Lydia and Laura are honoured to have recently been published in Occupational Therapy Now - a magazine published by the Canadian Association of Occupational Therapists. As some of our readers know, we started L&L Consulting out of work we did on our final fieldwork placement as part of our Master's program at University of Toronto. Read on to hear more about our experiences and how they have continued as L&L Consulting continues to grow.
From classroom to boardroom: How a role-emerging placement in workplace mental health turned into employment
Occupational therapists have always advocated for occupation in a wide variety of sectors. In recent years, we have seen our profession grow into new and unique areas. Canadian universities are using role-emerging fieldwork placements as a way to promote our profession in non-traditional sectors. Such[JM3] placements take place in a setting that does not have an established occupational therapy role and are supervised jointly by a non-occupational therapist on-site and an occupational therapist off-site. It is becoming increasingly evident through a growing body of literature that role-emerging fieldwork helps students develop the skills and knowledge required to work in non-traditional settings (Clarke, deVisser, Martin, & Sadlo, 2014). Over the past several years, universities across the country have been working to create role-emerging and non-traditional fieldwork placements. For instance, at the University of Toronto, significant time is spent developing relationships with new sites and supporting students in the creation of proposals for their own role-emerging placements. Each year, this results in 10-15 students completing their final fieldwork session in a role-emerging placement.
Program evaluation of these role-emerging placements occurs through surveying students and their non-occupational therapist supervisors after each placement. The students have reported increased skills in the roles of “practice manager” and “communicator” (Canadian Association of Occupational Therapists [CAOT], 2012) and noted they perceive the experience has made them more employable. Additionally, the non-occupational therapist site supervisors have reported an increased understanding and appreciation of the value of occupational therapy.
This article presents the story of how two MScOT students, Laura Kalef and Lydia Beck, developed a role-emerging placement in the corporate mental health context. Reflections are included from the perspective of both students and their occupational therapist preceptor.
Laura and Lydia’s journey
Many of us know friends, family and community members who have experienced mental health concerns related to the workplace. Mental illness affects more than one in five working-age individuals, is one of the leading causes of disability claims in Canada and is costing the economy billions of dollars annually (Centre for Applied Research in Mental Health and Addiction [CARMHA], 2012). Workplaces are facing major costs related to employee mental health issues due to turnover, lost productivity, absenteeism and presenteeism (when an employee comes to work while sick; CARMHA, 2012). The holistic lens of occupational therapy enables occupational therapists to support individuals and organizations facing mental health challenges in the workplace. This lens provides perspective on the multitude of interconnected factors that influence workplace mental health (i.e., individual, environmental and occupational factors) and facilitates the development of creative, holistic solutions “that support productivity and a positive workplace culture” (CAOT[JM5] , 2015, para. 1). As student occupational therapists, we wanted to use our occupational therapy perspective to address workplace mental health in a unique way, with the goal of raising awareness of its importance and increasing workplace supports.
In preparation for our desired role-emerging placement in workplace mental health, we conducted market research to learn about available services that support workplaces and to determine if organizations were interested in occupational therapy consultation. This process took several months, but we were able to identify organizations interested in supporting our role-emerging placement and secure their participation. We were required to submit a proposal to our professors to ensure that we had structured a placement experience that would meet our learning needs and stay within the regulatory requirements of the profession.
After approaching many organizations, four corporate organizations agreed to contribute to our fieldwork experience. Specifically, we worked with a law firm, an accounting firm, a recruitment firm and an insurance company. The companies were interested in learning strategies to improve their workplace mental health from health care professional students, as many mentioned this was a topic they were unsure how to approach. To ensure rich learning opportunities and adhere to regulatory requirements, it was necessary for us to have an occupational therapist supervisor. As there were no occupational therapists working at these organizations, one of our instructors from the University of Toronto, Andrea Duncan, acted as our occupational therapist off-site preceptor. Additionally, we had non-occupational therapist supervision at each company. Despite having all of these supervisors, we were still fairly self-directed in our work. We spent approximately one day per week at each company and completed mental health-related projects with each organization that were tailored to their needs. To ensure our projects were useful, our ideas were developed before our placement started, in collaboration with each company. Each project complemented and expanded on work the companies were already doing related to wellness, inclusion, disability and work-life balance. Working in harmony with each organization’s pre-existing efforts related to mental health helped to ensure that our offerings were timely and appreciated. Staff at the companies were intrigued about working with student occupational therapists and excited that we would be able to devote time and energy to this important area.
Though our projects for each company were different, they shared common themes. At two companies, we completed workplace mental health assessments. We conducted internal needs analyses to understand each workplace’s mental health needs. We collected data from employee interviews and from a review of internal disability and benefits data. We also researched best practices for supporting workplace mental health in corporate contexts. After completing our assessments, we generated recommendations to address the determined needs. We shared these findings with company leadership through presentations.
For the third company, we conducted research and developed a resource on the topic of compassion fatigue. Finally, at the recruitment agency, we delivered education on signs of mental health issues to the company leadership, [CH7] and provided resources they could share with their clients going through transitions.
The organizations we worked with reported being impressed with and appreciative of our work. They told us we exceeded their expectations with our deliverables and the recommendations we provided, which would help them to improve their organizational policies and employee programs. In post-placement feedback, one client reported “[Laura and Lydia] actively sought to understand the needs of [our organization] as a business, and customized the material and presentation as needed.”
After our placement ended, the companies informed us that they were working on implementing our recommendations. To date, one of the four companies has hired us to continue working on implementation. Two of the other organizations expressed interest in future work to support implementation, once they have worked through internal procedures and requisite planning. We have turned this successful placement into an exciting occupational therapy consulting practice.
Reflections from students
The corporate world was unfamiliar to us at the start of our placement, and we learned a great deal about how to conduct ourselves and communicate effectively in this environment. We had to make an effort to clearly explain our occupational therapy language so that we were understood by all professionals. We had to frequently remind people of our credentials, of how important it is to address mental health in the workplace and why occupational therapy is effective in this area.
We were amazed at the positive responses we received when we initially introduced our ideas for our placement to CEOs, managers and frontline employees in the corporate sector. Due to stigma and the public’s uncertainty around the topic of mental health, we were expecting to meet resistance, but found that professionals in various industries and in different positions were very interested in learning more, as they felt overwhelmed and uncertain about what they needed to do about mental health in their workplaces. A key learning from our placement was that companies know that mental health is a workplace issue, but they are unsure of how to address it. To make the topic of mental health more tangible, we used the Person-Environment-Occupation (PEO) Model (Law et al., 1996) to frame our findings and recommendations. As occupational therapists, we clearly see the benefit of this comprehensive way of thinking, but we were amazed at the positive reception we received from upper management and CEOs regarding this framework.
Reflecting on our experiences as student occupational therapists in a corporate environment, we realized that we had been able to gain unique skills. Learning about what professionalism means in corporate environments was highly beneficial to our professional development. We had opportunities to hone our written and verbal communication skills, in both formal presentations and more informal workplace interactions. When considering the needs of an organization rather than the needs of an individual client, we began to contemplate the “bigger picture,” feeling encouraged to advocate for system change rather than only individual services. It was amazing to have exposure to what the role of an occupational therapist can look like outside traditional hospital and community settings, as well as to learn to work within the boundaries of a new practice context.
This self-directed placement fostered our independence as student occupational therapists. We were able to take initiative, take chances and ask for support when we needed it, just as we would as newly graduated occupational therapists. Other students who are motivated to step outside the occupational therapy “comfort zone” and try something new can benefit from these types of placements, as they are extremely rewarding and educational, and prepare new graduates to thrive in the current job market.
We are grateful that we had this opportunity to explore an emerging area of occupational therapy during our final fieldwork placement. It is unlikely that we would have pursued workplace mental health consulting so early in our occupational therapy careers had we not had the opportunity to try it out with the support of our university. We learned a great deal of non-occupational-therapy-specific skills throughout this process, including how to start a business, make a financial plan, build a website, market ourselves and network, which had not been covered elsewhere in our program. As occupational therapists, we are lifelong learners, skilled at taking on new projects. However, as not everyone has an opportunity to participate in a placement like ours, we strongly encourage occupational therapy programs to place more emphasis on skills required for private practice.
Reflections from the preceptor
Being the occupational therapist preceptor for Lydia and Laura was an exciting and engaging opportunity, and I was thrilled to act as their supervisor. However, being a preceptor of a role-emerging placement requires careful planning and consideration. While role-emerging placements are an exciting way to promote the profession, advocate for occupation in non-traditional sectors and help students hone their skills, these placements have risks for the students, organizations and clients involved. In order to mitigate these risks, the planning process begins months in advance of the first day of placement. The first step taken at the University of Toronto is to have the students create and present a proposal outlining their ideas and how their work will lead to the achievement of their learning outcomes. This is an iterative process, as it forces the organizations, students and preceptors to think through issues such as the scope of occupational therapy, documentation, consent, day-to-day logistics and all parties’ expectations. Once a proposal is approved by the university and site, an understanding is established to ensure the students are set up for a safe and engaging learning opportunity. With a strong proposal in place, the students can then proceed with developing project plans, timelines and deliverables. These are new skills for many students, so considerable coaching and support is required at this stage.
Once Laura and Lydia began their placement, there was weekly communication between all parties that outlined activities from the past week and expectations for the following week. As a role-emerging preceptor, I was not present on site all the time, so these project plans and timelines allowed me to ensure that the students were receiving timely feedback and continuing to work diligently.
The role of a role-emerging fieldwork supervisor involves maintaining a fine balance between providing supervision and knowing when to step back and allow the students to try things on their own. To make this balance possible, regular communication was necessary. This did not necessarily mean face-to-face contact, but daily emails, texts and calls were important to ensure that the students were not only supported, but also had enough space to trial their own professional independence. The students knew they could reach out at any time for support, but trust was an essential aspect of this supervisor-student relationship.
From supervising other role-emerging placements, I have come to understand that they are not for all students. For such a placement to be successful, students need to be flexible, adaptable, independent and self-directed. Students who require regular cueing or need a rigid daily structure do not do as well in this type of placement as they might in a traditional one. Having had Laura and Lydia as students in the classroom, I knew they had the skills and diligence to make their placement a successful learning experience. I also knew they would represent the university in a positive manner.
Similarly, role-emerging placements are not for all preceptors. Preceptors also need to be flexible and willing to allow students a safe context to trial new skills and activities. Preceptors have to be willing to put in a little extra effort up front, as well as spend extra time with the students when necessary.
I would like to put out a call to action to all occupational therapists who think they have the skills to be a role-emerging preceptor. Reach out to your local university and explore how you can fill one of these valuable roles. You will be helping to advocate for the profession and developing our occupational therapists of tomorrow. The experience can be truly rewarding and can help expand your own practice.
As occupational therapists, we know the positive impact that occupation-focused interventions can have on the lives of our clients. It is important that we all work together to continue to advocate for the importance of occupation and promote this message in new and emerging areas. The role of advocate does not fall to only seasoned occupational therapists, but is also important for students. By providing students with more opportunities, tools, resources and skills in this area while they are school, universities will encourage more students to explore new areas of occupational therapy practice, build the profession, raise awareness of occupational therapy and create jobs for themselves.
About the authors:
Laura Kalef, BScKin (Hons.), MScOT, OT Reg. (Ont.), and Lydia Beck, BA (Hons.), MScOT, OT Reg. (Ont.), graduated from the occupational therapy program at the University of Toronto in 2014. They are the co-owners of L&L Consulting and also work part time at CBI Physiotherapy & Rehabilitation and Gowan Consulting, respectively. They may be reached at: firstname.lastname@example.org and email@example.com
Andrea Duncan, MBA, BScOT, OT Reg. (Ont.), is a lecturer in the Department of Occupational Science and Occupational Therapy at the University of Toronto, teaching program development and program evaluation. She is a principal managing consultant for Unicycle Consulting and president of Occupational Solutions. She may be reached at:
Canadian Association of Occupational Therapists. (2012). Profile of practice of occupational therapists in Canada. Retrieved from http://www.caot.ca/pdfs/2012otprofile.pdf
Canadian Association of Occupational Therapists. (2015). CAOT Position Statement: Occupational Therapy and Workplace Health. Retrieved from http://www.caot.ca/default.asp?pageid=1137
Centre for Applied Research in Mental Health and Addiction. (2012). Guarding Minds @ Work: A workplace guide to psychological health and safety. Retrieved from http://www.guardingmindsatwork.ca/info
Clarke, C., de Visser, R., Martin, M., & Sadlo, G. (2014). Role-emerging placements: A useful model for occupational therapy practice education? A review of the literature. International Journal of Practice-based Learning in Health and Social Care, 2, 14-26. doi:10.11120/pblh.2014.00020
Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., Letts, L. (1996). The person-environment- occupation model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63, 9-23. doi:10.1177/000841749606300103
Reposted with permission of CAOT Publication ACE. Kalef, L Beck, L & Duncan, A. (2015) From classroom to boardroom: How a role-emerging placement in workplace mental health turned into employment. Occupational Therapy Now 17(6) 20-23.