“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 writings reflect strong themes of the value of professional autonomy: “The occupational therapist of the future will need to understand medical thinking but insist on having their own pair of glasses with which to view the world, because society and people who have disabilities need another perspective. The occupational therapy profession will provide new opportunities for people who cannot be cured by medicine to achieve mastery over their environments and to participate in activity that is satisfying and life affirming,” Yerxa wrote in The American Journal of Occupational Therapy in 1992.
I believe if we settle into repetitive and rote clinical roles, if we hand over our autonomy to use our reasoning and skills as clinicians who provide occupationally based, evidence-supported and personalized evaluations and interventions, then we are functioning as mere technicians. Likewise, if we choose to follow company rules and demands that disagree with our professional standards of practice, clinical expertise or code of ethics, we devolve into mere employees who are paid to do as they are instructed and no more. We must demonstrate our skills and explain our reasoning to our clients and employers, whose understanding of what we do is based on what we show and tell them.
What practicing authentically means
Yerxa described occupational therapy as sharing the common purpose of improving lives with many other professions. However, she noted occupational therapists achieve that purpose through unique methods. To paraphrase Yerxa’s Slagle lecture, practicing occupational therapy authentically means:
• Understanding and using an array of media (i.e. activities) that will appeal to clients’ interests, needs and goals
• Collaborating with clients to select and engage in personally meaningful activities for them to do during their sessions
• Using our specialized skills and knowledge to expose clients to a variety of experiences that help them to try out new options, to learn their strengths and limitations and to strive to become their own truest selves
• Learning and blending current, solid science with genuine interpersonal connection and caring
• Giving of our time and attention to be truly present with our clients and ever respectful, caring, positive and genuine
Yerxa’s wisdom transcends the decades. Authentic occupational therapy is a uniquely effective and needed professional service that transforms lives when everyone else has given up.