Ableism, AHP, Blog Post, Occupational Therapy, RCOT

Let’s encourage an inclusive culture of understanding by using words. – Why we should stop using acronyms, and why occupational therapist should be leading the way.  #EncourageInclusiveCultures  #UseTheWords

Acknowledgment – This blog post is a personal opinion piece, based on thoughts and ideas about my own lived experience. I acknowledge these will not be shared others, and respect peoples rights to have, different even conflicting ideas.  This website has an accessible feature, that allows different accessible formats by simply clicking on a button labelled ‘Accessibility Menu’ that appears in green on all pages. It will provide you with a number of options to change the appearance to meet your accessibility needs.  This communication has been written by a dyslexic person. If you have any trouble with the meaning of any of the sentences or words, please do not be afraid to ask for clarification. I’m #MadeByDyslexia – expect creative thinking & creative spelling.

Acronyms – an abbreviation formed from the initial letters of other words and usually pronounced as a word.  

Acronyms are common place in most lines of work, particularly in health and social care, but in the interest of fostering inclusive cultures,  should we remove the use of acronyms altogether?  

Acronyms are useful, they save us time.  Good practice when using them in a document is to write out the full meaning first followed by the acronym. However this often does not happen, or they are so commonly used in some settings that the words they stand for are hardly used, sometimes becoming only known as the acronym.  

This can create problems with clear communication and levels of understanding for a number of reasons, 

  • Acronyms can often be a barrier to those not ‘in the know’. 
  • Levels of embarrassment about asking or a concern you may be considered ignorant leads to avoidance in asking.
  • Communicating effectively to others that don’t work in the same field can become difficult
  • Sometimes acronyms can mean different things to different groups or can stand for more than one thing. 
  • Those who are neuro-divergent, often find following the flow difficult when acronyms are used.
  • Sometimes making acronyms can create odd or funny words. 
  • We can become complacent, forgetting to explain terms to people accessing the services we provide. 

Detailed below are some examples from personal experiences;

A great example of an acronym that means more than one thing is OT.  This stands for both occupational therapy and occupational therapist,  often the context of the rest of the sentence might give a clue as to which term is being referred to, but it can also mean people aren’t sure.  

Recently I was involved in a project updating a resource in the national health service (NHS) trust I work for, and a senior occupational therapist asked if RCOT stood for royal college of occupational therapy or therapist.  They were so used to just hearing RCOT that despite being a member for many years, found themselves asking the question.  

My job title is lead occupational therapist –  When I was once talking to a police officer as part of my role he said to me so you’re a LOT? and giggled to himself.  

Often titles of meetings as referred to as their acronyms,  My diary is now full of them, PIPA, OTLGN, DDTV, LTHC to name but a few, often these meetings are just referred to as their acronyms,

Within an occupational therapy meeting I attend last month, I kept hearing the term ATR, later after asking for clarity,  it meant activity through recovery –  a book I know well, but never heard it referred to as an acronym,  perhaps evidences that we can create a quick and easy language for ourselves, that excludes new people. 

There are lots of other acronyms the occupational therapy profession, they become second nature, but aren’t easily understood by other professions, or our clients.    


Often it is said that occupational therapy is poorly understood,  surely we are not helping this when not fully explaining what we mean?  

For example, saying I have completed a MOHOST in a multidisciplinary team meeting, could be meaningless to other professions,  but saying I have completed a model of human occupation screening tool,  gives some context that could be understood at some level.  There is another common tool used within mental health settings MHOST (Mental Health Optimal Staffing Tool) using both has often course confusion. 

I’m a public governor for a local acute national health services trust, despite working for a mental health national health service trust for 20 years.  I’m coming across acronyms I am unfamiliar with as they are not commonly used in my area of work.  I’m having to ask constantly what something stands for, sometimes I can work it out, but I now always ask to make sure I understand, often other governors  thank me for asking.  

Today I held some interviews for some newly qualified occupational therapists, in the part where candidates can ask us questions, one person asked what the acronyms on the front of the job description meant.  The job description is a generic one for band 5 occupational therapists within the trust so on the front is has acronyms related to the different specialities AMH, MHSOP, CYPMHS, LD.  We are so used to using these acronyms within the trust,  we don’t even explain them on a job description for newly qualified staff that might be totally new to the field.  

I’m dyslexic and have long covid, both create difficulty with processing skills, often when I say acronyms out loud I get the letters muddled. For example CPD and CBT. I know the meaning of both, but because they are so similar my brain muddles them up.  I find saying the words stops this from happening.  

Continuing Professional Development,  

Cognitive Behavioural Therapy.   

When I hear another person saying acronyms out loud, my brain takes a little longer to process that information and recall the meaning, at times I lose the flow of the topic because my brain focuses on remembering what the acronym stands for, or wonders what it means and I get lost. 

I have lots of experiences of asking for clarity from colleagues, and having a response of annoyance that I asked, being told ‘I’m not going to explain that to you,’ or eyes rolled at me.  This used to make me not speak up, not contribute to meetings, in fear of being thought of as foolish or not worthy of my role.  However what I have learnt is that this sort of behaviour is not an inclusive way of working, it shows ignorance of others diverse needs and can be interpreted as ableist.   It’s that persons problem not mine and at least I am clear in what was meant and feel better informed.   

There has been times when people have kindly offered to make a crib sheet for me that includes common acronyms,  this although meant well, is ableist it could be interrupted as I hear you have a difficultly  but I’m not willing to change my pattern of behaviour, you need to conform to neurotypical ways of working.  

The health and care professions council (HCPC) have revised their standards of proficiency for registrants, they have significantly expanded the role of equality, diversity and inclusion (EDI), placing specific importance on making sure that practice is inclusive for all service users. Registrants must:

  • 5: recognise the impact of culture, equality and diversity on practice and practise in a non-discriminatory and inclusive manner
  • 5.1: respond appropriately to the needs of all different groups and individuals in practice, recognising this can be affected by difference of any kind including, but not limited to, protected characteristics, intersectional experiences and cultural differences
  • 5.2: understand equality legislation and apply it to their practice
  • 5.3: recognise the potential impact of their own values, beliefs and personal biases (which may be unconscious) on practice and take personal action to ensure all service users and carers are treated appropriately with respect and dignity
  • 5.4: understand the duty to make reasonable adjustments in practice and be able to make and support reasonable adjustments in theirs and others’ practice
  • 5.5: recognise the characteristics and consequences of barriers to inclusion, including for socially isolated groups
  • 5.6: actively challenge these barriers, supporting the implementation of change wherever possible
  • 5.7: recognise that regard to equality, diversity and inclusion needs to be embedded in the application of all HCPC standards, across all areas of practice

Expectations of registrants:

  • Registrants are always expected to provide care to all their service users and ensure their specific needs are responded to
  • Registrants should be able to identify when a service user’s care needs to be adjusted because they have a protected characteristic
  • Instead of waiting for a service user to raise the need for accommodations, a registrant should be proactively thinking about how to make the care they offer as accessible as possible

Occupational therapy has roots in social justice, which is key to inclusive ways of working. The royal college of occupational therapists statement on diversity says, 

“The principles of diversity and equality are core to the practice of occupational therapy and are enshrined within the RCOT Code of Ethics. We believe that all people should be treated with dignity and respect, above all as equal members of society with the same choices, rights and privileges. Discrimination and prejudice have no place in our practice and no place in society.”

Royal College of Occupational Therapists

By dismissing the ideas of at least making an effort to reduce your usage of acronyms it could be argued you’re not living up to the standards expected of you.

In conclusion there are many reasons to stop the use of acronyms,  it might feel hard, feel unnecessary,  but we have a responsibility to be clear and inclusive in clinical practise,  by embracing behaviours that foster clear communication ensuring we are understood, can only be a good thing.    

I hope reading this has given you time to reflect,  review your own use of acronyms,  discuss the idea within your teams.  

Join the campaign to change a culture of using terms that only includes those in the know, by saying what you mean, being clear and ensure others understand.  

Share your own thoughts and experiences, feel free to use the graphics below to spread the word, or create your own and share.  

I pledge to stop using acronyms and always use the words; so everyone can be included and have a clearer understanding.

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