Me, Myself, The OT
It's a diverse career. It's not elitist. That's the point of it. 
Krysalis Neuro OT, Jo Bresi-Ando
Having gained a grounding in the founding principles of occupational therapy after graduating from London South Bank University in 2006, Jo decided to specialise as a neuro occupational therapist four years later.
And it’s her passion for the speciality that prompted her to approach us.
“When you're in the NHS and working in a specialised service such as neurorehabilitation, you know what to expect and what the patient’s pathway will be,” she says.
“The client’s length of stay within the service is already defined and, whilst you try to be as holistic as possible, intervention is already pre-defined as to what you can do as part of that service.
“Out here in the independent sector, I think it’s a lot less defined when you're working with case managers and people self-referring without having a clear understanding about what you do and how you can help them.
The reduced limitations on which interventions can be used and provided encourages creativity, which is what I enjoy the most.
Nevertheless, anyone standing at the cliff edge of self-employment, contemplating the lone leap from the secure arms of a national organisation, could be forgiven for having a few concerns.
But that’s where Krysalis can help with a happy landing!
“When I decided to venture out into the independent sector,” Jo recalls, “I initially worried about becoming deskilled and not seeing enough neuro clients.
“But I know that I'm going to get neuro specific cases from Krysalis, and that's what I like about it.”
Jo’s transition to becoming a full-time independent occupational therapy practitioner in 2018 took two years and was motivated by two aspects of her life at the time.
“It was all about work‑life balance for me,” she reflects. “Whilst in the NHS, I worked mainly in stroke rehab, and I’ve always mainly been based in the community.
“Stroke rehab in the community is very hands-on, and it can be heavy work. As I got older, it was becoming more difficult to maintain that, and I wanted to slow down a little bit and work differently.”
Now, Jo works flexibly and, although she admits she spends “far more” hours running her own business than she did working in the NHS, she enjoys the benefits of this.
“One day, you might see a few more clients, and on another, like today, I'm having a bit of an admin day. So I'm able to catch up,” she says.
“I'm able to actually sit down and plan what I want to do next week with my clients.
“So, for me, the biggest thing is about having the space to think, ‘where am I going with this person and what do I need to do?’ And being able to be more creative
You find yourself doing things a little bit differently, and that, for me, is the biggest benefit of it.
Me, myself, the OT
Reportedly [1], only around eight per cent of members of the profession’s representative body, the Royal College of Occupational Therapy (RCOT), self-disclosed as minority ethnic OTs in the latest UK survey - and Jo is one of them.
She’s a supporter of BAMEOT UK, a group formed to highlight the issues surrounding minority ethnic under-representation within the profession and find solutions to identified problems. [2]
“BAMEOT emerged around the same time as the Black Lives Matter movement and following the death of George Floyd [3],” Jo recalls.
“It was nice to see it take a professional slant.
“I remember that it seemed to generate from America initially because they were feeling it there on the ground after George Floyd, and then the conversation kind of spread to the UK.
“There was this conversation that was gaining momentum around how what had happened in the US affected us as personal individuals, and it moved on to how it also impacted us professionally.
So, it was nice to see, and it was nice to be part of something that acknowledged the reality of being an OT from a minority ethnic background.
Before the global George Floyd protests, Jo adds, the conversations were “few and far between”.
She says, “You would see other minority OTs, but it wasn't something that was particularly discussed formally.
“You might recognize something that was going on, something you were not comfortable with. So you might talk about it on a one‑to‑one personal level, but not in a professional forum.
“But everyone has to be culturally aware, including me.”
To exemplify, she adds: “As somebody who is non-white, when I’m treating a person who is from the majority ethnic background of this country, I have an awareness of what that culture is and incorporate it into the way I build rapport and form a relationship with that person.
“The same should happen when an OT who identifies as white or of European ancestry works with someone from a minoritized background.
“It’s not just a one-way thing.
You have to be able to acknowledge the differences in culture at least and understand what's important to them and how that might affect what you do or don't do whilst working with them.
But she advises, “It’s also okay to say, ‘I'm not quite sure about that, or, if there are biases, acknowledge that you might have some biases.
“As someone from a minoritized background, I can also use little moments to educate.
“I think that has been the biggest battle sometimes because, whether you're working in the NHS or the private sector, you will often only be the only minority face within a team of professionals.
“And if you're treating somebody who also comes from a minority ethnic background, you do sometimes feel like you have to advocate a little bit.”
Word to the wise
From Jo’s observations and her interest in the BAMEOT movement, she’s concerned that up-and-coming OTs of minority ethnicity are having a harder time than ever.
“I think more BAME students are coming through in the OT courses now, and they are saying they feel like they’re more discriminated against,” she says.
“I think, particularly, placements can be difficult because you've got that imbalance in student educators from a minoritized background.
“It’s the same microaggressions that you might face anyway in daily life, but then to be on placement and have that in the workplace as well - that’s hard.”
However, Jo remains steadfast in her hopes for greater diversity in a profession that, after all, prides itself on its holistic and bespoke approach.
“What shouldn't happen is that minority health professionals should only work with minority patients. I would hate for that to happen,” she says.
Because it's actually through differences, sometimes, that you bring a different perspective, and that can bring a different element to somebody’s rehab.
She adds: “It's just about being aware and having the skill to understand that.
“Overall, it’s about being able to provide choice.
“For example, some male clients only want to work with male OTs, but they never get the chance because we don’t have enough of them in the profession.
“The influence has to start from school and to encourage people of all minoritized ethnicities to think that this is something that they could do.
“And listen to BAMEOT and other organisations within the profession who are saying to the universities and the RCOT, ‘We need you to produce a more diverse workforce’.
You can tune into the BAMEOT UK podcast here.
“It's a diverse career. It's not elitist. That's the point of it.”
Jo mentored students during her 13 years with the NHS and says she’d also happily support OTs entering private practice for the first time.
“People have asked me about getting into the independent side of work, and I’ve tried to support them from that point of view,” she adds.
“But yes, more mentoring is definitely needed.”
