I fancy myself as being in a rather unique position to address this question. In the twelve years since graduating from OT school, I've gone from full-time clinician, to full-time academician back to full-time clinician.
The "real" world of OT is generally considered to be the clinic. In this setting, theory and philosophy often take a back seat to rigors and demands of for-profit health care. Theory is not totally void in practice, but it certainly is not part of everyday discussion and in my experience it often does not drive practice. While there are many possible explanation for this, I offer only one. A theory is not a part of practice because it is not seen as having DIRECT application. These types of theory are abstract and difficult to 'pin down' in the real world. Clinician's minds are overwhelmed with practical clinical decisions and taking time to access abstract thought is not part of the time sensitive equation of daily treatment. Thus, well thought out theories are often left in the classroom or in clinician's notebooks. In my experience, clinician's cling to theories such as NDT, Bobath, constraint-induced treatment, etc. These "hard" theories all have an application and hands-on component lacking in "soft" theories such as Enabling Occupation, therapeutic relationship, Practice Framework, etc. But, I believe these soft theories are equally important and perhaps even more important to our profession. As clinician's we *MUST* integrate "soft" theory into our daily practice. We *MUST* develop a sense of who we are as both as a profession and individuals and this comes from "soft" theory. While are most easily grasped, developed and recognized, they tend to not define who and what we are. Obviously, I offer no solutions to the age-old debate of theory ~vs~ practice but I felt compelled to write something!! Ron -- Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
