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  • Reclaiming the Magic of Occupation: Witches, Healers, Makers & What's Next

    Reclaiming the Magic of Occupation: Witches, Healers, Makers & What's Next
    2026/11/02
    Hello everyone,Happy belated Halloween, Samhain, and Día de Muertos to those who celebrate!As we move through this season of remembrance, creativity, and cultural traditions, I’ve been reflecting on the ways occupation connects us to our identities, histories, communities, one another and the wisdom and innovations of our collective ancestors.I’m excited to share my latest article published through The Occupational Therapy Hub:Witches, Healers and Makers: Reclaiming the Magic of Occupation This HalloweenWhat can Halloween, ancestral healing traditions, folk art, and the early history of occupational therapy teach us about the future of our profession?Quite a lot!In this article, I invite readers to explore connections between Halloween and Día de Muertos the history of women healers, occupational therapy’s creative and reform-oriented roots, and the collective power of meaningful occupation.What You’ll Explore in the Article* The collective occupations of Halloween and Día de Muertos: How shared rituals, costumes, storytelling, remembrance, art, and community celebrations connect people across generations, preserve cultural knowledge, and foster identity, belonging, and collective meaning, while reflecting distinct cultural histories and traditions.* History and professional autonomy: How historical struggles over healing knowledge, gender, and professional authority continue to raise questions about whose knowledge is recognized and valued.* Creativity and collective occupation: How folk art, cultural practices, and shared occupations can become powerful expressions of solidarity, cultural continuity, and social change.* Our professional roots: What occupational therapy’s creative, community-oriented, and reform-minded history can teach us about responding to emerging healthcare and social needs.* Occupational possibilities: How occupational science helps us recognize opportunities for participation, inclusion, innovation, and systems change beyond conventional service delivery models.Read the full article on OT HubWhy Explore The Occupational Therapy Hub?Beyond my article, OT Hub offers opportunities to discover international perspectives, educational articles, professional resources, and conversations exploring the breadth of occupational therapy.I encourage you to explore the platform and discover perspectives beyond your usual practice settings and professional circles.Sometimes encountering a new perspective is all it takes to reconsider something we’ve long accepted as a given.Continue Exploring: Free Witches, Midwives & Nurses WorkshopCurious about the connections between historical healing traditions, women’s knowledge, and the evolution of modern healthcare?I invite you to explore my free Witches, Midwives & Nurses workshop, available inside the Evolved Living OT/OS Collaborative free Skool Community Classroom!Inspired by the work of Barbara Ehrenreich and Deirdre English, this educational workshop explores how gender, institutional power, and the professionalization of healthcare have shaped whose knowledge is recognized, valued, and legitimized.Through an occupational science lens, we’ll consider what these histories can teach us about professional identity, autonomy, creativity, and opportunities for more inclusive and collaborative approaches to healthcare.And there’s more to explore!Our free Collaborative also includes the Occupational Science 101 Guide, OS A–Z educational series, OTPF-4 resources, podcast episodes, articles, and opportunities for professional discussion and shared learning.Whether you’re a practitioner, student, educator, researcher, or interdisciplinary collaborator, you’re welcome to join us.Join the Free Collaborative & Explore the WorkshopBecause understanding where we’ve come from can help us imagine where we might go together.Coming Next: Hearsay Wearing a Lab Coat, Part TwoThis Substack is reader-supported. To receive new posts and support my work, consider becoming a free or paid subscriber.Speaking of professional history, authority, and the boundaries of our profession...If you’ve been following my recent Substack series, Hearsay Wearing a Lab Coat, you know I’ve been exploring what happens when institutional traditions, personal opinions, and professional assumptions become accepted as regulatory facts.Part Two is coming soon.We’ll take a closer look at conversations surrounding dry needling in Florida and what they reveal about regulatory literacy, professional gatekeeping, and the importance of distinguishing actual legal restrictions from assumptions about what occupational therapists are permitted to do.My intention isn’t to encourage anyone to practice beyond their competencies or disregard legitimate regulations. It’s to encourage greater curiosity, accountability, and clarity about the boundaries we sometimes place around ourselves and one another.After all, if occupation is woven into nearly every dimension of ...
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    6 分
  • Hearsay wearing a lab coat

    Hearsay wearing a lab coat
    2026/09/23
    You asked a careful question about your scope and got an answer delivered with total certainty and no source. Maybe it came in a comment thread, maybe in a team meeting, and you felt yourself shrink a little inside a profession you spent years training for. If that has happened to you, this essay is for you, and so is the free journal club I’m hosting this Saturday.Details are at the end, or you can join the Evolved Living Collaborative here now and meet us there Saturday.I see some version of this exchange nearly every week, in practice groups, in team meetings and in hallways outside treatment rooms. I’ve de-identified it, since what matters is how it works and nobody in particular.A practitioner asks whether OTs can perform digital stimulation as part of a bowel program for a client with a spinal cord injury. She has already checked her state practice act and the AOTA materials, found nothing explicit either way, and is asking before she proceeds. That’s exactly what a careful clinician should do.Someone answers in two words.Absolutely not.They cite no statute, regulation or professional standard, and often give no sign that they hold the credential they’re ruling on.That answer will land on somebody’s practice. Maybe not hers, since she was already reading the source documents. Somebody watching, though, will absorb “OTs can’t do that” and carry it into a team meeting six months from now, where a person who no longer remembers where they heard it will repeat it as fact.A scope shrinks one confident, unsourced sentence at a time, repeated until it hardens into something that feels like law.The missing-sentence fallacyThe reasoning under that two-word answer goes like this: I can’t find this intervention named in an OT document, so it must be prohibited.Our own professional resources ask for a much fuller process. That process includes checking whether applicable documents actually contain language prohibiting the practice (American Occupational Therapy Association [AOTA], n.d.-c), and I’ll lay out the whole sequence below.AOTA describes occupational therapy as a dynamic and evolving profession responsive to societal needs, system changes, emerging knowledge, research and technology. It also makes clear that professional documents do not supersede state laws and regulations governing practice (AOTA, 2021). Silence in a document tells you the document is finite, and by itself it proves nothing about prohibition.Sometimes that silence tells us something more hopeful. A practice that has not been extensively codified may simply be an area where the profession has not yet developed the evidence, competency infrastructure, educational resources or policy language practitioners need. People may already be doing pieces of that work in clinical programs and communities, while much of their knowledge stays in clinical reasoning, local outcomes and conversations with one another.That gap is an invitation to build, responsibly. When practitioners pool what they have learned, document outcomes, collaborate with researchers and communities, develop competencies, and bring that evidence into professional and regulatory conversations, today’s missing sentence can become tomorrow’s resource.I’m doing exactly that right now, working on a paper with Dr. Tim Dionne and Dr. Susan Burwash, and I’ll come back to it at the end.So when you can’t find a practice named anywhere, one question is absolutely whether you are permitted and competent to do this now. Another is who ought to be developing the evidence and infrastructure this area still needs, and sometimes the answer to that second question might include you.Where our certainty actually comes fromI’ve been watching how scope gets argued online for a long time, and the pattern is remarkably consistent. People who answer scope questions with total conviction are often drawing on something far more local than they realize.They’re drawing on when and where they went to school, and on what the curriculum emphasized in that particular decade. A clinician trained twenty years ago and one trained last spring can hold very different pictures of the same profession, and each may describe theirs as simply “what OT is.”They’re also drawing on the traditions of the agencies they’ve worked in, meaning the way a department has always done things and the precedent nobody has questioned since the manager before last.Very often they’re drawing on their own personal boundaries as well. “I would never do that” is a legitimate thing for a clinician to feel, and “I have not developed competence to do that safely” is an important professional judgment. Delivered as a statement about an entire licensed profession, however, that individual boundary can become personal preference dressed up as policy.Six things we collapse into oneMost scope arguments in our profession are really six different conversations wearing one label. Untangling them...
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    34 分
  • I wrote to CMS. But this is about more than policy.

    I wrote to CMS. But this is about more than policy.
    2026/09/16
    It’s Tuesday afternoon…You’re sitting in a care conference, IEP meeting, team meeting, or nursing station listening to someone explain why your client doesn’t need OT.You know what you have observed.You know what the client has told you.You know there is more happening here than what fits neatly into the criteria being used to make the decision.Maybe a discharge plan is being made and you weren’t included.Maybe someone in the district is telling you why a student no longer requires your involvement.Maybe someone in the nursing facility has already decided what happens next.Maybe the person making the decision simply has more organizational authority than you do.Your client wants something different.You see something that isn’t being discussed.And you can already feel the cost of being the person who says so.So you sit there doing the calculation.Do I say something?How hard do I push?Am I overstepping?Is this actually policy, or just how this organization does things?Will I be labeled difficult?Will speaking up change anything?What will it cost me if I do?What will it cost my client if I don’t?You want to be respected.You want to be collaborative.You also want to practice with integrity.And increasingly, those things can feel like they are pulling you in opposite directions.So you walk on eggshells.You notice how the system is affecting the client.You notice how it is affecting your colleagues.You notice how it is affecting you.But there is enormous pressure not to talk about any of it.Eventually, that constant calculation becomes exhausting.I think a lot of what we call burnout contains something more specific:Moral fatigue from seeing what is happening while feeling increasingly powerless to change it.I know that feeling.And I have been following the questions underneath it for a very long time.I didn’t find policy through occupational therapyOccupational therapy gave me language for questions I had been carrying much longer.I grew up in rural America with a mixed-race cousin who had a severe chromosomal disorder.I watched someone I loved encounter structural barriers to receiving care that recognized the fullness of her humanity.And somewhere inside that experience, I began imagining something different.I dreamed of a world where she and I could grow older together.Where disability did not automatically mean separation.Where the services someone needed could come to them.Where community, relationship, dignity, care, and belonging could be organized around a person’s life rather than requiring a person’s life to be organized around the limitations of a system.I didn’t have language like aging in place, community-based care, occupational justice, implementation science, or structural determinants yet.I just knew I wanted a world where we could age in place together.There was another story in my family, too.Before I was born, an uncle who was suspected of being autistic was institutionalized.He later died in circumstances my family understood in relation to neglect and the deterioration of social supports surrounding people like him.I inherited that story before I ever entered a policy classroom.Before I knew what an occupational therapist was.Before I knew how reimbursement worked.Before I understood that decisions made in legislatures, agencies, institutions, school districts, hospitals, insurance systems, and organizations could eventually determine extraordinarily intimate things:Where someone gets to live.Who gets to remain with their family.Who receives care.Whose needs are considered too complicated.Whose knowledge is believed.Who gets included in decisions.What support is considered worth paying for.And what kinds of lives our systems are willing to make possible.That is probably where my interest in policy actually began.Not in Washington, D.C.Not in a professional association.Not with CMS.At home.Eventually, I learned that these intimate experiences had structural dimensionsAs an undergraduate, I found student advocacy and lobbying alongside campaign and labor organizing work and study.Later came occupational therapy.School-based practice.Outpatient pediatrics.Acute care.Home health.Post-acute care.Mobile outpatient services.State and federal advocacy and policy work, including work related to shaping applied behavior analysis policy in Washington State, partnership with AOTA, AOTPAC-related involvement, and leadership development.Then occupational science, education, scholarship, and my growing inquiry into agency-centered, critical, and co-constructive implementation science.The settings changed.The scale changed.My language became more sophisticated.But I am not sure the underlying question ever changed:Who gets to participate in authoring what becomes possible for a human life?My clinical work kept giving me different views of that question.School-based practice showed me how policy, eligibility, institutional interpretation, educational priorities, and family ...
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    20 分
  • CMS Payment Reform: Your Voice Is Needed by September 14

    CMS Payment Reform: Your Voice Is Needed by September 14
    2026/09/09
    What happens when the people delivering healthcare actually participate in deciding how that care is valued?Right now, we have an opportunity to do exactly that.CMS is accepting public comments on the CY 2027 Medicare Physician Fee Schedule proposed rule, and the deadline is September 14, 2026.If you are a U.S.-based occupational therapist, physical therapist, speech-language pathologist, or another rehabilitation or allied health provider, this is a moment to pay attention and participate.Read the CMS CY 2027 Medicare Physician Fee Schedule proposed ruleSubmit a public comment through Regulations.govSearch for CMS-1848-P when submitting your comment.Why this mattersPayment policy is about much more than reimbursement rates. It influences what healthcare systems prioritize, how services are structured, what work is considered valuable, and what kinds of care are realistically available to patients.For rehabilitation providers, there can be a significant gap between the work that actually produces meaningful outcomes and what can be easily represented through a billing code.Think about what goes into a complex rehabilitation encounter. There is the assessment itself, but also the clinical reasoning behind it. There is communication with caregivers and other providers, environmental analysis, education, risk management, adapting interventions to the individual, coordinating care, and making decisions based on information that may not be captured by a single diagnosis or procedure code.For many of us, these are not extras added onto the work.They are the work.That makes this comment period important.Rather than simply saying that reimbursement is too low, we have an opportunity to explain what current payment structures fail to capture and what that means for patients, providers, and the healthcare system.What is changing?The CY 2027 proposed rule includes changes and requests for input related to how Medicare services are coded and valued, including the Practice Expense methodology and aspects of care management and remote monitoring.These are technical policy issues, but the questions underneath them are surprisingly practical:What does it actually take to provide good care?What resources are required?What kinds of clinical work happen outside the most visible portion of an encounter?How should payment systems recognize complexity, coordination, clinical reasoning, and the resources required to manage patients over time?These are questions rehabilitation providers have direct experience answering.OT Potential’s Sarah Lyon and colleagues have been particularly active in bringing OT and PT perspectives into this conversation. Their proposed recommendations include better differentiation in reimbursement for evaluation complexity and consideration of non-time-based therapist management codes to recognize some of the ongoing clinical work that occurs throughout an episode of care.You do not have to agree with every recommendation to see the value in participating.In fact, this is one of the things I appreciate about the public comment process. It gives us an opportunity to respond to what is actually being proposed, identify what we think is missing, describe unintended consequences, and offer alternatives based on what we see in practice.Start with Sarah Lyon’s episodeIf you want some context before diving into the policy language, I recommend starting with Sarah Lyon’s recent OT Potential episode on this issue.Listen to the OT Potential episode on YouTubeThe episode provides a useful overview of the current opportunity and the work underway to bring rehabilitation perspectives into the Medicare payment conversation.OT Potential has also created a 2027 CMS Comment Template for OT and PT care, which makes the process considerably easier if you are staring at Regulations.gov wondering where to begin.Access the OT Potential CMS Comment TemplateThe template provides language you can adapt, along with references and guidance for submitting your comment. I would encourage you to personalize it rather than simply submitting the exact same language as everyone else.Your own experience is what makes the comment valuable.What can you contribute?Start with the part of the system you know.Maybe you work with patients whose needs are more complex than the evaluation code adequately communicates. Maybe much of your clinical expertise involves adapting care to cognition, environment, caregiver capacity, health literacy, routines, transportation, safety, or other contextual factors.Maybe you spend substantial time coordinating with other disciplines and caregivers. Maybe your work involves preventing a problem rather than treating the consequences after it happens.Maybe you have watched a patient avoid an emergency department visit because someone identified a risk early. Maybe you have helped a family safely manage a transition home. Maybe your interdisciplinary team caught something that would have otherwise ...
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    3 分
  • Overlap Is Not Duplication: Making Space for Emerging OT Practice informed by Occupational Science

    Overlap Is Not Duplication: Making Space for Emerging OT Practice informed by Occupational Science
    2026/09/06
    I wrote this piece in response to some discourse I was tagged in around OT’s role in sports medicine and supporting high performance athletes.The reflection is specifically in response to this three-part LinkedIn series:Part 1: What OT Adds to Sports MedicineRead the original post on LinkedInPart 2: Collaboration and Professional RolesRead the original post on LinkedInPart 3: Advocacy, Scope, and the FutureRead the original post on LinkedInMuch of the discourse in the comments was centered on concerns of overlap with athletic trainers and presumptions that what OT is offering would be essentially duplicative and disrespectful to more traditionally prominent members of the sports medicine ecosystem.I had to modify my response on LinkedIn to match their character limit, so I thought I would publish the full response here. It covers content that feels relevant to much of the endless discourse that is largely driven by shorthand misinformation, presumptions, and various insecurities that get stirred when our focus is on eliminating rather than expanding possibilities for care and innovation.Why occupational science literacy mattersA big part of why I am a proponent of increased occupational science literacy for OTPs worldwide is to encourage us to use our own distinct lens and concepts when communicating about the innovations, roots, and foundations of our practice so we can get out of this trap of being reduced to limited paradigms and understandings of other professions in bad faith.First, we tend to be undermined for possibly not having the same competencies as another discipline or profession. Then, when we reveal that we do have the same competencies, or we catch up, we are framed as essentially duplicative or redundant and not unique.This is why communicating about our identity and skills from our own foundations and core terminology, including our cosmological, philosophical, epistemic, and emerging practice developments, on our own terms, alongside the formal policy developments that have shaped our practice from the beginning, is so important.Especially if we do so with pride in our unique integrative foundations rather than shame or presumed incompetence, very often this pattern is deeply rooted in the internalization of structural sexism and misogyny as it relates to female-dominated health care professions and integrated care approaches overall.OTPs need to start recognizing that when we are met with such suspicion and accusation, it can actually be a sign of our strength and competence as a threat rather than a sign of our own incompetence or need to prove or defend ourselves where we typically already currently belong.We keep de-skilling each otherIt’s so interesting how often in this type of discourse we default to pigeonholing and limiting all skilled providers to the bare minimum of responsibilities in institutional settings.For example, often between OT and PT the discourse can reduce both professions down to upper extremity versus lower extremity, even though we all know both disciplines in the real world are full-body therapists.With the discourse around athletic trainers, it seems like we’re reducing all professions to the most basic elements of those responsibilities, rather than exploring nuanced conversations about strengths, weaknesses, opportunities, gaps, and intersections that could lead to more comprehensive care.Unlike competitive athletics, health and human services are not competitive sports.When providers compete, our clients are always the ones who lose out on comprehensive care.I also think this pattern of discourse has consequences beyond any single profession. When we continually reduce skilled professions to their bare foundations and then treat overlap at that level as evidence of duplication, we can inadvertently create conditions that discourage innovation and advancement across health and human services.The bare foundations are the floor of professional capacity, not necessarily the ceiling.If we treat the floor as the ceiling, then every advancement into an emerging specialty, every new application of foundational knowledge, and every development in professional reasoning has to first defend itself against the existence of something another profession already does.That creates a very different condition for professional development than asking what becomes possible when skilled professionals build beyond their foundations.Overlap is not duplicationOverlap between providers is not new and never has been new. It’s actually essential to communication and efficiency for there to be essential overlap.One profession having a specific body area or modality in their scope does not mean that it is somehow unlawful or an automatic restriction or duplication for another provider to be skilled and competent in those areas. It simply means more than one profession has core competencies to perform a specific function.It means there are options rather than a basis for ...
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    34 分
  • Integrating Creativity and Spirituality in Occupational Therapy: Embracing Arts, Science, and Ancestral Wisdom with Libby Lamb OT, Poet, and Creativity & Spirituality Coach

    Integrating Creativity and Spirituality in Occupational Therapy: Embracing Arts, Science, and Ancestral Wisdom with Libby Lamb OT, Poet, and Creativity & Spirituality Coach
    2026/08/31
    Here is a voice-over of the article for those who prefer audioHi everyone! I’m thrilled to share this episode with you today. If you’ve been following this podcast since it started in 2023, you might know it grew out of my doctoral capstone project during my time in the University of Utah’s Post-Professional Clinical Doctorate program from 2019 to 2023. This journey unfolded during the challenges of the COVID-19 pandemic, which highlighted the global impact that devaluing public health initiatives has had on collective on health and well-being, and made deeply evident the barriers and costs to humanity created by maintaining dynamics of scientific elitism, and the lack of accessible frameworks for translating impactful health interventions and knowledge from the academy to the field, especially frameworks informed by disability and occupational justice.After navigating two stalled capstone projects due to pandemic-related challenges, I shifted my focus to creating resources for field clinicians to develop occupational science literacy for direct practice. Over three years, I poured my heart and all my spare time into building a fully virtual introduction to occupational science, using innovative online learning tools and best practices in adult education. If you’re curious, you can explore this project at engage.evolvelivingnetwork.com, and just by subscribing to this Substack, you can get free access to the OS 101 guide, which includes a glossary of all foundational occupational science terminology. My journey back into occupational therapy higher education began after feeling disillusioned during my first two years of clinical and school-based practice as a travel therapist. I was searching for a space where I could thrive using holistic approaches that integrated mental and physical health. Initially, I hoped to work in pediatric and school-based settings, but I quickly encountered policy limitations that narrowed the focus of occupational therapy to handwriting and fine motor skills. This was disheartening, especially since my master’s research centered on executive dysfunction supports for adolescents and assistive technology in schools, areas that were largely controversial for occupational therapists in traditional settings at the time.These challenges revealed deeper issues within the field, including limited access to occupational science developments and foundational frameworks like the “Occupational Therapy Practice Framework Fourth Edition.” I realized through my my more in-depth study that these barriers were tied directly to historical inequities, such as structural sexism in higher education and healthcare leadership sourcing all the way back to the 1500s. This understanding fueled my passion for creative problem-solving and building community around these issues. I have a free training in the evolved living collaborative skool community on how Occupational Science is integrated with the Occupational Therapy Practice Framework Fourth Edition for anyone who is looking to get caught up on out latest practice guidence updates. After graduating, I launched this podcast to raise awareness about Occupational Science and my capstone course. Later, I collaborated on a textbook chapter proposal for the “Occupational Therapy Without Borders” third edition, exploring innovative ways to circulate knowledge beyond traditional academic institutions. While the chapter ultimately missed the publication deadline, the experience taught me valuable lessons about resilience and navigating academic challenges.Since then, however, I have been challenged in relation to this podcast by writer’s block, perfectionism, shame around missing the deadline, and a lack of direction without the structure of a prompt, deadline, or institutional affiliation to prove the value of my work to or rebel against. I’ve been on a personal journey of healing and rediscovery, exploring the roots of occupational therapy in the moral treatment and arts and crafts movements, and deepening my understanding of decolonial healthcare frameworks. This has included honoring the wisdom of indigenous and folk healers whose contributions have often been suppressed or commodified by modern healthcare systems. To support my own recovery, I created a podcast and community called “Rewilding the Mythic Self,” where I’ve been reconnecting with creativity, spirituality, and interdisciplinary collaboration outside of formal institutions. Over time, however, I have come to realize that fracturing out these parts of myself wasn’t really possible and was actually disconnecting me from the type of integrative work I am passionate about reviving in Occupational Therapy practice throughout the world and thank goodness I am not alone in this mission! One of the most transformative moments in this journey recently has been discovering the work of Libby Lamb an occupational therapist and poet (Author of the Acacia Project) based ...
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    1 時間 19 分
  • Clinical Reflections on Occupational Apartheid: Ethics, Policy, and Systems Change in Occupational Therapy

    Clinical Reflections on Occupational Apartheid: Ethics, Policy, and Systems Change in Occupational Therapy
    2026/03/17
    Why this Occupational Science series mattersIf you are an occupational therapy practitioner in the United States, chances are you are already using occupational science.You just might not have been given the words for it yet.That gap is part of why I created this Occupational Science Alphabet Series, a public learning series designed to make occupational science more accessible and more visible in everyday life and traditional practice settings.This first composite series begins with A for Occupational Apartheid.Recording Timestamps:00:00 “Occupational Apartheid Analysis”06:01 “Occupational Apartheid Challenges”16:11 “Systemic Barriers in OT”18:04 “Enhancing Accessibility through Advocacy”25:20 “Defining Occupational Apartheid”33:06 “Occupation and Systemic Inequality”39:23 “Advocating Equity in OT Practice”45:04 “Occupational Therapy for Healing”48:04 “Advancing Occupational Justice”54:55 “Occupational Ethics Evolution”58:50 “Occupational Apartheid Ethics”01:03:58 “Justice and Veracity”01:10:17 Healthcare Bias and Scientific Integrity01:15:59 “Addressing Maternal Health Disparities”The phrase can feel intense at first.It should.Because it names something real.It gives language to the ways people are systematically denied access to meaningful participation in everyday life, not simply because of individual impairment or diagnosis, but because of how social, economic, political, and cultural systems are organized.And that matters deeply for occupational therapy.Because when we only look at barriers inside individual bodies, we miss the wider context shaping participation.We miss the insurance policy.The school policy.The zoning code.The inaccessible architecture.The transportation gap.The labor condition.The funding cap.Occupational science helps us see those patterns clearly.And once we can see them, we can respond more ethically and more effectively.The Secret of OccupationOne of the most powerful insights of occupational science is that occupation always transcends the individual.Yes, participation includes personal capacity, motivation, and health status.But occupation is also shaped by:environmentculturepolicyhistoryeconomicssocial relationshipsWhen occupational therapists work with clients, we are rarely working with bodies alone.We are working with people in systems.Occupational science simply gives us a language to describe those systems more clearly.Why Occupational Apartheid MattersThe concept of occupational apartheid helps us name situations where social systems restrict access to meaningful participation in everyday life.Frank Kronenberg describes occupational apartheid as:“systematically enacted negations of humanity that divide and subjugate collectives of people to the benefit of some at the expense of others.”(Kronenberg, 2018) These restrictions can occur through intersecting social mechanisms such as:racismclassismsexismableismxenophobiaeconomic inequalityThese forces shape who has access to resources that sustain dignified living.They shape who can participate fully in everyday life.And they show up in everyday occupational therapy practice more often than we might initially realize.When Systems Become HabitOne of the most profound insights connected to occupational apartheid comes from the concept of occupational consciousness, developed by Elelwani Ramugondo.Occupational consciousness invites us to examine how systems of power become embedded in everyday activity.Because the truth is:Systems do not reproduce themselves automatically.They reproduce themselves through what people do every day.Policies become habits.Beliefs become routines.Social hierarchies become normalized through everyday actions.Over time, these patterns become so familiar that they operate below the level of conscious awareness.This is where occupation becomes incredibly important.Occupation is the point where ideas turn into action.And when those actions become automated habits, they can quietly reproduce systems of inequality, even after the laws that created them have been formally abolished.When Systems End but Patterns PersistHistory shows us that oppressive systems rarely disappear completely when policies change.Segregation in the United States was formally dismantled decades ago.Apartheid in South Africa was officially abolished in the 1990s.And yet racial disparities, inequities in access to housing, healthcare, education, and safety persist in both societies today.Why?Because systems do not only exist in policy.They exist in everyday occupations.They exist in patterns of:where people livewho receives serviceswho gets referred to carewhose needs are believedwho feels welcome in public spaceswho has access to transportation, education, and healthcareThese patterns often persist through habits and assumptions that operate subconsciously.Occupational consciousness asks us to notice those patterns.Occupational apartheid helps us name their structural ...
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    1 時間 18 分
  • Global Conversations: Cross-Discipline Collaboration in Epidemiology, Occupational Science, Disability, and AI with Emmanuel Ampomah Boadi

    Global Conversations: Cross-Discipline Collaboration in Epidemiology, Occupational Science, Disability, and AI with Emmanuel Ampomah Boadi
    2026/03/09
    Evolved Living Podcast with Dr. Josie Jarvis OT Global Conversations: Cross-Discipline Collaboration in Epidemiology, Occupational Science, Disability, and AIwith Emmanuel Ampomah Boadi---Episode OverviewIn this episode of the Evolved Living Podcast, Dr. Josie Jarvis welcomes Emmanuel Ampomah Boadi, a Ghana-based researcher working at the intersection of occupational science, epidemiology, biostatistics, rehabilitation, and disability studies. Their thoughtful, wide-ranging conversation explores how participation in daily life is shaped by social, structural, and systemic forces far beyond individual clinical encounters.Dr. Josie Jarvis opens the episode by reflecting on her diverse clinical background, spanning home health, schools, memory care, and acute and orthopedic rehabilitation. Her journey—deepened by doctoral work amid the COVID-19 pandemic—led her to occupational science as a discipline uniquely equipped to investigate barriers to participation at the population (not just individual) level.--- Key Topics Discussed- What is Epidemiology? Emmanuel Ampomah Boadi grounds the discussion by defining epidemiology: the study of how health, disease, and disability are distributed across populations, and the factors influencing those outcomes. He emphasizes that "it is the backbone of public health," using stories from Ghana and references to public health icons like John Snow and John Graunt to illustrate epidemiology’s roots in mapping, measurement, and understanding the interplay between environment and human behavior.- Bridging Disability Studies and Occupational Science Emmanuel Ampomah Boadi describes how his academic journey—spanning disability/rehabilitation studies and biostatistics—inspired him to explore the overlap between occupational science and population health. He highlights the importance of looking not only at medical conditions but also at social and environmental context, power imbalances, and race—reminding us that “everybody has some form of disability” and that “there is nothing like normal.”- The Role of Data and AI The conversation explores the need to “quantify” our observations to strengthen advocacy. Emmanuel Ampomah Boadi sees artificial intelligence as an assistive technology—valuable, but ultimately limited. He urges clinicians and researchers to retain the clarity and accountability of human interpretation, using AI as a support rather than a replacement for nuanced judgment.- Ethics, Equity, and Systemic Barriers The episode doesn’t shy away from difficult truths. They discuss well-known ethical breaches in research history (Tuskegee Syphilis Study, Nuremberg Code violations) and highlight how, without active attention to equity and ethics, scientific progress can deepen injustice. Dr. Josie Jarvis and Emmanuel Ampomah Boadi both reflect on their lived experiences of systemic inequity—from global vaccine access to the design of research and public health interventions.- Cultural Humility and Community Engagement Emmanuel Ampomah Boadi shares a poignant research anecdote from Ghana: an infrastructure project failed because outsiders did not consult the community, ultimately building a water borehole atop a sacred space. The lesson: knowledge translation is only possible with true cultural humility and partnership, not top-down assumptions.---Concepts ExplainedOccupational Science: A discipline that examines human participation (“occupation”) in everyday life, considering both individual and system-level factors—policy, environment, economics, and history—that enable or restrict engagement.Epidemiology & Biostatistics in Rehab: Not just tools for infectious disease, epidemiology provides frameworks for understanding disability, health disparities, and the structural determinants of participation. Biostatistics helps quantify these patterns and decipher root causes, moving advocacy from anecdote to evidence.Occupational Apartheid & Social Models of Disability: The episode contextualizes “occupational apartheid”—a situation where social, economic, or policy barriers systematically exclude groups from meaningful participation in everyday life. Emmanuel Ampomah Boadi distinguishes between the medical, social, and biopsychosocial (ICF) models of disability, urging listeners to see how “systemic barriers” create or intensify disability.---Practical Wisdom for Listeners- Integration is Key: Solutions come from teamwork—integrating medical science, social science, community wisdom, and policy. “You need to involve the community—what you believe to be the best solution may not fit their real needs.” - You Belong in Science: Dr. Josie Jarvis and Emmanuel Ampomah Boadi both stress that occupational science and health advocacy are not reserved for those with doctorates or prestigious affiliations. Efforts—however imperfect—matter. - Share and Connect: The conversation encourages clinicians, students, and community members ...
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    1 時間