Sharing Politics

While trying to score a sensory profile in my 'office' Tuesday, I was distracted from the columns of numbers by a heated conversation from the adjoining treatment room. It involved 3 pt's and 1 therapist, arguing over the coming election, all in a seriously irrational manner. The "one issue voter," "crazy partisan voter," and "completely crazy voter" were all represented. And as I groaned audibly and closed the door, I was reminded of how against my beliefs of pt. care this situation really is.

It's a common social more in the US that religion and politics should not be discussed in polite company. While I don't think that these conversations should be totally off limits, it is something to tread carefully around. Coworkers often engage in brief conversations about these topics (possibly expanding as they work together longer) but people are usually careful to ease into these discussions so that they don't strain what is a comfortable working relationship. However, I believe that despite politics and religion being important parts of an individual's occupational profile, therapists should not discuss these topics with their clients. Here's why...

While people must make their own decisions about how much information to share on these topics with coworkers, they should be very cautious about what or any information is discussed with clients. No matter how often we try to empower our clients during the therapeutic process, we still often hear, "do what you think is best, you're the expert." This is not a relationship with equal footing. You, the therapist, are billing the client for the time that you are spending together. The client is agreeing to pay for your expertise to assist them in working toward their goals. They are not paying to be proselytized, and they should never be confused into feeling that is what they are getting for their money.

Part of OT is the universal respect you must hold for your client to enable them to "Live life to its fullest." If you are disparaging his political party's beliefs, will they really believe that you hold full respect for them? If you are constantly talking about your opinions and beliefs, will they feel defensive when their views differ from your own? Some might say that they only have these type of conversations with clients who are receptive, but do you yourself instantly come down on everyone who shares an unwanted opinion? It would be difficult to assess how receptive a person forced to sit through your therapy small-talk really is, and whether they are just trying to be polite, conclude their appointment, and go on with their life.

Full disclosure: I am very immersed into politics. I make a concerted effort for my pt's to feel free to discuss that interest, but not know in what way I will be voting. I was very concerned in making sure that they would be able to vote, despite being hospitalized, as that is a critical occupation for many. (sidenote- our Care Manager on the SNF floor directed all the efforts in that direction, getting absentee ballots and representatives from the various counties to appear and verify voters. It's very doable, make sure your residents maintain their rights) Even though I consider intrusive conversations about politics to be inappropriate, I have a way to discuss the topic with those who seem interested. If they are watching election coverage, I can ask them what's happening, what's interesting them. When they express a belief, I don't contradict it, even if it's not founded in fact. I can ask about their speculations, such as, "our state voted Republican both times for Bush and Democrat both times for Clinton. Which way will we vote this time?" This is nonpartisan and doesn't ask about their own views.

If you really needed convincing that you should tread lightly involving politics and patients, consider this in your conversations: how often is the person pushing their value statements on you, extolling the virtues of their candidate, and trying to convince you to vote similarly? How would you feel if they constantly were doing that instead of listening to your instructions or doing the work they needed to do to get better? And you would stop their conversation because it would be detrimental to their progress, and you, as the therapist and 'authority figure' are responsible for helping them achieve progress. Keep it in mind and keep your opinions in check as the election season winds down.

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