Professionalization and rehabilitation : the case of Swedish occupational and physical therapists

Sammanfattning: Swedish occupational and physical therapists find themselves in a field of tension, on the one hand dominated by different health care and educational reforms, on the other hand by an ongoing professionalization process. The aim of this thesis is to study how the therapists perceive their working situation in changing surroundings. The empirical base is the SIROP study (Situation of the Rehabilitation Personnel Occupational and Physical Therapists), performed in different phases, using a qualitative interview study (n=6), and an intensive time-budget study (n=21). In the last phase ideas and hypotheses from the two former phases are tested on randomly selected occupational and physical therapists (n=702), and the empirical data is presented in a licentiate dissertation and in four articles. The use of a variety of research approaches should be regarded as an attempt to gain insight into empirically and theoretically complex questions, linking professionalization issues to psychosocial working issues.One idea behind the study is a desire to provide a broad description of the work situation for the responding occupational and physical therapists, as they themselves perceive and express it. Another idea is to get a closer picture of the work content and knowledge systems of these rehabilitation groups. The comparative approach employed is indebted to ecological ideas highlighting the relative positions of each vocational group within the rehabilitation field, and also the ideas of professionalization as related to interprofessional competition and struggles over jurisdiction.The findings show that a majority of the therapists experience high feelings of job satisfaction and professional self-concept. Most of the working condition variables turned out to be positively correlated to overall job satisfaction. Only 50% in each vocational group reported a fair possibility to develop and learn new things at work, and a minority admitted autonomy concerning identification of the patients' rehabilitation needs. The therapists' main problems seem to be related to a lack of understanding and appreciation by the physician and by society at large. As the reasoning on professionalization focuses on the notion of special knowledge, autonomy, and closure as important categories in understanding the role and status of different professions in modem society, a conclusion is that a failure to be recognized as the owner of specific knowledge with high abstracting power and with an empirical base of reflective practice, and to monopolize a clearly defined rehabilitation function might be serious barriers for the development of the therapists' self-confidence and professional identity.