Episode 1: Scope Creep, Ego, and the OT Identity Crisis

In this episode of Outspoken OT, Michelle Eliason dives into one of the most misunderstood topics in rehabilitation—scope of practice. What began as a debate about “who’s doing what” has turned into a culture of professional policing, leaving occupational therapy caught in the middle. Michelle challenges that mindset by reframing scope through the Occupational Therapy Practice Framework (OTPF), showing that our identity is rooted in reasoning and occupation—not task ownership. In This Episode You’ll Learn: 1. Why “scope creep” is misunderstood and how it distracts us from deeper issues 2. How the OTPF defines OT’s true identity as a science of human occupation 3. Where OT and PT intersect and how to collaborate without losing professional clarity 4. How activity analysis strengthens advocacy and professional credibility 5. Why defining our value through science and reasoning—not tasks—protects our future Key Takeaways: Scope isn’t a turf war—it’s a mindset. The OTPF is a guide, not a rulebook, designed to evolve with the profession. Collaboration works when we lead with curiosity instead of control. Administrators and insurers can’t value what we can’t clearly define. OT’s distinct power lies in how we think, not just what we do. Mentioned Resources: AOTA (2020). Occupational Therapy Practice Framework: Domain and Process (4th ed.) Youngstrom, M.J. (2022). Evolution of the OTPF and What It Means for Practice. American Journal of Occupational Therapy APTA Clinical Practice Guideline Manual WHO International Classification of Functioning, Disability, and Health (ICF) Listener Challenge: Take one activity you often document and analyze it through the OTPF lens—identify the structures, functions, and contexts involved, and determine where the true occupation lies. Bring that insight to your next team meeting and start the conversation about how OT adds depth, not duplication. Join the Conversation: Have you experienced scope confusion or blurred professional lines in your setting? Share your story or tag @Buffalo.OT with #OutspokenOT to keep saying what needs to be said.