The effect of the use of discretion on occupational therapists' professional identity

Author: Grant, Aimee

Source: The British Journal of Occupational Therapy, Volume 76, Number 9, September 2013 , pp. 409-417(9)

Publisher: College of Occupational Therapists

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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.


Document Type: Research Article


Publication date: September 1, 2013

More about this publication?
  • The British Journal of Occupational Therapy (BJOT) is the official journal of the College of Occupational Therapists. Its purpose is to publish articles relevant to theory, practice, research, education and management in occupational therapy internationally.

    BJOT publishes research articles, critical reviews, practice analyses, opinion pieces, editorials, letters to the editor, book reviews and an annual index. Please refer to the author's guide at

    Submissions can be made at

    The 2012 Impact Factor for The British Journal of Occupational Therapy is 1.096.

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