7 years of blogging! When I started my blog 7 years ago, I hoped I might still be here but I didn’t think it would shape my disability confidence and professional identity as much as it has. My blog has almost been a roadmap for me as it has enabled me to get down and make sense of so many feelings I have had being a disabled occupational therapist. Without these reflections, my disability confidence wouldn’t be what it is today and I don’t think I’d be exploring disability confidence on the level I am within my PhD.
Throughout my life, I have always been disability confident and willing to share details about my cerebral palsy as I have always had to do this to have access to the support I needed. Socially, this wasn’t always the case for example, as I was a teenager I didn’t want to share my struggles with my peers as I wanted to fit in but when it came to accessing support , such as educational support, I always disclosed.
In September 2018, I started the occupational therapy course at Sheffield Hallam University, and, as always, before the course had even begun, I was in contact with my future lecturers and disability support services about my access needs. This also involved planning for placement, for example, partaking in pre-placement visits with my lecturer. When it came to my first placement, I was happy to be open and honest about my needs so I could receive the support I needed to enhance my success on placement. However, I soon realised that I could only disclose so much due to never working in a clinical environment before and not being sure of what support I needed or even could have access to within that environment.
I had similar issues on my second placement, and I remember my educator asking what support I needed and I expressed that ‘we will have to cross that bridge when we come to it ‘ as I didn’t know what challenges I may face. During the placement, it became apparent that I needed to disclose other symptoms such as fatigue that I’d not even thought about disclosing. I used to do full days at college only 18 months prior without feeling this severe fatigue. Why couldn’t I do it then?
Due to other barriers faced in the placement, I had to get my university tutor involved. With support from my tutor, I learnt a lot about myself on that placement, a big one being that my needs fluctuate depending on the environment. Therefore, we updated my placement support plan, and I now have access to this document, as I working document so I could change this as and when I needed to.
Two things struck me in this placement, first being an occupational therapist, I know that we cannot assess someone without knowledge of the environment (Duncan, 2021). Thus, how can we expect learners to walk in and know what they need in practice-based placement without having knowledge of that environment? Yes, they may know what they might need, but they can never know for sure if they’ve not worked in that context or like some learners have never worked at all. Secondly, on this placement, I experienced ableism and was told to get referred to speech and language therapy. Obviously, there’s an element to this situation of my not being able to hide from my speech impairment. However, it was also felt that the need to make this comment was due to my willingness to be open about my communication needs. Therefore, this made me hesitant to disclose so much about my communication in my next placement due to the fear of receiving more discrimination.
I’ve always been a reflector and I have spoken openly on here about the challenges faced about being a disabled student and this idea of disability disclosure was a common theme in my reflections. Naturally, when I qualified, I became curious about the topic, then when I started my job in academia it came up again but this time from the educator’s perspective. ‘How can I support a learner with additional needs on placement if they don’t disclose?’ a question I hated! My automatic response was always ‘Have you considered why? Maybe they’ve had a bad experience disclosing previously?’.
I aired my views to colleagues and engaged in more reflection around this and realised that there is a magnitude of reasons why learners don’t disclose such as: fear of being judged or not believed, internalised ableism, not knowing they need to disclose or not knowing what support they need, the list goes on. But I also investigated why learners may disclose as I wanted to find ways to promote disclosure to learners. Facilitators to disclosure include: getting reasonable adjustments, open communication, a greater ability to demonstrate competencies, and being likely to reduce stress and anxiety before placement. From this, I then developed a session with my colleague around ‘positive disclosure’ which we took to the Royal College of Occupational Therapy Conference in 2023 for the learners to engage in as part of preparation for practice.
The session covered reasons for and against disclosure, and how to approach disclosure. The session title ‘positive disclosure’ and other content in the session also highlighted that disability is a strength and not a weakness and that our experience of disability can be used as a tool to aid practice. My colleague and I thought it was important to state why an individual does not disclose in that session to make sure the learners understood that we as ‘academics’ acknowledge disclosure isn’t an easy journey. This developed into more conference presentations, to both practice educators and the bigger audience of occupational therapy, which was great people were listening. I even got invited to speak about disclosure at an Equity, Diversity and Belonging Insight Session for the Royal College of Occupational Therapists. Yet, the only problem was that there wasn’t a lot of research on what I was saying and to take this further and implement ‘positive disclosure’ into practice and policy we need substantial research. Therefore, I wanted to take this further… Hence came the PhD!!
As someone with lived experience and an academic, I have many emotional and political beliefs surrounding disability disclosure, I am aware of the potential biases this could bring to my research. I have a strong belief in the lack of a supportive culture in whereby disabled learners can disclose their disability positively. Throughout my thesis, I hope to explore how these experiences of disability disclosure in practice-based placement shape the occupational identity of newly qualified professionals.
I have so many thoughts and ideas on ways to go with this, my head is spinning but I’m very excited and even more excited to have recently got permission to use my blog as a tool throughout this process! This reflection today is my first draft of my positionally statement which is why it reads like the massive brain dump it is. My reflections will obviously evolve much more throughout the 6 years and I can’t promise I’ll share every one as plans change but for now I’m very excited to combine my passion for blogging with my PhD and it feels like old times! So, yeah…watch this space!!
Thank you for reading,
Georgia
References (APA 7th)
Duncan, E. A. S. (2021). Foundations for Practice in Occupational Therapy. (5th ed.). Elsevier.
