Blog post written by: Clara Neilsen, Occupational Therapy student, Concordia University, WI
According to the United Nations High Commissioner for Refugees, a refugee is “someone who has been forced to flee his or her country because of persecution, war, or violence.” They have a well-founded fear of persecution for reasons including race, religion, nationality, political opinion, or social group membership, often unable to return home (UNHCR, 2023). As of October 8, 2024, over 122.6 million people have been forcibly displaced worldwide due to humanitarian crises and violence in regions such as Palestine, Ukraine, Syria, Central Africa, Afghanistan, and Cuba (UNHCR, 2024).
How can occupational therapists (OTs) help this population?
Our profession upholds that all individuals, regardless of cultural background, race, gender, age, ability, socioeconomic status, or origin, have the right to participate in occupations that promote health, well-being, and life satisfaction aligned with their cultural beliefs (World Federation of Occupational Therapists, 2006). OTs possess a unique skill set to aid refugees during resettlement by facilitating community integration and helping them regain meaningful occupations, habits, and roles lost in transition. Advocating for our role in addressing occupational injustices reflects our values of justice, altruism, freedom, and equality. Research indicates that OT can significantly benefit this population (Smith et al., 2013; Trimboli & Taylor, 2016; Whiteford, 2005).
Refugees experience various forms of occupational injustice and the adverse effects of forced displacement, including:
Occupational deprivation due to external barriers
Loss of meaningful roles, routines, and cultural practices (Scaffa, 2020)
Lack of normalcy
Occupational imbalance
Preoccupation with survival, leading to reduced participation
Occupational alienation is characterized by feelings of isolation and powerlessness (Scaffa, 2020)
Trauma and mental health issues, including PTSD, anxiety, and depression
Social isolation
Limited choices in host countries (e.g., detention centers, refugee camps)
Difficulty navigating unfamiliar systems and communities
Cultural or racial discrimination
Unemployment
Our focus on meaningful occupation and holistic well-being positions us well to support this vulnerable population in rebuilding their lives and promoting overall health. However, we are often absent from this landscape. Relevant areas within OT’s scope include:
Occupational needs assessment
Mental health and trauma-informed care
Coping mechanisms and emotional regulation
Cultural competence and client-centered practice
Promoting engagement in meaningful occupations
Redeveloping daily routines and roles
Building life skills
Supporting community reintegration and resource navigation
How Can OTs Support War Refugees?
Collaborate with local or national resettlement agencies
Advocate for policies that enhance refugee integration
Connect with local non-profit organizations supporting refugees and asylum seekers
How can OTs collaborate with existing refugee resettlement organizations?
Reach out to local refugee resettlement agencies (Wisconsin Department of Children and Families) to explore volunteer opportunities and learn about community resources. Share how your OT expertise can support their mission and assist refugee reintegration. By engaging in this work, we can expand OT’s impact and help war refugees rebuild their lives and find purpose in their communities.
References
Kern, S. B., Reitz, S. M., Seruya, F. M., Silveira, J., Smith, B. C., Thompson, T., Kilkuskie, K., Santos, G., & Nguyen, A. (2020). Promoting occupational participation in marginalized populations. In M. Scaffa & M. Reitz (Eds.), Occupational therapy in community and population health practice (3rd ed., pp. 457-487). F.A. Davis Company.
Scaffa, M. E. (2020). Community and population health concepts. In M. Scaffa & M. Reitz (Eds.), Occupational therapy in community and population health practice (3rd ed., pp. 22-37). F.A. Davis Company.
Smith, Y. J., Stephenson, S., & Gibson-Satterthwaite, M. (2013). The meaning and value of traditional occupational practice: A Karen woman’s story of weaving in the United States. Work, 45(1), 25-30. https://doi.org/10.3233/WOR-131600
United Nations High Commissioner for Refugees (UNHCR). (2024). What is a refugee? https://www.unrefugees.org/refugee-facts/what-is-a-refugee/
World Federation of Occupational Therapists. (2006). WFOT position statement: Human rights. http://www.wfot.org/ResourceCentre.aspx
Spreading the word about OT
As occupational therapy practitioners and students, we have a deep understanding of OT and the impact it could have on many areas of life and health. Unfortunately, there is a lack of understanding in the general public and in healthcare regarding what OT is. This lack of knowledge limits our reach, and there is a need for advocacy to help us break into new areas of practice.
Maternal mental health
One emerging practice area in OT is maternal mental health. The physical health of mothers after birth has historically been the primary aspect of health that is emphasized, at the deficit of other aspects of health such as their mental wellbeing (Atif et al., 2015). In order to holistically care for mothers post-partum, all aspects of health must be addressed. Depression is one of the primary mental health challenges that mothers experience after childbirth. It is estimated that around 20% of mothers experience post-partum depression (Atif et al., 2015).
OT in this setting
Occupational therapists are uniquely equipped to support mothers in transitioning after a child is born because our profession recognizes the need to address the health of the whole person including factors related to the mind, body, and spirit (AOTA, 2020). With OT’s unique foundations in both psychology and physiology OT professionals are competent to address the interactions between these factors and support new moms in a more holistic way. OT professionals also have a unique perspective on roles and routines which go through major changes after the birth of a child (Khan, 2023). OT professionals would be a great asset to the healthcare team in this setting and could address factors that may be overlooked otherwise. One of the main barriers to women receiving occupational therapy post-partum is a lack of knowledge regarding how OT could fill this care gap. It is up to us to spread the word about the potential impact of OT in this emerging practice area.
Discussion and call to action
Think about how you could add to the spread of knowledge regarding OT and our scope of practice. Do you know a new mother who could benefit from OT? Do you have colleagues or friends in the area of maternal healthcare? How could you inform about the value OT could bring to this practice setting?
Consider the potential reach of OT. This week, have a conversation with someone about the unique strengths of OT’s holistic approach to health.
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed). American Journal of Occupational Therapy, 74(Suppl. 2), S1–S87. https://doi.org/10.5014/ajot.2020.74S2001
Atif, N., Lovell, K., & Rahman, A. (2015). Maternal mental health: The missing “m” in the global maternal and child health agenda. Seminars in Perinatology, 39(5), pp. 345–352. https://doi.org/10.1053/j.semperi.2015.06.007
Khan, S (2023). Occupational therapy’s unique role in maternal health and well-being. American Occupational Therapy Association. 28(8), pp.12-15. https://www.aota.org/publications/ot-practice/ot-practice-issues/2023/occupational-therapys-unique-role-in-maternal-health-and-well-being
Thank you to Sarah Schlagel, OT student at Concordia University for this blog post!
Our blog post this month will bring you up to date on recent legislation that affects the profession of OT in Wisconsin.
Legislative advocacy is one of the most important things that WOTA does and one of the many reasons to become a member and maintain your membership in WOTA! WOTA works with lobbyists to promote the profession of OT and to ensure that we are represented in bills that affect our day-to-day work and the clients and communities we serve.
Below is an update of the most recent legislative session.
Assembly Bill 507 (AB507) didn't make it to the Assembly, which effectively “killed” the bill. AB507 would have authorized the first 12 visits of occupational therapy, physical therapy, speech therapy, or chiropractic visits before requiring pre-authorization. It would have required a health plan to re-authorize coverage of a service for which previous coverage was approved within three business days. WOTA worked with PT, chiropractic, and lobbyists for the insurance companies to word the bill in a way that would increase chances of getting the bill passed.
Assembly Bill 959 (AB959) passed the Assembly, but did not get onto the Senate floor, which also “killed” this bill. AB959 would have created an Occupational Therapy Examining Board independent of the Medical Examining Board. The goal of this bill was to generate more efficient processes for OT regulations, scope issues, and licenses.
Assembly Bill 90 (AB90) passed the Assembly in January, but did not get onto the Senate floor, which also “killed” this bill. AB90 would allow third parties (like WOTA) to process license applications for OTs and OTAs instead of the Department of Safety and Professional Services (DSPS).
In February of 2023, WOTA and The Welch Group hosted OT Day at the Capital. About 100 OTs, OTAs, and OT/A students came to the capital in Madison to meet with legislators and their aides to advocate for the profession of Occupational Therapy.
WOTA has representation at all Medicaid and licensing board meetings so that our collective voice can be heard; and so we can keep you, our members and the OT community of Wisconsin, updated.
Original by en:User:Chris 73, updated by en:User:Diberri, converted to SVG by tiZom, CC BY-SA 3.0 , via Wikimedia Common
Depolarization
During depolarization, positive charges enter the cell and if the threshold is reached there is an action potential.
When advocating for the “action potential” of our Occupational Therapy profession, we need to be engaged to reach the threshold for action. We have many channels in which we can follow our passions. We can advocate for change by attending a Day at the Capitol, contacting our legislators, or voicing our distinct value to an interdisciplinary team. We reach the threshold for action by embracing diversity and inclusion, demonstrating formal and informal leadership, and defending the scope of Occupational Therapy practice. At times, we face failed initiations. Collaborating with other Occupational Therapists and allying with interdisciplinary teams is key to reaching thresholds that effectuate change.
“We must be bold and use our OT skills to step into new areas and expand our reach, continuing to advocate for the value of OT and acknowledge one’s training.” (Emmert & Petrone, 2022)
Repolarization
During the repolarization stage, the cell membrane becomes negatively charged.
As a therapist, I equate the repolarization stage as an opportunity to be a reflective practitioner. As we reflect on our daily tasks, we gain insight as to how we could implement changes that improve our practice. Through evidence-based research we improve our approach and interventions. We contemplate areas of practice that spark our interests and passions. We can take on informal leadership roles by taking on a new project or responsibility. If we are stuck in a stage of repolarization and negativity, we can envision pivoting to a different practice setting or with a new client population.
Resting state
At the cellular level, during the resting state the outside of the cell membrane becomes more positively charged. The negatively charged neuron cell attains its resting membrane potential between -40 to -90 mV.
As Occupational Therapists, we face many demands through work and life. We need rest to recharge. As Occupational Therapists we work as caregivers, healthcare workers, and educators. Our work is physically, emotionally, and mentally demanding. We face several external negative factors such as productivity requirements and increasing medical complexities in our patient populations. We need to rest to preserve our work life balance and our strength as effective therapists.
Cindy Steinert, OTD, MSOTR/L, CLT
References:
Emmert, C., & Petrone, N. (2022) Unlocking the potential of occupational therapy in new settings, SIS Quarterly Practice Connections, 7(4).
The Action Potential - TeachMePhysiology
Reflection and Call to Action:
Occupational Therapy is a beautiful profession with unlimited potential. Unfortunately, real world limitations set in and we can experience burnout and frustration with the systems we work in. OT practitioners can respond in a variety of ways, and it is the hope of the WOTA Advocacy Committee that Wisconsin OTPs choose to see opportunity in our future. Our goal with the blog is to provide a safe place to share AND explore solutions and innovation to move the profession forward.
Wisconsin Occupational Therapy Associationwota@wota.net
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