About Debora Davidson, PhD, OTR/L

Debora Davidson, PhD, OTR/L, has practiced OT since 1979. Her clinical career initially centered on children and adolescents with behavioral and emotional problems. For 20 years she served as an OT faculty member at several nationally ranked universities. In 2011 Debora left academia to initiate Bright Futures in Focus, a private practice serving young adults with disabilities who want to achieve a satisfying transition to adulthood. From 2011-2015 she was the OT Clinical Editor for OnCourse Learning. She is a clinical occupational therapy blogger for TodayinOT.com. Debora initiated Authentic Occupational Therapy to inspire OTs who want to regain their clinical mojo. Join the conversation at www.facebook.com/AuthenticOT.

Yerxa’s Authentic OT

“Occupational therapy begins when everyone else has given up.” ----E.J. Yerxa, OTR- 1966 The Eleanor Clark Slagle Award and Lecture is an annual event that honors an American Occupational Therapy Association member who has made unique and substantial contributions to the body of knowledge of our profession through scholarship or clinical practice. In 1966, the brilliant Elizabeth J. Yerxa, PhD, OTR, FAOTA, was honored with the award. The words she shared during the lecture resonate with wisdom, and can guide and challenge us as much today as then. Yerxa is a distinguished emeritia professor at the University of Southern California, Los Angeles. In her lecture, Yerxa reflected on whether occupational therapy would achieve its status as a true profession. That this was ever in question might be unsettling, but it was an issue many occupational groups were debating in that era. Sociologists defined occupations as “professions” when they met certain criteria, such as: a unique and well-defined body of knowledge, a unique vocational niche, a common language, university-level educational programs, a national association, a code of professional ethics and a credentialing process. Occupational Therapy has long had well-designed and rigorous standards for OT and OTA education and credentialing and a unique body of knowledge. We have standards of practice and a code of ethics. More research always is needed, but key occupational therapy theories and methods have been tested scientifically. Occupational therapy’s position as a true profession is no longer controversial, but we must continuously grow our science and guard the integrity and fullness of our practice if we are to maintain our professionalism. Yerxa’s viewpoint Yerxa’s writings reflect strong themes of the value of professional autonomy: “The occupational therapist of the future will need [...]

Feeling stressed in your SNF? You’re in good company

Bosses sometimes ask therapists to treat patients who refuse care, don’t need it or are in advanced stages of illness, therapists say. Recent interactions with OT colleagues in distress have left me wondering just how widespread the extreme pressure for productivity is. An Aug. 16 article in the Wall Street Journal provides some answers. The article said the rate of classifying Medicare patients as recipients of ultra-high therapy (at least 720 minutes per week) has increased from just 7% in 2002 to a whopping 54% in 2013. The article stated many of these older adult patients are too frail to tolerate intense intervention, as their therapists are well aware. I have been communicating with OTs across the country who are anxious because they are pushed to take actions they know are inappropriate and try to compress too much work into too little time. I know I’m preaching to the choir here, but I am compelled to state the obvious when things are going off the tracks for so many of us. The Wall Street Journal story highlights a tragic case in which a frail 96-year-old man with dementia was the recipient of ultra-high therapy. If the report is accurate, the patient went into medical crisis and died weeks after being hospitalized for dehydration. I was mortified to read excerpts from the OT and SLP records that reflected how ill and disabled this gentleman was. My heart goes out to those therapists. Although I don’t really know their side of the situation, I imagine they are like so many others across the U.S. who must follow rigid protocols and productivity demands. The article references interviews with healthcare providers and administrators across 17 states who indicated they [...]

Tell me a story: The oral tradition of OT

By Debora A. Davidson, PhD, OTR/L I have always been fortunate to practice OT among an amazing community of clinical role models with whom I have shared stories about our ways of practicing. I recognize the enormous effect these stories have had on my development as a therapist. I was and am part of a wonderful community. The oral tradition has taught me there are many ways to influence people’s occupational lives. I’ve learned that OTs can develop their own best strategies and avoid mistakes based on stories shared by peers. Here is one of my best stories. I am sharing it to illustrate the power of clinical story-telling. I have left out or changed critical details to protect my patient’s confidentiality, but it’s quite true. I’ve used this story in my classes to springboard discussion among my OT students about safety in the workplace. I’ve also relayed it to experienced OT pals to generate a laugh. It was 31 years ago. I was a young OT, newly hired onto the child psych unit of a large teaching hospital. I had worked with lots of kids in community settings. I felt quite confident in my skills and was eager to prove myself. My patient, a young adolescent boy who was about my size, seemed fatigued and depressed. Those traits were not uncommon for kids in our unit. I decided that what he needed was mildly aerobic activity. I decided we’d play badminton in the gym. My colleagues raised their eyebrows when I announced my plan, but I was not worried. I knew this kid, and we had a solid therapeutic alliance. Off we went. I was well aware that what brought this patient into our [...]