Sunday, 20 October 2013

SHOUT attends ENOTHE Conference 2013 in York

On Thursday and Friday, pairs of SHOUT members attended the ENOTHE conference in York. We were delighted that our work - a new poster demonstrating how membership of SHOUT helps to develop citizenship qualities - was accepted to the conference. We enjoyed the opportunity to share what we do and the skills we acquire through SHOUT with European delegates.

This year’s theme, “Citizenship”, infused every aspect of the event and one word could be heard over and over again in lectures, asked in questions, discussed in workshops, murmured over coffee…. 


Speaking about the occupational therapy (OT) viewpoint on citizenship, Jytte Rotbol began Day Two of the conference with her keynote address, highlighting participation for people with mental health problems. Recovery is more than recovering from illness, she said, but recovering work roles, social roles, finding belonging in society through participation. Activity is one of the prerequisites for a “good life”, she explained, an essential component of a good society. But she cautioned that what one person thinks is a good life, may not be for another – this unpredictability of activity is a human condition , she said.

Although this unpredictability sounds challenging, I feel this is part of the beauty of OT – we cannot predict or prescribe activity as one-size-fits-all. We have to work with each person on an individual basis to get to know what matters to them, what makes them tick, what unique activities / occupations are the key to their health, wellbeing and participation in society. This takes time and might even feel emotionally “risky” - we can’t find safety in a tried and tested medicine, instead we have to take the risk of getting to know someone, giving something of ourselves to them in order to help them share something of themselves with us. This two-way conversation, a partnership, finds a way forward based on activities identified by each person as having true meaning, enabling participation in their own lives and in society as citizens. As Jytte said, "action creates relationships".

#ENOTHEyork conference tweet

Hetty Fransen presented joint work on OT’s contribution to citizenship. The team included SHU lecturer Nick Pollard, described as having “a brain the size of a planet” – I have a feeling that any OT students who have been taught by him may agree! The presentation was stunningly illustrated with artwork by Peter Doig. While working on the project in Edinburgh, the team came across Doig’s exhibition, noticing a "doing" element to his work. Inspired by this, Hetty encouraged us to “do it”, to “do” citizenship.

By artist Peter Doig

“There are no foreign lands, it is the traveller only who is foreign” 
Robert Louis Stephenson

The team’s journey around citizenship led them to find congruence between citizenship terms such as restricted participation and occupational science terms such as occupational injustice. Citizenship is a fundamental principle of OT, said Hetty, linking to human rights and social inclusion.

#ENOTHEyork conference tweet
How do we enact citizenship, she asked, as citizens of the world? Social change has greater effectiveness, Hetty said, when we as practitioners engage in doing rather than doing to people. Remember that you are a citizen first, she said, then an OT. She asked the question “should we be citizen-centred?”.

#ENOTHEyork conference tweet
“OTs like participation” Hetty said, opening up the value we place on this word to critical debate. What if a person does not participate? Are they still a citizen? Are there “good” and “bad” citizens, she asked? This highlighted the power relationship between state and individual or client and therapist or between cultures. Defining and categorising people according to the level to which they participate with us, with their world or with society can be disempowering. It made me think about how easy it is as an OT to judge a client when they do not participate in therapeutic activity, how labels such as “unmotivated” can be carelessly used. If citizenship is about human rights, the right to be included and to actively participate, does it allow room for the right not to participate and yet still be respected and equal?
#ENOTHEyork conference tweet

For OTs to enable citizenship and participation, Hetty advised that we need to think strategically: get involved on a political level, form an idea and be part of the solution!

#ENOTHEyork conference tweet

After these two thought-provoking lectures, the rest of the day was spent in workshops or mini-lectures. In Debbie Kramer-Roy’s session “Emancipatory OT research and practice with marginalised ethnic minority clients” I learnt how action research is consistent with OT principles and occupational justice, helping people to participate in action and bring about change as co-researchers. Artwork and photography were shown to be beautifully expressive and inclusive ways for co-researchers to participate in research. A piece of work created by a Pakistani mother (and British citizen) whose child was disabled depicted the pressure she felt under, like a vase that might one day crack, and her struggle with belonging, inclusion and participation in society due to the stigmatisation she and her child faced.

This was a really strong learning point for me: the client is always the expert. The artwork expressed more powerfully and clearly than I could ever articulate in words, the depth of emotion, pain, strength and determination of the mother and the deep examination she had made of her life through the painting. I wish I had taken a photograph of the work to share, it was so moving. 

The workshop concluded with discussion about participation in OT education and it was wonderful to hear the lengths an OT school in Antwerp had gone to in overcoming cultural barriers that had prevented a group of orthodox Jewish women from participating in university study. The lecturer explained that it was a process of collaboration, of finding solutions, and then making these adaptations available to all their students.

#ENOTHEyork conference tweet
The day ended with a discussion between students about how to create an international student forum. I felt humbled that my ability to participate in the discussion was only because of the excellent language skills of the other students who spoke such good English. It was a privilege to spend time in the company of OTs and students from countries across Europe and it struck me that I have a very UK-focussed OT outlook. 

Clockwise from top left: Austrian students, German students,  Kramer-Roy workshop with Tiska from Amsterdam and Morel from Bordeaux, Student forum discussion

It seems to be rare for OT students to meet with their colleagues in other countries but very much needed if we are to learn from each other. The collaborative working skills we are learning at university could be harnessed to help us bring about a forum that would reinforce our collective identity as OT students and European citizens whilst celebrating and learning from our cultural and practice differences, thereby participating in each other’s development. SHOUT will be keeping an eye out for how this unfolds and hope to be involved in the forum in future years...

Thank you #ENOTHEyork, you were wonderful.

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