The Effect of the Use of Discretion on Occupational Therapists' Professional Identity

Introduction: In the United Kingdom, one strand of New Labour's welfare reform agenda was the introduction of the Condition Management Programme. In many areas of the United Kingdom, occupational therapists took a leading role in service delivery. This research article examines occupational therapists' use of discretion within the programme and its effect on their professional identity. Method: In-depth face-to-face interviews were undertaken with 13 staff members employed by the Condition Management Programme, including six occupational therapists. Interview transcripts were analysed thematically using ATLAS.ti 6 software as a data management tool. Findings: Within Condition Management Programmes, managers had a large amount of freedom in service design and created a service staffed in the majority by occupational therapists. While some decisions were made as part of a multidisciplinary team, occupational therapists were allowed considerable clinical autonomy in delivering the service. The impact of this autonomy on their professional identity is discussed. Conclusion: As a central part of the Condition Management Programme service, occupational therapists and other allied health professionals were allowed considerable autonomy. Concurrently, occupational therapists reported a strong professional identity. There is a need for further research within mainstream National Health Service departments to examine how discretion affects professional identity.