106 – Semantics and Platitudes in OT

So many times over my career I’ve heard cliche’s and platitudes used by therapists and often wondered….do they know what that actually means? Recently I’ve had a number of discussions on this podcast about terms used that are used incorrectly OR used as lip service and I thought it was about time I did an episode and explored some of these.

Terms explored in this episode include:

Woo Woo
and more….

Tune in to hear my reflections from my brain and a dictionary.

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Brock Cook 0:00
A quick message to let you know that occupied plus has launched over on Patreon. If you are looking for some extra value from occupied extra podcast episodes, downloadable resources, access to me supervision, mentorship, and many, many, many, many more things that I will be continually trying to add more and more to than jump over to patreon.com forward slash occupied plus, and check us out tiers starting from $4 us a month, it is bargain basement for extra value that can add to your clinical practice. Now let’s check out this episode. I’ve been meaning to record an episode like this for some time. And I finally got around to putting it together and bringing this to you. There are quite a few things that ot say on the daily that I see very regularly on social media, in ot related groups, etc. that I don’t feel like OTS fully understand what they’re actually implying when they use certain terms and certain words. So I was actually have a look at the definition of some of the things that we say and see whether or not it actually matches up with what we are intending it to say. Get a My name is Brock Cook and welcome to occupied. In this podcast. We’re aiming to put the occupation in occupational therapy, we explore the people, topics, theories and underpinnings that make this profession so incredible. If you’re new here, you can find all of our previous episodes and resources that occupied podcast.com. But for now, let’s roll the episode. All right, so firstly, I want to lay out there that this is absolutely in no way intended as an attack on anyone or anything like that. This is simply me looking at patents that I see within promotional material things that people put out there with regards to the profession, how we work, what we do with people, etc. That has never fully sat right with me because I just had this sort of gut feeling that some of it didn’t make a lot of sense based on my understanding of the definitions of these words. I know often the the the term semantics is often thrown around for Potato Potato. Why does it matter? But semantics matters, semantics is the use of linguistics, the study of language and what words actually mean. So it’s kind of important, especially from a profession that is continually complaining that the one word that we use to define our our profession is used or known for a different definition by the general public. I don’t think we can have our cake and eat it too in this instance. So I just wanted to have a look at some of these words. If you’ve got other ones, let me know. And I can do a follow up and we can explore other words, but these are a few that. Some of them I’ve spoken about before some of them I have never mentioned. But let’s have a roll, let’s have a look and see what we can find. So the first one is one that I’ve explored many times on the podcast, but I would be remiss if I left it out, and that is function. So actually having a look at definitions of functions, it’s looking at effect is related to or dependent on other factors. Now when I explained my aversion to using the term within our profession, I use the example of mathematics as does this Deaf dictionary definition as well, where it explains that this factor dependent on other factors is for example, the price is a function of supply and demand. That’s some basic mathematical formula that you can use to work that kind of stuff out. But when you input some set of numbers at the end, you’re going to get exactly the same

format the exact same function out the other end of it because it’s consistent, and people are not consistent. People do not conform to if I input the same data into one situation in a person, I’m not always going to get exactly the same outcome. So that’s my aversion to function. There are certain professions that use that term quite successfully. For me Apple, if you’re looking at sort of manual muscle testing and that sort of stuff, if you put a certain charge through a muscle, you’re going to get a certain reaction, there are parts of the body that do behave in a functional manner. But the person as a whole, yes, there is some predictability but not completely to the point where you could say, Yeah, they’re they work functionally. In that instance, and we have other words, we have occupation, as a lot of therapists have an aversion to using the term, I’ve explained quite a few times how you can explain it, that just makes sense to people. But we have terms that we can use that one better explain what we actually do. But to also better encapsulate the breadth of service that we actually can provide. The next one that I want to have a look at. And I know that some of these words are going to get some people’s backs up. But what I would encourage you to do is if you do have an aversion when I bring up a word or a term, have a think have a reflect, because why you’re reacting to something is also a very important thing to reflect on. So the next one I want to bring up is holistic. For a long time, I’ve often been of the ilk that we’re not holistic, OTS are not holistic, there are very few professions, if any profession that actually are holistic. When we look at the definition of the term, from a philosophical point of view, it’s the theory that whole entities as fundamental components of reality have an existence other than as the mere sum of their parts. So you know, that you will have heard that in textbooks that people are more than the sum of their parts, that kind of thing. There is more to a person, then just the different systems within the body, you know, we have our limbic system and our gastritis, and all those sorts of things. And we put those all together, and that is a person. No, there’s a lot more to it. And yes, if you’re looking purely at that, you could probably maybe justify ot as holistic. When we look at medicine, like a medical definition. It’s looking at the care of the entire patient in all aspects of wellbeing, including physical, psychological, and social. And I believe that if you take those last three areas out of context of the whole definition, then yeah, OTS, right, we look at those things, as a profession, as an individual therapist, you should be at least see during those things. But we don’t care for the entire patient, based on all three of those things at the same time. Ideal? Well, yeah, it would be amazing if we can. But in reality, as a profession, there are probably enough people working in enough different areas that we could call IoT, as a profession, holistic

as a health service, I would hope that a really well designed Health Service has enough different professions, looking at all of the different aspects that make up a person’s health and well being that the health service could be deemed as holistic. Now, I know there’s a lot of issues with different health services. So I’m not going to say that health services are but in the ideal world, you would hope that a well designed well resourced health service could follow fall into that classification. And individual therapists, I think you would really struggle. I know for one, me as a, an OT work who worked in mental health, yeah, psychological social, all over that. All over that the physical stuff, I can make recommendations, there are a lot of physical aspects of ot I have absolutely no idea about and I would not look at, I might get someone else to do it. But again, that’s because the health service I was working within was holistic, not me as a as an occupational therapist. And I believe that the I guess morphing of this term, is where we’re getting slightly stuck with our use of it. So yes, we do look at the person as a whole but we don’t provide care for that person as a whole. We can’t, we can’t we just don’t have have the resources, I don’t know if one any one person has even the brain capacity for the amount of knowledge that would be required to do that. But the term in more recent years has almost been hijacked and sort of modified in this term holistic health. And what Holistic Health tends to look at is those professions that aren’t generally you identified during general health discussions. So you’re gonna have things like counseling, art therapy, being a youth worker, kinesiologist hypnotherapist, a lot of Eastern style, alternative and air quotes, alternative medicine type professions, tend to come under the moniker of holistic health. Now, that’s not to say that those individual professions are holistic in unto themselves. But I believe that the term is trying to, I guess, encapsulate a more holistic health view as an umbrella term by bringing in a wider variety of Health Professions into health discussions. The The, the thing that OTS get caught up in is there are a lot of 80s that are now looking at providing these sort of, for lack of a better term, I’m going to call them alternative health services. There’s a lot of 80s that, especially in the states that often start off studying kinesiology, before they move into it. There’s a lot of 80s that I’ve seen online that you know, now providing meditation, mindfulness yoga, guarantee you that there is oddities out there that also provide art therapy. Sure, we could find an OT that does hypnotherapy out there somewhere. But ot is trying to expand their skill set into other areas is why one, if it’s them, I guess, trying to expand their scope, because the for whatever reason, it could be that they’re not comfortable, or that there are with the the scope of ot itself, or that they feel like they’re personally able to bring more to their clientele with this extended skill set, whatever the reason is, it’s not important for this discussion. But that holistic health is then is then being tied in with OT, because people are expanding their scope of practice into this, quote, unquote, holistic health realm. When described like that, I don’t feel like there’s too much issue in using the term if it’s being used correctly. I it’s a red flag for me, when anyone is describing themselves as a holistic health profession or a holistic anything other than, like, I’m a whole person, but that’s about it. Because straightaway, I’m like, well, there are definitely things that you can’t look at and you can’t service and that you can’t provide care for.

I know a lot of therapists that actually have dual degrees in very in different health settings. So I know a couple of people that are also OTS and physios. I know at least one person is OT and a nurse. And having these dual roles provided, you know, the registered and both and all of those sorts of things would allow you to provide definitely a broader range of services to the people that you work with. But even then there’s still gonna be things that you’re not able to do. So, holistic health or whole, being holistic, I feel like yes, it’s definitely a term that gets used in health. I do feel like often it gets used incorrectly. And I do feel it’s kind of often used as a marketing tool because it sounds fancy and it sounds New Age and it sounds work and all of that. But I think having an understanding of how that word actually frames your service. If I was going to our holistic health profession, I would be expecting that person to be able to do everything, because that’s what the term means. Alright, let’s move on to from that onto one that tends to often go hand in hand from from my observation.

Woowoo. And I won’t spend a lot of time on this because I don’t think it needs a lot of time. I see a lot of OTS describing themselves as woowoo. And one, it never made sense because the term itself just doesn’t click with me. But also when you actually look up the definition, the very first word, in the definition is derogatory. And then it goes on to explain that it’s slang based on or involving irrational superstition. So if someone is woowoo, then they’re basing their ideas, their concepts, their thoughts on irrational superstition. Now, if I was going to any health profession, with the knowledge, that Oh, and I found out that they’re basing their treatment and their care on irrational superstition, there’s a fairly good chance I’d be canceling that appointment and finding someone better. I understand that if there’s a cultural thing around woowoo. With it, again, being art, you know, often used in the context of Oh, you know, I’m just fine and a bit quirky. But when you actually look at what that means, it’s pretty much the complete opposite of what the profession is. I don’t want an OT or any health profession that is irrational, and basing their their treatment options on superstition. So I’ll put that one aside for now, because I just feel like it has no place in the profession. And again, my opinion, another one slightly off topic to the slightly off of brand to the ones that we’ve looked at so far. But the the concept of serving, and I know this one’s gonna be slightly controversial. I know people are gonna have different opinions about this. But I have the microphone. So here’s my opinion. When we’re looking at definitions of serving, I know a lot of OTS do talk about I’m serving my clients, or I’m serving this population, etc. And it’s never sat well, and I never really understood whether it never sat well, because I don’t like being told what to do, or whether there was a more sort of genuine reason for me not seeing a correlation with ot. So I’ve sat down and actually put a lot of reflection into this one specifically. And I think I’ve kind of worked out why I don’t like it. So when we’re looking at definitions, the definitions is either acting in service or distributing something that’s kind of the two different trends of the the various definitions of serving. So we’re acting in service. So we’re serving someone, or we’re distributing something. So we’re like, you know, we’re we’re serving dinner or something, we’re serving our service of some sort. Either way, either one of those two, I think, and this is the big thing that that irks me and sort of my intuition never really clicked with the term is either way, neither of those are collaborative. Collaboration is one of the biggest things I see in a contemporary occupational therapy profession. And I feel like that’s where the profession is moving more and more is collaboration with our clients. If I’m serving them, then it’s almost like the complete opposite end of the spectrum to me being prescriptive and giving them a service and fixing their issues. It’s me almost taking that very passive role. And whatever you want, I’ll do that, that’s fine. We can off we’ll we’ll get an idea in our heads of what serving just as a general term, not in a healthcare setting sort of means. But it’s a very passive, it’s a very standoffish, it’s a very submissive role. Generally, in any serving profession. There’s not a lot of collaboration, if any inner serving profession. The other thing of distributing a service again, that’s probably more closer to the prescriptive role where I can serve out information and I can serve out, you know, equipment, and some people’s roles may fit that. That’s not what they should be in there. If they if your role does fit into that category, I’d be strongly advocating for you to advocate an upgrade of your job description because that’s that’s not really what it is I meant to do. But this collaborative, or lack of collaboration, when we’re looking at serving people

is the reason And why I don’t feel like it’s fully encapsulating in a really good way. Hopefully not Anyway, what we’re doing with people. I think a lot of the time it gets used because it sounds altruistic. It sounds like oh my god, you’re such a good person, you’re serving these people. And these, you know, it almost it very much, to me, an accident image of an awesome them, in my mind, if I’m serving someone than I am below them. And, you know, I am at their beck and call and fulfilling their needs, whatever they are, in this instance, that would be some sort of health care need, obviously, but what we’re trying to aim for within this profession is collaboration, we want to be putting the the person that we’re working with on the same level as us, yes, we’re bringing a different skill set to that collaborative team, but so are they. And we want to make a good mix of those skill sets. And essentially try and build the best team work that we can, in order for that person to get the best service that we’re able to provide. If I’m submissive, if I’m below them, same as if it’s the other way around, I’m not able to give them the best service that I potentially can provide to them. That that power differential, which we talk about, and anyone who looks at any of the bigger practice framework models, the one I’m thinking of, particularly as the Canadian practice framework model, because that’s what we tend to teach our fair bit of here in Australia will know that negating a power differential is an important part of that as his collaboration. But negating that power differential doesn’t mean swinging it to the other extreme, that’s not negating your power differential, that’s just shifting it to the other foot. So that’s, that’s where I have issues with serving, and I’m not 100% Sure. What an alternative, if there is needed to be an alternative, I do feel like it’s often being used as a marketing term for therapists, I do feel like they’re, you know, promoting it for almost like a virtue signaling like, Look, I am serving these people. And below you, I am at your service, use me for whatever you need. But I am of service to you, which in reality, it might sound altruistic, but I can guarantee you the service that you’re actually providing isn’t you’re not of service, you, hopefully, are aiming for that collaborative middle ground. So the next one I wanted to bring up is motivation. And I don’t want to bring up because this is this is one that I don’t think people are, like, shouldn’t be using, because we definitely need to look at motivation, I believe that some of the concepts and the understanding around motivation is not very well understood by OTS. So the the main, I guess, example that I hear quite often is a person or even themselves sometimes in the description has no motivation, which isn’t a thing. I feel like we have, for whatever reason, probably through this process of learning, standardized assessments got into this mindset, that motivation is

able to be measured quantitatively. When it’s not like that. It’s not like we have these seven buckets for the different activities we do. And we have to put some motivation in each one, in order to get them done. It doesn’t work like that. So when we’re looking at the actual definitions of it, we’ll This one here is it’s looking at the state or condition of being motivated, or having a strong reason to accomplish something. And that’s the important part is the reason to accomplish something. So you’re motivated when you have a reason. Now, if someone in for in the earlier example, when I was saying someone’s being described as having no motivation. Generally, that’s not a very well, that’s not a very helpful thing to look at. You’re not going to be able to do anything with that particular assessment of the situation. But being motivated means someone has a strong reason to do whatever it is. If someone is lacking in motivation, or they’re not feeling very motivated, then it means that they don’t have a very good reason. Now there’s a couple things that you can look at with that is one, you’re trying to get them to do something that they just don’t about like, there’s literally no reason at all for them to be doing it. ie, you can probably think of some kind of standardized ot assessment that the person just cannot relate any reason to actually be doing it, that makes it hard to actually get the motivation to do it. The other reason is that

you kind of think of this as like a tug of war. that reason, there might be a reason, again, you can think about these weird and wonderful standardized ot assessments for many moons ago. Things like pegboards. And that sort of stuff, there may be an actual reason. But it might not be strong enough to overcome the reason that they want to do something different. So I have a choice right now, in that I can sit at this desk, and I can record this episode, or it’s a beautiful day outside, I can go down to the beach. Now, my motivation to do both, there’s definitely a reason I can do both reason to go to the beach is I enjoy it, it’ll be nice and cool. It’ll be lovely weather for the first time in quite some weeks. It’s good for mental health, blah, blah, blah. Reason number two is I’ve been putting this reason not Reason number two, but reason for doing the alternative, which is recording this podcast is I’ve been putting this off for a long number of weeks, I really want to, and I’m really curious about your opinions, as to some of these words that I’ve been thinking about for quite some time. At this point in time, my motivation, my reason to do either of those activities, this one, as you can probably tell, because you’re listening to me, is a stronger reason. To me, it’s a more important thing, it’s something that I feel at this point in time, there are less barriers to the is I’m going to get more accomplishment out of and I feel like I can do the other one later on. There are other ways around it. So my reasoning behind accomplishing both of those activities. I just happened that at this very point in time, this one is stronger than say going to the beach. Now different time. Again, I would need to reassess if I had a scratchy throat that’s going to impact on which of those I feel like my reason or need to accomplish it is gonna change because I’m like, well, I’ve got a scratchy throat so I could push through, it’ll sound like crap. And I’m not going to be happy with it when I’m done. Which is that sense of accomplishment, I’m not going to get as much sense of accomplishment out of it. Or I can go to the beach where I don’t need to worry about my scratchy throat, do that. Do the podcast and other day. Yes, it’s been put off. Yes, that’s, that’s not adding to that barrier, because I’m putting it off again. But if I’m going to do something I need to me I need that sense of accomplishment. So a lot of those sorts of processes, often we do without thinking about them. Like I Unless Unless I wasn’t was actually recording this podcast, I probably wouldn’t have thought about those two particular activities, and go on. Hmm, I wonder what my reason might be for doing them and what the polls, the barriers etc, are, and which one’s stronger, etc. I just like our gut feeling, I’m going to do this podcast. Intuition is really powerful when it comes to motivation. And it can be, again, something that we may, a person may not have explored in depth or reflected in depth about the reason why they do or don’t want to do something. But it’s just a gut feeling. Often that gut feeling probably 90% of the time in my experience, that gut feeling, if you actually do then sit down and look at the reasoning. There is reasoning there. It’s very rarely wrong. But it’s important that intuition, which doesn’t often get taken into account, when we’re looking at motivation is actually looked at, in doing it that way. And we’re looking at reason, as opposed to motivation as a quantity. We’re going to have much more successful outcomes with the people that we work with, because we have a much better understanding of why they’re doing things why they’re choosing to or not choosing to engage in certain activities. Why aren’t you wanting to do your rehab exercises that the physio gave me? Okay, well, it’s because they don’t see the reason for it, or the reason isn’t very clear to them, which means it’s not going to be very strong. And they have all this other stuff, work stresses, family stresses, that sort of stuff, which to them the reason, the reason in quotes as a noun, getting on top of that stuff. is a much more important thing, because they can see the reason for that, you know, keep the family happy and healthy, keep the household running, etc, etc. So we need to look at it on terms of reason, which, for an OT really shouldn’t be that difficult. Because a lot of the times when we’re looking at occupation,

we should be looking at a reason for engagement. That reasons for engagement is exactly the same process that we’re using to look at the reasons behind when we’re looking at motivation. So if we’re looking at reasons for engagement, as opposed to just here’s the activity, and what’s your motivation, we’re killing two birds with one stone. So we’re going to get an understanding of how motivated they’re going to be, it might simply be a matter of looking at a broader range of occupations, like for example, the two, the two things that I could potentially have done today, or right now this afternoon. And looking at the reasons I would want to engage in those, and then you can sort of compare and discuss collaboratively about which is stronger, and which is going to have the most pool or at what time because obviously if it’s at nighttime, okay, cool, it’s during the day now, maybe go to the beach now and at night, when there’s not much point in being at the beach, because a lot of the benefits of the beach disappear at night, you can maybe do your podcast. So that’s the level that we need to be that’s a basic level that we need to be getting to an understanding of the people that we work, when, especially when we start looking at motivation. But motivation isn’t quantitative, we don’t, you don’t measure it. Not I’ve got three quarts of motivation. And I need three and a half to get this done. Like it doesn’t work like that. Alright, one of the last ones and a big one. And I put this out to Instagram the other day, just to get some other people’s opinions, the art and science of occupational therapy. Now, this one, I know a lot of people are going to have opinions, because a lot of people sent me their opinions on what they felt like it meant. And the interesting thing was, and I haven’t shared these responses on Instagram, because I felt like it might follow other people’s opinions. So the interesting thing about it was every single person sent me something completely different. There was there wasn’t even any system it really in the answers about what the art and science of ot actually me. So let’s start with the definitions. Obviously, we know what the definition of science is, I would be hoping to know the scientific processes, we know that ot is being backed up by a many different sciences, including occupational science, and some psychology and other things, some philosophy as well. But there are many sciences that go into constructing our perspective of what occupational therapy is. But we’ll say for the sake of argument that we’re going to look at that from an occupational science point of view, given that that’s the field that was essentially designed to try and support the profession. So that means we need to have a look at what art is. Now, there’s a million different definitions of art. Surprisingly, I didn’t think there would be I never actually had considered what the definition of art is. But there is a common theme between them. And its aesthetics. Which is interesting. Because that’s again, that wouldn’t have even been something that I may have considered putting in a definition of art. So majority of the definitions are either looking at creating something according to an aesthetic principle, or improving something’s aesthetics, presumably according to the same principles. So you can, quote, add up something as in, you know, dress it up, improve it, etc. But it’s specifically looking at aesthetics. So when I’m thinking about how that might relate to the art and science of occupational therapy, obviously, we know the sciences that that very, that very structured research background, and how we should implement and the types of things that we should implement as a profession. So what exactly is the art and I did have some people sort of try and explain to the, in their opinion it was to do with how it was implemented, but then that also gets covered under the science. If you’re going to have a best practice, then the best practice needs to include how things are actually implemented as well as what’s implemented because that’s otherwise it’s not a best practice, it’s just the best resource. So that was interesting. But the I don’t feel like there’s anything that

we do that’s particularly sore specifically to do with aesthetics. But then in reflection, the only thing that I could think of, and I am curious to your thoughts, a lot of the interventions that we do, we try and make them relevant to the individual. So a person has a hand injury, we need to try and find how we can help improve that injury. Improve that area of that person’s life using the things that they do in their day to day life, using their occupations. The art aspect that I could, the only way I could find to justify it based on the actual definitions was, is the art aspect of the art and science of occupational therapy, looking at how we take a complex scientific concept, and, again, for lack of a better term, dress it up, so that it seems one more appealing. And two more relevant to the individual that we’re hoping will actually engage in that for their their benefit. That’s the only way I could try and sort of make the two concepts fit. And I am curious, I wasn’t able to find too many sort of different specific definitions on the art and science. But it was mainly through reflection and discussion that these these thoughts started coming. But I feel like dressing up the aesthetics, so to speak of the information and the resources that we have discovered through the scientific process could potentially be our way that we could utilize the time within the profession. Now, how have I seen it utilized? The main way that I have seen it utilized by occupational therapists, which is the reason why red flagged for me in the first place was I feel like everyone has a relatively good understanding of what the science of it looks like. And then people would justify absolutely anything else that came up as if the art I, okay. Why? No answer. So I, anytime there’s no, I think, why is probably the question I asked the most. And I’m sorry, to my students, but I feel like critical thinking is something that the, the the profession needs. And while we’re on the topic, looking at critical thinking definitions is disciplined thinking that is clear, rational, open minded and informed by evidence. So if you were not able to critically think about what this art is, then does it actually need to be there? The interesting thing is that it has to be informed by evidence anyway, so how that wouldn’t make it a science. So even the art of occupational therapy is actually science. Oh, is a deep rabbit hole. But it’s something again, I don’t have a definite answer. But I am definitely curious to hear your thoughts around what you feel the actual art and science of occupational therapy is, and be able to explain why in a clear, rational, open minded way. I am more than than happy to do a follow up episode. If people do have opinions on any of the words that we’ve explored here today, I find it really interesting. And I do, again, I reiterate, from the very start, I do feel like semantics are important, the linguistics, the words that we use, as a profession are important. And I feel like we need to, as a profession, be a bit more consistent with how we’re using these times. And I know that we are very broad and diverse and all of that stuff. But I do feel like one of the reasons maybe that people don’t understand what we’re doing is because we’re very inconsistent as a professional in using some of these terms. If we have our heads around them, and we understand them better. I mean, we shouldn’t be using terms we don’t understand anyway. But especially, for example, particularly the ones that we’ve discussed today, if we have a heads around these, and we’re discussing them, consider Instantly across the profession, I feel like one it’s going to make for a much more consistent professional identity, which is also going to assist us in being able to support and explain what occupational therapy is to the people that we work with.

So, that’s enough of your time that I have stolen from you today. Thank you very much for listening. Please do drop a DM, drop a comment, send me an email if you do have any other words that you feel like OTS might be misusing or misunderstanding. If there are any of the ones that we’ve explored today that you feel particularly strongly about? please do let us know. And let’s start this discussion because these discussions are how we make the magic happen. So thank you very much, and I’ll see you in the next one. If you liked this episode, and want to check out more, head over to occupied podcast.com or search occupied podcast in your favorite podcasting app. If you have thoughts or reflections on the topics discussed today, please do get in contact, we’d love to hear from you. And lastly, if you got some value from this and you want to help us out, like, subscribe, share it with a friend. Remember, be good to yourself, be good to others and always keep occupied