Crowd favourite Dr Khalilah Johnson is BACK! and this time we are delving deep into the realities of inclusive practice. We started out discussing her research around including within a disability context but soon exploded to inclusion in many other contexts.
There are many parts of OT that need improvement and we explore the lip service that is often payed to topics around inclusion with different populations. This is an important topic, especially in todays overly connected society where information and access to news is faster than ever before. Where social capital is now derived from what one says and not what one does. How does this impact the work that so many therapists have lived and/or dedicated their lives to? Tune in to hear our thoughts on all of this.
Brock
@brockcookOT
brock.cook@me.com
www.occupiedpodcast.com
Automatic Transcription
105 OT Needs to be Doing Being and Becoming MORE ft Khalilah Johnson
00:00:00 – 00:05:03
We want to look at your your journey Into how you got where you are now and into the causes and the the research that you’re you’re currently looking into and how far back does that does that. Does that janney start before you started. Iot over. Half are baxter. We delve to start with. I don’t know that we want to start all the way back. Ot sixteen years now and we did. We did have a little bit of like hey going to the profession and stuff in the lawsuit that you’re on that’s right. Well i guess i could start is sort of the clinical experiences that I think really changed the trajectory of my work. After i moved to north carolina to pursue my hd at university of north carolina I was Subcontracting through a company that was providing services to the state in developmental centers or intermediate care facilities for adults with intellectual and developmental disabilities and was just really finding it very difficult to do my job Basically being told not only by the facility but really dictated by the state sort of what the range of an occupational therapy evaluation like And the expectation for me not Write a treatment plan or do any additional consultation with staff pertaining to addressing any sort of Occupational needs of the residents there. And so i’m sort of looking at this will want what. What’s the point of occupational therapy. Then if it is not for me to draw on it by professional expertise to say here here are some things. That are problematic weather. It’s just about being able to participate Or if they’re real real safety considerations in these facilities and here’s how we can address them or develop a treatment plant. Always you know in collaboration with staff. They wanted no parts bet. And so the more i pushed more. They pushed and Just went to buy adviser. Nancy bagatelle and said i don’t i don’t care what my dissertation is about but it has the center these sorts of issues So it’s like. What are the really the the policy that mediate not only what i was able to do as a therapist. That really how the people were the issue in these facilities are just able to live regular. Is you know Even what’s wrong with that kind of stuff because we have similar kinds of issues in australia as well. Do you think that the issue is like outdated policies or policies that have just been made in uninformed way a little bit of both right. you know. There’s definitely some historical towards people with disabilities that informed the policies when they were ready some time ago but they earn supposedly revives with you know thinking well ardal supporters in person centeredness and all of these things.
00:05:04 – 00:10:13
But you still have all these antiquated ideas of what that supposed to look like. He can’t be person centered without actually considering the person you know. How do you have a conference about what somebody can do. They’re there for you know. The even their caregivers are included in the decision. Making it makes sense. Yeah yeah it’s like you know. The the literature ari tells us that with appropriate support. People can participate you. But because they’re in this congregate situation there. It’s the thought or up the various a culture of the entire enterprise right that The folks who live in these facilities can’t make decisions can’t do themselves don’t know what’s best for themselves all of these ridiculous things that we hear all the time even each facilities. I mean happens in group homes to. Oh they’re out in the community. It’s like now. These have institutional qualities is experiencing the same thing in various mental health settings impassioned community same thing and one of the real simple things that we push full before i moved in academia was getting the person involved in their own case. Conference like sean. We’re can have a group of people sitting around talking about them but then people were worried about bringing them in because of all they’re going to hear what we say. I’m like yeah. They can hear what you say. You’re talking about them. What are you saying about them. They can’t hear oh that they shouldn’t here in. Does that one does that thing. Need to be said if there is something or a you just making out of a molehill and a lot of the the pushback that we had was more seemed anyway more just because all. We’ve never done that way. It’s always been done this way. I’m going well. It doesn’t mean you can’t change it but this kinda stuck in their ways. There’s no there wasn’t a policy saying that it couldn’t happen it was more just This is how we’ve always done it all. Is that all quicker if we just went through it among is thanks. Here it’s for the state specifically They’re op. There are policies in place to include people would As well as people with mental health as they fall under the same set of standards and guidelines But in practice. It doesn’t happen which is bizarre to me and just like you’re not even income. I at when you worry about compliance. All right i’m going to be in compliance when the state servier shows up. Yeah so where did you. Where did you so that was for your what did you. What did you find that. Basically we legislate ourselves into these holes right and it’s in. It’s all said by attitudes that you know again. People with intellectual and developmental disabilities Are not a musician to Contribute to their own care In ways that people believe are are safe or that make makes sense And that ease facilitation centers or developmental centers On paper say that they’re there to sort of support Bit availability skills and all these things to help. People return to the community. When in fact they. All they do is perpetuates custodial care. They’re really sort of built like skilled nursing facilities. You know with the exception of some adolescent programs respite programs and that sort of thing And that be happy. Let the state and national level. Who i think truly understand that the things we’re talking about about human rights. This isn’t about you know just simple healthcare sorts of things this is you know people have a right to choose what they want to eat and when they eat it you know people have a right to be out in the community like people have the right to the very basic things that we take for granted. And they’re not there. These ask are not exceptional. They’re not exceptional. No it’s not. Stop treating it as such The the people who were charged with their care twenty four hours a day. You know these frontline workers Their their work is grossly undervalued. They’re not treated as experts in the care people with id because they don’t have a particularly isis right so even how The the programming happens is very lowest in a way.
00:10:13 – 00:15:09
it’s like. Oh well if. They’re not the psychologists that are not this. They’re not that than one you have to take. You know their opinions of what you know mr. Tom can do with a grain of salt. Because you know what. They really understand about x. Y. and z. I can’t tell you how much that showed up in my in my data you know so. We have so much more work to do. Not just with how these facilities operate. Although i am in favour in abolishing all of them But in doing so we have to make sure. There’s a cultural shift Just about people with disabilities in general. But really you know understanding that we’re talking about basic human rights you know meeting the threshold people to be able to live the lives. They want to lead and then saw interesting. Because i’ve always found a number of conversations with clinicians about essentially the people with the highest paychecks usually know the least about the people that treating and like and another thing. I used to have her into whatever had students get to know the cleaners because i can guarantee on zone. It was on the key in it. They know everything about everyone. And everything that happens on that ward and if you need help doesn’t even matter what it is if you need help they know who can give it to bob la la. They were more helpful resource than any other clinical highly educated multiple degrees high paycheck stuff that could ever walked through that front door. Because that just around the people hold on bassa they get to them absolutely absolutely. I was a clinical instructor early. before going. back to school. I would do the same. The interdisciplinary team is not just the licensed folk talk about has during the entire environment. Is everybody in it. You know like you said like you said in. Its in its wild. We preach that an ot right but it’s really not practice. I used to get so like The rehab managers and thing