Leveraging Practice

There are enough gaps in literature and service to suggest studying or doing almost anything. That does not mean it needs to be done at all, done by an occupational therapist, or done as a priority now. 

Instead of rushing to fill the gaps we see around us (Fortune, 2000) we first situate ourselves and first draw on a rich understanding of our context, our profession, and our personal strengths.

We situate our professional reasoning with questions such as:

  • what could an occupational therapist contribute to this particular situation,
  • at this particular time in history,
  • in this particular place with its ecosystem of actors, interests and efforts?

This enables us to first think expansively and theoretically before considering what is salient to this specific time and place.

We draw on our professional reasoning with questions such as:

  • what are the occupational experiences of people who have been displaced,
  • what are they already striving for, and what are the barriers,
  • who else cares about these occupational needs and rights?

This heeds the call to engage displaced people and other actors as partners in the development of context-specific strategies to respect, protect and fulfil occupational needs and rights (WFOT, 2014).

We locate ourselves by identifying what we can offer with questions such as:

  • what could I bring to bear with my skills, strengths, and resources,
  • how would my contribution relate to other actors and momentum,
  • how would my contribution be seen through the lens of other interests at play?

This draws on self-awareness and ourselves in relation to others. Not to dilute our autonomy, the hallmark of a professional (WFOT, 2007), but to be shrewd as we define our role and determine what actions would have the biggest impact on the occupational opportunities for displaced people.

As we sift through practice options, we include questions of leverage:

  • what would be the most strategic,
  • what would have the biggest impact,
  • what would be the most sustainable?

The resulting wide array of practices rightly reflects diverse priorities and contexts. 

The reality of constrained and competitive resources requires that practitioners consider from the outset:

  • can it work? (efficacy – doing more harm than good)
  • does it work? (effectiveness – acceptability and usefulness to people)
  • is it accessible to those who need it? (availability – scaling it)
  • does it make economic sense? (quantifying costs and consequences of doing it vs doing nothing, or doing something different)

Leveraging practice is to verify, consolidate, and build on ‘what works’ over time as a precursor to sustainability and scale.

The field of practice is then characterised then by depth as well as breadth.  


Fortune, T.  (2000). Occupational Therapists: Is our therapy truly occupational or are we merely filling gaps? British Journal of Occupational Therapy, 63 (5), 225 – 230. Retrieved from: https://www.researchgate.net/publication/233697816_Occupational_Therapists_Is_Our_Therapy_Truly_Occupational_or_are_We_Merely_Filling_Gaps

World Federation of Occupational Therapists (WFOT). (2007). Occupational Therapy – Profession Autonomy. Position Paper. Retrieved from: http://www.wfot.org/resourcecentre.aspx

World Federation of Occupational Therapists (WFOT). (2014). Human Displacement. Position Paper Revised. Retrieved from: http://www.wfot.org/resourcecentre.aspx