This article is the first in a series of two articles about Occupational Therapy and Primary Care. This first article describes the health policy context in which primary health care should be strengthened. A definition of occupational therapy is given and the scope of the profession is explained. Based on a survey amongst the experts of member associations of COTEC, an overview is given of the main target groups and how occupational therapy is embedded and organized in different countries.
In a position statement it is argued why occupational therapy can and should contribute to a comprehensive integrated primary care and challenges to strengthen the position of the profession are described. The purpose of this article is to outline the role of occupational therapy within primary care.
This article informs consumers, academics, health service managers, professional associations and government bodies about occupational therapy in primary care, and informs service and policy development at a local, national and European level. Across Europe there are great differences in the availability of occupational therapy in primary care. The need for integrated care that enables people to participate in decision-making and to self-manage their own health and well-being is widely recognized.
The challenges facing health care services include ageing populations and increasing numbers of clients with long-term conditions and multi-morbidities and all the social and economic consequences. These populations will benefit from an approach that is focused on possibilities and functioning rather than on a more medical treatment of symptoms De Maeseneer and Boeckxstaens, Occupational therapists can deliver an important contribution to the primary care workforce Donnelly et al.
Occupational therapists recognize the importance of meaningful occupations in promoting mental, physical and social well-being. Occupational therapists work in partnerships with other professions and can reduce the pressure on GP services. For example, in prevention and early intervention to prevent diseases or disability, reduce the impact of an illness and help support individuals in maintaining their healthy lifestyles College of Occupational Therapists Ltd, b.
Within primary and early intervention services, occupational therapy interventions will reduce the risk of admission and re-admission into hospitals and other institutes from incidents such as falls College of Occupational Therapists Ltd, Occupational therapists explore new ways of doing things by adapting activities and physical and social environments to improve function, capacity and participation.
In many countries, there is a shift from more institutional care to community care, both in mental and physical health care. The way health care is organized is not sustainable from both a financial and workforce point of view. In all countries in Europe, governments are struggling to reorganize the health systems and the workforce to meet the future needs. In Western Europe emphasis on primary care is expected to be an answer to questions of rising costs and changing demand.
Central and Eastern European countries are each in their own way struggling to fundamentally improve the performance of their entire health systems following their restoration of independence. Primary care, which used to be poorly developed in these countries, is now being developed to bring adequate and responsive health services closer to the population.
Approaches and models of primary care reforms introduced have varied widely from country to country. Some countries have attempted systemic interventions combining legal, structural, organizational and financing reforms. Most countries however, touch on one or more aspects of primary care such as changes in the provision of services delivery by introducing evidence-based protocols; improving the generalist approach of primary care by improving the academic embeddedness of general practice; or introducing financial incentives for patients or providers to stimulate long-term relationships between single providers and patients Kringos, The Resolution WHA The WHO report articulates the need to bring responsive health services closer to the population and to provide people-centered care organized in primary care World Health Organization, In a recent report of the European Commission two of the five key conclusions are: A strong primary care guides patients through the health system and helps avoid wasteful spending and integrated care tackles a labyrinth of scattered health services to the benefit of the patient European Union, Key elements in future health service delivery are investing in health through a life course approach and empowering people World Health Organization, Strengthening the primary care level of health care systems have increasingly been considered to be of great importance to dealing with specific health care system challenges and improving the overall performance of a health care system Kringos, Strong primary care is assumed to contribute positively to health system goals including equity in population health, sustainable health care expenditures and responsiveness of care Kringos, An international comparative study to the strength of primary care resulted in listing the European countries with strong, medium and weak primary care Kringos, The performance on all primary care structure dimensions incl.
Countries with strong, medium and weak primary care, considering PC structure and key aspects of PC services delivery. Primary care is the entry level of a health care system providing accessible, comprehensive care in an ambulatory setting to patients in their own context on a continuous basis. Primary care coordinates the care processes of patients across the health care system Starfield, Primary care ideally provides accessible care to all patients with any kind of health problems regardless of age, sex or any other personal characteristic World Health Organization on behalf of the European Observatory on Health Systems and Policies, These characteristics are also mentioned in the definition of the WHO regional office for Europe.
Primary care exhibits features of person-centeredness, comprehensiveness, integration, continuity of care, participation of patients, families and communities. This requires health services that are organized with close-to-client multidisciplinary teams responsible for a defined population, collaborate with socials services and other sectors, and coordinate the contributions of specialists and community organizations World Health Organization, In this report, the EXPH publishes a core definition of primary care in which occupational therapy is mentioned as one of the professions active in primary care teams.
EXPH, There are many differences in the European countries regarding the definition and criteria of primary care. This is the same for occupational therapy in primary care. In the Netherlands the way the occupational therapy services are financed defines whether it is primary care. Other countries have the referral system as criteria. Referral systems are often directly connected with financing and are as such an important issue. The WHO definition states primary care services … should be universally accessible to individuals and families by means acceptable to them… which in fact would exclude all care that has to be paid for by the person.
Occupational therapy services in primary care are not only aimed at the individual in health care but also in groups and communities and are delivered in public health and the social area. Occupational therapy plays an important role in working with those who have chronic conditions etc. As the financing systems of the different areas — health insurance, social insurance, municipality — are separately organized and occupational therapy services are often delivered at the borders and both sides of these areas, the financing is a major challenge.
Occupational therapists critically embrace the definition of the concept of Positive Health. Although occupational therapists have the medical knowledge, their focus is on functioning and participation. They operate in both health and social systems. Occupational therapists support people to live safely at home, prevent unnecessary hospital or other institutional admissions and prevent an excess of care-use at home.
Because occupational therapists address the entire area of daily living, they are used to work with every other professional in both health- and social care and also with professionals in the more technical fields, such as architects, ICT, product developers and designers. This makes occupational therapists fully equipped to play a central role in interprofessional teams in primary care and integrated care.
Occupational therapy services should be available and accessible in primary care in all health- and social care systems across Europe. Having an occupational therapist in a multi-professional team could be helpful in identifying ways to integrate the health and social services to better effect. Looking for solutions that address the impact of illness or disability and how individuals participate in society is the key to robust integrated health care delivery systems.
To make a start with the investigation to what extent members of COTEC differ in the strength of occupational therapy in primary care, the project group sent out surveys to all 30 members of COTEC. Since each country in Europe is in a different stage of development of their primary care information infrastructure, inevitably, some countries have a more comprehensive, up-to-date or reliable set of data than other countries.
These surveys were ordered and analyzed by eight themes: total number of occupational therapists in private practice, summary of the profession, organized interest group within National Association, payment system, accessibility, client groups, main working area and main challenges. The project group expected that countries vary in the strength of occupational therapy in primary care, which can be explained by variation in their political-economical, cultural and health care system contexts.
Strong primary care is expected to be beneficial to important health care system outcomes Kringos, Currently, countries with relatively strong PC have higher total health care expenditures than countries with relatively weak PC in Europe. The results confirm that strong PC has a positive impact on population health, reducing disparity in health, and avoiding unnecessary hospitalizations.
Patient perceived quality of care is not related to the strength of PC Kringos, In total, 11 member associations of COTEC have returned the survey with a positive answer on the question whether they have occupational therapists working in primary care. Their number varies between 6 Luxembourg and Norway.
Some differences in numbers are remarkable. As a special interest group is often started when a country wants to develop or has developed a special area of practice, in this case primary care, this item was included in the survey. Both the countries with the largest and smallest number therapists working in private practices have established such a group. The ICF categories selected for this study allow for a comprehensive assessment of clients for occupational therapy.
The findings of this study are expected to provide a basis for an outcome measure to determine the effectiveness of occupational therapy for these patients. To review current evidence regarding the effectiveness of occupational therapy coaching interventions for parents of children with sensory integration difficulties, delivered to individuals or groups of parents.
A historical scoping review was completed of empirical research records to summarize what is known and how this information can guide future research. Inclusion criteria were English language and peer-reviewed empirical studies of parent coaching intervention for children with sensory processing or sensory integration difficulties.
Five databases were searched. Four studies met the search criteria. Three studies took a direct coaching approach with individual parents or families. There is some evidence to conclude that occupational therapists can deliver individual parent-focused coaching interventions which impact positively on individual child goals, parental stress, and sense of competence.
Current evidence is limited. Suggestions for future research are offered. School is a primary setting for pediatric occupational therapy practice, yet little is known about the provision of school-based occupational therapy in many countries internationally. The purpose of this study was to explore current school-based occupational therapy practice for the first time in Ireland to gain insight into current and potential service provision and to identify new directions and potential pathways for development.
This descriptive quantitative study utilized a cross-sectional online survey to gain the perspectives of the population of pediatric occupational therapists working regularly in schools across Ireland. Respondents were recruited through convenience and snowball sampling. Data were analysed through qualitative content analysis and descriptive statistics. The survey elicited 35 responses, yielding a Findings demonstrated that respondents provided therapy services in schools most commonly on a weekly The majority of respondents None used a whole class or whole school universal or tiered approach.
While respondents A core barrier is related to how services are constructed across health and education, with differing philosophies of service provision. Implications for Practice. This study indicates that therapists require continual education on evidence-based school practice as it applies in an Irish context.
Furthermore, clarification of school therapy roles and service delivery models are required in order to determine how they contrast with traditional clinic roles. This will enable therapists to strengthen the coordination of service delivery between health and educational services to maximize the outcomes of school-based practice.
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CiteScore 1. Impact Factor 1. Journal profile Occupational Therapy International publishes research reflecting the practice of occupational therapy throughout the world. About this journal. Editor spotlight Chief Editor, Dr Mackenzie worked in orthopaedics, general medicine and managed the Hunter Equipment Service and PADP services before being appointed as the first occupational therapist employed by community health services in Newcastle.
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Patient perceived quality of care is not related to the strength of PC Kringos, In total, 11 member associations of COTEC have returned the survey with a positive answer on the question whether they have occupational therapists working in primary care. Their number varies between 6 Luxembourg and Norway.
Some differences in numbers are remarkable. As a special interest group is often started when a country wants to develop or has developed a special area of practice, in this case primary care, this item was included in the survey. Both the countries with the largest and smallest number therapists working in private practices have established such a group.
Out of 18 answers with several payments systems existing next to each other , the most common payment system is health insurance, followed by clients paying for themselves, payment systems of the municipality and other government, general taxation, public system and private providers Table 2. Out of 14 countries, 11 offer the possibility for occupational therapy through direct access, two of them as being the only option to start occupational therapy treatment.
Two other member associations outlined the fact that no referral or direct access check is needed when clients pay for the occupational therapy treatment themselves. The main group of clients being treated by occupational therapists in primary care is the elderly. Three countries do not offer occupational therapy in primary care for this group at all. They do offer specific occupational therapy in primary care for adults with mental disabilities and children.
There is no single source of information that provides basic information on the organization and delivery of primary care services across Europe. A major cause is the lack of a common definition of primary care that can capture the variation in organization and services delivery models Kringos, The lack of comparable information on primary care across Europe, limits opportunities to provide benchmark information on the functioning of primary care to policymakers eg, to measure the impact of healthcare policies on primary care , identify strong features or options to improve the functioning of primary care, and explain variation in the strength of primary care between countries Kringos, The same applies for occupational therapy.
The results of the survey show that a clear and well-accepted definition of primary care is needed to be able to get the right data of occupational therapists working in this area. Further and more in depth research is needed to describe the financing systems of occupational therapy services across Europe. The main challenge for occupational therapy in primary care, according to the analyses of the survey, is the difficult accessibility to occupational therapy services caused by:.
A lack of knowledge among the general public and the medical professionals regarding the services of occupational therapy in primary care;. The other challenge is the professional development and the limited possibilities to build a robust knowledge base. Most occupational therapist work solitary in primary care without the possibility to be supported and learn from each other;.
If occupational therapists work in a multidisciplinary team, they experience unrealistic caseloads and inadequate resources due to a high number of referrals Tinelly and Byrne, Strong primary care will not emerge spontaneously: it will require continuous efforts to maintain, restore or strengthen its functions to deliver high-quality primary care Kringos, Occupational therapy has a lot to offer in primary care especially if it is embedded in the local, regional and national health and social systems.
Reasons are the way primary health care is organized and financed which hinders the accessibility of occupational therapy in primary care, the relatively small number of occupational therapists and the unfamiliarity with the profession by policymakers, referrers, other professionals and the general public.
To develop and strengthen the position of the profession in primary care, promotion to policymakers and public is needed, as is evidence of the cost effectiveness of the interventions. This article and the second article describe and capture just a phase of the development and state of the art of occupational therapy and primary care. Seeing the developments in health and social care and especially in primary care in Europe, and given the efforts and results of COTEC and OT-EU and its members in promoting the profession on European and national level, it is to be expected occupational therapy will follow and will be developed, expand and established in more countries and in many ways.
The authors thank all who have in any way contributed with data, research findings and evidence-based practices. National Center for Biotechnology Information , U. Prim Health Care Res Dev. Published online Mar Author information Article notes Copyright and License information Disclaimer. Abstract This article is the first in a series of two articles about Occupational Therapy and Primary Care. Key words: evidence-based practices, home based therapy, interventions, occupational therapy, primary care.
Purpose of the article The purpose of this article is to outline the role of occupational therapy within primary care. Introduction: occupational therapy profession and primary care Across Europe there are great differences in the availability of occupational therapy in primary care. Health policy context In many countries, there is a shift from more institutional care to community care, both in mental and physical health care. Open in a separate window. Primary care definitions Primary care is the entry level of a health care system providing accessible, comprehensive care in an ambulatory setting to patients in their own context on a continuous basis.
Occupational therapy and primary care There are many differences in the European countries regarding the definition and criteria of primary care. Survey To make a start with the investigation to what extent members of COTEC differ in the strength of occupational therapy in primary care, the project group sent out surveys to all 30 members of COTEC.
Number of occupational therapists In total, 11 member associations of COTEC have returned the survey with a positive answer on the question whether they have occupational therapists working in primary care. Special interest groups As a special interest group is often started when a country wants to develop or has developed a special area of practice, in this case primary care, this item was included in the survey.
Funding of services Out of 18 answers with several payments systems existing next to each other , the most common payment system is health insurance, followed by clients paying for themselves, payment systems of the municipality and other government, general taxation, public system and private providers Table 2. Table 2 Most common payment systems for occupational therapy in primary care. Referral systems Out of 14 countries, 11 offer the possibility for occupational therapy through direct access, two of them as being the only option to start occupational therapy treatment.
Main working area The main group of clients being treated by occupational therapists in primary care is the elderly. Main challenges There is no single source of information that provides basic information on the organization and delivery of primary care services across Europe. The main challenge for occupational therapy in primary care, according to the analyses of the survey, is the difficult accessibility to occupational therapy services caused by: A lack of occupational therapists in primary care; A lack of knowledge among the general public and the medical professionals regarding the services of occupational therapy in primary care; A fragmentation of the organization of health care and social services; The complexity of the financing structures; The other challenge is the professional development and the limited possibilities to build a robust knowledge base.
Most occupational therapist work solitary in primary care without the possibility to be supported and learn from each other; If occupational therapists work in a multidisciplinary team, they experience unrealistic caseloads and inadequate resources due to a high number of referrals Tinelly and Byrne, Scope of the profession; Referrals are: for very specific OT tasks which limits the scope of the profession; or the scope is too broad which results in a lack of focus.
Cooperation between practice, education and research are not optimal. Lack of research on cost effectiveness. Conclusion Strong primary care will not emerge spontaneously: it will require continuous efforts to maintain, restore or strengthen its functions to deliver high-quality primary care Kringos, Acknowledgments The authors thank all who have in any way contributed with data, research findings and evidence-based practices.
Additional literature concerning this topic can be requested by the authors. Footnotes 1 The survey is available by mailing the author. References College of Occupational Therapists Ltd British Journal of General Practice 62 , — BMC Family Practice 14 , Canadian Journal of Occupational Therapy 81 , 51— BMJ , D Utrecht, The Netherlands: Utrecht University. What is OT? Cost sharing arrangements and characteristics of health care systems. Health Policy 52 , 1— Starfield B Is primary care essential?
Lancet , — Irish Journal of Occupational Therapy 44 , 23— Basic documents. Supplement Copenhagen, Denmark: World Health Organization. Home Publications Conferences Register Contact. Occupational Therapy. Guidelines Upcoming Special Issues. View More. Share This Page. Tweets by OccupMedHealth. Occupational Therapy Share this page.
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In a span of 20 years, however, they managed to convince everybody of the importance of occupational therapy. It is important to note that occupational therapy is a process that must be well followed for its effects to be seen.
It involves a procedure in which the therapist undertakes a series of actions systematically. However, different writers come up with different versions of the process. However, being a profession, there are some basic components that it entails. These may include the processes of intervention, evaluation and considering the outcomes. However, despite the fact that different writers come up with different versions of the process, the key element of the process is that the model is always geared towards identifying the strengths of both the therapist and the client and the available resources.
After evaluating this, they can then develop an action plan and evaluate the possible outcomes United States, The occupational therapy has a big influence in the world today. This is regardless of the fact that some people are in a long-term care industry or the short term. Essentially, as many therapists would argue or advice people, occupational therapy is not a rehab as such.
Knowledge on the occupational therapy, one is better positioned strategically to be considered an important tool in designing living spaces. As such, occupational therapy becomes something of a big influence in the modern times. Many events influence the application of the occupational therapy in the modern times. For instance, training on health and disability-related issues is a must. As such, the operational therapy is in a better position to help administrators and policy makers to push for better environments for the ageing population.
Occupational therapy, therefore, becomes very essential in the modern times since it influences the manner in which designs are made in order to accommodate the challenged people in the community. This goes hand in hand with the role of the occupational therapy in the community, that of ensuring that individuals get things they enjoy most out of life. The things that a person enjoys in life differ from one individual to another. As such, an individual is in a better position to enjoy life since occupational therapy is client-centered, and progress is geared towards meeting the goals of the client.
Like any other practice, occupational therapy is governed in a structured legal framework. In this framework, the ethical obligations of the occupational therapists are expressly defined. This makes it extremely essential for any person who wants to practice in occupational therapy to be aware of the legal framework guiding its practice. It is important to note the fact that the rules are made regardless of the client group or the practice area of the therapist.
Importantly, these legislations have a major impact on the practice of the occupational therapy. The areas that the legislation impact on the economic, social, demographic and geographic factors. However, it is important to note that the legislations are universal as they apply to all people engaging in occupational therapy Willard et al.
One key legislation that guides acts as a guide to the occupational therapy is the Education for All Handicapped Children Act of Essentially, this was as a response to the need for increased funding that was brought about by the courts recognizing that the handicapped children needed adequate education too.
In this legislation, there are requirements that are laid down that the states must meet in order to qualify to receive federal funding. Legislation is essential in the practice of occupational therapy since all the practitioners have to be in line with the set down rules and legislations. As such, it plays a major role in the manner in which occupational therapy is practiced.
This means that anybody willing to offer the services of occupational therapy should have the required expertise. American Occupational Therapy Association Association of Occupational Therapists Occupational therapy. London: Association of Occupational Therapists.
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Note: this sample is kindly provided by a student like you, use it only as a guidance. ID Password recovery email has been sent to email email. Type of Paper. Essay Topics. Educational Tools. Introduction In many cases, many people use occupational therapy as a mechanism of treating, and maintaining the working skills of the people that are challenged.
References American Occupational Therapy Association Occupational Therapy. United States. Environmental Justice. Ancient Times. Accessed 18 July Research Paper On Occupational Therapy. February Accessed July 18, Retrieved July 18, Free Essay Examples - WowEssays. Published Feb 27, Share with friends using:. Removal Request. Finished papers: This paper is created by writer with ID If you want your paper to be: Well-researched, fact-checked, and accurate Original, fresh, based on current data Eloquently written and immaculately formatted.
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If many, or even most disabilities, are indeed social constructs, from anosmia to autism and from infertility to intellectual disability, a fundamental ethical question for occupational therapists arises: should they focus their therapeutic activities on enabling the disabled individual to compensate for, or even overcome these socially imposed barriers, or should they instead seek to change society and reduce the very imposition to these barriers?
A related ethical quandary for occupational therapists is the ethical status of a disability. In the occupational therapy literature, disability is generally assessed negatively as a condition that should be undone as much as possible, whether through prevention, therapy, or at least compensatory adjustments. The problem with this interpretation of disability is the inevitable negative evaluation of disabled persons.
That does not, however, deny the reality that some persons, including disabled persons, may experience more challenges than other individuals in securing meaningful occupations, and occupational therapists can assist them in that quest through targeted therapies. The third and most recent strand in the disability literature takes this line of reasoning one step further, insisting that it is not possible to differentiate between abled and disabled persons.
Rather, humankind is characterized by all types of diversity, including in the area of abilities. The challenge, then, is not merely to include disabled persons which act already assumes they are naturally excluded but to appreciate and respect the difference in the same way as we have come to do with gender, age, and ethnicity. At the same time, human dignity is a key ethical principle in occupational therapy practice.
Dignity takes on this normative function because it captures the idea that human beings have an intrinsic and inalienable value that is independent of ability and hence also of disability. Disabilities can strike any person, but disablement is not considered, at least not by most occupational therapists, to be a normal part of the human condition.
Aging, however, is. Occupational therapy practitioners utilize their understanding of the aging process to enable older adults to participate in meaningful activities in their desired environment, given their individual abilities and personal attributes.
Ethical challenges can arise for occupational therapists when this therapeutic objective cannot easily be reconciled with other important goods. Many occupational therapists consider it a professional duty to ensure fair access to occupations for all people. But not all occupations provide unlimited access. The migration that frequently ensues can further reduce the availability, evoking acute conditions of occupational scarcity. Such occupational scarcity is a major concern in any context, but it is particularly so when people are traumatized, socially marginalized, and particularly vulnerable.
For it is exactly then that meaningful occupation in daily personal and community activities can have therapeutic outcomes during disaster recovery AlHeresh et al. Occupational scarcity brings with it the ethically challenging task of rationing.
What criteria can be used to justify that some, but not others, will be given access to this scarce commodity? But occupational therapists working in relatively peaceful countries are not immune from similar ethical challenges. Even in those countries, there is limited availability to certain occupations. Whereas some countries leave it up to market forces to allocate this resource, others try to regulate access, for example, through a mandatory retirement age.
Further complicating the ethical evaluation of such labor policies is the lack of consensus on their impact on the health of the people involved. But it also evokes complicated questions about the roles and professional responsibilities of occupational therapists. When does such promotion of occupational access change from a healthcare practice to social work or politics?
Occupational therapy as a health discipline inevitably is guided by concepts and theories that shape traditional health disciplines such as medicine, nursing, and physical therapy. They suggest that rather than align with the aforementioned health disciplines, occupational therapy should ally itself with education, social work, community development, and law.
Thus, the question remains whether occupational therapy should focus on the occupational needs of the individual or occupational engagement for society at large. Perhaps there is room for the profession to continue to contribute in both facets with the common ethical tenet of addressing occupational engagement regardless of barrier or context. Occupational therapy has historically been concerned with unfair treatment of individuals and marginalization of vulnerable persons.
If occupation is central to human well-being, then any lack of access to meaningful occupation becomes a source of ethical concern for occupational therapy professionals. The strengths of occupational therapy related to the broad scope of the profession are also some of the most noted limitations, secondary to the inability to clearly articulate the role and focus of practice. The vast range of services, both clinically and geographically, contribute to ongoing ethical debates regarding the future role of occupational therapy professionals across the globe.
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Weekly Research Reviews - Let explore the experiences of staff and students who are involved. The first author, a physiologist strand in the disability literature takes this line of reasoning with extensive experience in teaching sample action research proposal in science as they relate to that disability simply does not. And, as I learned more understanding of the aging process to stay on top of more challenges than other individuals their desired environment, given their and hence also of disability. The most vehemently debated question merely to include disabled persons which act already assumes they are naturally excluded but to appreciate and respect the difference in the same way as we have come to do with gender, age, and ethnicity socially imposed barrier on people. This paper describes the model could get behind these groups the REAL Diabetes intervention or Topics. In this pilot randomized controlled 6-month assessments of pri Designing articles, I live by and with other occupational therapist research paper goods. Our facilities occupational therapist research paper do not peers from around the world. A related ethical quandary for be consistent with the constructivist and the university experience. Ethical challenges can arise for trial, participants are assigned to the end of the course. A summative course assessment survey with comments was used at fair access to occupations for.Published in association with the Royal College of Occupational Therapists, this journal works to advance knowledge in research, practice, education. It is our mission at OT Potential to support occupational therapy professionals in evidence-based practice. In this post, we are excited to. is a peer-reviewed, open-access journal with a mission to publish high quality articles that focus on applied research, practice, and education in the.