Occupational therapy on the margins

Development of the Refugees and Asylum Seekers Occupational Satisfaction (RASOS) Assessment Tool

The objective of this study was to develop an occupation-centered and client-centered assessment tool for refugees and asylum seekers. A preliminary tool outline was produced based on a literature review, while considering previous published tools' strengths and limitations. A qualitative study was undertaken via focus groups to improve on the tool's design and adequacy for its purpose, resulting in the creation of a pilot version of the tool. Convenience sampling included 8 Greek and Cypriot professional and student occupational therapists with experience in the field, 8 international expert occupational therapists, 4 laypeople, 4 humanitarian professionals, and 5 refugees and asylum seekers. Basic qualitative content and thematic analysis led to topics regarding tool modifications that concerned categorization, formation/structure, wording, administration, and assessment scale. Corresponding tool revisions ensued. This study led to the development of the pilot version of the Refugees and Asylum Seekers Occupational Satisfaction (RASOS), which can also be used to identify underlying personal and environmental factors that contribute to self-perceived low satisfaction. A future quantitative study is required to establish the psychometric properties of the tool.

Exploring the Praxis of Occupational Therapy-Community Development Practitioners

Background. A growing body of occupational therapy knowledge and practice focuses not on health but on social transformation, and couples occupational therapy with community development. A tension in both these fields is the disconnect between what practitioners espouse and what they do, limiting the potential of practice. To address this, practitioners are encouraged to engage in praxis-the critical synthesis of theory and practice. Purpose. To explore whether and how Australian occupational therapy-community development practitioners engage in critical praxis. Method. A critical dialogical method was employed to complete multiple in-depth interviews with four occupational therapy-community development practitioners. Interviews were transcribed and analyzed using thematic analysis. Findings. Practitioners appeared capable of praxis but were not consistently employing it. Findings were grouped into themes: disjointed praxis, authentic praxis, supporting praxis, and praxis challenges and solutions. Implications. Occupational therapists need to be supported to develop, use, and maintain skills in critical praxis.

Re-engaging in our role with communities: The coupling of occupational therapy and community development

INTRODUCTION

A growing number of occupational therapists are re-engaging in work with communities and populations to advance a social justice agenda. To assist in this endeavour, many are coupling occupational therapy and community development theory, as reflected in the social occupational therapy field. Social occupational therapy practitioners work with groups of people who do not necessarily have a health diagnosis or illness but who nonetheless experience occupational issues due to structural barriers within society. Practitioners work across micro- and macro-levels to not only alleviate symptoms of these issues but also to transform their root causes. Although community development is a logical partner to assist such practice, there are inherent tensions in the coupling of these disciplines. This study aimed to explore what theory occupational therapists were using from occupational therapy and community development to guide them in their social occupational therapy practice.

METHODS

This study employed a collaborative and participatory qualitative research method. Four occupational therapy community development practitioners each participated in two one-on-one dialogical interviews with the first author. These were transcribed and analysed using Braun and Clarke's method of thematic analysis.

FINDINGS

Findings were grouped into two themes: (a) Occupational therapy and community development - synergies and tensions, and (b) Of the profession but not in it. Findings highlighted the theoretical shortcomings of occupational therapy for community development practice, theoretical tensions between the two disciplines, and the 'underground' nature of occupational therapy community development practice.

CONCLUSION

Practitioners should be supported by the occupational therapy profession to be effective community development practitioners, capable of advancing the profession's vision of social justice. Future research should explore methods to support practitioners to navigate tensions between occupational therapy and community development, and bring this practice 'above ground'.

The (dis)obedient occupational therapist: A reflection on dissent against disciplinary propaganda

Abstract Introduction Despite struggling to establish itself as an autonomous profession, occupational therapy remains extensively regulated and controlled by discursive authorities inside and outside the discipline. After overcoming the profession’s reformist ideals, the military governance that supported its rapid expansion morphed into civil institutions but both were based on similar grounds: occupational therapists should obey a strict set of rules while disobedience and dissent are consistently repressed or silenced. Objective The objective of this article is to deconstruct dominant (consensual) discourses that shape the status quo in occupational therapy and envision alternative paths for the development of the discipline. Method Drawing on the work of Erich Fromm and Jacques Rancière, we propose a (critical) theoretical analysis of the concepts of disobedience and dissensus as they apply to occupational therapists. Results The concepts of disobedience (Fromm) and dissensus (Rancière) can be used to revisit the consensus shaped by discursive authorities inside and outside occupational therapy and expose the political nature of such processes. We argue that remaining oppressive forces similar to those of a warfare regime persist in regulating occupational therapy practice and knowledge by enacting a form of ‘disciplinary propaganda.’ Rather than threatening the development of the discipline, disobedience and dissensus constitute critical responses to disrupt dominant discourses and give rise to healthier concepts. Conclusion The use of politically charged terms such as disobedience or dissensus can be seen as controversial and unsettling for a profession like occupational therapy but we believe they are necessary for the future of our discipline.