Have you heard the one about the blindfolded therapists and the elephant?
An OT, a PT, a speech therapist, and a psychologist wearing blindfolds are lead into a huge room. Unbeknownst to them, there in the middle of the room is an elephant. In an attempt to better understand and conceptualize their surroundings, they begin to feel around. Each therapist feels one different part of the elephant’s body, such as the tusk or the tail or elephant’s side. In an attempt to help his fellow therapists, the OT, who is closest to the tusks, calls out, “I know what we are dealing with!” and describes the long, curvy, hard surface in front of him. “What are you talking about?” cried the PT. “That’s not it at all. Let me explain what it really is,” she says as she moves her hands along the elephant’s rough skin. “No, I see why you would think that, and you are on to something, but let me give you a clearer idea of what we are really dealing with,” says the psychologist as she manipulates the tail. “That can’t be right,” responds the speech therapist. You get the picture.
The moral of the story is that humans have a tendency to project their partial experiences or understanding of a situation as the whole truth. We often ignore other people’s different experiences rather than consider that we may have only partial information and therefore, be only partially right. I like to end the story by having the elephant become so irritated by the therapists prodding him and arguing over him that he whacks them all down with his trunk, busts through the wall of the room, and leaves them lying there completely dazed. But that’s just me.
This old parable is still quite applicable today, especially in the many fields of wellness. Western medicine, for example, is infamous for a system of physicians in highly specialized areas of practice focused on part or one system of the body. They often poke and prod, hypothesize, and then refer, leaving patients bouncing between multiple doctors with few definitive answers. This is not so different in the field of pediatric practitioners – physicians, mental health providers, behaviorists, OT, PT, speech, educators. We each have our area of specialized understanding of the developing human organism and we all fall victim to believing partial picture of the individual is the best answer. In these situations, it is not the practitioner’s practice that suffers but the child we are dedicated to helping. This does not have to be the culture of practice. Far from it!
Clinicians can choose to actively participate in interprofessional collaboration (IPC). This model is not the same as a multi-disciplinary model. What’s the difference? In the IPC model, team members share in decision-making with equal voices and have a foundation of mutual trust, respect and familiarity with each other’s roles. The IPC model is dedicated to obtaining a comprehensive view of the person. Although this concept is currently getting a lot of attention in medical models (like hospitals where typically the physician is at the top of a hierarchy), it isn’t necessarily a new concept to those of us who have worked in early intervention or schools. In these settings, the model is team based, with the family at the table as an equal team member (at least in theory). Outside of these settings, there are many other opportunities for this kind of work. For example, STAR Institute has integrated an IPC approach into its treatment model. All clients are seen by a treating therapist (OT and/or speech therapist) and a family support worker (mental health specialist). Opportunities for family meetings with the therapists and therapist collaboration time are built into the child’s therapy program. In some cases, STAR Institute provides an interprofessional team evaluation that includes OT, speech, mental health and other professionals. This team meets before seeing the child to plan out the assessment process and after to analyze the results and develop a treatment plan. In both scenarios, practitioners and family members are part of a collaborative process where all voices are equal and outcomes are based on parent priorities. It is part of the culture of STAR Institute and one of its most valuable assets.
In truth, practitioners of any discipline can create a culture of IPC, even around a project versus a client. The recent Play for ALL Conference co-hosted by STAR Institute and Landscape Structures Inc. is an excellent example of this. Here, OT, landscape architecture and play equipment designers came together to discuss their roles and collaboration in creating amazing play spaces that are accessible, enhance development, support interpersonal relationships, and are fun to use!
Whether you work in a multi-disciplinary setting or function as an independent practitioner, I encourage you to consider the IPC model and how it can be used to enhance your practice and outcomes. It is ideal to work with others in order to better understand your elephant before the elephant leaves you lying dazed in the rubble.
Mim Ochsenbein, MSW, OTR/L
Director of Education & Occupational Therapist at STAR Institute