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Exploring transition back to occupational therapy practice following a career break.

Abstract

Background: This small-scale grounded theory study explored how occupational therapists within New Zealand experienced and managed the return to practice after a career break.

Method: Data was gathered and analysed from demographic information forms submitted by sixteen participants, and from subsequent semi-structured interviews undertaken with six participants.

Findings: The conditions that enabled participants' successful return to practice included a strong sense of professional connectedness (sense of belonging and social connectedness to the profession) professional identity, accessibility to resources, and flexibility of employment options.

Conclusion: The findings highlighted a need for the profession to provide support and guidance to those returning to practice.

Key words

Return to practice, professional connectedness, competence, occupational therapist, grounded theory

Reference

Dodds, K., & Herkt, J. (2013). Exploring transition back to occupational therapy practice following a career break. New Zealand Journal of Occupational Therapy, 62(2), 5 - 12.

Introduction

Many transitions occur over a person's life span. Transitioning, a central concept in occupational therapy practice involves risk, adjustment, and adaptation resulting in shifts in behaviour, roles and self concept (Blair, 2000). Occupational therapists consider the impact of transition on others as an everyday part of practice. However, a search of the literature shows there is a lack of research into the impact transition may have on occupational therapists during their own life span. This article reports the findings of a small scale grounded theory study that looked at how occupational therapists experienced the return to occupational therapy practice in New Zealand (NZ) after a career break. The aim of the study was to explore the process of transition and to identify the enablers, barriers, and the outcome for therapists.

Literature review

Bridges (2003) described transition as a "three stage [psychological] process that people go through as they internalize and come to terms with the details of a new situation" (p. 3) caused by a change in life circumstances. Firstly, transition is seen to start with an ending, a loss, or a letting go of the old identity or ways. The next phase, the neutral zone, is an in-between time when the old is gone but the new isn't fully operational, a time when old clarities break down, anxiety rises, people feel disconnected and need to reorient. Realignments and re-patterning occurs. The final phase is described as a new beginning. This is when people develop a new identity, experience new energy, and a sense of purpose that makes the change begin to work (Bridges, 1996 & 2003).

Blair (2000) stated that transitional changes (such as that of a role change) "have significant effects upon self esteem and self-concept" (p. 231) and that transition is often painful for the individual. Wolfin and Foreman (2004), authors of a self-help manual to assist women returning to work, claimed that returnees face three major personal barriers when planning a return to work: loss of skills, loss of confidence, and loss of identity. Chick and Meleis (1986) described transition as a movement from one life phase to another (cited in Clingerman, 2007).

Requirements for returning

The Health Practitioners Competence Assurance Act (HPCAA) 2003 stated that the regulatory authority must provide mechanisms "to ensure that health professionals are competent and fit to practice their profession" (HPCAA, 2003, p. 7). The Code of Ethics for Occupational Therapists requires therapists to be "responsible for actively maintaining and developing their personal professional competence" (section C, 2.1, 2000). Moyers (2009) advocated that "practitioners who have not consistently updated their knowledge and skills could be a source of practice errors" (p. 244). For these reasons, occupational therapists returning to practice after a career break are expected to meet legal requirements and demonstrate their competence in order to gain recertification. The Occupational Therapy Board of New Zealand (OTBNZ), under the HPCAA (2003), is responsible for monitoring the competence of occupational therapists (OTBNZ, 2012a). This is achieved by using the Continuing Competence Framework for Recertification (CCFR) as a tool. In seeking recertification therapists returning to practice, who have not held an Annual Practising Certificate for three years or more, must complete the Competence Assessment Application (CAA). This document requires the returnee to demonstrate their competence in all seven of the Board's competence areas (OTBNZ, 2012b). Other health professions within New Zealand, including nurses and physiotherapists, also have competencies which they must meet to recertify before resuming practice (Nursing Council of New Zealand, 2012; The Physiotherapy Board of New Zealand, 2012).

The Occupational Therapy Board Annual Report (2011) indicated that of the 2,757 practitioners who were registered, 38 practitioners had conditions on their scope of practice due to their recent return to practice.

Reasons for taking a career break

Occupational therapy is a female dominated profession and therefore it is likely to be affected by women's related life roles (Wilson, 2004). Studies by Bailey (1990a & b), Smithson and Sutcliffe (1989), and Sutcliffe (1992) identified the main reasons occupational therapists undertook a career break from practice were maternity leave, child rearing and geographic location. It is therefore understandable that many occupational therapists will leave and later wish to return to the profession.

Previous research undertaken

Whilst there has in the last decade been a paucity of research on this subject, the literature that exists indicates that those returning to practice should be supported through the provision of refresher courses or on the job retraining opportunities, (Bailey, 1990b; Sutcliffe, 1992; Turner, 1992) as well as flexibility of employment hours, and available and affordable childcare (Sutcliffe, 1992). Turner (1992) indicated that the amount of preparation and planning undertaken by the returnee prior to their return, and support offered from the employee for both returnee and their supervisor, impacted on the success of the therapist's transition back to occupational therapy practice.

Bailey (1990b) surveyed via questionnaire 696 female occupational therapists within the United States of America (USA). Thirty eight percent of the survey's respondents felt professionally out of date on return to practice, more than half of the women could not find refresher courses or on-the-job retraining opportunities, while 12.5% of the participants felt they could not compete for jobs with younger and more recently trained therapists. These sentiments are similar to those identified by Blair (2000), and Wolfin and Foreman (2004). Bailey suggested that these problems (or barriers) may be alleviated by providing re-entry programmes that include confidence building sessions along with updating the therapist's occupational therapy knowledge. Turner's (1992) research confirmed Bailey's opinion that employers should offer support for returning therapists, also identifying that the needs of returning therapists were different to those of new graduates and therefore, a specific orientation was required. No research literature was found which identified how occupational therapists within New Zealand went about and coped with returning to practice after a break from the profession.

Ethics approval

Ethics approval, reference number 448, was granted by the Otago Polytechnic Research Ethics Committee, on the 8th July 2009 enabling research to proceed with the study titled "Occupational therapists within New Zealand experiences and management of the transition to practice after a career break from the profession of three years or more".

Methods

Grounded theory, a qualitative research methodology, was chosen for this study as it allows perceptions and experiences of the individual(s) to be studied (Beaulieu, 2007). It aims to develop a theory of processes or experiences that "might help explain practice or provide a framework for future research" (Creswell, 2007, p. 63). Stanley and Cheek (2003) state that "grounded theory has application in occupational therapy studies of practice, [and] professional issues and education" (p. 149). Returning to practice is one such professional issue.

Grounded theory involves researchers in the "simultaneous involvement in data collection and analysis" (Charmaz, 2010, p. 5). Coding forms the "pivotal link between collecting the data and an emergent theory to explain the data" (p. 46), from these codes categories are formulated. The research constantly compares the findings from the data and utilizes memo writing to "elaborate categories, specify properties, define relationship between categories and identify gaps" (p. 6).

Participant recruitment

This study sought to collect demographic information and to interview participants who had previously worked as occupational therapists in NZ and who had taken a break from the profession of three years or longer. They needed to have: already transitioned back into the profession after a break (in the previous 5 years), or they were currently going through the process of re-entry, or considering returning to the profession in the near future. Throughout the research participant confidentiality was maintained by using pseudonyms, and removing other identifying information.

In order to locate participants the researcher employed the following techniques: a call for participants was placed within the Special Interest Groups hosted by and located on the New Zealand Association of Occupational Therapists (NZAOT) website, an advert was placed in the OT Insight Magazine published by NZAOT and finally, a 'snowballing' technique was employed whereby participants who returned a demographic information form were asked to pass on a form to those they felt might fit the criteria for the research project. A signed consent form was required of all participants.

Data gathering

The questions on the demographic information form were formulated using the knowledge gained from previously published articles on therapists' experience of a return to practice (Bailey, 1990a; Bailey, 1990b; Sutcliffe, 1992; Turner, 1992). The form provided the researcher with self reported data for analysis on the participants' reasons for leaving, returning or considering returning to practice. The data included length of time in the profession before taking a career break, length of the career break and areas of practice previously worked in. The participants were able to expand on their past and present occupational therapy professional experiences and their life experiences gained while on a career break. They recorded perceived barriers to, and facilitators of, returning to practice.

Nineteen participants expressed interest in the project. Of these 16 returned completed the demographic information form (see Table 1). The participants who responded were representative of both North and South Islands of NZ, and rural and city settings. Thirteen had returned to practice and three were considering a return, career break length varied from 3.5 to 21 years. Of the respondents 15 were female and 1 male.

The forms provided information that assisted the researcher, using theoretical sampling, to identify those participants that would most likely contribute to the evolving theory on therapists' experience of the process of returning to practice (Corbin & Strauss, 2008). Six participants were chosen to take part in semi-structured interviews.

Interviews

There is an acknowledged fit between grounded theory and interviewing: both are "open-ended yet directed, shaped yet emergent and paced yet unrestricted" (Charmaz, 2010, p. 28). Interviews which were conducted by telephone lasted between 30-60 minutes and expanded on the knowledge gained on the demographic information forms e.g. "What has assisted you in this transition back to practice?" Additional questions were included as the researcher sought to confirm themes raised by other participants, e.g. "What would you recommend a returning therapist put in place before they leave the profession [to take a career break]?" Transcripts of the recorded data were returned to the participant to give them an opportunity to confirm its accuracy.

Data analysis

The data was then analysed using grounded theory methods. This resulted in the information being coded as the researcher identified the common themes emerging from the data. "Coding represents the operations by which data are broken down, conceptualized, and put back together in new ways" (Strauss & Corbin, 1990, p. 57). As part of the grounded theory process a constant comparative method of analysing the data was employed. This requires the researcher to compare "incident against incident for similarities and differences" (Corbin and Strauss 2008, p. 195). An incident identified as being conceptually similar to another is given "the same conceptual label and put under the same code" (p. 195). For example, during the interview process several participants referred to the process of returning to practice as "daunting", "unbelievably difficult" and "overwhelming", others described feeling discouraged. These similar concepts were given the label of "finding it daunting". Daunting implies being disheartened and discouraged when considering the steps and actions required to return to practice. Memoing assisted the researcher to understand how all the pieces fitted together in the process known as <transition back to practice>. These codes were then linked into categories, known as axial coding (Strauss & Corbin, 2008). The 'Finding it daunting' label became a category for the paradigm component 'Contemplating' as described in further detail in the Findings section.

The researcher used Strauss & Corbin's (1990) conditional paradigm model as a guide to link "categories in a set of relationships" (p. 99). The paradigm model identified components which assisted the formation of this research's Conceptual Model outlining how therapists managed and experienced a return to practice (see Figure 1).

Trustworthiness of data

The four criteria employed throughout the study in order to establish trustworthiness of the data were credibility, dependability, transferability, and confirmability (Lincoln & Guba, 1985, Pilot & Beck, 2006). These criteria are considered the 'Gold Standard' by qualitative researchers and are "often used by researchers in all major traditions" (Pilot & Beck, 2006, p. 332).

Credibility, which refers to "confidence in the truth of the data and interpretations of them" (Pilot & Beck, 2006, p. 332) was employed by the use of triangulation, peer debriefing; and member checking (Denzin & Lincoln, 2005; De Poy & Gitlin, 2005; Creswell, 2007). Pilot and Hungler (1997) suggested that a demonstration of credibility within a study is sufficient to establish its dependability. Transferability "refers to the extent to which the findings from the data can be transferred to other settings or groups" (Pilot & Beck, 2006, p. 336). Due to the small size and context of this research, care must be taken with any generalisation of these findings. To ensure confirmability, memoing was employed in order to demonstrate that the theory which developed was grounded in, and had emerged from the data (Stanley & Cheek, 2003; Pilot & Beck, 2006; Pilot & Hungler, 1997).

Findings

The core category was identified as 'Navigating' and represents the main theme of the research. The research revealed that participants had to individually navigate their own path to return to practice. Whilst each journey was unique, there were common core threads. Navigating is the concept that all the other factors relate to in the conceptual model that was developed.

Causal condition: Contemplating

'Contemplating' was identified as the causal condition that led the therapists to return to practice. This was a period of time in which participants weighed up both practical and personal reasons for wanting to return. The reasons for returning included: wanting to engage the brain, to trade in on occupational therapy training, and to return to an area of work/practice that they knew and liked. This is evident in comments such as: "Being a full time Mum... I need some kind of mental and social stimulation" (Participant K) and "I wanted to be able to use the skills that so many years ago I had trained in" (Participant G).

Other participants identified that the timing was right for them to return because their children were of an appropriate age. Some wanted to return to practice now to avoid the need to submit a Competence Assessment Application (CAA), and finally to improve their financial situation. For many participants not knowing where to start in the process of returning to work, and/or how to work through the OTBNZ process, was an obstacle to returning to practice. "I am finding it difficult to find a starting point in terms of updating myself with the changes that have occurred in OT.... this is quite daunting" (Participant O).

For some it was daunting due to their time away from the profession. These issues led them to question their competence to practice, which then impacted on their confidence.

The period of contemplation for 13 of the 16 participants led them to embark on the process of returning to practice. Three study participants were still in the contemplation stage at the time the research was undertaken, with two seriously considering not returning to occupational therapy practice. The 13 participants who returned found their ability to manage the transition to practice was impacted by several factors or intervening conditions.

Intervening conditions: Professional connectedness

The intervening conditions which acted to facilitate or inhibit the participants' ability to manage a return to practice are represented by the notion of 'professional connectedness' referring to the participants' sense of belonging and connectedness within the profession. Additionally, the participants' experience of returning to practice was impacted positively or negatively on the relative strength of their personal identity as an occupational therapist.

Feeling isolated from the profession pre-career break, whether geographically or by a lack of connection and/or sense of belonging, impacted negatively on participants' ease of returning to practice. It was more difficult for participants in this position to make a decision about whether to return in the contemplation stage and to identify the field of practice they wanted to work in. This also affected their confidence and ability to do the job when they found work. The degree of belonging to the profession at the time of initially taking a career break had a direct relationship to how much the participant kept in contact with, and stayed connected to, occupational therapist colleagues and the profession during their career break. Those who lacked a connection or sense of belonging to the profession found the transition back into practice more difficult. Maintaining social connections to the profession through occupational therapist friends and ex-colleagues was identified as a facilitator for the participants' return to practice. "[an OT colleague] was really good, she helped me go through and identify the right things to put in [the re-registration application]" (Participant B). Those participants without strong social and professional connections struggled to find the assistance they required from the profession, whether trying to re-connect with their local occupational therapy professional network, to look for employment or work experience, or to find support with their application for recertification.

Professional connectedness therefore grew from the participants 'grounding as an occupational therapist'. This was made up of three facets. Firstly, the length of time the participant had spent in the profession, secondly, the time spent in an area of practice before taking a career break, and finally their involvement with professional activities. The more grounded therapists were in occupational therapy practice before the career break, and the greater their sense of a positive professional identity, the easier it was for them to return. Professional connectedness either facilitated, or if absent, constrained the participants' ability to maintain focus on the tasks involved with navigating a return to practice. To manage their transition back into practice returning therapists employed a range of activities.

Action strategies: Maintaining focus

The participants who understood the alignment between the activities they undertook while on a career break (e.g. being a helper at play group/undertaking volunteer work overseas), and who undertook these activities whilst holding to the professions values and beliefs found it easier to navigate through the recertification tasks (specifically in regards to completing the Competence Assessment Application). They retained a strong identity as an occupational therapist and subsequently found it easier to maintain focus on the process of returning.
[when undertaking volunteer roles] I felt that I was doing the OT thing
and representing my profession... I was still involved but not in... a
normal capacity (Participant K).

I started some volunteer work... I tried to do things that were OT
related to kind of get me in the right field and to make it easier for
when I went back to work (Participant A).


Before returning to practice many participants wanted to regain or increase their occupational therapy knowledge and fitness to practise. Participants' indicated that their first response was to try to locate courses specific to returning to practice, however such courses are not available in New Zealand. Participants also sought local training opportunities. However, some reported that workplaces actively blocked their attendance at local in-services and workshops as they were not employees.

All therapists spoke of both needing and/or finding support from someone who had understanding and expertise in the application process for re-certification "... another friend and OT... was really supportive and just so encouraging and signed me off... and helped me get my practising certificate up and running... someone I could ask the dumb questions of" (Participant B). The ability to maintain focus with the end point of gaining employment for participants was impacted by two key factors: access to information and the need for flexibility.

The context: Accessibility

Participants' management of their return to practice was impacted by their ability to access information. Whilst they could read the information on the OTBNZ website some were unable to understand the information enough to be able to work through the process themselves. This caused them to seek the support of others:
I rang the OT Board and asked them to introduce me to another OT that
had already been through the process to re-enter work and they had
no-one they knew of! I rang NZAOT and they didn't have anyone they
knew of to help (Participant J).


Those who had maintained their social connectedness to the profession more easily located people to access the information they required during the process of returning to practice. Those who plucked up courage to seek support from previously unknown therapists or workplaces, unfortunately too often found their confidence dented when support was not offered and barriers were put up. For many of the participants their family commitments meant that they were seeking jobs that offered flexible employment hours, and these were difficult to find. Four participants eventually found family friendly hours and part time work in private practice. However, flexibility was not an option within traditional health care settings "because [I] work in private practice... you have got that flexibility of the hours we work... I don't know how easy it would be for a therapist that was based in a hospital" (Participant B). The process of returning to work resulted in the participants making many discoveries about themselves including the strength of their determination and their commitment to the profession.

Consequences: Discovery

Many participants discovered practice was different to how they had experienced it previously. Changes had occurred in funding processes, models of practice, the ongoing need to show evidence of professional development (CCFR), the language the profession was now using and the occupational focus of practice. All participants who had returned to practice inevitably had to learn new skills on their return. Some reported that over time there had been a strengthening of their professional identity and increased confidence in their abilities to work as an occupational therapist. "[Returning to practice has] renewed my passion for what I do and made me realise the things I am actually good at... and that has been really good for my self-esteem and confidence" (Participant K).

Some therapists initially felt out of place on returning to practice and had a sense that they did not belong. Not belonging appeared to be linked to a poorly developed professional identity, difficulties establishing themselves into their new role, the quality of the orientation to the job and the support and supervision offered. In most cases this quickly resolved as they settled into employment, became more confident in their role as an occupational therapist and found a supportive work environment.

For one participant whilst having gained employment, the lack of on-going support, guidance, professional role modeling and professional connectedness created the potential for her to leave the profession.
... the courses that I go to are mostly filled with [other health
professionals], they are so welcoming of me, when I go to the LANS
[local area network meeting], the support is not there from OTs..., I
do want to be an OT, but I want to be accepted (Participant G).


Discussion

This study sought to answer the question: How do occupational therapists within New Zealand experience and manage a transition to practice after a career break? The study found that from contemplation through to discovery the process of transition back into the occupational therapy profession tested their personal strength, professional identity and their professional connectedness. The process of recertification through to finding work was labelled as 'daunting' by many participants.

The findings of this study are consistent with the international literature on occupational therapists returning to practice inasmuch as participants' main reasons for taking a career break are maternity leave and child rearing (Bailey 1990a & 1990b; Smithson & Sutcliffe, 1989; Sutcliffe, 1992). Other reasons identified in this study included a desire to travel or to try a new career.

The conceptual model that was developed as part of the research was consistent with transition theory and the process of transition, as outlined by Bridges (1996 & 2003) (see figure 1). That is to say, Bridges (1996 & 2003) identified transition as a three stage process that people go through when considering entering a new life stage. The first stage was that of 'the ending', this aligned with the contemplation stage where participants weighed up letting go of some of their current roles and identity formed while on their career break, and the potential advantages and disadvantages both personal and financial of returning to practice.

Having decided to proceed with returning to the occupational therapy profession participants of the study followed a process that would test their professional connectedness, the strength of their occupational therapy practice (grounding as a therapist), their ability to access resources (both people and information) and to juggle the registration process while finding suitable work that in many cases needed to suit family needs. This aligns with an in-between or 'neutral' phase identified by Bridges (1996) as an anxious time where reorientation and realignments occur.

It is important to acknowledge that even when the CAA has been completed, registration and employment gained, the transition is not complete until the returnee feels confident, competent, has a sense of belonging, and has established a new professional identity. As noted by Bridges (1996 & 2003) and Blair (2000) transitions involve a psychological component and so returnees' emotional and social well-being must be addressed by appropriate support. Without this they are likely to struggle and question the changes they have made. It is therefore important upon returning to practice that therapists receive a well-developed orientation programme, support, supervision and ongoing professional development.

This research highlights the importance of transitions within people's lives and the management and support needed for a transition to be successful. It challenges the profession to support colleagues undergoing transitions. Facilitators to returning professional practice include the support of other occupational therapists, workplaces, friends and employment that enabled the juggling of dual responsibilities i.e. work and family. Barriers to returning to practice include a lack of job opportunities in the returnee's residential area, inflexible working hours and no access to programmes to assist with up-skilling and re-entering the profession.

Participants in this study would have welcomed access to professional development opportunities such as in-services, workshops, and formal retraining programmes however, financial constraints impacted on what they were able to do. The opportunities available to participants involved significant costs for a non-earner and often courses required them to be working in an area of practice related to the course. These findings suggest that a low cost retraining course that could be easily accessed without travel would be beneficial. Therapists wishing to return to work would also benefit from having access to workplace training and in-services. Moreover, participants noted that the cost of maintaining membership of the NZAOT was prohibitive and this prevented access to opportunities presented by the organization.

Professional connectedness was a main theme to emerge from this research. Participants with a sense of professional connectedness had a strong professional identity and sense of belonging to the profession. If this was present before they left for their career break, and maintained whilst on a career break there were a number of positive outcomes. Participants were more easily able to identify how experiences and activities undertaken during their break could be linked to OTBNZ competences and the Competence Assessment Application (CAA), they felt a stronger link to current practice and used their career break experiences to assist in gaining employment and to support their practice.

Interestingly, due to the participants need to have flexible employment within their local community a number of the participants considered or gained employed in non-traditional workplaces. Whilst it is perceived to be important by the profession for occupational therapists to move into new settings, professional support for these therapists is not readily available. This may be due to issues around availability of supervisors, the cost of supervision and/or employers not recognising the value of the support.

Recommendations for returning to practice after a career break

A number of recommendations arise from this research. For therapists contemplating a career break, the findings suggest the re-certification requirements need to be understood before leaving. Furthermore, constructive action during a break can ease the return process. Keeping a record of activities undertaken whilst on a career break could be linked to the OTBNZ competencies (e.g. volunteer work, projects, caregiving). This would assist re-entry. Likewise, staying connected to occupational therapist friends, colleagues, workplaces and professional bodies was deemed to be helpful.

Workplaces and practising occupational therapists have an essential role to play in the return to work process. They can provide encouragement, support, resources, knowledge, continuing education opportunities, supervisors and those able to undertake a third party sign off. Additionally, workplaces need to consider providing flexible job options and extra support for the first year, to retain these employees.

Recommendations for governing bodies

The findings indicate that the OTBNZ needs to strengthen the support they offer therapists returning to practice. The recertification process was considered difficult, lengthy, confusing, and expensive. Although all the participants had access to the same information, many felt they needed more support in undertaking the process and guidance to understand the requirements. Establishing support from a staff member at OTBNZ made it much easier. It is therefore recommended that the OTBNZ routinely assign a specific contact person to those wishing to return to practice. Additionally, to send out regular communications to those on the non-practising register reminding them of the information they need to collect or consider to assist their return to practice (e.g. the need for those who have worked in other countries to provide a police check). Also, to consider providing a template on the website which therapists on a career break can access and utilise to store information on how they are continuing to meet competencies.

The NZAOT should consider providing targeted support. For example, a 'Career Break' Special Interest Group offering guidance and practical support to those considering a career break, on a career break, or those who are transitioning from a career break.

Limitations

This research project was undertaken as part of an occupational therapy honours programme. The size of the research was limited, impacting on the quantity of data that was collected and analysed. The New Zealand context may limit the generalisability of the findings however, commonalities will exist.

Further research

This research has highlighted a number of areas for further research. Firstly, undertaking research to explore how therapists manage and experience their first year of practice following a career break. Additionally, research which explores the attitudes occupational therapists in the profession have towards returning therapists and the challenges when supporting a returnee.

Conclusion

Maintaining a sense of professional connectedness and professional identity before and during a career break enables a successful transition back into professional practice. Likewise, understanding the OTBNZ registration requirements for gaining an annual practicing certificate, being able to locate flexible employment opportunities and support from occupational therapists within the workplace are all equally important. If these key factors are not accessible the process of returning to practice is daunting.

Acknowledgement

Sincere thanks are extended to the participants who made this project possible. This study was undertaken in partial completion of the first author's Bachelor of Occupational Therapy with Honours from Otago Polytechnic and was supervised by the second author.

Key points

1. Therapists who are well connected to the profession, who have a strong sense of belonging and professional identity find returning to practice easier.

2. Support though social connections and professional pathways is important to the process of regaining registration and finding work.

3. Access to practicing therapists, and opportunities to enhance knowledge and skills before re-employment increases therapist's confidence and self-esteem.

4. Therapists transitioning back into practice have unique supervision and support needs. Practical, targeted support increases their sense of belonging, and feelings of competence and confidence.

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Kylie Dodds & Jackie Herkt

Corresponding author:

Kylie Dodds, BOccTher(Hons) Dunedin, 9013

Email: kyliedodds@gmail.com

Jackie Herkt, MHSc(Hons) School of Occupational Therapy Otago Polytechnic Dunedin
Table 1 - Demographic Information

Participant   Years as      Area of practice          Career
              OT prior to   prior to break            break
              break                                   (years)

A              1-3          Neuro Rehab               13-15
B              1-3          Acute physical,            7-9
                            Private practice, MH,
C             10-12         Paeds, Neuro,              7-9
                            Community
D              4-6          MH                        13-15
E              4-6          MH, Vocational rehab,     16-18
                            Acute physical
F              1-3          Mental health, Neuro       1-3
G              1-3          Mental health             19-21
H              7-9          Mental health              7-9
I              7-9          Acute physical,           19-21
                            Community, Physical
J              4-6          Neuro rehab,               4-6
                            Community, Acute
                            phys
K              4-6          MH, Private practice       4-6
                            Neuro rehab
L             Not           MH                        Not
              specified                               specified
M             10-12         Rehab, Gen Med,            7-9
                            Neuro rehab,
                            Community
N              4-6          Community,                 4-6
                            Intellectual & Physical
O              7-9          Gen Med, Neuro             4-6
                            rehab, Orthopaedics,
                            Voc rehab, Paediatrics
P              7-9          Paediatrics                4-6

Participant   Reasons for              Other areas of
              career break             employment
                                       during break

A             Travel,                  Volunteer/disability
              Poor health              service
B             Finding a more           Teacher aide
              flexible job
C             Travel,                  Self employed in
              Children                 health service
D             Children                 Admin, Self-employed
E             Children, change in      Self-employed,
              career                   Activity co-ordinator
F             Care for family          None stated
G             Children,                Voluntary work,
              No flexi OT work         Admin
H             Children                 Childcare
I             Children,                Support staff for local
              Change in career         groups
J             Children, relocation     Health services
K             Travel                   Volunteer rehab
L             Travel,                  Mental Health support
              Children
M             Children                 Not specified
N             Generic clinical staff   Generic clinical staff
O             Children                 Taught health and
                                       safety
P             Travel                   OT positions abroad

Participant   Reasons for               Current area of
              returning                 practice

A             Improved health           NeuroRehab
B             Children grown,           Private practice
              financial
C             Recertification           Considering returning
D             Children grown,           Pain
              change in career          management
E             Children grown,           Acute physical
              change in career
F             Not specified             NeuroRehab
G             Children grown,           Private practice
              financial,
              recertification
H             Children grown            NeuroRehab
I             Children grown, job       Community
              opport, recertification   practice
J             OT Job opportunity,       Private residential
              recertification
K             Competencies, avail       Private practice
              flexible OT work
L             Returned from             MH
              overseas, financial
M             Children grown, use       Considering returning
              OT skills
N             Required to have APC      MH
              for position
O             Children grown            Considering returning
P             Returned to NZ            Paediatrics
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Article Details
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Title Annotation:RESEARCH ARTICLE
Author:Dodds, Kylie; Herkt, Jackie
Publication:New Zealand Journal of Occupational Therapy
Geographic Code:8NEWZ
Date:Sep 1, 2013
Words:6430
Previous Article:EDITORIAL.
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