Abstract
Family is a metaphor for the connectedness that occupational therapy practitioners and students feel for one another, for the American Occupational Therapy Association (AOTA), and toward those served. Exploring values and cultural practices that emanate from family experiences affects how we practice occupational therapy and engage with families; how we serve and lead; and how, as the profession approaches its 100th anniversary in the United States, we strengthen AOTA by welcoming all 213,000 practitioners and students who could become active, engaged members. The heartfelt connections experienced across our worldwide occupational therapy communities, giving support and nurturance to those who show promise, breaking down barriers and creating community as extended family, creating a sense of home and belonging, encouraging participation, and building excellence, strengthen the AOTA family. AOTA Vision 2025 serves as a means to facilitate the profession's future, where health, well-being, and quality of life are the outcomes of effective occupational therapy.
Keywords
Virginia (Ginny) Stoffel, PhD, OT, BCMH, FAOTA
I have been honored and humbled to serve you in my final months as the 29th president of the American Occupational Therapy Association (AOTA). “Coming Home to Family: Now Is the Time!” is how I title my closing presidential address, and I urge you all to grow our family and welcome everyone home to AOTA, just in time to fully participate in our 100th anniversary! Wouldn’t it be fitting to honor the first 100 years of occupational therapy in the United States by reengaging in our national professional association and reconnecting with those who were with us from the time we entered our occupational therapy education programs?
I chose to use family as a metaphor to apply to how occupational therapy practitioners frame their relationship to one another, to occupational therapy, to our state and national professional associations, and increasingly to our world colleagues through the World Federation of Occupational Therapists (WFOT). The culture of our profession in the United States has been shaped over nearly 100 years. With an intentional focus on being a globally connected community of dedicated students, clinicians, researchers, administrators, educators, advocates, and leaders, I hope to share stories with you that illuminate our strength as a community with its own unique culture, embracing family as central to our practice in occupational therapy.
Connecting With Our Occupational Therapy Family
Each year, AOTA and the American Occupational Therapy Foundation (AOTF) present the AOTA–AOTF Presidents’ Commendation “to honor a respected leader of the profession who has made sustained contributions to occupational therapy over a lifetime of service.” Last year in Nashville, I listened carefully to Greg Smith as he accepted the Presidents’ Commendation awarded to his wife, Dr. Jane Case-Smith, posthumously. Greg said,
What she always valued most about being an OT was that personal connection. . . . You OTs do seem to be unusual in your focus on the whole family, and in our case, on people that all you really know about is that your friend really loved them. I think that focus on maximizing life and the importance of family is why Jane loved occupational therapy.
These words reflect many of the comments I hear as I travel across the United States and worldwide—that in our profession, the connectedness we have to one another and to occupational therapy is deeply felt and valued. In fact, I believe that our connections to one another and to the distinct value we offer as occupational therapy practitioners may be central to our effectiveness based on our strength in intentional therapeutic use of self. By extension, we connect with those we serve in ways that respect and celebrate family.
Just a few weeks ago, I was taking an early morning ride to the airport in Medellín, Colombia, with colleagues from the Japanese Association of Occupational Therapy after a WFOT council meeting. After talking about our respective experiences in leadership roles, my Japanese colleague said, “Isn’t it interesting how connected we are to one another? Almost like we are family!” I smiled at her and said, “How interesting it is that you see it this way! Did you know my presidential address will be about occupational therapy and our relationship to one another as family?” In the dark interior and close quarters of the airport van, we talked about how connected each of us felt with our occupational therapy colleagues and how, compared with other professionals we worked with, the connection was undeniably personal and authentic.
Remembering My Own Family
During the past few months, especially while swimming laps, I have been doing lots of thinking about how family is reflected in our traditions and culture and how some of our own early family experiences echo later in our professional lives. While I share my stories with you, I encourage you to think of your own stories that shape the way you connect with one another and our profession.
As the seventh of nine children in my family, you can imagine that our household was always a vibrant and busy place to be. With my sister Betsy 2 years older than me, my brother Tom 2 years younger than me, and our youngest sister Anne 5 years after Tom, I found myself vying for just a few minutes every day to see if I could get 100% of our mom’s attention. Around the age of 4, each afternoon around 4 p.m., I “ran away” to the farthest corner of the block where our house was located. Mom would call our neighbors, Fran and Joe Doran, to ask if I was waiting for her at the corner. When, predictably, they replied “Yes!” she would take a stroll to come get me and bring me home, and with those minutes alone, I got just what I was hoping for.
Over time, the Dorans encouraged me to help as they harvested onions, mint, and rhubarb in their garden, and they invited me into their home for a snack, knowing they had my parents’ permission to do so. They became a part of my extended family when, on my 7th birthday, they gave me the gift of weekly piano lessons along with their love and attention after observing my interest in playing their piano. For years, I spent every afternoon practicing on their piano, and when they moved, they made arrangements for us to “store” their piano until we got our own.
As occupational therapy practitioners, we create extended family when we show each other encouragement and support and sometimes extend our own personal resources toward those who show dedication, talent, and motivation, much like the Dorans did for me. It might be in the form of building a scholarship fund or a research fund with our alma mater or the AOTF, or it might be in writing a strong letter of recommendation for a promising practitioner or educator as he or she reaches for a promotion or fellowship. As an undergraduate student at the College of St. Catherine in St. Paul, Minnesota, I received scholarships and work–study positions, served as a resident assistant, and in my final year received a federal rehabilitation traineeship grant, all of which allowed me to fund my occupational therapy professional training and, most importantly, recognize the importance of giving back and paying forward.
Nurturing Our AOTA Family
One of my occupational therapy professors was Sally Ryan, the first occupational therapy assistant to be honored with the AOTA Roster of Honor award and to serve on the AOTA Board of Directors. Sally and all of the faculty at St. Kate’s were key to my being exposed to AOTA leadership opportunities. Sally said something like this to me:
Sometimes people think of the members of AOTA as “we” and the organization of AOTA as “they,” and when that happens, power struggles and challenges build. As a leader, think of AOTA and its members as “we,” and the profession will build constructively. Don’t allow a wall to keep the organization from changing, being shaped by members who serve as leaders.
From that day forward, I took that lesson to heart. Ultimately, I coined the phrase “Every Member a Leader,” which was fully embraced by our Volunteer Leadership Development Committee to illustrate a vision in which all (using today’s numbers) 213,000 occupational therapists, occupational therapy assistants, and students of occupational therapy who could be AOTA members and leaders are active and engaged members. And when I met with student leaders from across the country who participated in the Assembly of Student Delegates, I reinforced “Every Member a Leader” by adding “A Member for Life!”
Do you think it’s possible to actually get the attention and commitment of all 213,000 of us? What can you do to welcome them to next year’s AOTA Annual Conference & Centennial Celebration in Philadelphia? With your help, I hope to welcome them home to our AOTA family as I welcomed the 500 new and returning AOTA members who joined us at the 2016 AOTA Annual Conference & Expo. Welcome to our growing family!
Let me share with you a heartfelt note sent to Maureen Peterson, AOTA’s chief professional affairs officer, from Rebecca Geller, president of the Student Occupational Therapy Association at the New York Institute of Technology last fall. The Monday after the 2015 AOTA/National Board for Certification in Occupational Therapy National Student Conclave, Rebecca sent Maureen an email saying,
Your kindness, generosity, and words of encouragement did not go unnoticed. Our program has recently made many great changes, and our primary focus is to get as involved with AOTA, our community, and our profession as possible. This conference turned out to be a great start toward reaching our goal, and it was an indescribable feeling to have that be recognized by our very own chief professional affairs officer! My fellow classmates and I are still ecstatic about your generous Twitter posts. That alone was an amazing boost of confidence and has already encouraged students to get more involved with future events. . . . We thank you for showing us what joining the AOTA family and the world of occupational therapy is truly about!
I was thankful to receive a copy of this note, and I immediately put it in my 2016 Presidential Address folder because Rebecca’s words conveyed exactly what AOTA leaders and staff have embraced: making AOTA a place where people feel welcomed, where their talents are needed and their capacity is built, and where the sense of family provides a vibrant place to contribute and participate well into the future. We reflect this in how we greet one another, in how we model professional engagement and leadership, and even through the words we choose to share on Twitter and Facebook.
When I think of family, many words come to mind . . . giving and receiving unconditional love, being committed, doing with and together, watching out for one another, sharing a full range of emotions from joy to despair to fear to happiness, working hard, stretching beyond our comfort zones, and celebrating the dreams that life presents. Just before the conference, Melissa Tilton reflected with her Facebook friends on her experiences across the past 8 years as she served on the Accreditation Council for Occupational Therapy Education®. Melissa later took the oath of office to become a member of the AOTA Board of Directors. In her reflection, she used many of the words I associate with family:
For the past 8 years, I’ve regularly seen these people 3 times per year and talked with at least one of them weekly. I’ve essentially grown up with them. The smiles, laughs, tears, memories, and activities are too many to share here. They are family to me. I cannot express just how much you all mean to me, how much you’ve taught me, inspired me, led me, and pushed me. I would never have gone back to school without your inspiration and push, would never have experienced the confidence to run for treasurer, would never have learned how to be a strong, engaged occupational therapy assistant without you all.
I hope that Melissa’s reflection encourages you to acknowledge the incredible journey you have shared with your family and your occupational therapy community. Know that you can create the same safe haven for one another, which, in turn, gives us all the inspiration and empowerment to do even more effective work.
Connecting Family and Culture
So far, I have used a few stories to highlight the heartfelt connections experienced across our worldwide occupational therapy communities, giving support and nurturance to those who show promise, breaking down barriers and creating community as extended family, creating a place where all who enter and support occupational therapy find a sense of home and belonging, encouraging participation, and building excellence. I thought it might be helpful to see what our professional literature might add to enhance our understanding of the connections among the concepts of family, culture, and occupational therapy and how those connections enhance our practice.
Maureen Fitzgerald, a medical anthropologist, is part of the faculty at the School of Occupational and Leisure Sciences at the University of Sydney, Australia. In 1997, she and her occupational therapy colleagues published an article in the Australian Occupational Therapy Journal, and she updated her work in a 2004 article in the American Journal of Occupational Therapy. Fitzgerald, Mullavey-O’Byrne, and Clemson (1997) carried out a project in the 1990s in which they conducted and analyzed qualitative ethnographic interviews with 86 occupational therapists practicing in Australia about their perspectives on an occupational therapy situation in which culture was an issue. They found that family roles and responsibilities influenced the occupational therapy process and that cultural differences with the family being served were sometimes at odds with their own professional values of independence, productivity, holism, and person-centeredness in their approach to the therapeutic relationship. Fitzgerald et al. stated,
Therapists who are aware that families play a different, and often more intimate, role in therapy, and that including them when it is culturally appropriate may lead to a more successful and satisfying outcome, often view families as collaborators and assistants rather than adversaries or barriers to overcome. (p. 14)
Therapists who are culturally competent, the researchers noted, are more likely to avoid stereotyping and are comfortable handling cultural differences, especially involving family roles and responsibilities.
Fitzgerald’s 2004 essay offers deeper reflections on how occupational therapy practitioners come to understand families, no matter how they are defined, as key contexts and reference points for our socialization process:
It is within families that we learn how to be in the world—how to understand and interact with the world and the people around us. Families provide the context for learning the beliefs, values, attitudes, and customs that guide much of our lives. We learn how to be occupational beings in and through families—or by reference to ideas about families when they are absent from our lives. Although there are other influences on our lives, for most people families continue to be important throughout their lives, whether or not they are physically or emotionally accessible. Families can be a source of both support and frustration and problems. They are a cultural universal and a cultural icon. (p. 489)
Fitzgerald’s and her colleagues’ work helps us make the links between our personal experience of family and how we expand our understanding of family as culture when we engage in the practice of occupational therapy:
Familial interactions and the roles played by family members are influenced by many factors influenced by culture, including perceptions of health, illness, disability, normality, expectations about the role, and the rights and responsibilities of all the people involved. . . . If therapists are to address the needs of the clients or families with whom they work, they must keep culture in mind with all clients or families. (Fitzgerald, 2004, p. 495)
Learning about oneself as a cultural being and engaging in deep reflection “about cultural influences on their own personal and professional behavior, roles, values, and attitudes, plus those of their clients” (Fitzgerald, 2004, p. 496) are key to cultural competence. Hence, my suggestion that we take a deep look at our own family roots; appreciate the family connectedness we have to one another, our profession, and AOTA; and further explore how an authentic appreciation for family as culture benefits those we serve may not be a totally original idea but perhaps one that deserves your time and attention!
Guiding Our Family Into the Future: Vision 2025
Let me link this focus on family and reconnecting with your occupational therapy family by exploring AOTA’s newly adopted and unveiled Vision 2025, the statement that will guide our profession’s path in the United States for the next decade or so: “Occupational therapy maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living” (AOTA, 2016). The goal of Vision 2025 is to provide a unifying statement of purpose for the profession and the outcomes occupational therapists and occupational therapy assistants are working to create. I want to reflect on how we arrived at this statement, some of the ways you helped shape this statement, and what kinds of opportunities the future holds for our profession with this vision in mind.
During the past 18 months, McKinley Advisors facilitated an objective and research-based process to review the Centennial Vision (AOTA, 2007) and adopt a vision that would guide the AOTA and the profession beyond 2017. Multiple methods were used to tap into the perspectives of our AOTA family, including past and current leaders, occupational therapist and occupational therapy assistant active and lapsed members, students and other stakeholders in the interprofessional community, the health care and education communities, and the international occupational therapy community. These methods included telephone interviews, focus groups, and surveys, both before and after draft statements were developed.
In October 2015, nearly 80 participants from across the United States and abroad spent 2 days in reflection and discussion, synthesizing new ways of thinking about our profession’s future. Rather than simply updating the Centennial Vision, participants reached a consensus that a new statement was called for, confirming the significant level of progress made since implementing the Centennial Vision in 2006. In early December 2015, more than 5,000 people participated in an online survey, and more than 3,000 not only completed the survey but also offered qualitative comments and input on the Vision 2025 statement. The draft vision was sent to 58,000 members of the occupational therapy extended family, who gave it a 78% approval rating. After careful reflection and discussion, the Board of Directors approved the Vision 2025 statement and used it to shape AOTA’s 2017 budget priorities.
Given the decade of experience we have had with the Centennial Vision, we know that the power of alignment with a vision creates an important dynamic in eliciting the passion of our members and willingness to stretch and reach more boldly into creating a vibrant future. In particular, we aimed to be sure that both current practitioners and students, our future practitioners, endorsed the key concepts in Vision 2025 across all practice areas (including hospitals, schools, long-term care facilities, community, and academia). I am hopeful that through our family connectedness, we will build our commitment to being champions in making Vision 2025 come alive! Just think about a future in which outcomes related to health, well-being, and quality of life are carefully measured by scientists and practitioners and, more importantly, experienced at the individual, family, community, and population levels, demonstrating that occupational therapy delivers what matters most to those we serve.
Reflecting on Our Family
As I remember back to my year of being president-elect, I recall a discussion with then-President Florence Clark. She talked about how important each of her four presidential addresses were in shaping her presidency and the work of the association. I couldn’t agree more with how powerful it is to stand in front of 10,000 or more of your occupational therapy colleagues, and even more online and virtually, with what you hope will be thoughtful and inspiring messages that serve to activate and create synergies in the profession. And I also discovered that the act of writing, practicing, and delivering these addresses has had an impact on my own capacity that is powerful and long lasting. Three years ago, I presented to you in San Diego the kind of president I hoped to be (Stoffel, 2013). My theme, “From Heartfelt Leadership to Compassionate Care,” helped me embrace a servant leadership approach to my role as AOTA president, and you responded in a warm and engaged manner, asking, “How can I help?” We grew our membership that year to exceed more than 50,000!
During the course of that next year, I gained a sense of how important it is to continually be involved in growing personally as a leader, supporting the growth of others, and always keeping in mind the needed growth of the capacity and reach of AOTA. This awareness led to my address in Baltimore in 2014, “Attitude, Authenticity, and Action: Building Capacity” (Stoffel, 2014). During that year, we were actively engaged in health care reform changes; developing our statement on the distinct value of occupational therapy (AOTA, 2015); and building awareness of the important role we play in mental health, primary care, work and industry, and communities.
Last year in Nashville, I highlighted what I see as keys to our future as we reach for excellence through “Engagement, Exploration, Empowerment” (Stoffel, 2015). I suggested that by building a membership culture of professional engagement in concert with the well-developed therapeutic tool of occupational engagement, we optimize our distinct value. Exploration keeps us relevant, fresh, and vibrant as a profession. Empowerment creates new futures in occupational therapy. When we attract and prepare a workforce that is empowered to lead, shape, and embrace exploration and innovation, occupational therapy thrives. And we sustain excellence when we are joined by a critical mass of active and engaged members—hence this year’s emphasis on “Coming Home to Family: Now Is the Time!” Our family in the United States could be as big as 213,000, and it will take each and every one of us to bring 4 new members apiece to reach and exceed our fullest capacity! Now is the time: We’re 99 years strong, and our greatest strength is moving forward together.
Acknowledging Your Support
I need to say thank you to some people who are here and others who are here in spirit. I want to thank you for the support, growth opportunities, and family connectedness that you warmly shared with me as I completed my role as AOTA president. I want to thank you for contributing your resources, time, and talent as members of AOTA and supporters of occupational therapy.
I thank you for electing me to the WFOT first alternate delegate role, which will give me the opportunity in the next 4 years to represent AOTA members living outside the 50 states on the Representative Assembly. I also look forward to the opportunity to work with Moses Ikugiu, our WFOT delegate, in representing AOTA and building support and connections with occupational therapy professionals worldwide.
I thank Amy Lamb, who served with me as AOTA vice president for my first 2 years and during the past year has been at my side during her year as president-elect, sharing her insights and growing her readiness to assume the role of the 30th AOTA president. In particular, I thank the AOTA officers, including Shawn Phipps, who served us all as AOTA vice president during the past year; Patrick Bloom, who served as AOTA treasurer the past 2 years; and Brent Braveman, who not only served as secretary but also chaired several important ad hoc groups during these past 3 years.
I want to thank all members of the AOTA Board of Directors, both those currently serving and those who served with me across my 7 years on the board. The path to leadership that each of us has taken epitomizes the paying forward generosity that is a piece of our professional culture.
I thank Fred Somers, our executive director, who ventured out into expanded territories with me as we made connections across the world. I thank Ellen Phillips, who ensured that I knew what meeting, report, travel plans, and reception I would need to be prepared for or attend. I thank all the members of the AOTA senior management team, Maureen Peterson, Christina Metzler, Neil Harvison, Chuck Partridge, and Christopher Bluhm, who with Fred coordinated and rallied the talented AOTA staff and volunteers to carry out the vision and mission of AOTA to ensure our bright path forward. I thank each of you who build our family culture and use it effectively to welcome all to AOTA as you contributed in your roles on the official, ad hoc, and informal AOTA bodies that carry out the work of the organization.
On my home turf, I thank the following:
My University of Wisconsin–Milwaukee family—faculty, students, and staff—who share me with you
My family and friends who were able to join us today—my husband Bob; our son Eric; Nicole and Adam; and Brian, Ali, and Lucy, who are attending via the Internet
My six sisters, Sue, Maureen, Kathie, Angel, Betsy, and Annie, and two brothers, Matt and Tom
My book club friends who are attending their 4th AOTA conference, Carol and Martha, and Lynn and Lane, who are here for the first time
My Stoffel family, Sheila and Sally, who are here today, and especially my sister-in-law, Cindy, whose photography enriches many of my presentations.
May you find time to support many others to come home to family and create a stronger and more engaged AOTA membership as we approach our AOTA Annual Conference & Centennial Celebration in 2017. I am grateful for your support across these past 3 years, and it has been my honor to serve as AOTA president as we achieved our Centennial Vision and have launched Vision 2025.
Finally, I ask that you continue your active engagement with and support for Amy Lamb in the role of AOTA president for 2016–2019. I believe we have a bright future, and I know AOTA will be stronger when we join Amy as active leaders and advocates for our profession. May you find every opportunity to promote health, well-being, and quality of life in your own family, in the families you serve, and in our occupational therapy family!