Occupational Therapists Defining Occupation Dr Anne Roberts Associate Professor, Plymouth University 2011
Rationale and aim At the moment our understanding of the term occupation is defined by what is written in academic, mainly Western literature. However, with praxis in mind (the interface between theory and practice), I am interested in how occupational therapists themselves understand and define the concept of occupation; by occupational therapists I mean novice and experienced local and international occupational therapists.
This paper synthesises the findings of three small studies which explored how occupational therapists define and explain what occupation is. The findings are presented as a basis for discussion of the components of occupation as they cannot be widely transferred to other settings at this point.
Research question How do occupational therapists understand and define the concept of occupation?
The studies All three studies employed a qualitative design, using semi-structured interviews and thematic analysis. All received ethical approval. The first study (Roberts and Rugg 2008) was of 6 experienced occupational therapists from a range of UK settings. It also looked at whether they were occupation focused in practice. The second was a study of 8 experienced international occupational therapists (Roberts and Rugg 2010) (by e-mail interview) The third was a study of 12 third year student occupational therapists in the UK (Roberts, Gane, Harris, Hymer 2011).
Findings Occupation was described as providing accomplishment/fulfilment, social connection, satisfaction and fun, selfidentity/social identity/self esteem, roles and routines, feelings of health and wellbeing. These findings concur with the theoretical and empirical literature
Common findings Occupation is Student OTs UK OTs Worldwide OTs Social connectedness Belonging Hammell (2004) Ikuigu (2005) Leufstadius et al (2008). Wright St Clair et al (2005). Hasselkus 2011. Self identity Christiansen (1999) Wright St Clair et al (2005) Accomplishment/fulfilment/purpose Doing Wilcock (1998);Hammell (2004) Leufstadius et al (2008) Ikuigu (2005) Satisfaction and fun Self reward value (Persson et al 2001) (Leufstadius et al (2008). Ikuigu (2005) Feelings of health and wellbeing (Leufstadius et al 2008. Being (Wilcock 1998 Hammell 2004). Flow (Czimihalyi Routines/structure to the day Leufstadius et al (2008). Christiansen (2000). Ikuigu (2005). Hasselkus (2011). Townsend & Polatajko (2007) being part of a community through doing, giving and sharing with others, supporting each other, socialising, having company, being with friends and making friends everyone knows me as a horse person and yes, it totally is my identity it s a charity which does seem particularly well run, that has very good principles you feel part of something bigger that s doing a really good job and have got high standards that has meaning to me If it s windy you ve got the oh my god this is terrifying feeling and your heart starts beating really fast..like being on a roller coaster there s no time aspect when I m pottering about.i just feel very centred and very in the moment It (cooking) has a definite beginning, middle and end. That s good for me the activity has got a discernable structure It doesn t matter what people do, so long as it involves being with people and having some purpose. Occupation can be any social activity, helping someone adapt, from Cats Protection League to free-fall parachuting. *she started volunteering in the school she had a chair, a big red comfy armchair.and the kids would queue up to read to her And she absolutely loved it, the teacher loved it, the kids loved it eventually we got her working as a WRVS helper, doing the coffee bar people coming in in a bit of trepidation, and she s able to have a cup of tea and a chat, so then she gets positive feedback she s gone from strength to strength. And they are going to benefit from it but if you can find something that ticks all the boxes and is fun and enjoyable and they look forward to it if you can engage people and facilitate them in engaging themselves in something new or something they had in the past it can just do so much for them Golf is key, absolutely key, to her existence and to her week, her structure, her sense of self-esteem. Occupations help you to fit in with society's norms; contributing and functioning in society I believe it is meaningful to someone when the occupation has significance in their lives. and the values and beliefs of a person help shape what people find significant The successful completion of a small task can motivate the person to do something else. Occupation allows people to feel better about themselves the things that just need to get done daily part of daily routine things you invest your time in. that bring fulfilment, enjoyment or achievement
However.. These concepts were inter-related! It seems overly simplistic to separate them, as we can see from the quotes that follow
Social connection, role, self esteem, self identity She became absolutely, hugely depressed and very ill she d lost her role, she lived alone... she had very little going on eventually we got her working as a WRVS helper, doing the coffee bar she s a very social person, so it s ideal people coming in in a bit of trepidation, and she s able to have a cup of tea and a chat, so then she gets positive feedback and she s gone from strength to strength. (Experienced OT)
Enjoyment/satisfaction/ routine/self esteem Golf is key, absolutely key, to her existence and to her week, her structure, her sense of self-esteem. Experienced OT
Social connection/ role/ self esteem feelings of wellbeing A lady called Beryl who was in her seventies and had never married and was adopted and her family had all died, so she was entirely on her own and in her younger days she had been a midwife and had absolutely loved children; she lived in a tiny flat with almost no view and no neighbours that were particularly friendly or anything and she got very depressed mental health team etc. and so I see her and out comes this thing The Beryl Chair
Fun/satisfaction/self identity Enabling people to do what they want to do International OT. Occupation can be any social activity, helping someone adapt, from Cats Protection League to freefall parachuting. Experienced OT Dilys age 72
The Environment also has a role in shaping occupation Finally the student OTs and the experienced UK OTs recognised the importance of environment.. Working with the whole picture in a less than ideal environment keeping a favoured occupation at all cost. Experienced OT. participants described the importance of being outdoors, Student OT
BUT occupation can also be... Passive (sleep, rst) Anti-social Pleasurable, relaxing and not health giving occupation may not be all positive as it can also contribute to a poor sense of self and feeling of failure. International OT so whether we like it or not someone s occupation for them might be not very pleasant in terms of this society's benefit, you know drug taking occupation doesn t mean its good for all but it might be meaningful to that individual Experienced OT
Any questions? Contact details: Dr Anne Roberts anne.roberts@plymouth.ac.uk
References Christiansen C (2000.Identity, personal projects and happiness: Self construction in everyday action. Journal of Occupational Science 7 98-107 Christiansen C (1999). Defining lives: Occupation as identity. An essay on competence, coherence and the creation of meaning. American Journal of Occupational Therapy 53 547-558 Hammell K W (2004). Dimensions of meaning in occupations of daily life. Canadian Journal of Occupational Therapy 71 296-305 Hasselkus B (2011). The meaning of everyday occupation. (2 nd ed) Thorofare NJ; Slack Ikiugu M N (2005). Meaningfulness of occupations as an occupation-life trajectory attractor. Journal of Occupational Science 12 102-109 Leufstadius C, Erlandsson LK,Bjorkman T, Eklund M (2008). Meaningfulness in daily occupations among individuals with persistent mental illness. Journal of Occupational Science 15 (1) 27-35 Persson D, Erlandsson L K, Eklund M, Iwarsson S (2001). Value dimensios, meaning and complexity in human occupation. A tentative structure for analysis. Scandinavian Journal of Occupational Therapy 8 7-18 Roberts A E K and Rugg S(2008).Occupation defined by practising occupational therapists.. Book of Abstracts College of Occupational Therapists 32 nd Annual Conference, Brighton. Roberts A E K and Rugg (2010). Defining occupation:a global perspective. Book of Abstracts World Federation of Occupational Therapist Congress, Chile. Roberts A E K, Gane E, Harris S, Hymer P(2011). Exploring the Characteristics of Meaningful Occupation. 35 th Annual Conference of College of Occupational Therapists, Brighton Townsend EA and Polatajko HJ (2007). Enabling Occupation II.Ottawa, CAOT publications. Wilcock A (1998). A theory of human need for occupation. Journal of Occupational Science. 1 17-24 Wright St Clair V, Hocking C, Bunrayong W, Vittayakorn S, Rattakorn P (2005). Older New Zealand women doing the work of Christmas: a recipe for identity formation. Sociological Review 332-350