I visited the grave of my great-grandfather in Pennsylvania last summer. I had only been there once before, as a child on a trip with my family, and I realized how little I knew about him. He immigrated to the United States with nothing, worked in a railroad foundry, and died at a very early age during the influenza epidemic. That is nearly all I know. When I arrived at the gravesite, I found a stone cross—once the top of his headstone—lying broken on the ground. It struck me then how fragile memory is, how easily the markers of a life can be worn away or broken over time. After my great-gra ..read more

When I bought a vintage Narragansett beer tray on eBay, I thought I was just adding to my collection. But when the seller sent me a heartfelt note about how his mother kept that tray on her mantle for many years, I realized I had done something more—I had brought a piece of someone's past back home. That moment reinforced a deeper truth: collecting isn’t just about the things. It’s about the stories, the connections, and the shared history that comes with them. A similar thing happened with a Schreiber’s Manru Beer tray—a beautiful piece of Buffalo brewing history. The seller reached out, tel ..read more

Lately, the conversation around gender in athletics, education, and therapy has gotten a lot more complicated. Questions about fairness, biology, and statistical interpretation are at the heart of some heated debates—whether it's about competitive advantage in sports or access to essential services like therapy. While these issues might seem separate, they both hinge on a common problem: how statistics are used (or misused) to justify decisions. I recently came across a post from an athlete who was assigned male at birth but is now competing in women’s sports. This issue connects directly to ..read more

New York’s Bill A.5474 proposes expanding the role of occupational therapy in schools by requiring the state commissioner to issue a guidance memorandum on OT services, particularly in early intervention and mental health support. Additionally, it calls for regulatory changes to formally include OTs within pupil personnel services and establish qualifications for a “school occupational therapist.” On the surface, this appears to be a step forward in recognizing the value of OT beyond special education, but a closer examination reveals significant gaps. With no attached funding, no mandate f ..read more

The Accreditation Council for Occupational Therapy Education (ACOTE) Standards have evolved over time, with the 2023 updates reflecting a continuation of a broader ideological trend in the profession. Specifically, these updates prioritize Diversity, Equity, and Inclusion (DEI) in ways that raise fundamental questions about the balance between professional accreditation requirements and academic freedom.  The 2018 Standards recognized diversity as an important foundation for occupational therapy education. While encouraging awareness of diversity issues, these standards avoided prescribi ..read more

I read the ACOTE Director's Update - January 2025 with interest as it reported new Vision, Mission, and Values statements for ACOTE as follows: VISION: Lead, innovate, and advance occupational therapy education in a global environment. MISSION: Support quality, inclusion, and innovation to advance entry-level occupational therapy education. VALUES: Quality; Innovation; Collaboration; Inclusion; Integrity. For reference, the previous ACOTE statements were: VISION: Committed to the establishment, promotion, and evaluation of standards of quality in occupational therapy education. To this end ..read more

I saw several re-posts today of someone's meme that occupational therapy was a "quiet rebellion against the reductionistic view of health..." etc.  Is the idea of holism in health care a rebellion?  In concept I agree that the occupational therapy profession has historically positioned itself in a 'holistic' light, although I don't know how well it does to practice what it preaches.  This tension between reductionistic and holistic practice probably contributes to discontent among young occupational therapy practitioners because the health care system does not comport with the ..read more

I've struggled to find models that help me understand the challenges facing my private practice. I have never really been strongly interested in pop-thought conceptual non-fiction books because they tend to be overly simplistic and repetitive. 'Who Moved My Cheese' is a classic example, even if it did resonate with a lot of people in its time. Anyway, I have been thinking about change and adaptation because I have been trying to pump figurative bullets into our private practice for a couple years now and it just won't die. A global pandemic didn't kill our private practice - we were propped ..read more

In this blog and in my textbook I have expressed some concerns about application of occupational therapy theory into distal contexts that are only marginally related to the profession.  Specifically, I have stated that although concerns about topics including the climate and social justice are fine areas for people to be interested in, we are obligated to consider whether or not application of these concepts to the occupational therapy process is generative or distracting. It is my opinion that these topics are frequently distracting, and that they confuse our stakeholders. I revisited ..read more

  I know that sometimes I start stories and they don't always get finished.  Sometimes that happens because there is no ending - or at least there is not an ending to be found with the framing I was using. That was always the nature of my private practice - and my hesitancy in discharging children and their families. Who is to say that any person's needs are completely addressed? Or that as a therapist I was able to generate a perfect and complete answer that would persist over time? Sometimes the stories I think about finished themselves and were easy to write even if it hurt.&nb ..read more