The Power of Our Why: Advocating for Occupational Therapy in a Changing World: Highlights from the OOTA 2025 Annual Conference Keynote
by Bonnie Boenig, MEd, OT/L, C/NDT
Energy filled the ballroom at the 2025 Annual Conference of the Ohio Occupational Therapy Association as practitioners from across the state gathered, students, clinicians, educators, and leaders representing every practice area from early intervention to skilled nursing. The keynote session opened with an engaging exercise led by Sabrena McCarley, MBA-SL, OTR/L, CLIPP, RAC-CT, QCP, FAOTA, who asked participants to “raise your hand if…” they had worked a certain number of years or in certain settings. Within moments, the audience saw itself mirrored across the room, a vibrant, connected community united by purpose and passion for occupational therapy.
Sabrena McCarley is widely recognized as a leader, advocate, and visionary in the occupational therapy profession. A Fellow of the American Occupational Therapy Association, she has more than two decades of experience spanning clinical practice, leadership, education, and advocacy. She has served as a consultant and national presenter on topics of skilled nursing reform, quality improvement, and professional development, and her ongoing work centers on advancing the visibility and influence of occupational therapy in a rapidly evolving healthcare landscape. Her keynote, “The Power of Our Why: Advocating for Occupational Therapy in a Changing World,” was a fitting centerpiece for the conference’s theme of connection, purpose, and unity.
McCarley began her presentation with a question that set the tone for reflection: “Why did you become an occupational therapy practitioner?” Her next slides humorously contrasted common frustrations with the deeper motivation behind the work, “Because you LOVE to document,” “Because you LOVE productivity,” and finally, “Because you are driven by possibilities.” The final line captured the essence of her message. Occupational therapy, she reminded attendees, has always been rooted in possibility, the possibility of helping individuals live fully and meaningfully, regardless of circumstance. It is this shared why, she explained, that unites practitioners across experience levels and settings and sustains the profession through periods of change.
McCarley then turned to the realities of healthcare in 2025, noting the many shifts the field has weathered, including reimbursement reductions, rising costs, and workforce challenges. While she acknowledged these pressures as genuine, she encouraged participants to view them as opportunities for transformation. Her slides highlighted “Healthcare Costs,” “Payment Reform,” and “Workforce Challenges,” each underscoring that the forces shaping care delivery are complex but not insurmountable. Her message was one of agency: healthcare challenges are real, but occupational therapists have the ability and responsibility to respond with creativity, leadership, and advocacy.
A central focus of McCarley’s keynote was the growing importance of Social Determinants of Health (SDOH) and health equity. Using references from the CDC and the World Health Organization, she presented the five domains that shape individual and population outcomes, economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context.
These determinants, she noted, influence health outcomes far more than medical interventions alone. Occupational therapy, with its holistic perspective, is uniquely positioned to address them.
McCarley urged practitioners to conduct comprehensive evaluations that reflect both performance skills and the environments in which clients live, learn, work, and play. Expanding assessment beyond the individual enables therapists to recognize barriers to participation and advocate for changes that promote lifelong well-being. She referenced national frameworks such as the CMS Framework for Health Equity and the Age-Friendly Health Systems initiative as examples of large-scale movements that align naturally with occupational therapy’s mission to promote engagement and quality of life.
In another section, McCarley revisited one of OT’s most familiar tools, the Occupational Therapy Profile, and invited attendees to see it through a new lens. While the profile is often viewed as a procedural requirement, she suggested it can also serve as a platform for advocacy. By documenting who a client is, what matters most to them, and how environmental or systemic factors limit participation, occupational therapists provide meaningful evidence that can influence care planning and policy. When framed this way, documentation becomes more than compliance, it becomes a vehicle for communicating the value of occupational therapy within teams and organizations.
McCarley’s presentation also underscored the role of collaboration in effective advocacy. One slide, titled “Multidisciplinary Partnership,” displayed an expansive list of professionals involved in patient care, from physicians and pharmacists to social services, psychologists, and even departments such as housekeeping and maintenance. The message was clear: occupational therapy’s impact extends across disciplines. By working alongside others who shape a person’s environment, OTs can influence outcomes at every level of care. McCarley’s examples illustrated that collaboration is not just a logistical necessity, but an advocacy tool that transforms silos into systems of support.
McCarley also pointed to technology and innovation as emerging forces shaping occupational therapy’s future. A slide labeled “Technology & Innovation” prompted discussion about the tools and approaches transforming practice. She encouraged practitioners to view technology not as competitive but as a means of expanding reach, supporting evidence-based practice, and improving access to care. Digital tools and adaptive equipment, when used thoughtfully, can strengthen connections and make interventions more equitable. The takeaway was practical and balanced, technology should enhance human connection, not replace it.
Throughout the keynote, the recurring theme of advocacy tied every message together. Several slides reinforced this point with powerful simplicity: “Advocacy Turns Barriers into Bridges,” “When We Advocate, We Win,” and “Advocacy = Everyday Action.” McCarley reminded attendees that advocacy does not occur only at the legislative level. It happens every day in the way practitioners communicate with families, educate team members, mentor students, and represent the profession in their workplaces. Each action contributes to the visibility and value of occupational therapy. Her approach grounded advocacy not in politics, but in purpose.
As the keynote drew to a close, McCarley returned to themes of unity and shared strength. Her slide titled “Transforming Challenges Together” served as both summary and rallying point. She reminded participants that the profession’s resilience depends on its members staying connected, through associations like OOTA, through mentorship, and through active engagement in policy and education. Strength and unity, she emphasized, allow the field to convert obstacles into opportunities for sustainable change. Her closing question, “What will you do on Monday that honors the strength of our profession?” left the audience reflecting on immediate, tangible ways to act on what they had heard.
In the days following the conference, many attendees described McCarley’s keynote as energizing and reaffirming. Her presentation acknowledged the realities of practice, productivity pressures, documentation demands, and systemic change, while reframing them within a larger narrative of purpose and possibility. At its core, “The Power of Our Why” reminded occupational therapists that advocacy is not something added to practice, it is woven into the fabric of everything they do. Whether educating others about the profession, promoting equitable access to care, or simply ensuring that a client’s goals are heard and honored, every therapist contributes to advancing the field.
McCarley’s message reflected both the challenges and the promise of modern occupational therapy. In a changing world, she suggested, the profession’s success depends not just on adapting to new systems but on shaping them, through unity, creativity, and unwavering focus on what truly matters. As attendees left the ballroom that afternoon, many carried with them a renewed sense of direction and pride in their collective “why.” The final message lingered long after the applause: when occupational therapists advocate, individually and together, they strengthen not only their clients, but the entire profession.
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