DEIJAB Book Club – Interview with Karla Reese

OOTA Staff: Could you tell me about your initial interest in starting a DEIJAB (Diversity, Equity, Inclusion, Justice, Accessibility, Belonging) book club? What were some of the predicating thoughts, or the experiences that led to that idea?

Karla Reese: So as you know, I’m the inaugural DEIJAB liaison for OOTA. In this role, I’m trying to find ways to really put that into practice and I think we’re living in a time right now where there’s a lot of misinformation about what diversity, equity, inclusion, justice, access, and belonging mean. Especially with diversity, equity, and inclusion, because there are a lot of people who think that D.E.I. efforts and work are solely about hiring practices and don’t see how it applies to our profession.

For me, it’s really about client outcomes.. If we don’t take the time to understand how our diverse patient population affects the way we connect and communicate with each person, we’re going to struggle to achieve the best outcomes for our patients.​​​​​​​​​​​​​​​​. A book club helps us move away from that older approach to cultural competence, when I was first becoming an OT, it was all about learning facts about different cultures like checking items off a list. It was this very rigid way of thinking where you’d go learn about a culture and then assume you could just apply that same information to every person you met that was part of that culture.​​​​​​​​​​​​​​​​

There’s been a shift to cultural humility, which is the idea that, yes we can learn a lot, but we’ll never know everything. People are individuals and we need to come to each client with as much information as we can, but then also learn from our clients and adopt more of a growth mindset. And then one step further would be cultural responsiveness, which is where I really live my life and I see my role in the DEIJAB liaison for OOTA. 

[Cultural responsiveness] is more about actionable items – really making systemic change and that is where I think the book club helps. 

Getting people together to discuss the first book during round one was pretty straightforward, since we used a non-fiction book that was more serious and direct.A fun summer book club is a little different, because any OT practitioners can jump in, read the book, and just enjoy it at face value, but there’s are a lot of levels to the book about all these contextual factors that we as OT practitioners would typically think about in relation to an intimate partner relationship, which is something that we should be considering. So, in the book there’s people dealing with grief, there’s people managing life with hearing impairment – there’s a lot of different factors that bring up the cultural humility questions.
 
OOTA Staff: That makes a lot of sense. So on one hand I hear the book itself is providing some of the value – there’s information there that might be new information for OT practitioners, which could inform their future practice – but also, on the other hand, just in providing the space for conversations around these issues to take place, the book club itself is also delivering a different kind of value.

Reese: Yeah. And it also delivers that belonging aspect of DEIJAB, creating a sense of belonging within the OT community in Ohio.

OOTA Staff: So, in thinking about those two kind of “buckets” that the value [of participation in the book club] falls in – one being the space to have the conversation and experience the belonging and navigate these questions together, and the other being the information provided in and of itself – are there any specific books, articles, or conversations that have informed your own knowledge around the DEIJAB principles and how they’re applied to the work of occupational therapy?

Reese: Wow, there are so many I don’t even know where to begin. There’s a book called “Me and White Supremacy” that was huge in my life. It talks about systems of white supremacy and our role in that – everybody’s role in that – and also How to be an Anti-Racist. I really like books that show you how to unpack systemic racism and how it plays out in the real world.

It’s impossible for me not to consider how these things affect patient outcomes. Like I know that where I live in Ohio – and I believe across Ohio – black babies are more likely to die than white babies, even when you control for all other factors like socioeconomic status and education level.. So as a healthcare worker, I get curious about why that is. What are the systemic things in place that are causing these poor patient outcomes? All of the most impactful books for me make me think about patient outcomes afterward.

Another great book – “A People’s History of the United States” – the one about indigenous history​​​​​​​​​​​​

OOTA Staff: Yes, by Howard Zinn.

Reese: Again, thinking about the long-term trauma – the forced assimilation and how that still applies today – and how that affects healthcare. Do we have implicit bias when we look at our clients or about what we expect from them? Are we thinking about their cultural histories and what is truly important to them? Because we say as OT practitioners that “we work on what is most meaningful to our clients,” but are we really considering all of the cultural contexts?

When it comes to the book I chose for this summer, on the surface it’s just a fun romance. Quite honestly, it’s a fun, smutty romance, but it’s the first in a series of seven or eight books. Each book focuses on a different family member, and every family member has some disability or impairment – there’s autism, there are limb differences – everybody kind of has something different going on. And each book explores how the characters navigate intimate relationships with those things going on in their lives, which is in our wheelhouse as OT practitioners.

OOTA Staff: Absolutely. Fiction and nonfiction are both great chances to, you know, practice empathy. So it sounds like on some level you want the participants in this book club to develop their ability to identify bias in themselves and others, and then more than that, to take it a step further towards addressing that bias explicitly, or affecting some sort of, you know, justice in their day to day lives. 

Reese: Yes.

OOTA Staff: That’s an incredible goal for a book club like this. What might that look like, if you had to paint a hypothetical scenario? So, I’m asking you to kind of, tell me the hypothetical story of someone who participates in the book club, what they come away learning, and how they end up practicing differently.

Reese: I mean- even if you just pick up one thing. I don’t want to give away key points of this book that we’re doing this summer, but there are things that stood out to me in the navigation of a romantic relationship with someone who has hearing impairment.

It’s really easy, especially in a medical setting, to get hung up on dressing, bathing, toileting, and forget about everything else, but if practitioners could start thinking more about all those other things that truly bring quality of life, the little pleasures to life beyond being able to wipe your butt and get dressed, and wiping your butt and getting dressed are very important, but there’s more to life than that – thinking about the importance of somebody being able to hold somebody’s hand, to give them a hug, like standing up and giving them a hug – thinking about those things is really important to me in occupational therapy practice. 

I want to help make it so that people have a high quality of life, that they’re not just getting by. I would love that to be the takeaway that people start to get from these discussions and readings.

OOTA Staff: Thinking about round one of the book club and the Occupational Identity book, what were some of your takeaways or insights from the experience? That could be anything from the use of Fable as a platform, to OOTA’s audience reception or what the participation looked like.

Reese: I loved how vulnerable people got. It was a small group, which was nice for that particular book. It was an easy book to read, but hard things to take in – I guess is how I would describe it. But people got really vulnerable and people really were open in admitting their biases and things that they maybe didn’t consider. 

I think Fable helps that, because you’ve got this asynchronous “safe space,” so you have time to think through what you want to post. It’s not an in-person discussion where, you know, a lot of people when they’re put on the spot, understandably, they get uncomfortable and they don’t know what to say, especially with difficult topics.
The app really made it so that people could kind of think it through. The people who were comfortable jumping in and starting a conversation or answering the questions could do that. The people that wanted to sit back and kind of see how other people were responding and really process things more had that time. 

Fable also kind of allows you to share as much about yourself as you want. Like I have my actual face as a profile picture and it’s fine. You don’t have to. You can come in with a fake name if you want. So you can really create a safer space with Fable. 

There were a few things that were tricky with Fable. Some of it had to do with this particular book not being loaded correctly, which if you hadn’t used Fable, you wouldn’t have known, but the chapters kind of loaded weird, which made some of the discussion tricky. It’s hard when it’s a new app. 

OOTA Staff: Were there any unexpected challenges with the first cohort?

Reese: I don’t think so, but I am a very growth mindset person, so even when things aren’t going maybe the way they’re expected, I’m like, “That’s okay, it’ll work its way out.”

OOTA Staff: Maybe a different way to ask the question then is, based on your experience from the first round, is there anything you’d specifically like to do differently with round two? Or anything you’re looking to improve in an iterative fashion going forward?

Reese: I would like to find more ways to engage the group area on Fable a little bit more, to try and find a little more connection within the greater OT community.

OOTA Staff: All right, great. As staff, I’m taking a side note here – that’s a great thing for me to be aware of [Laughter].

I only have two more questions, and they’re kind of tied together. One is, do you have any advice or insights for OTPs or other individuals that want to pursue similar work? So, starting a book club, starting some sort of protected space to have difficult conversations, etc. What advice would you have for someone who was looking to kind of take inspiration from what we’re doing with OOTA here, and apply it elsewhere?

Reese: Do it. Don’t overthink it. That’s my only answer to that. Go on with your next one.

OOTA Staff: All right, great. Well, then the next question is, how do you hope that this evolves within OOTA? So, in addition to using the group area more consistently on Fable, are there any three-to-four-years-down-the-road aspirations, or opportunities that you see the book club working towards?

Reese: I would love it to build a kind of solidified community of practice around these topics, where there’s people working beyond reading the books to create actionable items – not just for OOTA, but for the greater occupational therapy community – creating resources, creating educational opportunities to really allow the people who are getting something out of these books to then make that an actionable item in a community of practice.

OOTA Staff: Fantastic. All right, I don’t have any more questions, so I’ll just thank you for your time! 

Reese: Thank you!