Friday, November 4, 2022

Moving Beyond The "Effective" or "Ineffective" Dichotomy in Occupational Therapy

Today online a community member in one of my support groups asked whether weighted and/or compression materials (such as weighted blankets) were a useful tool in occupational therapy (OT). As a professional OT themselves, they were noting that their professional groups weren't recommending such items as a therapy tool anymore.

The conversation got me thinking about this desire we seem to have for "well, does it work or not?". As I've continually detailed, such questions seemingly ignore the Fundamental Property of Human Uniqueness (post coming soon on that). The idea being that each human has their own unique needs. We can find commonalities but no two humans are exactly alike.

What follows then is my reply to the notion of how we discuss effectiveness in behavioral health and therapy contexts...

Post Reply

The entire paradigm of "effective" or "ineffective" as some kind of binary is absolutely ludicrous, and an artifact of social science being forces to use techniques designed for natural sciences (p-values, etc.)

Thousands upon thousands of anecdotal reports include some people absolutely loving using weights/compression as a tool for self-care (in some but not all situations), and others not liking them at all.

And we're also lacking the context. If a child is watching their parent get violently assaulted every day, a weighted blanked is not the solution for the distress - a better home environment is. But if that same child is simply a bit overwhelmed about a test they actually are equipped to handle, then a weighted blanked to help with a bit of a calm break before calling a friend or trusted adult for support could work excellently.

This sort of nuance seems, sadly, so often absent from OT efforts, broadly, as a field.

Also note that what I'm describing above is absolutely evidence-based. What it isn't is packaged into the only forms of research accepted by institutional power structures (formal academia, journals, government agencies etc.). Places that are, on average, extremely hostile to working with lay-persons, service users, on-the-ground efforts, and alternative forms of knowledge generation.

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