Rivers of doing, becoming, being, belonging: exploring occupational therapist identity

Abstract

Occupational therapy is a profession that has struggled with defining its identity and the result is often difficulties with professional identity in therapists. A lack of a professional identity has been linked to role confusion (Finlay, 2001), work stress and burnout (Edwards and Dirette, 2010), and attrition (Rugg, 1999). In contrast, a strong professional identity can lead to increased job satisfaction (Öhlén & Segesten, 1998), commitment to the profession (Roberts, 2000), and improved team work (Molyneux, 2001). Using a hybrid methodology of constructionist grounded theory and narrative inquiry, this project sought to identify key traits and factors related to the formation of an occupational therapist professional identity, while using the Kawa model as a novel data collection and analysis method. In-depth interviews with five practicing occupational therapists were conducted to develop a theory of professional identity formation in occupational therapists and generate stories of “becoming an occupational therapist”. Data were analyzed using narrative analysis as well as through the generation of representations of identity formation using the Kawa Model. A four stage model of identity formation was constructed. Five key identity traits were identified: spirit, pragmatism, ethic of care, habitus of occupation, and ‘knowing how to play the game’. Contextual factors included personal context, institutional context, relationships with clients, relationships with occupational therapists, relationships with teams, and relationships with managers. Participants also reported three major barriers: role clarity and expectations, the field of medicine, and time. This model is represented using the Kawa, clarifying the relationship between elements. Results of this study can inform pre-professional recruitment, university programs, and practice sites in order to best recruit, educate and support occupational therapists in professional practice.