The (dis)obedient occupational therapist: A reflection on dissent against disciplinary propaganda

Abstract

Introduction Despite struggling to establish itself as an autonomous profession, occupational therapy remains extensively regulated and controlled by discursive authorities inside and outside the discipline. After overcoming the profession’s reformist ideals, the military governance that supported its rapid expansion morphed into civil institutions but both were based on similar grounds: occupational therapists should obey a strict set of rules while disobedience and dissent are consistently repressed or silenced. Objective The objective of this article is to deconstruct dominant (consensual) discourses that shape the status quo in occupational therapy and envision alternative paths for the development of the discipline. Method Drawing on the work of Erich Fromm and Jacques Rancière, we propose a (critical) theoretical analysis of the concepts of disobedience and dissensus as they apply to occupational therapists. Results The concepts of disobedience (Fromm) and dissensus (Rancière) can be used to revisit the consensus shaped by discursive authorities inside and outside occupational therapy and expose the political nature of such processes. We argue that remaining oppressive forces similar to those of a warfare regime persist in regulating occupational therapy practice and knowledge by enacting a form of ‘disciplinary propaganda.’ Rather than threatening the development of the discipline, disobedience and dissensus constitute critical responses to disrupt dominant discourses and give rise to healthier concepts. Conclusion The use of politically charged terms such as disobedience or dissensus can be seen as controversial and unsettling for a profession like occupational therapy but we believe they are necessary for the future of our discipline.

“Ah, it's best not to mention that here:” Experiences of LGBTQ+ health professionals in (heteronormative) workplaces in Canada

“…Within the health professions, heteronormativity is entrenched, expressed and taught through formal and informal curricula, and through professional cultures of conformity (Jackson, 2000 ; Risdon et al, 2000 ; Eliason et al, 2011a , b , 2018 ; Röndahl, 2011 ; Robertson, 2017 ; Murphy, 2019 ; Turcotte and Holmes, 2021 ). “Professional behavior” is assessed and evaluated, with discourses of professionalism masking the demands that new entrants comply with expectations of bodies, comportment and behavior that are inherently white, Western, middle-to-upper-class, heterosexual and cis-masculine (Beagan, 2000 , 2001 ; Martimianakis et al, 2009 ; Jenkins et al, 2021 ).…”

Occupational (Therapy's) Possibilities: A Queer Reflection on the Tangled Threads of Oppression and Our Collective Liberation

“…Though liberation is an aspirational concept central to the efforts of many civil rights groups, it is rarely mentioned as such in our literature. However, when I began to engage with the concept, I started to notice brief side references to it in occupational therapy podcasts, personal conversations, and the writings of a growing number of occupational therapists/scientists ( Lavalley, 2017 ; Musharrat et al, 2022 ; Ramugondo, 2018 ; Turcotte & Holmes, 2021 ; Zafran & Hazlett, 2022 ). Though not discussed as a grounding concept, at least in the Canadian discourse, the idea of liberation is beginning to bubble up.…”

“…Cependant, quand j’ai commencé à utiliser le concept, j’ai remarqué de brèves références dans des balados sur l’ergothérapie, des conversations personnelles et un nombre croissant de publications (p. ex. Lavalley, 2017 ; Musharrat et al, 2022 ; Ramugondo, 2018 ; Turcotte & Holmes, 2021 ; Zafran & Hazlett, 2022 ). Bien qu’il ne s’agisse pas d’un concept de base, au Canada à tout le moins, la notion de libération est en train d’émerger.…”

Unbecoming change agents

“…Defined in a professional development email listing as “a person who promotes and supports structural, organizational and/or personal transformation” (CAOT, personal communication, December 7, 2021), the role of “change agent” has been widely promoted within the occupational therapy profession during the past decade. However, within a broader socio–politico–historical context in which critically informed scholarship has raised awareness of how professions are often complicit within oppressive power relations, occupational therapy has been challenged to move beyond the taken-for-granted assumptions and practices formerly constituting the boundaries of the profession's status quo (Turcotte & Holmes, 2021). Accordingly, the new Competencies for Occupational Therapists in Canada document (ACOTRO, ACOTUP & CAOT, 2021) does not contend that occupational therapists are, or should aspire to be, “change agents”.…”

“…Ce rôle d’agent de changement, défini comme « une personne qui favorise et soutient la transformation structurelle, organisationnelle et/ou personnelle » (ACE, communication personnelle, 7 décembre 2021), a largement été encouragé au sein de la profession d’ergothérapeute au cours de la dernière décennie. Or, dans un contexte socio-politico-historique où des perspectives critiques ont mis en évidence la façon dont les professions sont souvent complices de relations de pouvoir oppressives, les ergothérapeutes ont été mises au défi d’aller au-delà des postulats et des pratiques qui, tenues pour acquises, constituaient autrefois les frontières du statu quo de la profession (Turcotte & Holmes, 2021). En ce sens, le nouveau Référentiel des compétences pour les ergothérapeutes au Canada (ACORE, ACPUE & ACE, 2021) n’affirme plus que les ergothérapeutes sont des « agent·es de changement » ou qu’elles devraient aspirer à l’être.…”