Occupational Therapists in Action: Local and Global

The World Federation of Occupational Therapists (WFOT) brings a global perspective to local activity and local concerns to global professional decisions. Many local education programs are accredited by the WFOT, and many local professional associations are affiliated with the world body. The WFOT also provides opportunities through committees and the international congress for local entry points to the global “community of colleagues. ” The sometimes slow and bureaucratic processes of the WFOT can and do facilitate change on a global scale for an entire profession. It is rare to find a profession where local activity and membership can relate to global strategy and belonging. Consequently, the theme chosen for the 2006 Congress of the World Federation of Occupational Therapists—”OTs in action: local and global”—is a good one. It is the central challenge facing occupational therapists of the 21st century. It provokes the question of how we might build a unified global profession in the context of local diversity. Although Cusick (2001) has previously explored this in relation to national priorities for Australian occupational therapists, it is worth considering the unity–diversity paradox in relation to the WFOT congress challenge of local and global action. Tension between local and global issues is probably greater now than it ever has been in the history of the profession. In part, this is because of the success of the profession: it is now active in more countries across the globe and serves an ever-increasing population base. Local concerns and contexts affect the nature, process, and outcomes of many aspects of our profession (e.g., student recruitment and retention, accreditation and registration, professional development, and consumer access). At the same time, global priorities influence local activity. Recent global issues that have challenged local activity include the nature and accreditation of occupational therapy education programs and the emergence of evidence-based practice. Other international trends with local effects include use of institutionalized research performance assessment; effects of chronic and infectious disease; commercialization, regulation of health services, or both; burgeoning economic rationalism in university and health sectors; global effects of poverty and marginalization of communities; consumer rights and activism; recognition of individual and cultural diversity; and an increased emphasis on ethics and litigation in education and practice. The local–global dichotomy presents “OTs in action” with questions that are both exciting and uncomfortable. One “old chestnut” is fieldwork quality assurance in WFOT program accreditation. There are also new and more complex questions emerging. For example, how does the profession respond to cultural diversity in occupation norms and values while maintaining unifying core assumptions regarding occupation (Hocking & Whiteford, 1995)? How should we understand and manage differing contexts of occupational therapy (Whiteford & Wright-St. Clair, 2005)? How can the profession apply evidence in ways that do not undermine the occupation focus of our practice (Polatajko & Craik, 2006)? Should we adopt a universal language for communicating aspects of occupation, participation, and health (Craik, 2005; Polatajko, 2005)? Should we consider professional epistemologies in relation to the “modern” world and, if so, what does this mean for a global context (Hooper, 2006)? Do we need agreement on research priorities (Ottenbacher & Christiansen, 2005)? These and other questions are tasks facing “OTs in action: local and global” who work in a profession where the tension between unity and diversity is daily reality. Journals such as OTJR: Occupation, Participation and Health will provide a means for continued debate, scholarly research, and thoughtful reflection on these issues long after the WFOT congress is over.