Occupational therapy is booming across the world with a growing number of countries finding their role in this scientific field. Now Occupational Therapy Associate Professor Kate Barlow, OTD, OTR/L, IMH-E®, is making sure these countries around the world stay connected.
By Jeffrey Martin
O ccupational therapists primarily help people adapt, helping them overcome pain, injuries, illnesses, and disabilities to do everyday activities and tasks. What is your area of focus and why did you ultimately choose to work in occupational therapy (OT)?
I primarily work in pediatrics. I have two specialty areas— one of them is in pediatric feeding and the other one is in early identification of delays. I became an occupational therapist because my mother was a physical therapy assistant and her best friend, Gerri, was an OT assistant. I was in high school and I didn’t know what I wanted to do. I wasn’t really sure I wanted to even go to college. My mom said, “. . . You’re going to college.” I wanted to play the timpani drums. My mom was like, “Okay, there’s one Eastern European that has a job in Boston playing the timpani drums and you’re just not good enough. I love you, but you need a skill.” She told me to go see what Gerri does. She was working in the public schools, and she was doing a music group with children all sitting around in a circle. She had them all close their eyes and she had a bunch of musical instruments in front of her in a circle. She would pick one up and play it and have the children guess. I was like, “Wow, that’s awesome!” I was watching her for the rest of the day and she was just playing with children all day. I asked, “You’re getting paid to play?” And she was like, “Yep!” That was when I decided I’m going to school to be an OT.
You know, I did not think that drums were going to be part of the equation, but that’s awesome.
[Laughs] I know! When you’re a kid, you think, “What do you want to do?” Well, I wanted to be in a jazz band. I loved playing the timpani drums, that’s what made me happy.
About three years ago, you founded the International Interprofessional Mentorship program. What is it and how did you see this need in the OT community?
I did my doctoral work in Ghana. It was on developmental milestones. My advisor was really looking to validate a pediatric assessment tool for Ghanaians. I did some of the work towards that. In 2018, I went to the World Federation of Occupational Therapy conference, which was in South Africa, and I ran into some of the OTs that I had met in Ghana. They were like, “Kate, we need help, we need mentorship,” because they were the first OTs in their country. Ghana graduated their first class of OTs within the last five years, so they have to get mentorship from another country or from physical therapists. I said, “Yes of course I’ll mentor you!” I’m also a member of the WFOT, or World Federation of Occupational Therapy Task Force, for the University of Guyana. Guyana graduated their first class of OTs the same year as Ghana. So you have these two countries—on two different continents—who need the same thing. I was providing mentorship already to these clinicians. Janet O’Flynn, an OT director in Haiti, and myself were already doing mentorship for these OTs in pediatrics. So, I said to the chair of the WFOT, “I’m doing this separately—this is crazy. I want to combine my efforts for [the sake of ] my own time,” but there are so many other people who need this. OT is being newly established in different countries like Madagascar and Morocco where they have the same issue. So, I started this mentorship program, and it’s online so that new therapists and clinicians could get mentorship. It’s all in English—even though we have so many different languages and time zones, like Zimbabwe, and they’re eight hours ahead. This is my volunteer work; this is my passion. Global outreach is what fills my cup.
Your sessions not only include these presentations and Q-and-A sessions, but also informal meet-and-greet sessions. What is the importance of building a network, especially one with an international emphasis?
The world gets so much smaller with technology. It’s helpful because we help each other. For instance, I am the CDC’s Act Early Ambassador for the state of Massachusetts, and I got an email asking if I knew anyone who could translate from a list of six languages. I went online and saw that these people [from the mentorship program] in Iran speak Farsi and these people in Morocco speak Arabic. I fired off these emails to these people in different countries telling them that the CDC needs people to volunteer their time for interpreting. Within twenty-four hours, I was able to write the CDC back. They’re helping us and we’re helping them. Here in the US, we have so few materials in other languages.
It’s a total partnership—OT in other countries looks very different and they’re educating us on how it is in their country. Cultural humility is big for clinicians and they’re helping us learn that. At the same time, we’re helping them with their [OT] skills. Here in the United States, OTs all have a master’s degree or a doctorate degree. All of the therapists that I work with have either a three or four-year diploma or a bachelor’s degree. So, the level of education is very different. It’s a real give and take. The people who volunteer their time and present feel so needed and useful. It’s a good feeling for the mentors to provide the service and the mentees really appreciate it because I’m having the experts in the field participate. Everyone’s been so willing to volunteer their time, but I’m certainly not an expert in everything, so I reach out to someone who is a brachial plexus injury expert and that’s not my area. I’m asking the clinicians who are the experts in their field within occupational therapy to present. Everyone benefits: the mentors benefit, the mentees benefit, and we’re building this global community.
You said that OT looks different in other countries. What are some of the biggest hurdles you face connecting with occupational therapists from parts of the world that you may not be familiar with? Are there cultural gaps that affect the way occupational therapists go about treating their patients?
In countries like Kenya, occupational therapists are really trying to differentiate themselves from physical therapy. In Guyana, OT is also very new, so how can we differentiate ourselves from physical therapy, but also, how do we prove the value of our services so that the government will pay for us and create more jobs? If your [medical field] is brand new, there are no jobs. There’s no “OT Wanted” [ads] when there aren’t any OTs in the country. If you’re the first eight or nine OTs to graduate, then there are no OT jobs because you’re the first. If you go on Indeed.com [where OT is established], you’re going to get all these OT jobs. So, it’s been very hard I think for these new therapists to really create their scope of practice and show their worth and really show the distinct value of occupational therapy.
This is my volunteer work; this is my passion. Global outreach is what fills my cup.
I saw that the next three International Interprofessional Mentorship programs’ sessions are focused on: upper extremity limb loss, orthopedic conditions, and falls; oncology; and risk management. With such a long list of potential areas of focus, what are some challenges that come with being an OT and helping patients/clientele?
In the United States, OTs have the luxury of working in one area. I work in pediatrics—my coworker [AIC Occupational Therapy Professor] Dr. Allison Sullivan, works in mental health. [AIC’s Occupational Therapy Director] Dr. Patricia Meyers works in adults. [AIC Associate Professor of Occupational Therapy] Dr. Jennifer Nordstrom works in acute care. We have the luxury of really honing in and specializing in one area. That is not the case where OT is new, they’re really generalists. They’re expected to know everything. So, I have the mentees let me know what they want for presenters, what areas they want presentations on.
For countries where occupational therapy is newer, is the goal to have it reflect how the field looks here in the US?
No, the goal of this program is to eventually have spinoffs. Rwanda has its first spinoff and has created their own mentorship program. It’s the same format as this one and I’ve been helping them with that. That’s what I want for other regions. Kuwait has been trying to do this for a couple years, so I just connected them with someone who I just met this year and is from Saudi Arabia. I want to turn my program into an ECHO [Extension for Community Healthcare Outcomes]. AIC Dean of Health Sciences Karen Rosseau is amazing to me and she’s so supportive. AIC administration went through all the paperwork and signed the ECHO contract. So, I want my program to turn into an ECHO and I want to have regional mentorship programs. Zimbabwe has one in their language, Kenya has one in Swahili in their time zone, Kuwait has one in Arabic in their time zone, and Colombia has one in Spanish in their time zone. That’s the ultimate goal. I would still be running the mentorship ECHO where everyone can still come and still see the presentations in English. One of the things the mentees love the most is that after the presenter comes on, they have their contact information, so they can reach out to these experts across the globe and ask them questions. It’s making connections so they’ll always still have my US-based mentorship [program], but I’d like it to be so that each region has their own [program] in their own language, in their own time zone.
What would you say is something that you’ve learned that has really surprised you?
I guess I would say the [internet] connectivity issues in other countries. One of my members, Emmanuel, who comes every month, was telling me afterwards that he didn’t have electricity. He left his phone with his neighbor, plugged into the generator, so that when he came back from work, his phone would be charged, and he could join in on the meeting. One of the other group members said they go up to either their mother’s or their aunt’s two hours away so that they have the good internet connection for the meetings once a month. They plan their trips based on connectivity for my meetings. I feel so spoiled here in the US and I don’t think about connectivity or the hours I have electricity. That’s been the most eye- opening for me. When I’m running a meeting, they’re all muted, and they all keep their cameras off for connectivity and they’re constantly being kicked out and coming back in. This is the norm.
You won the National Board for Certification in Occupational Therapy’s (NBCOT) Innovation Award this year for your work in developing the International Interprofessional Mentorship program. What does this recognition for you and the program mean to you?
I am so honored and humbled to win the NBCOT award. Volunteer work is so often underappreciated, and I hope promotion of this tele-mentoring program will inspire others to get involved in global outreach. Each of us has so much to give.
You’ve taught here at AIC for seven years. What do you love about teaching at AIC? And how do you balance everything you’re a part of?
I’m an extremely efficient person. What I love about AIC is that occupational therapists are traditionally white and female. That is not the patient population that we serve. I feel like the OT program at AIC is really making a difference because we’re changing the face of occupational therapy through our diverse OT program. We are making a difference. I love that our class has males and is not all white. As a white female, especially with my international work, it’s really important that we can connect and have good rapport with our patients. The best way to do that is through that one-on-one connection with that cultural humility piece. I think it’s important, especially in the Springfield area, to have bilingual therapists. We want what’s best for the patients, and sometimes having someone look like you matters.
You mentioned this earlier—the CDC appointed you as the Learn the Signs. Act Early. ambassador for Massachusetts—your second term. Congratulations! What is this initiative and what does being the state’s ambassador entail?
The ambassador program has really changed my personal outlook on occupational therapy to really want to emphasize the importance of OTs working in public health. The CDC created a developmental monitoring program called Learn the Signs. Act Early. This is important because currently, more than half of the children that need services before age three are not identified, so they’re not receiving early intervention services. So how can we better reach these children in the community? This is where developmental monitoring comes in because it can be done by everyone: parents, librarians, daycare workers. The program comes in more than six different languages; the app comes in English and Spanish. We need to reach these children in the community and one way we can do that is by everyone paying attention to milestones and knowing when children are late with a milestone. For OTs and PTs at AIC, by the time a child comes to us, they’ve already been identified. So, we need to reach the children that are not being identified. This is where the campaign comes in.
My work as the ambassador has been really focused on working in Headstart. Last year, I wrote a grant and I was working at Headstart here in Mason Square [a neighborhood in Springfield] two days a week. This kind of community outreach is important because there is a migrant program here in Mason Square where most of the children are from Guatemala. How they feel about milestones, or their understanding, is different from ours. These relationships are what make change. If we want the migrant Headstart teachers to start implementing something, it’s really about relationship-building. I think that’s really what’s so important in my role as ambassador, to build these relationships across the state.
Before I go, is there anything you want to mention that I haven’t already asked about?
You asked about how I do it and it’s really been the support of the director and the dean in AIC’s OT program that really allows me to spread my wings. Without AIC’s support, I wouldn’t be able to be the ambassador or get the ECHO program for my mentorship program. They’ve been supportive of all my efforts and I think that has allowed me to do all those things. •