Developing the occupational therapy professionthrough leadership and mentorship: energizingopportunities

Julie Lapointe(Canada)

Sue Baptiste(Canada)

Claudia M. von Zweck(Canada)

Janet M. Craik(Canada)

A b s t r a c t : To successfully advance the profession of occupational therapy and improve access to our services, we needleadership as well as mentorship strategies and initiatives. Leaders help push boundaries and champion advancements inpractice, policy, research and education to develop and promote client-centred, occupation-based enablement. To furtherdevelop leadership capacity, we need to put in place multiple, innovative mentorship strategies. This article illustrates someconcrete strategies and initiatives undertaken by the Canadian Association of Occupational Therapists (CAOT) to fostermentorship and leadership such as the creation of a new Fellowship program. Our goal in sharing this information is toinspire and encourage occupational therapists worldwide to develop personalized and creative initiatives to foster the roleof leaders and mentors.

Key w o r d s : Mentorship, leadership, development of the profession.

Introduction

Leadership and mentorship are active processes that con-tribute to making something extraordinary happen, propellingchange and enabling the development of an individual's orcollective's full potential. In oeeupational therapy, our leadershelp push boundaries and champion advancements in prac-tice, policy, research and education to develop and promoteclient-centred, occupation-based enablement (Rodger 2012).For students, new graduates as well as more experiencedoccupational therapists, mentorship creates relationshipsthat encourage grov^h towards set goals to help a personto develop in a professional capacity.

In accordance with its mission to advance excellence inpraefice, the Canadian Assoeiafion of Occupafional Therapists(CAOT) recognizes that fostering leadership and mentor-ship are key elements to the continuous development ofthe profession of oeeupational therapy. This article willintroduce key concepts of leadership and mentorship in thecontext of professional development for both the individual

therapist and the profession of occupational therapy. Con-crete examples of strategies and initiatives undertaken atCAOT to raise awareness of an occupational perspective ofhealth, well-being and justice, and occupation as a healthbenefit v«ll be presented along with some of the subsequentoutcomes.

In response to the growing awareness that persistent,inequitable access to oeeupational therapy constitutes acritical issue (Tovrasend et al 2011), the second edition ofEnabling Occupation II: Advancing an occupational therapyvision for health, well-being, and justice through occupationintroduces the Leadership in Enabling Occupation (LEO)Model as a proactive leadership initiative (Townsend andPolatajko 2013a). The conceptual perspective of the Leader-ship in Enabling Occupation (LEO) Model will be presentedand will set the basis for the description of CAOT strategiesand initiatives.

The intent of this article is to energize occupational ther-apists with ideas for fostering leadership and mentorship

38 WFOT Bulletin Volume 68 November 2013

initiatives adapted to their context and realm of possibih-fies. Leadership and menforship are the keys fo develop,promote and propel fhe client-centred profession of occupa-tional therapy for fhe ulfimafe benefif of fhe populafion.

Key concepts in leadership andmentorship

In order to achieve the full capacity of a profession, leader-ship should be a philosophy of practice for all, be it prac-fitioner, educator, researcher, manager or policy maker(Clark 2010, Townsend and Polatajko 2013b). Occupationaltherapists in the entire mosaic of pracfice areas and typesof employment within and beyond health services have arole to pioneer, lead and make changes from individual fosysfem level inferventions. Our style of leadership can be oneof comfort wifh our professional mission and values (Bapfisf e2000). Value-based leaders ensure thaf the needs of others aremet (Greenleaf 1991, Lawson-Porter 2009, Waterman 2011).Efficient leaders esf ablish key partnerships to devise creativesolutions to solve the increasingly complex populafion's healfhneeds (Helgesen 1995). Great leaders empower others andposition them to succeed for fhe sake of individual as wellas the collecfive benefif (Dillon 2001). Considering leadershipfrom fhis perspective can help oeeupafional therapists betterappreciate the leadership role they often endorse. Indeed,helping our clients to set goals and develop fheir vision ofpossibilities is asserting leadership skills (Reimer 2000).Oeeupafional therapists illustrate leadership every fime theyuse fheir key enablement skills of coaching, coordinatingand educating (Townsend and Polafajko 2013a).

Mentorship is fundamental to advancing skills and devel-oping into a proficient professional (Wood 2011); compefen-cies cannot be acquired solely fhrough reading and theo-retical learning (Reimer 2000). Through guidance, supportand training, mentors facilitate growth and help developprofessionalism (Lawson-Porter 2009, Reimer 2000). Thementorship relationship may result in positive benefits suchas an increased commitment towards the profession forboth fhe menf or and the mentee (Milner and Bossers 2005).Mentorship is an essential ingredient for the developmentof a profession as a whole. It is important fherefore to mentoroccupational fherapisf s in the development of their leader-ship skills, particularly in a contexf of a female-dominatedprofession, with few senior leaders and where many maybe working part-fime (Clark 2010, Townsend et al 2011).

The Leadership in Enabling Occupafion (LEO) Model offersa conceptual perspective f o support actions that respond f othe increasing demands on evidence and accountability in fheshift of health and social policy. The LEO Model is a visualrepresentafion of fhe inter-relafionship of four key leadershipelements, namely scholarship, accountability, funding, and

Figure 1. Leadership in Fnabling Occupation (LEO) Model.

Townsend, E.A., Polatajko, H.J., Craik, J.M., von Zweck, CM. (2011)Introducing the Leadership in Enabling Occupation (LEO) Model. CanadianJournal of Occupational Therapy, 78, 255-259.

workforce planning (see Fig. 1) (Townsend ef al 2011). Thesefour pillars are the foundation from which professionals canassert their leadership to create optimal conditions for, andaccess fo, occupational therapy services. In other words,this model offers the conceptual tools fo devise actions thatraise awareness of an oeeupafional perspecfive of health,well-being and justice, and occupation as a health benefit.

Leadership and mentorship initiativesand strategiesThe Fellowship program: realizing the LEO Model

Although the Profile of Pracfice of Occupational Therapistsin Canada (Canadian Associafion of Occupational Therapists2012) outlines a broad range of roles of occupational fher-apists, most occupational therapists work in well-developedand tradifional areas of pracfice, usually involving individually-based clinical inf ervenüon. Few formal learning opportunitiesexist to mentor occupational therapists in less traditionalareas of pracfice such as associafion management, advocacyand policy development. In response to this, CAOT launcheda Fellowship program for a 12-month research analyst posifionat the CAOT National Office. This Fellowship was designedto provide a learning opportunify to a recent graduate of aCanadian university oeeupafional fherapy educafion programto develop leadership, promote fhe role of occupationaltherapy and advance research in practice. For CAOT, thisFellowship was an opportunify to demonstrate leadershipas an association to acknowledge and promote less tradi-tional occupational therapy roles (Table 1).

The Fellow candidate was selected through a competitiveprocess that involved evaluation of academic performance,a written essay, referee recommendafions as well as personalinterviews. This Fellow was mentored by the CAOT Director

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Table l. Goals and expected positive impacts of creating theCAOT Fellowship program

Goals:• Develop leadership capacity;• Promote the role of occupational therapists in policy and

representation;• Address current professional issues influencing

occupational therapy through the development and/orapplication of research in practice.

Expected positive impacts:• Enhance interest and leadership for the role of

occupational therapists in policy and representation;• Increase effectiveness and impact of association activities;• Develop potential workforce capacity for CAOT and similar

occupational therapy organizations;• Raise awareness among new graduates regarding the work

and membership benefits of CAOT.

of Professional Practice. Scheduled weekly meetings allowedfor the mentor-mentee relationship to develop and enablethe Fellow to receive guidance in the conduct of the manyprojects and responsibilities that were assigned to her. Theefficiency of this mentorship was in great part due to opencommunication and giving enough space and time to discussideas and develop action plans as they emerged. The mentorwas generous in sharing her knowledge and experience ofmany years in association management, advocacy actions,representation activities and dissemination of knowledgein occupational therapy at a national level. The mentor alsointroduced her mentee to several CAOT members, collabo-rators and stakeholders which allowed for the building ofstrategic alliances, essential for the success of many under-takings. The goal was for the Fellow to gain knowledge andskills to conduct actions in areas of public policy, knowledgedissemination, public awareness and service to members.This experiential learning opportunity offered the essentialelements to build leadership that advance the practice ofoccupational therapy in the areas of direct client services,education, research and policy development within a lead-ing national association. The Fellow was enabled to designstrategies and conduct projects that were integrating thefour elements of the LEO Model (see Table 2).

The element of scholarship was the fundamental part ofall Fellow's projects since throughout this journey severalstrategies assured that evidence was used to position occu-pational therapy for leadership (Townsend et al 2011). Suchstrategies included monitoring and comparing evidencerelated to local, national and international policies, research-ing empirical data and gathering experts' opinion on diverseand pressing occupational issues and building partnershipsto advance knowledge generation and exchange. Accountabilitywas the area of concern when preparing written commu-

Table 2. Example of responsibilities of the Research AnalystEellow

Scholarship• Reviewing and monitoring research literature regarding

cost-effectiveness of interventions.• Managing projects to develop and disseminate evidence-hased

tools and resources.• Writing articles for professional and public journals and

newsletters.• Monitoring and advertising professional development

opportunities for occupational therapists.• Participating in team work in the development of new tools

and resources.• Participating in and facilitating collaborative writing of

position statements.

Accountability• Organizing and facilitating meetings on strategic planning.• Performing inventories of provincial and territories pohcies

and regulations.• Representing the association and participating in national

initiatives.

Funding• Monitoring funding opportunities and writing grant applications.

Workforce planning• Collaborating with other professional associations in

advocacy actions.• Preparing representation material for different stakeholders

and decision makers.• Meeting with decision makers to discuss the added-value of

occupational therapy services.

nications, conference or webinar presentations and surveysto inform and collect the input of CAOT members aboutthe association's activities. Monitoring and appl}dng forfunding for project proposals from government and researchgranting agencies was another area of responsibility of theFellow. Finally, the element of influencing workforce plan-ning was enacted through multiple representation activitieswith decision makers. The Fellow also needed to contactorganizations to advocate for the inclusion of occupationaltherapists upon relevant workgroups or committees.

As part of her role, the Fellow conducted several litera-ture scans and reviews to support the work of other CAOTstaff. Evidence supporting the effectiveness and cost-benefitof occupational therapy interventions were an importantfocus of these searches. These literature reviews were notuniquely within the academic arena. For instance, theFellow was asked to complete an inventory of the differentCanadian provinces and territories' policies on the duty toreport medically at-risk drivers by occupational therapists.Such an inventory existed for physicians but was not avail-able for occupational therapists. As the vocabulary relative to

40 WFOT Bulletin Volume 68 November 2013

legislations and polieies were not part of her former trainingin oeeupational therapy it was an opportunify for her to gainknowledge and build alliances. Indeed, the Fellow followedthrough with the advice of her mentor and contacted differentpeople to validate her understanding of the legal documents.

The Fellow's responsibilities also included the developmentand diffusion/exchange of evidence-based CAOT resourcesto practitioners and members of the public. One project,the older drivers' project, related to the management of agrant the association received to translate and disseminatea series of brochures on driving safety for older adults inChinese, Italian and Punjabi. To conduct this project, theFellow was able to draw from a past experience as projectmanager. The Fellow benefitted from her mentor's revisionof her strategic plan and succeeded to produce the brochureswithin the required timeline. In partnership with the CAOTCommunication Officer, the Fellow devised a multi-step dis-semination strategy which garnered success in many forms.For instance, the careful preparation of the press releasedocument paid off as it generated more than 50 publications,three radio interviews and one direct 8-minute televisioninterview. In many ways, this older drivers' project alsoexemplified the element of accountabilify of the LEO Modelin that it entailed the obligation to respect and proceed withtbe intended original goals and acknowledge the financialsupport received by the granting agency.

To develop leadership skills in representing the professionand advocating for funding and workforce development,the Fellow also participated in the securing of meetingswith government representatives and decision makers. Shemet with some of f hem to discuss the role of occupationaltherapists in areas of public interest particular to that politi-cian or government representative. To build her capacity inthis new role, the Fellow benefitted from the guidance andsupport of her mentor as well as that of the CAOT Publie PolicyOfficer. She prepared and practiced her key points of dis-cussion and made sure to read on the targeted subject andon the work done by the person with whom she was meeting.Each meeting was a privileged occasion to exchange viewpointsabout improving health services and helping to create a moreinclusive society for Canadians. However, at the beginningof each of these meetings it was essential to present the roleand areas of expertise of occupational therapists. Theserepresentation activities had many positive impacts in theshort term and probably even more so in the longer term.

This Fellowship program was also the occasion to setand pursue personal goals. One of the Fellow's projectswas the creation of the scientific reading clubs. This projectallowed her to add value to CAOT membership by the shar-ing of her newly acquired set of competencies in research.The Fellow needed to follow the management processesused at the CAOT National office, namely the setting of

objeetives, writing of the strategic plan, enlisting of keypartners, running of a pilot session, adjusting the processand objeetives, running the "real" session inviting all CAOTmembers, and writing of a final report with a detailed report.She was able to engage with CAOT members about theimplication of research on practice and even to mentorthem in the appraisal of scientific evidence.

It is however important to recognize that implementingsuch a fellowship is an important commitment in terms ofhuman and financial resources for the organization. Train-ing a person through a fellowship programme thus needs tobe seen as a long term investment, an investment requiringstrategic thinking and direction. The most benefits can beachieved by aligning the portfolio of the fellow with the mostpressing professional issues. The key is to identify areas thefellow can contribute the most and generate enduring out-comes. The fellow also needs to be fiexible and open mindedregarding the possibilify that priorities and contributionsmight be modified over his or her mandate in order to befterserve the interest of the profession and the members. It is alsoimportant to monitor the impact the fellow has and evaluatethe contributions achieved through the fellowship program.Blackwood (2006) suggests a mixed method approach (i.e.quantitative and qualitative methodologies) to be most usefulin monitoring and evaluating outcomes in the context of imple-menting complex mentorship and leadership initiatives.

Elder abuse project

Several other strategies and initiatives are underway toensure that oeeupational therapy is valued and accessibleto the people in Canada (see Table 3 for web links). Theelder abuse project is a strategy covering the elements ofscholarship, accountabilify and workforce planning. It aimsto equip health care providers to address and be account-able if they suspect a situation of elder abuse/mistreatment.A series of knowledge dissemination initiatives were exe-cuted to help therapists learn about the indicators of elderabuse/mistreatment prevention, assessment, andintervenfionprotocols. Further knowledge dissemination activities areunderway using a train-the-trainer approach to cascadethe learning on to others, and increase capacity to respondand manage situations of abuse. Trainers attend a full daytraining session and are expected to prepare and deliverthree customized elder abuse workshops to build the capaeifyfor health care providers in their region.

Online mentorship

To assist members with their everyday practice, in Spring2013, CAOT introduced Momeníum, a new online mentorshipmodule to foster professional growth through a guided reflec-tive process. Momentum consists of four synchronous onlinesessions that explore the concepts of mentorship and provide

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Table 3. Links to CAOT strategies and initiatives

CMPT = Caseload Management Planning Tool: http://www.caot.ca/default.asp?pageid=23.'^iCOTF Research Grant = Canadian Occupational Therapy Foundation Research Grant: http://www.cotfcaiiada.org/index.php/research-grantsElder abuse project = Strategies to address elder abuse/mistreatment: http://www.caot.ca/default.asp?pageid='^Q26IEOT = Internationally Educated Occupational Therapists (IEOT) Web Portal: http://www.caot.ca/default.asp?pageid=2iQqMomentum = Online mentorship module: https://www.caot.ca/defaiilt.asp?pageid=42::!O and http://wvyw.caot.ca/defaultasp?pageid=^íQ26Older Drivers' Project = Translation and dissemination of brochures for the older drivers: www.olderdriversafety.caOTepp = Occupational Therapy examination and practice preparation project for internationally educated occupational therapists:http://www.otepp.ca/

an opportunify for members to be matched with a suitable

mentor. With Momentum, the goal is to generate positive

outcomes in the elements of scholarship, accountabilify

and workforce planning ofthe LEO Model.

Internationally Educated Occupational Therapists(IEOT) Web Portal

From collaboration between CAOT, the Association ofCanadian Occupational Therapy Regulatory Organizationsand the Association of Canadian Occupational TherapistsUniversify Programs, the Internationally Educated Occupa-tional Therapists (IEOT) Web Portal has been created. Theweb portal is an online navigation tool providing IEOTswith information to assess their interests and qualificationsto work in Canada, as well as links to web sites that willprovide information regarding registration and immigrationrequirements and processes. Among the IEOT resources,there is a link to the Occupational Therapy Examination andPractice Preparation Program for Internationally EducatedOccupational Therapists (OTepp). The program assistsInternationally Educated Occupational Therapists (IEOTs)and Canadian re-entry occupational therapists to meet theirlearning needs in order to successfully transition intoCanadian practice. The program consists of four academiccourses and an eight-week supervised practicum that leadsto a certificate of completion from McMaster Universify. Inthe past, the OTepp program offered work readiness, examprep and mentorship modules but mentorship and exam prepmodules are now offered by the CAOT. Plans are underwayto also offer the work readiness module by the CAOT infuture. Like the Momentum initiative, these resources aimto create positive impacts for the profession from the per-spective of scholarship, accountabilify and workforce plan-ning as outlined in the LEO Model.

Interprofessional Caseload ManagementPlanning Tool (CMPT)

The Interprofessional Caseload Management Planning Tool(CMPT) is another initiative and the product of a collab-orative partnership between the CAOT, the Canadian Asso-ciation of Speech-Language Pathologists and Audiologists

and the Canadian Physiotherapy Association. It is anevidence-based tool with a structured set of considerationsthat are designed to assist individual professionals, organi-zations and policy makers in determining effective caseload/workload management processes for occupational therapy,physiotherapy and speech-language pathology services. Itsintent is to facilitate the effective and efficient matching ofhuman resources to a wide variefy of client populations andservice delivery models. Practitioners may use the CMPTto examine and refiect on their caseload and practice man-agement and, in collaborafion with managers, discuss strate-gies to address workload imbalances. This thorough exam-ination is providing objective facts to conduct advocacyactions through which to improve the funding of services.This evidence-based tool can support all four leadershipelements ofthe LEO Model with an emphasis on the work-force planning and funding.

ConclusionThese concrete examples are offered to occupational therapistsworldwide to support the ongoing generation of creativestrategies and initiatives to ensure that the profession becomesa strong force in practice settings and sociefy overall (Townsendand Polatajko 2013a). This requires the financial commitmentof salary and extra human resources to provide mentoring,as in the example of the LEO initiative. Leadership andmentorship are two important means to achieve our mission,advance a vision of health, well-being, andjustice throughoccupation (Townsend and Polatajko 2013b).

To develop the profession successfully and improve accessto our services, we need active and involved occupationaltherapists. We need leaders and we need to mentor ourcolleagues to develop leadership capacify. This article illus-trates some concrete strategies and initiatives undertakenby CAOT to foster leadership and mentorship.

AcknowledgmentsThe Canadian Association of Occupational Therapists (CAOT) would liketo acknowledge the financial support received from Health Canada, thePublic Health Agency of Canada (PHAC), the New Horizons for SeniorsProgram (NHSP), the Human Resources and Skills Development Canada

42 WFOT Bulletin Volume 68 November 2013

(HRSDC), and the Government of Canada's Foreign Credential RecognitionProgram. CAOT would also like to acknowledge the inspiring and groundbreaking work of the OTepp team from the School of RehabilitationScience at McMaster University in Ontario, Canada. OTepp is funded inpart by the Government of Canada's Foreign Credential RecognitionProgram and by the Government of Ontario.

ReferencesBaptiste, S. (2000) Visioning together for leadership. Canadian Journal

of Occupational Therapy, 67(2), 81-85.

Blackwood, B. (2006) Methodological issues in evaluating complex health-care interventions. Journal of Advanced Nursing, 54(5), 612-622.

Canadian Association of Occupational Therapists (2012) Profile of practiceof occupational therapists in Canada (p. 33). Ottawa, Canada: CanadianAssociation of Occupational Therapists.

Clark, F.A. (2010) Power and confidence in professions: Lessons foroccupational therapy. Canadian Journal of Occupational Therapy,77(5), 264-269. doi: io.2i82/cjot.2Oio.01.77.5.2

Dillon, T.H. (2001) Authenticity in occupational therapy leadership: Acase study of a servant leader. American Journal of OccupationalTherapy, 55, 441-448.

Green, M.C. (2000) Ask an occupational therapist about the skills forthe job of living. Occupational Therapy Now, 2(5), 3-4.

Greenleaf, R.K (1991) Servant leadership. Mahwah, NJ, USA: Paulist Press.

Helgesen, S. (1995) The web of inclusion: Architecture for building greatorganizations. Washington, DC, USA: Beard Books.

Lawson-Porter, A. (2009) The Elizabeth Casson memorial lecture 2009:Rethink, reimagine and refocus. British Journal of OccupationalTherapy, 72(7), 286-293.

Milner, T., Bossers, A. (2005) Evaluation of an occupational therapymentorship program. Canadian Journal of Occupational Therapy,72(4), 205-211. doi: io.2i82/cjot.O5.ooo3

Reimer, L. (2000) Leadership: it's our future. Canadian Journal ofOccupational Therapy, 67(3), 141-145.

Rodger, S. (2012) Leadership through an occupational lens: Celebratingour territory. Australian Occupational Therapy Journal, 59,172-179.

Townsend, E A , Polatajko, H.J. (2013a) Enabling occupation II: Advancingan occupational therapy vision for health, well-being, and justicethrough occupation (Second ed.). Ottawa, Canada: CAOT PublicationsACE.

Townsend, E A , Polatajko, H. J. (2013b) Section IV: Positioning occupationaltherapy for leadership. In E.A. Townsend, H.J. Polatajko (Eds.). Enablingoccupation II: Advancing an occupational therapy vision for health,well-being, andjustice through occupation (Second ed., pp. 273-364).Ottawa, Canada: CAOT Publications ACE.

Townsend, E.A., Polatajko, H.J., Craik, J.M., von Zweck, CM. (2011)Introducing the Leadership in Enabling Occupation (LEO) Model.Canadian Journal of Occupational Therapy, 78(4), 255-259. doi:10.2l82/cJ0t.2011.78.4.7

Waterman, H. (2011) Principles of'servant leadership' and how they canenhance practice. Nursing Management, 17(9), 24-26.

Wood, W. (2011) Navigating the shifting sands of occupational therapy:Lessons from wise wayfinders. New Zealand Journal of OccupationalTherapy, 58(1), 14-20.

Address for correspondence

Janet M. CraikDirector of Professional PracticeCanadian Association of Occupational TherapistsCTTC Bldg, 3400-1125 Colonel By DriveOttawa, ON KiS 5R1 CanadaTel: 613-523-2268 ext.244 / 1 800 434-2268Fax: 613-523-2552Email: practice@caot.ca

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Students learned a great deal from the actual experience ofparticipating in the disaster response efibrt. It would have beenbetter if they had received some training as part of their curricu-lum in order to prepare them for such an experience. In con-clusion, good physical health and preparation is necessaryfor occupational therapist to be involved in disaster response.It is also important for occupational therapy students to beequipped with knowledge of disaster management and pre-paredness, emergency skills training, and cultural competency.

Sabdono, E. (2006) Final Report - 2006 Javanesse Earthquake. Jakarta:Yayasan Emong Lansia.

USGS Preliminary Earthquake Report (2006) The website of UnitedStates Geological Survey, Earthquake Hazards Program. Available at:http://earthquake.usgs.gov/eqcenter/eqinthenews/2006/usneb6/)

World Health Organization (2006) Situation Report #7: Yogyakarta andCentral Java earthquake. Available at: http://www.who.or.id/eng/php/content/jogjacentraljava/Sitrep%20lndonesia%2oJogja-Central%20Java%2OO4-o6-o6%2O(7).pdf

ReferencesAOTA (2006) The role of occupational therapy in disaster preparedness,

response and recovery. American Journal of Occupational Therapy,60(6), 642-649.

Address for correspondence

Trl Budi SantosoEmail: ot_budi@yahoo.com

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