Wednesday, October 19, 2011

Community Development



I just read this article:

Heidi M. Lauckner, Terry M. Krupa & Margo L. Paterson (2011). Conceptualizing community development: Occupational therapy practice at the intersection of health services and community, Canadian Journal of Occupational Therapy, 78(4), 260-268.

I love the idea of doing community development work. For those who are not familiar with it, community development is a way of empowering and assisting groups of people to join together to identify their problems, and work toward solutions. That's not an official definition, just mine. If you Google Community Development, you will get a whole bunch of official defititions.

The authors in this article found three different situations where Occupational Therapists were doing community development, and from interviewing the therapists and the stakeholders, found common themes related to the OT role. From this, they came up with a model for showing the OT role in community development.

It's not a light read. The model required careful reading (and re-reading) of the article to understand it. I personally prefer models that are a little more simplistic, but this one is definitely a great start to looking at this field of practice that I think is under-recognized.

How many times have you worked with an individual client and been frustrated with systemic and larger societal issues? As a health care professional, it is easy to feel powerless to help in these situations. Often the best we do is help the person advocate for what they need, and sometimes we do this over and over again. Often, we find creative ways of getting around the system instead of making any real changes to the system.

This has often seemed inefficient to me - we end up running into the same issues over and over again. It also seems like a disempowering way to work - it means that our clients need to keep coming to us to help solve their problems.

When someone does not have the ability to fully participate in community life due to having a disability, it affects everyone in that community. People are a great resource, and if they are given the opportunity, can contribute significantly to that community.

In 2009, I went to a presentation by Terry Krupa (one of the authors of the article listed above) and Glenda Carter on a community development initiative they were doing. Basically, they were addressing the fact that people with psychiatric illnesses, on average, had a much lower level of education than the general public. This was impairing their ability to find meaningful employment. However, it also affects everyone. If they cannot find employment, it is a loss of productivity, and it costs our system. If they are not fitting in well to schools as the schools are, this may be time-consuming for staff and disruptive to others.

The usual approach to this dilemma would be to try to find funding for a supported education program. Not a bad idea. However, it places all the responsibility for a community-wide issue on one health care program. Workers in the program would slug it out, case by case, advocating for more appropriate services.

Instead, they pulled together all the stakeholders, very few of whom had anything to do with healthcare. They coordinated a plan that everyone could contribute to. Wow - now that has the potential to create widespread change. It also has the potential to benefit everyone.

What a love about community development is that it involves working on the larger issues that have the ability to impact so many people. You help people organize and work together to find the solutions that will work for them. It recognizes that people are the experts on themselves. This represents a significant shift in power.

In terms of health care dollars, it really makes sense. If you can mobilize the resources that are already out there, it has the potential for a lot of benefit with very little spending.

I hope this will be an area of practice that continues to grow.




Photo Credit: Joe Shlabotnik


2 comments:

  1. Linda,

    Thanks for this post, it helps me develp my understanding of an issue that has bothered me for some time, namely: how to apply principles of occupational therapy at the community level, to promote health, to manage dysfunction, and to increase social capital for us all.

    I have found that attending community development workshops and networking in my community holds the possibility for developing this role, and I hope to see more opportunities in this area open up for OTs.

    Thanks again for the post!

    Claire

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  2. OTs in Africa and Asia use the Community Based Rehabilitation model and I think OTs should be taught this. Inclusion, collaboration, cross-service partnerships are important aspects of this type of work.
    The WHO website has all the manuals,albeit designed for resource limited settings. However the principles can still apply. Here is one reference. OT is not mentioned in the list in the slides I guess because there are so few of us on the ground. This is an opportunity worth seizing.
    http://www.gtid.net/AP_CBR/pdf/27.pdf

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