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It's all about "you": unfurling the koru within.


Malo e lelei! Greetings!

E nga tangata whenua, tena koutou / To the home people greetings

Ki a koutou te mana whenua o konei / To you the locals greetings

Ki a koutou e whakaroko ki / To you who are listening to this I greet you

He mihi mahana ki a koutou katoa / Warm greetings to you all


Ko Rangitoto me Te Tatua a Riukiuta? Tamaki Makaurau toku Maunga / My mountain is Rangitoto and Big King Volcano Three Kings, Auckland

Ko Te Moana nui a Kiwa, toku Moana / My sea is the Pacific Ocean

Ko Tonga me Ingari me Aotearoa nga whenua / My nationality is Tongan, English and New Zealander

Ko Cocker me Jackson toku Tipuna / My ancestors are Cocker & Jackson

Ko Ida Cocker toku Mama / My Mother is Ida Cocker

Ko Trevor Simmons toku Papa / My Father is Trevor Simmons

Ko Carolyn Simmons Carlsson oku ingoa / My name is Carolyn Simmons Carlsson

He Kaihaumanu Turoro ahau / I am an Occupational Therapist

My thanks to the New Zealand Association of Occupational Therapists (NZAOT) for the invitation to speak at this year's conference. I am humbled at the thought that I have been handed Penman's challenge from her 2006 Frances Rutherford Lecture, in being chosen as the local "expert" to keynote at our conference.

As has been acknowledged throughout the conference, there are so many more treasures who are equally deserving in our country and long may we follow this new tradition of acknowledging them as keynote speakers, alongside our invited treasures from afar. Nga mihi mahana hoki ki a Yvonne korua Karen, tena koutou.


I would like to begin by sharing with you one of my most treasured whakatauki (proverb).

He aha te mea nui o te ao? He tangata, he tangata, he tangata

What is the most important thing in the world? It is people! It is people! It is people!

When preparing for this talk, I was told by a former colleague that this whakatauki was originally a kuia's (old woman's) lament from long ago when all the tangata (men folk) had been taken from the Pa, as a result of war. Nowadays this proverb often symbolizes the pivotal importance of people; for without people there is no 'us'; a central thread that has run throughout the conference. Although perhaps overused, speaking personally, this whakatauki encapsulates the centrality of 'you' and 'I' in our professional and personal lives. Moreover, the whakatauki sits at the heart of the korero (conversation) I wish to unfold with you today, which is 'all about you', and in saying this I include myself.


Purpose of presentation and an invitation

I have woven this presentation around a significant symbol of Aotearoa/New Zealand - the koru

I trust the use of metaphor will give the desired sense of motion and action that I am after, as befits today's conference theme: ACTION. For me, the action of the unfurling koru encapsulates how we as individuals unfurl throughout our professional journeys, some even into the brilliance of the mighty ponga (silver fern) tree such as our leaders, our colleagues with postgraduate doctorals, or those who represent us on our professional association. Similarly, the image of the koru encapsulates the concepts of ENERGY and INSPIRATION, the two other themes of this conference.

Drawing from symbolism, my intention is to speak to the therapist within, as both 'person' and 'professional'. When you go back to your lives after conference, I invite you to remain inspired and energized; take individual action towards unfurling the professional koru that is within each of you in your day-today practice lives to 'become' and 'be' the very best occupational therapist that you can be. I also encourage you to act in concert with others in the profession, to busy yourselves with activities that lead to staking our occupational claim in Aotearoa/New Zealand. I know that the conference will have already played a large part in contributing to our collective unfurling, so this presentation is more of an invitation for you to pause, to reflect, and to each open yourself to the further unfurling of the koru within.

The metaphor of the ponga tree But first, let me begin my path of symbolism by using a further metaphor, that of the hardy ponga. Bear with me if you are not into visual imagery; perhaps you can use this as an opportunity to flex your learning style. However, as you have seen and heard throughout conference, this is a conference of metaphor. The use of a tree as metaphor for this portion of the presentation was inspired whilst searching the worldwide net for images of the koru. I happened upon the writings of Ross (2006) who used the metaphor of a tree to explore the concept of the ethical leader. Drawing from Ross's visualizations, I offer a simple conceptualization of an Aotearoa/New Zealand Profession Tree (see Figure 2).


The ponga roots

At the base of the ponga are its roots, embedded within the nourishing soil. The foundations of our profession sits at this base. These are our professional roots; our heritage, planted in a rich mix of history and guiding knowledge-base. For example, it includes our core values and beliefs as a profession, our language, our culture, and ethical framework, our key assumptions and our fundamental conceptualization of the human as an occupational being. It also includes our belief that occupations hold therapeutic value and that occupational engagement brings meaning that is culturally, individually, and contextually ascribed (see Townsend & Polatajko, 2007). Situated alongside our occupational perspective are also the models and maps that we each choose to follow. For example, the Canadian Model of Occupational Performance and Engagement (CMOP-E) (Townsend & Polatajko, 2007) which goes beyond a focus on performance and into occupational engagement, or the essentially metaphoric, Eastern worldview of the Kawa Model (Iwama, 2006), to name but two. I very much look forward to one day using our own home-grown Aotearoa/ New Zealand model as suggested by Trisha Egan (2008).

The earth-soil-sustenance bind

The roots are embedded in soil; the soil holds the tree firm and brings sustenance. Simplistically, I liken the soil to society, the people, the language, the culture, and the land, the laws, policies, and legislation, Te Tiriti o Waitangi (Treaty of Waitangi). As custodians of the profession we must ensure that we plant our ponga in a place where the impact of floods will not wash away the precious earth that cleverly binds and holds the ponga to the land, despite its modest array of roots. Similarly, we must pay equal homage to what comes from above (sky/heavens) as well as below (earth-soil) as sources of sustenance coursing through the ponga's foliage and trunk alike.

The ponga trunk

The trunk of the ponga represents the core of our profession and its bound collective strength, linking our foundations with the upper canopy of fronds. At the core of this trunk sits occupations, the central vein of who and why we are as a profession. With each added layer of occupational understanding, through korero, hui (gatherings/meetings), research, and professional growth, the trunk will continue to grow and expand over time. It will consolidate and grow even stronger to stand the test of time, brave against the elements, and support the collective professional identity and occupational culture growing up through the fronds.

The ponga fronds

The fronds of the ponga represent the various strands of our practice fields as well as the many people of the profession. Each small stem within each large frond represents the individual occupational therapist, each unfurling in his or her own time, place, and space. As time goes by there is of course natural decay of the fronds; mature fronds will wither and simply hang down from the trunk, like a skirt. Care must be taken not to pull these old fronds off as they provide protection

for both the trunk and the crown of the ponga. So, we do not discard our founders and forbears, nor do we throw the baby out with the bath water! Similarly, trends in practice will evolve as we become clearer and more sure of who we are and what it is that we are about as occupational therapists; some trends will wither and droop. Equally, some aspects of practice will wilt and even fall off to be picked up by others, diversional therapy is a prime example. On the other hand, there will be some practice areas where we may actively pull the fronds off and discard them. Take the proverbial bicycle fretsaw for example, but even so, care must be taken when tending to the fronds that we do not pull off the wrong fronds, or those that are still viable, as this may weaken the spirit of the ponga. So, as we continue to distance ourselves from bio-medical model perspectives and come closer to a truly occupational viewpoint of health, well-being, and justice, so too will some fronds wither and retire. Similarly, individual occupational therapists may also wither and drop, or fall off along the way. Be it for whatever reason, one hopes it will be rarely from disillusion or lack of sustenance.

Growth and re-growth

Whilst there is natural decay for the ponga, there is usually the perpetual promise of growth, re-growth, and rebirth. At the top of the trunk, our occupational therapy schools for instance nurture the tender tendril fronds, until they are ready to emerge as new growth. Seeds are sown. For example our emergent graduates, but also our growing group of post-graduate occupational therapists. Those who are practising continue to be nurtured and grow to push the larger fronds out until they form the magnificent corona that is so typical of the ponga; this corona being symbolic of our collective chosen profession. Growth and re-growth is not without the need for sustenance however.

The nutrients

The ponga takes nourishment from both the earth and the sky to sustain its growth and well-being. This will include that which comes from the uniqueness of Aotearoa/New Zealand and the challenges therein for being true to the bicultural milieu. For the profession, nutrients may include rich learning experiences from formal and informal education opportunities, from the underpinning knowledge base and research, and from engagement in a continuous cycle of questioning, refining, and consolidation of practice; of life-long learning. Nutrients will come from rigorous engagement in professional governance activities that allow us to stay current and competent, for example the many and varied activities as illustrated in Figure 3 below, which list but a few (Simmons Carlsson, 2007a).


Such activities rest on a clear commitment to evidence-based practice, research, and the use of specific outcomes and protocols to ensure high quality client-centred services. These types of activities serve to keep our practice bright and vibrant, like the impact of the rain that falls on the ponga fronds washing away any dust and grime, so that we remain true to the spirit of occupation coursing through the deep veins of our ponga tree. All parts of the whole are vital in the metaphor of the mighty ponga-profession tree.

To conclude the metaphor, consider that the ponga may represent one individual occupational therapist, a group of occupational therapists (a ponga clump or forest), and it can also represent the profession as a whole (one ponga tree). You (the audience) can use this metaphor to map who you are as an occupational therapist, situated within the profession. What would you write down as being representative of your roots, trunk, foliage, and nutrients? How do you ensure your growth and re-growth and your sustenance as a professional?

The Koru as a metaphor

Let me now turn to expand on the metaphor of the koru and further explain my musings, which form part of my own perpetual growth and re-growth. Like the mighty ponga, the spiral shape of the koru is symbolic of Aotearoa/New Zealand; our land; our country; our people; our treasures. Symbolically, I believe the koru speaks to us as practitioners and it can act a source of inspiration. The koru is symbolic of the way life can both change and stay the same. So too, in many ways does our profession and practice change and stay the same, at times. For instance, how far has our action truly taken us in realising an occupational perspective that would liberate us so that we may work in diverse ways with people; enabling them to do what they want and need to do? Whiteford (2006) challenged us to do this in her keynote at the 2006 NZAOT conference. Have we taken up this challenge?

As the koru unfurls, it extends towards the light seemingly striving for perfection, or in the profession's case, excellence. Its circular, yet opening shape conveys the idea of perpetual movement; of energy and action. Moreover, as it unfurls, the koru develops into a unified whole, its form and structure made up of many small parts, each of which in turn, unfurl. So too, does our profession unfurl within Aotearoa/New Zealand; each of us a small part of the greater whole, magnificent, and uniquely situated within occupational therapy in Aotearoa/New Zealand, as is the koru. As suggested by Christine Rigby in her summing up of Rebeiro Gruhl's keynote, we need to get our act together; we need to pull together and form the whole. We need to be clear about who we are and why we are, both individually and collectively as occupational therapists in order to get our act together.

In its unfurling, the koru is symbolic of new and positive beginnings. For the new graduate the unfolding of a new life and a career as an occupational therapist; for the seasoned practitioner the heralding of regeneration (rebirth), maintenance, and extension. For our educators, scholars, and leaders, who often tend to the soil, roots, and fronds of the ponga, the koru may symbolize their opportunity to lead us, nurture us, and to grow the profession, so that we may navigate our way through a complex and constantly, even rapidly, changing world. For the individual practitioner, the koru may symbolize the need for us to be true to our professional foundations, our values, and to meet the needs of our clients, to acquire the right knowledge and skills, to question our underlying professional assumptions about ourselves, our practice, and our world, to contribute to the growth of knowledge, and to transform our practice.

The duty to develop practice, theory, and research

We have a duty to develop our practice as individuals, to ever unfurl and to integrate theory, practice, and research within the unique context of Aotearoa/New Zealand. An example of this is one's pursuit of continuing education. Another is the slow, but steady increase in the uptake of post-graduate level studies by occupational therapists, for out of such scholarly activity springs works that may guide and inform our professional journey on the home front. This is the stuff that nurtures and enriches our collective home-grown foundations. For example, the emerging home grown body of knowledge related to occupational therapy with children and youth, which is not exhaustive, however it provides a picture. (The underlined authors signal masters' level thesis from AUT University and Otago Polytechnic whereas the non-underlined authors are honours level undergraduate dissertations from the Otago Polytechnic School of Occupational Therapy.

In 1999, Higgins wrote about family involvement in paediatric occupational therapy. Pullinger wrote about pencil grip and handwriting legibility/speed. In 2000, Ryder wrote about understandings of family centred service. McLintock wrote about an aspect of sensory integration approach. In 2001, Vaughan Jones wrote about on the history of occupational therapy in special education. In 2003, Tutty researched teacher aides experiences working in regular schools with students with special education needs. In 2004, Marshall explored on stories of youth experiencing difficulties with learning. In 2005, Dunstan wrote about the use of sensory strategies in the home environment. In 2006, Simmons Carlsson explored the culture of practice of a group of therapists working in regulars schools with students with special education needs. In 2007, Hasselbusch wrote about the consultation model utilised school-based practice with students who have autism, and Langdon and Nisbet wrote about aspects of childhood dyspraxia.

This is surely something for celebration by the profession, but are these works readily accessible? Do we seek them out or even know how, or where, to find them to inform our practice, or use them to critique what we know and do in practice? Similarly, what other processes might we use to think about our practice? Do we, for instance, reflect in action? Are we skilled at this process?

The duty to reflect in action--The 'inward coil'

As occupational therapists, I believe one of our key tasks is a duty to reflect in action. Thus, returning to the koru metaphor, as the koru unfurls, we can see that its inward coil (loop/helix) suggests a return to the point of origin; a turning back in on oneself. Metaphorically, this is akin to the perpetual motion of critical reflection in practice and the necessity for each of us to reflect in action. In my mind's eye, the koru therefore represents not only growth, but also renewal, and hope for the future of self and profession. By now, as reader, you might be asking, so what?

The 'so what?' of all this ... knowing!

As mentioned above, Whiteford (2006) put forward that as 'we' become increasingly clearer about our core beliefs as a profession and what makes us unique, so too comes recognition of diversity in ways of 'being', 'doing' and 'understanding' within our profession. To this end, I believe a process of 'knowing', beginning with knowing one's self, serves to support and strengthen this recognition, and I suggest that no one can unfurl this state of knowing without the individual's active participation, that is no-one can unfurl the koru within, but you. In part, this rests upon one's individual commitment to seeking out and actively participating in growth promoting activities that are 'all about me'.

So, my suggestion is that we need to begin by knowing the following: 'Who I am?' and 'Where have I come from?' Plus we need to know, 'To whom and how am I connected', not only at the professional level, but also at the person level. We also need to actively engage in the process of knowing at many other levels including: 'Knowing my profession', 'Knowing my context', and 'Knowing my purpose as an occupational therapist in my particular work setting'. Furthermore, we need to use this knowing as an integral part of the foundation upon which to stand and look forwards in our professional journeys. For instance, it is encouraging to see that we have taken a step in this direction through the NZAOT Values Exchange forum, the web-based decision making system founded on substantial ethical theories where we as occupational therapists may address health and social issues of professional concern. So, here's an invitation: let's get going with capturing and exchanging dialogue about our values and professional culture. How might this site contribute to the development of an Aotearoa/New Zealand model of occupational therapy?

The concept of knowing

Let me now unpack the concept of 'knowing' just a little bit more, as I have conceptualized it within the realms of this presentation. The verb 'to know' is epitomized in the thesaurus by meanings such as: identify, recognize, be acquainted with, be familiar with, understand, be aware of, be knowledgeable about, see, experience, live through. These are all desirable outcomes of exploring knowledge, skills and competency. 'Knowing' processes help us renew ourselves and vision a hopeful future, not only for ourselves, but also for the profession, and most importantly for those whom we work alongside in partnership - our clients. So, here's my conceptualization thus far, drawn from experiences of working as a practitioner, supervisor, educator, professional leader, and human being, and from readings over time. Therapist: Know thyself! Own thyself! Grow thyself! and Know thy practice context!

Know Thyself!

The first area of knowing one must explore is to: Know Thyself! That is, to understand one's own cultural underpinnings, experience, background, attitudes, and value-system, including one's quirks and foibles, strengths and weaknesses. Take a moment to reflect on the 'me' side of things. As practitioners we co-create meaning in everything that we do and this meaning varies based on our own perceptions, values, and sociocultural context. However, Fearing and Clark (2001) challenge, do we really take the time to reflect on questions that reveal such things? For instance, take a moment to quietly reflect on the questions below:

* As an occupational therapist/person: Who am I?

* What do I stand for?

* What are my values about my profession and practice?

* What are my values about partnerships with clients?

* Do I really believe and act in accordance with these values and beliefs?

* Which of my behaviours might other people recognize as my living out of these values and beliefs?

* What do I bring to the client-therapist partnership?

Own Thyself!

The second area of knowing is linked to a duty to: Own Thyself! By this I mean own your choices, your decisions, your emotions, and your actions. In part, owning thyself is about developing emotional intelligence alongside learning to be resilient. By emotional intelligence I mean developing the ability to appraise one's emotions, understand them, and grow insightfully; to express and channel one's emotions in positively constructive ways; to grasp and understand other peoples' feelings and perspectives; and hone one's interpersonal skills, and develop flexibility, and resilience (Carroll & Gilbert, 2005).

According to the American Psychological Association, (APA) Washington DC, resilience can grow from making meaningful connections and establishing good relationships, which are reciprocally supportive and helpful. It involves learning to avoid seeing crises as insurmountable problems--stress happens! How one interprets and responds to stressful events is one of the keys to resilience. Resilience also includes accepting that change is a natural part of living and encompasses looking for opportunities for self-discovery, taking decisive actions, moving towards one's goals, and keeping things in perspective. And it includes nurturing a positive view of oneself, maintaining a hopeful outlook, and staying flexible. Both emotional intelligence and resilience are strengthened through the process of critical reflection, including conscious reflection and review in supervision, as well as through peer review and audit processes. More of these processes further on.

Grow Thyself!

The third area of knowing is related to a duty to 'know thyself ' through: Growing Thyself! Within this lies a duty to nourish one's competency and well-being, including the heart, mind, body, and spirit. Not just through listening to the experts in the field, but through thoughtful and insightful listening to what is going on with 'me' and how this impacts on my practice. It involves learning and growing to be an evidence-based practitioner; drawing from not only the best available research and literature, but also most importantly from client and cultural perspectives, and from one's own wisdom of experience. Dare to be visionary. Question and critique thyself.

Know Thy Practice Context!

Finally, the fourth and last area of knowing that I wish to propose focuses on the practice context: Know Thy Practice Context! It behoves us to know and understand our practice contexts, the work setting. This includes identifying organizational values and culture, strategic directions, and what may shape or potentially hinder practice and service to our clients. Ask yourself, are your values aligned with that of your work setting and the organization that employs you? Practice from the stance of ecological theory; keep the 'big picture' in mind, remember the subsystems. Understand that each person is significantly affected by interactions and interconnections between overlapping ecosystems (Figure 4).

At the centre sits 'you', the therapist subsystem bringing your personal and professional "baggage" to the practice context. This subsystem interacts with people (clients, consumers, colleagues, peers), each, in turn a subsystem. Consider that we each connect, and interconnect with other systems - we are not alone! There is always culture, policies, procedures; the 'way things are done', the 'taken for granted customs'; the 'norms' of a work setting. Such things are often invisible and pushed to one side; however, I believe they need to be up front and cognizant. Know too, the communities in which your clients live and engage in the occupations of their everyday lives. And, as Rebeiro Gruhl highlighted, seize opportunities to stake our occupational claim; seize opportunities to be politically active for our clients on issues of occupational injustice within those communities.


So, let me now look at some of the processes that we might partake of during our professional journeys to foster such knowing. In my experience, there are several processes; however, for the purpose of this presentation I will only highlight three key processes: supervision, peer review, and audit. Each process has its own inherent loop for critical reflection and reflection in action which fosters the knowing processes I have put forward thus far.


The first process is supervision. Supervision is a formal, contractual, structured, and supportive relationship built on the principles of empowerment and encouragement. It can be one of the most influential processes whereby practitioners may perceive and relate to their agency (Morrison, 2000). According to Morrison, good supervisors and supervisees are not born. They are developed through clear policies, good training, continuing supervision, the development of skills, and an individual commitment to supervision. Given that the focus of supervision is learning (Carroll & Gilbert, 2004), supervisors are therefore facilitators of processes that facilitate 'learning from experience' through the application of the process of 'thinking together in dialogue'. Supervision is for supervisees, not for supervisors, and it cannot be expected, nor provided unless one has first learned how to receive supervision and be a proactive supervisee (Hawkins & Shohet, 2007).

The learning gained from supervision is applied when the practitioner returns to their work. Skilled supervisors have a role in ensuring practitioner selfcare as part of supervision, situated within accountability to oneself, one's clients, one's organization, and one's profession, and facilitating the supervisee to become a reflective practitioner; to think about the work as they do the work; to truly learn to reflect in action.

Peer review

The second process I wish to highlight is peer review, and in particular formal peer review (Simmons Carlsson, 2007b). This process is, I believe, as yet under-utilized in our profession. Peer review may be described as a collaborative process of critical evaluation, or critique. It offers a formal process and opportunity for direct feedback on one's work (Brown, Esdaile & Ryan, 2004). The process contributes to the systems we have in place for monitoring quality of practice, such as performance appraisal and the Occupational Therapy Board of New Zealands' (OTBNZ) Continuing Competence Framework for Recertification (2004). A robust peer review process allows for open discussion, exposing one's practice to collegial comment by soliciting open and professional reactions from another practitioner. This process should lead to mutual learning from systematic, independent and external evaluation of vignettes of practice. Thus it allows individuals to seek and gain some informative feedback, necessary for genuine development of practice (Ministry of Health, 2004).


The third process that may facilitate and capture knowing is audit. Audit, whether clinical, or otherwise, is an activity that may lead to improvements in practice, with resultant improvements in outcomes for clients (Ministry of Health, 2004). Like peer review, it is a formal process, allowing for the systematic, critical review of the quality of practice by a team. Audit compares actual practice to standard of practice, be it the New Zealand Association of Occupational Therapists 'Occupational Therapy Process Standards' (2007) or other standards in the work setting. As a result of such comparison, any deficiencies in actual practice may be identified and rectified (Ministry of Health, 2004). However, note that audit is not to be confused with research: "research discovers the right thing to do ... audit ensures it is done right!" (Ministry of Health, 2004, p. 7).

In summary, I believe these three processes serve to enable the koru within each of you to unfurl. Such processes allow us to stand in a space, time, and place to turn back in on oneself; to stop and reflect on the past, and to make connections, in order to look forwards and progress. Reflection, or rather, critical reflection being one of our recognized cornerstones of professional competence, so acknowledged by the Occupational Therapy Board of New Zealand's competency for recertification framework under the auspices of the Health Practitioners Competency Act (2003). And, I invite you to tend to your wellbeing and growth by engaging in such processes, not because you have to, but because you want to, and because you see value in doing so. Furthermore, I invite you to be cognizant when choosing such processes, for, in my experience, processes that allow one to turn back in on one's self can be most powerful for visioning self, and nurturing the process of unfurling, challenging as this may, at times. Go on, dare to unfurl beyond where you are now.

It behoves us all to question and critique ourselves through the processes of supervision, peer review, and audit, for these processes, in particular, enable us to get beneath 'doing', as Bryan, Esdaile and Ryan (2004) recommend to access our experiences, our knowledge, our feelings, our expectations, our assumptions, and our attitudes, beliefs, and values. This will go a long way to strengthen one's knowing of oneself, one's thinking, and one's deep understanding of one's practice. So, here are a few questions for further take-home reflection:

* By now, we should all be in a supervision partnership given that it is mandated. However, what is the quality of the supervision that you receive or give? Is your supervisor trained and skilful in supervision? Does supervision make a difference to you and your practice? If not, why not?

* How robust is the formal peer review process at your place of work? Do you have one in place and do you ensure that both parties in the review understand the purpose and process by having clear guidelines?

* Do you engage in rigorous clinical and professional audit of your practice? If so what aspects do you audit? Why those and not others?

* How do you define your standards? What do you draw from to develop such standards? Do you draw from overseas standards or home-grown material? What have we in place to draw from in Aotearoa/New Zealand?

* When do you engage in such activities? How do you disseminate your findings from these processes so that the whole profession benefits? Should you?

* As a practitioner do you truly seek opportunities for genuine feedback, or do you just play at it?

* What value do you place on feedback, and whose voice do you value in terms of feedback?

* Lastly, do you truly know what reflective practice is? And are you expert at it?

These are just a few questions to ponder and take deliberate action to answer. If you answered 'Yes of course I have these things' to all of these questions, well done! Make yourself known to the profession, so that you may be tapped for the purposes of benchmarking, consultation, coaching, supervision, and mentoring. Take ownership of your mastery.

Concluding comments

To conclude this presentation, I invite you to be accountable and responsible for yourself. Tend to your well-being and growth by engaging in the many processes of knowing, not because you have to, but because you want to, and because you see value in doing so. Seek no less than quality supervision ... with a skilled supervisor! Engage in a robust peer review process! Develop and implement quality audit projects! Above all, learn how to, and engage in critical reflection, inwardly and alone, and outwardly with others, both formally and informally, for these are some of the key activities that will facilitate knowing. Furthermore, I invite you to be cognizant when choosing such processes.

I want to be part of a profession that is consciously thoughtful and mindful of ways of being, doing, and becoming; where our thinking processes and our actions reflect our values and our foundations and our unique Aotearoa/New Zealand heritage. I want to be part of a profession that tends to its unfurling, both at the individual level and at the collective level, like the koru and the mighty magnificent ponga. Like the whakatauki I started with, I believe our profession rests upon people. That is you and I. We must take the time to invest in ourselves and nurture ourselves and our individual roots, so that, like the koru we may also unfurl, not only within, but also without, and like the mighty ponga become and be the very best occupational therapists that we can be.

Wha-ia te iti kahurangi. Ki te tu-ohu koe, me he maunga teitei! Pursue excellence--should you stumble, let it be to a lofty mountain!

No reira, tena koutou, tena koutou, tena koutou katoa.

Kia Ora! Therefore greetings to you all. Thank you.


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Fearing, V. G., & Clark, J. (2000). Individuals in context: A practical guide to client-centred practice. Thorofare, NJ: Slack.

Hawkins, P., & Shohet, R. (2007). Supervision in the helping professions. (3rded.). Berkshire: Open University Press.

Iwama, M. (2006). The Kawa Model: Culturally relevant occupational therapy. Edinburgh: Churchill Livingstone Elsevier.

Ministry of Health. (2004). Toward clinical excellence: An introduction to clinical audit, peer review and other clinical practice improvement activities. Wellington, New Zealand: Author.

Morrison, T. (2001). Staff supervision in social care: Making a real difference for staff and service users. Brighton: Pavilion Publishing.

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Ross, S. (2006). Picturing an ethical leader. St James Ethics Centre in Sydney, AustraliaRetrieved November 4, 2008 from ethics-subjects/leadership/article-0466.html

Simmons Carlsson, C. (2007a). Clinical governance--is for all allied health practitioners! OT Insight, (7), 8.

Simmons Carlsson, C. (2007b). In pursuit of excellence: A slice of the 'clinical governance pie. Peer review of practice. OT Insight(7), 9.

Townsend, E. A., & Polatajko, H. J. (Eds.). (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, and justice through occupation. Ottawa, Ontario: CAOT Publications.

Whiteford, G. (2007). The koru unfurls: The emergence of diversity in occupational therapy through thought and action. New Zealand Journal of Occupational Therapy, 54(1), 21-25.

Carolyn Simmons Carlsson MHSc (Hons) NZROT

Professional Leader--Occupational Therapy

Allied Health, Physical Health Services

Auckland District Health Board

Address for Correspondence:

Allied Health Management--Physical Health Services

Level 11, Support Building

Auckland City Hospital

Private Bag 92024

Victoria Street West Auckland 1142

New Zealand

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Title Annotation:Carolyn Simmons Carlsson
Publication:New Zealand Journal of Occupational Therapy
Article Type:Report
Geographic Code:8NEWZ
Date:Mar 1, 2009
Previous Article:The politics of practice: strategies to secure our occupational claim and to address occupational injustice.
Next Article:Developing evidence-based supported employment services for young adults receiving public mental health services.

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