beginning. 


Lindsey Vestal Josie what where in the framework specifically are you thinking this is mentioned? 


Josie The, the occupational therapy practice framework is a relatively recent addition to the field of occupational therapy. From what we can see, it looks like it started in the early 2000s, which is really just almost just a decade since occupational science even existed, since occupational science really got its footing in academia starting in 1989. So it as a field is about 33 years old and the practice framework is younger than that. So there is a significant proportion of field clinicians that are still practicing today to that never got the opportunity to really be introduced to the practice framework in its context where it came from. And one of the criticisms that I have for the American Occupational Therapy Association is we tend to just have about usually an average 10% of the practicing arts in the United States are active members of Aota, and they are pretty classic for somewhat gatekeeping. A lot of their information. You really have to be a member to even access really essential parts of their website. So you have to purchase the most recent editions of the practice framework and it's free for you if you're a member and you have access to the American Journal of Occupational Therapy there, you can access it. But it would be such a gift to our profession. I think if we made this information more accessible and we start addressing some of these barriers and misunderstandings of occupational therapy is in part is because we've kept the information on our practice so, so tightly secret. So behind these locked doors that, you know, many of us as clinicians and the clients that we support, they don't have the time and the budgets for textbooks and conferences and journal access, and it's a pretty sizable fee. So, you know, there's a significant percentage of clinicians that are still not fully up to speed on the development of the practice framework. But it's a document that gets updated about every five years based on the current developments of our literature leaders in our field and is meant to be something that is developed in partnership with clinicians through the American Occupational Therapy Association. Our most recent addition in 2020, which is what formally defines what occupational therapy is and somewhat how it's considered to be. It's sort of our national expression of our scope of practice and what defines the domain and process of occupational therapy and every, you know, current and emerging practice settings as OTi peeves, we're meant to be following the sequence of the domain and process and developing our interventions or evaluations. And it's what creates consistency within the great diversity within the occupational therapy profession, at least when it comes to the United States. And I know particular for me, this is a really important development because in Washington state I'm more familiar with our scope of practice here, but I imagine this is true for many other states. The only thing that is really formally and technically protected as a scope of practice within the state of Washington is anything that's defined as occupational therapy. So in the world of kind of more that not just abstract in theory, but the pragmatic legal definitions and looking at the semantics of things, it really matters what the formal definitions of occupational therapy is, what a process is meant to be in the United States, and how these terms are actively defined. So occupational science plays a really active role in sort of exploring and defining what these core constructs of our field are. Things like occupation, things like occupational balance, occupational disruption, co occupation. So where you're going to see a lot of incorporation of occupational science into our practice framework, into our regulatory documents is through our connections to theory, philosophy and terminology that are now infused in embedded within the occupational therapy practice framework in our domain in process. Some of the key changes that have happened with the current edition of the practice framework include expanding the scale of service delivery of occupational therapists from individuals to include groups and populations, which is part of the influence of occupational science in that and Wilcox that envision occupational therapy as part in occupational scientists as something connected to public health and outside of just individual by individual interventions and sort of that mechanistic paradigm of going from a dysfunction within a body to also conceiving the dysfunctions within a system. One of the more recent podcasts I listened to from yours was doing a very beautiful job of, you know, shifting the focus to top down therapy and thinking about the routines before we think about this function of the body. And it's a beautiful representation of where the practice framework is nudging us to take a more occupation based occupation centered and occupational focused approach. We've actually had preparatory activities removed and redefined, which are sort of rote, meaningless exercises. They want us to be more occupation centered, occupation infused. So really, if you take a look at the most recent update of the practice framework, not only does it make explicit reference to occupational science, but it's infused throughout the document, throughout the process, and it even centers this notion of not pre deciding what our interventions are. We actually need to follow a process of mindfully listening and partnering with our clients before determining what the interventions are and what the occupational outcomes are that we're focusing on together. 


Lindsey Vestal I love that. I love that. I love that. Jersey Do you have any tangible examples of what this could look like in more traditional settings? So how can OTs continue to move away from this biomechanical model to our back, to our roots, back to this place of empowering our clients? And really, if we listen to our intuition taking us back to why we chose to begin with, do you have any kind of like tangible examples that my listeners can kind of like sink their teeth into in traditional settings? 


Josie Definitely. And I think that's why developing an occupational lens is such a powerful practice. And one of the things that I've learned from engaging now with the field of occupational science for the last couple of years is that the first and most practical step that you can take as a human being has a clinician is starting with yourself. So it's so important, I think, to start engaging with what occupation means in your own life, in your own community context, and really honoring and validating your own perspective. So one of the ways that, you know, I, I somewhat had to go back to academia to almost reclaim myself and reclaim my soul because I had so many decades of sort of repressing myself in order to I needed to kind of reenter academia in a more empowered way and to take on some of these questions in a way that was personally meaningful. And I think it is so important as a practitioner to be the best therapist that we can be for ourselves and to engage with. What does occupational balance mean in my own life? What are my values and how are they driving when you bring awareness to your own self, right? One of the things I love about your podcast so far, and it sounds like you're also creating a course on this, adopting more of a bio psychosocial perspective, which you might be hopefully excited to hear that the bio psychosocial perspective, one of the first people to articulate that specific wording, Adolf Meyer, who is a psychiatrist that contributed immensely to the development of occupational therapy in the United States. So it really has been a core conversation, which is this idea that all of those elements are inseparable, and yet we work in a commercialized health care and social service system that is very invested in separating those things. One of the current conversations that I've been following within occupational sciences, it's critiquing what's called like a Descartes ten view of, I guess in some ways the human body. So many people probably heard of Descartes, who is he conceived of philosophy, where I think therefore I am. And it's sort of detached the brain and consciousness from the human body. And by building our systems kind of to mirror the structures of academia, which were early in separating these parts of humanity and creating distinct disciplines. So one of the. Historical foundations of academia. With that Descartes approach was separating the mental health system from the physical health system. And we see sort of problems extending back from that root that we've been studying. Even I see it today, you know, like with neuroscience is we still separate these body parts and we don't understand how they relate in synthesis. And occupational therapy was one of the first professions to mindfully engage that question and. I guess I should circle back to your initial question. I think it's so important to start viewing your own life and community through this lens where you start to break down some of those barriers that have prevented relating to yourself as a bio psycho social being and your own health with that perspective. If you can do that, it then becomes a lot easier to carry that with you no matter where you're practicing. So now that I've been engaged with occupational science for a couple of years now, it's a lens I carry with me. No matter where I practice, where I'm at. I think of all humans as potentially occupational beings with their own distinct life routines and perspectives. It's not something I can pretend to understand beforehand. I love that metaphor of OTs's plumbers, right? That we really have to show up and listen and respond and understand other humans as psychosocial beings, as occupational beings. It then becomes a very natural thing, and it can affirm your confidence to show up in your practice and humanize your clients. Having a very conversational because now I have this this lens I've been able to develop with myself. It doesn't matter how much time the system gives me, even if it only gives me 15 minutes with a client, which is common in acute care. In putting those occupations first and having conversations, maybe an acute care, we prioritize getting them connected to nourishment and food after our visit. I'm not thinking first about their shoulder range of motion. We're thinking about do you know how to use your cell phone in order to get set up with Meals on Wheels or to need me to support you in that? How can I be a human with you and support your occupational striving? Where? What is the most pressing occupational need for you in this moment in starting? If that is something that you can offer yourself, you can start being more mindful and humble in building that partnership with your clients. That's kind of where the biggest starting point is, because learning about occupational signs that it can be what's called like a disorienting dilemma where maybe in the first time of your life you're starting to question some of those solid assumptions, like maybe it's an unquestioned assumption, like all the body parts being separate. Having to mediate all of a sudden conceiving them as a cohesive meld or thinking through other cultural cultural mindsets about how they make sense of their place in the universe. In some ways, it's kind of disruptive to our whole body system. So we have to give ourselves some grace and we almost have to put ourselves through a transformative learning experience. And it's so nice to give yourself that space to do that and almost play around with these concepts in a low key scenario before you feel pressure to show up in your work environment. You've got to be patient and gentle yourself while you begin to adopt new perspectives. 


Lindsey Vestal Incredible urgency. You are an absolute wealth of information, and I know one of your goals is to really make this information so much more accessible for OTs who want to learn about occupational science empowered practice. Talk to us about how you're doing that. 


Josie Certainly. And it's continually evolving project in some ways. I just before I came on here, I highly recommend it to everybody here to I was listening to the OTs Lifestyle podcast interview with Michael Obama, which is prompting me to even reflect on this project as well in commenting on how much even occupational science is really grounded in some Western conceptions. And one of the common critiques of things that develop for more of a Western cultural context is that there's a really strong legacy of hierarchy within Western social systems that are often, you know, one of the things I think that we've had to battle with in is part of my lived experience is some institutional sexism that has played a strong role in the progression of occupational therapy throughout the world. So one of the things is that we part of the reason why we don't have occupational science a lot sooner is that women have not always been an empowered position within Western social hierarchy. And so there tends to be sometimes privileged disciplines in different realms of thought are given a higher status in Western worldviews than others. And that's one of the things that it's good to be mindful about deconstructing. So with a bio psychosocial story, this is a bit of a tangent, but part of that bio psychosocial perspective, right, is that you're not privileging biology over the psychology or the social part. You're equally valuing how that could be a, quote, influence on each other. In occupational science we call it transactional ism, where you're seeing systems having a mutual influence on each other and it's much easier to do that. In my mind. It's a much more accountable form of science when you're not privileging one part of knowledge above another. And I think part of what we're coping with the United States is that we privilege the physiological in the biomedical perspective above other ways of knowing, such as indigenous science and ways that traditional cultures have built their relationship to their community and cultures and land without necessarily going through academia. Right? Academia is inherently an exclusive and privileged part. So anyway, part of what I'm engaging in in this project, in trying to create some inroads to support occupational science literacy for I'm starting with U.S. Space Clinicians is developing a experimental online learning community where it's not so much about showing up and getting, you know, abstracts of the current literature about what randomized controlled trials say about a specific diagnosis. It's creating space for dialog and play and inclusion around the foundational questions of our fields and creating in-roads to start an active and supportive conversation. One of my pet peeves about often discourse that I see in online communities is there's a kind of a can't do tendency. I don't know if you've run into that, Lindsay, that sometimes it's difficult to find options to engage in conversations about what occupational therapist can do and what we can be empowered to do with the right supports and the creativity. And I think we all, as teachers, deserve to be connected to our bio psycho social work roots and deserve to be in an empowered position in imagining what the new areas of OT can look like and how we can offer occupation based occupation and focus services in all our traditional settings and not just in private in emerging practice. I think we need space to do that without the sense of having to go into more student debt. And I think that maybe a lot of other OTS are like me and I started my career in travel therapy, so I don't get to talk to a lot of OTs. And often sometimes I think care providers we can almost be more competitive about who's approach is better. And O.T. there's almost a lot of insecurity because each of us might be defining occupational therapy in a different way, and there can be schisms in our diversity of thought. So I've been developing an online curriculum that's meant to help constructively mediate. Us being included in these conversations in a way that's also inclusive to occupational therapy assistance. And to start doing, like I said before, of of playing with these concepts and understanding in our own lives and having a safe place to play with them and to engage with them and to inspire new open boxes and new learning and in a less of a formal environment or a rigid environment. So yeah, I have foundations of occupational science that will be released in the new year and a podcast that is going to be engaging in dialog with other occupational scientists to at least support other clinicians in being able to access and play with these conversations. And by no means is it meant to be a definitive say about what occupational therapy is, but it's a space to play and engage with what occupational therapy can become, especially as we engage with more diverse perspectives. 


Ad I will definitely link to that in the show notes and any other resources you'd like to share with our community. Josie I am so honored that you joined us today and value your perspective and your enthusiasm so very much. 


Josie Awesome. And I do have you included in the link I did put together in Occupational Science 101 guide that at least goes over a lot of the major terminology from occupational science that has been incorporated in the practice framework and regulatory documents. So it kind of outlines in many of those documents just where these concepts have been infused. And it includes a list of really prominent international occupational scientists that you can click in and see the body of their work and the different textbooks that are out there. So if you are maybe not wanting to join a learning community right away, you can also just download that for free. And the vision of this exercise in creating accessibility around engaging with occupational science. It's not meant to be financially exclusive. So this educational community, it will be freely available. You can join the Facebook group right now. It's called OHS Empowered OT to start sharing this information and building conversation about it. So I just love how I can tell from your audience that they're curious and we really need clinicians to be part of this conversation. And if we create more occupational science literacy amongst ourselves, it also has the potential of empowering our clients and creating some clarity, too, in how we're distinct from other schools of thought in other professions. So if you start to read through the literature on occupational science and the current developments for theoretical field, it is just so incredibly palpable how different we are from physical therapy, for example, and how different we are from other realms of psychology. Classically over the last few decades, in part because occupational science hasn't been very accessible as a profession, we've been mostly developing our foundations by adopting the perspectives of other fields. And so it's so important about engaging with our own science base is it's a space where you don't have to be walking on eggshells about borrowing things from other professions and other disciplines. You can have a really empowered system and foundation just within own to yourself to start building some clarity and some ownership of our own identity. 


Lindsey Vestal Hydroxy. Thank you. Thank you so much. Really, really value our conversation. And I am absolutely going to throw all of those things to our show now. It's such a pleasure to have you on today. 


Josie Thank you so much, Lindsey. 


Outro Thanks for listening to another episode of OTs and Pelvic health. If you haven't already, hop on to Facebook and join my group OTs for Pelvic health, where we have thousands of OTs at all stages of their pelvic health career journey. This is such an incredibly supportive community where I go live each and every week. If you love this episode, please take a screenshot of this episode on your phone and posted to IG Facebook or wherever you post your stuff and be sure to tag me and let me know why you like this episode. This will help me to create in the future what you want to hear more of. Thanks again for listening to the OTs and Pelvic health podcast. 



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Lindsey Vestal

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