DISCOURSES OF RISK: CRITICALLY DECONSTRUCTING IMPLICATIONS FOR OCCUPATIONAL THERAPY

Background: In the Western world there is a growing aversion to risk and a concurrent increase in policies and procedures to manage exposure to risk (Ceci, 2009). Provision of occupational therapy to older people living in a... [ view full abstract ]

Background:
In the Western world there is a growing aversion to risk and a concurrent increase in policies and procedures to manage exposure to risk (Ceci, 2009). Provision of occupational therapy to older people living in a rural and remote community context has not escaped the increased attention to risk aversion however the intensification of focus on risk for occupational therapy practice in this context has not been critically examined.
Method:
We conducted qualitative interviews with 4 Australian occupational therapists practicing within a rural context, and collected relevant institutional documents designed to guide their attention to risks to themselves and clients. A critical discourse analysis (Laliberte Rudman & Denhardt, 2015) approach was taken to analyse both sets of data in to elucidate how risk was conceptualised and how therapists variously negotiated the discourses.
Results:
Although organisational documents predominantly conveyed a technico-scientific focus on risk as objective, measurable, and able to be proactively managed, therapists discussed risk as complex, not always predictable, having subjective elements, contextualised and dynamic.
Conclusion:
These differing conceptualisations of risk created tensions in practice which could limit therapists’ abilities to practice in client-centred and occupation-focussed ways, and decreased professional autonomy.
Application to Practice:
There is a need for occupational therapists at individual and collective levels to actively contribute to reformulating how risk is conceptualised and addressed to enable practice that acknowledges the rights of clients to engage in occupations that may be risky, and values the expertise that therapists have in negotiating risk to themselves.