Summary and Reflection

In conclusion occupational therapists who work in rural or remote areas practice in a specific way that suits this setting. It is seen that the approach a therapist takes might differ slightly due to the location of where they practice. Also that the caseload may be quite varied compared to a therapist who works in a more urban setting. This would appear to be a generalised concept for different parts of the world.

In reflection the findings about the practice of occupational therapists in remote settings are very similar to my own view of how a therapist may have to work when working in such a different setting. The need for the therapist to change in areas such as the approach taken when working in such a different environment as well as having quite a different caseload to what is considered to be the norm. 

Some influencing factors that I consider to have impacted on my view of this role of an occupational therapist would include:

• Family members who work as nurses in remote areas of Australia
• Family who have accessed occupational therapy services in rural Alaska and their experiences of this
• Peers who have had the opportunity to work in community settings in New Zealand that has had a remote element to it and their experience of how their therapist practiced in that setting
• Courses throughout this course have also challenged my thinking around the role of an occupational therapist and how this differs between settings.

Overall the experience of creating this blog has continued to develop my interest in this practice area. I hope from these postings you have learnt something about this area of occupational therapy and how this profession may differ in ways yet remain the same in essence.

Scope of Practice for Occupational Therapist in Remote Settings

Boshoff & Hartshorne (2008) state, “it is important to note that country therapists mostly have a varied caseload” (p. 257). This is in relation to the conditions clients have on their caseloads. Thus therapists in rural areas need to be versatile as they could be seeing clients with mental or physical health issues and they could be of paediatric age to older persons and everything in between.

At an undergraduate level, learning is currently varied among these areas that it would be an ideal way of incorporating this knowledge learned into practice by being in a setting where the caseload is so varied. Yet the concept of having a varied caseload could be quite daunting, especially as a new graduate where the knowledge used to practice is at this stage based off theory and limited experience. If practicing in this area as a more experienced occupational therapist I could see this as being a challenge and a way to improve in areas of learning, in regards to the clients the interventions used and the approach taken to meet the needs in a remote setting.

Boshoff, K., & Hartshorne, S. (2008). Profile of occupational therapy practice in rural and remote South Australia. Australian Journal of Rural Health, 16, pp. 255-261. doi: 10.1111/j.1440-1584.2008.00988.x

Practicing in a Rural Setting

This post will briefly identify the way a clinician would practice in a rural setting. Identifying key skills and approaches the therapist needs and some problems that may be encountered requiring the therapists use of these particular approaches. 

Firstly, it is important to remember that an occupational therapist remains the same in that their values and beliefs are constant regardless of what setting they are in. Thus the role of the occupational therapist does not differ greatly in a remote setting; the main aim of occupational therapy is constant in that they are working with people to optimize functional occupational performance.

The aspects in a rural setting that may change is the approach that the therapist takes. Thomas & Clark (2007) identify six themes that emerged from a qualitative research study of allied health professionals working in remote locations of Northern Australia. One theme identified is that the clinician should be “organised but flexible”, this has been highlighted as an approach clinicians should take as there are variables that are encountered in rural areas that may not be as common in a more urban setting. This includes the range of places interventions may be carried out, the need to improvise and use limited resources creatively, and the ability to ‘go with the flow’ as community issues may arise in remote areas which the clinician has to be flexible towards in order to “try and work something out just as it unfolds” (Thomas & Clark, 2007, p. 217).

Another highlighted approach is that of “cooperation and mediation”, in remote settings it is stated that “infrequent visits, time limitations and scarce resources necessitated effective communication and cooperation with others” (Thomas & Clark, 2007, p. 118), this is identified as an approach to use with other allied health professionals in the setting as well local services and health workers in the rural location. It is identified that clinicians working in remote settings often have to establish relationships with key people in the communities they visit as direct communication with clients can sometimes not be efficient and therefore having established relationships in their communities will help with this. It is identified that communication is a part of training yet in this practice setting it is important for clinicians to extend the standard realms of communication of client-therapist to include the wider community.  

The third key theme discussed in Thomas & Clark (2007) is “culturally aware and accepting communicators” (p. 219), this theme is specific to the location of the research conducted however the points from this theme are likely transferable into other remote locations in the world. Thomas & Clark (2007) discuss this approach in relation to the Indigenous populations in many remote communities of Northern Australia, in order to have a safe cultural practice it is suggested that clinicians alter their communication with Indigenous people by being sensitive to their style of communication. This includes clinicians reading body language and non-verbal signs, as well as having the ability to wait for responses without filling the silence.

Therapists who use a consultative approach in remote settings are seen to “demonstrate a level of respect and power sharing with clients, which is necessary to empower communities to find solutions to health problems that are sustainable and that reduce dependency on the ‘visiting experts’” (Thomas & Clark, 2007, p. 219).

Thomas, Y., & Clark, M. (2007). The aptitudes of allied health professionals working in remote communities. International Journal of Therapy and Rehabilitation 14, (5), pp. 216-220.