Critiquing representations of intellectual disability in occupation-based literature

BACKGROUND

Within and beyond occupation-based scholarship, concerns abound regarding the pervasiveness of discourses that promote a negative, deficit-based view of intellectual disability and associated consequences for disabled people's lives. Such representations risk reducing the complexities of human doing and being and can limit the occupational possibilities of this group. Yet, there is a lack of critically reflexive research exploring how disability is discursively constructed in occupation-based literature.

AIMS/OBJECTIVES

This paper critically analyses representations of intellectual disability within occupation-based literature. It considers the influence of such representations on the occupational possibilities of people labelled intellectually disabled.

METHODS

This review employed a critical interpretive synthesis of 21 peer-reviewed articles from occupational therapy and occupational science that focused on intellectual disability.

RESULTS

Three analytic threads were identified as contributing to how intellectual disability was represented across the reviewed literature: habilitating expected doings, becoming productive citizens, and activated, but insufficient.

CONCLUSION & SIGNIFICANCE

Occupation-based discourses have powerful influence within society, particularly within occupational therapy, regarding understandings of intellectual disability and how these shape occupational possibilities for persons labelled intellectually disabled. Drawing attention to taken-for-granted representations of intellectual disability is essential to promote transformative occupational therapy practice and enhance occupational possibilities for this population.

"Making change by shared doing": An examination of occupation in processes of social transformation in five case studies

BACKGROUND

As social and health inequalities deepen around the world, scholarship in occupational therapy and occupational science has increasingly emphasised the role of occupation as a powerful tool in transformative processes.

OBJECTIVE

To explore how opportunities for everyday doing together may contribute to processes of social transformation by identifying ways occupation is being taken up in socially-transformative practice.

MATERIAL AND METHODS

A generic descriptive qualitative case study design was utilised in order to describe current practice examples and identify ways occupation was being taken up in five initiatives working towards social transformation located in Canada, Germany, South Africa and the United Kingdom.

RESULTS

Focussing on the positioning of occupation within the initiatives, three themes were developed: The intentionality of the process, the nature of occupation within the initiatives, and the role of occupation within the processes of social transformation.

CONCLUSIONS AND SIGNIFICANCE

Providing examples of agency on the micro level and of engagement with socioeconomic, political and cultural power structures at the societal level, this analysis raises important considerations in addressing how occupational therapy practice can move in socially responsive and transformative directions.

A scoping review on occupational science research in European contexts

BACKGROUND

A survey showed European occupational scientists cover a broad range in occupational science (OS) research, however, no contemporary overviews of European OS research exists, and current research may provide valuable information for OS and occupational therapy.

AIM

The aim was to provide an overview of contemporary European OS research.

MATERIALS AND METHOD

A scoping review was performed, including studies conducted in Europe and published in the British Journal of Occupational Therapy (BJOT), the Scandinavian Journal of Occupational Therapy (SJOT) or the Journal of Occupational Science (JOS) between 2015 and 2020. The journals were systematically searched, and quality assessment and thematic analysis were undertaken.

RESULTS

Findings from 93 articles identified many studies from the Nordic countries. Most studies applied qualitative research methods. Theoretical concepts from OS were used in data generating and discussions. A wide range of demographics, and living conditions were explored. Recent articles took a reflexive stance on the positionality of the researcher/s.

CONCLUSIONS

This review highlights the diversity of OS research, suggesting a solid theoretical knowledge base within European OS research.

SIGNIFICANCE

The results contribute to further development and maturation of the discipline of OS in Europe and internationally.

Occupation's Role in Inclusion of Spanish-Speaking Older Adults in a Senior Center

Occupation-based literature has not explored the specific community-level occupational processes that support inclusion or exclusion of Latine older adults in senior centers. This study examined occupation at the community level and its role in the inclusion or exclusion of older adult Spanish speakers in a senior center community. In addition, it sought to examine potential roles for occupational therapy practice in this realm. A 6-month ethnographic study used interviews, observations, document review, group mapping activities, and collaborative analysis to explore occupation of a senior center as the community and staff welcomed older adult Spanish speakers. Being culturally proactive, considering values and interests, offering regular activities, and cross-group doing together encouraged cohesion and communal habits of inclusion. These tailored modes of community occupation benefit Spanish-speaking older adults. Occupational therapy practitioners have opportunities to utilize tailored community occupations to support community inclusion and cohesion for this population.

Exploring potential for occupational therapy practice models within areas of social deprivation: A qualitative inquiry within a community-centred food cooperative

Background

A health inequalities gap exists between wealthy and deprived areas. Community-level occupation-focused interventions may support citizens and address inequities within their environments. Since the global financial crash of 2008 and fiscal policy changes within the United Kingdom, there has been a rise in food insecurity. Community volunteer initiatives have responded by providing for their residents. The aim of this study was to explore how occupational therapists may be agents for social change through exploring perspectives of members and volunteers from a community food cooperative in an area of social deprivation.

Methods

Eight semi-structured interviews were conducted with cooperative members and volunteers within a food cooperative established to address food insecurity in a local community. Data were analysed using thematic analysis.

Results

We found three main themes: It’s Not a Foodbank, Shared Hardship and a cross-cutting theme of Community. The results suggest occupation-focused responses can support the development of community and collective occupations thereby contributing solutions to shared problems.

Conclusion

A community-centred, rights-based approach has supported local community need where socio-economic disadvantage and health inequalities were identified. Scope exists for occupational therapists to work genuinely with (not for) communities to address occupational injustice through collective occupation.

Organizações sociais civis em tempos de pandemia: um relato a partir do conceito de reconstrução ocupacional coletiva

RESUMO Introdução Este artigo relata ações coletivas desenvolvidas por participantes de duas Organizações Sociais Civis representantes de pessoas com diagnóstico de esclerose múltipla, localizadas na região Sul do Brasil, durante o período da pandemia de COVID-19. Objetivo Evidenciar as estratégias e ações que constituíram parte do processo de reconstrução ocupacional coletiva das Organizações Sociais Civis. Portanto, descreve os resultados de processos coletivos a partir da reflexão sobre os fenômenos observados pelas autoras. Método Trata-se de um trabalho descritivo, do tipo relato de experiência, com a abordagem qualitativa. As práticas ocorreram de forma remota durante o período da pandemia (entre março e dezembro de 2020). Resultados Verificou-se que os dispositivos de mídias sociais contribuíram para a manutenção das ocupações coletivas do grupo, facilitando o processo de reconstrução ocupacional coletiva das Organizações Sociais Civis. Entre os dispositivos utilizados, destaca-se os aplicativos de mensagens e de videochamadas, que facilitaram o desenvolvimento das práticas coletivas, minimizando os impactos negativos do distanciamento físico. Conclusão Os dispositivos de mídias sociais apresentam-se como recursos potentes para a manutenção do fazer coletivo e nos processos de reconstrução ocupacional.

Civil society organizations in times of pandemic: a report from the concept of collective occupational reconstruction

ABSTRACT Introduction This article reports collective actions developed by participants of two Civil Society Organizations representing people diagnosed with multiple sclerosis, located in southern Brazil, during the period of the COVID-19 pandemic. Objective To highlight the strategies and actions that comprised part of the collective occupational reconstruction process of the Civil Society Organizations. Therefore, it describes the results of collective processes, based on reflection on the phenomena observed by the authors. Method This is a descriptive, qualitative research based on an experience report. The practices occurred remotely during the pandemic period (March to December 2020). Results It was found that social media platforms contributed to maintain the collective occupations of the group, facilitating the process of collective occupational reconstruction of Civil Society Organizations. Among the used tools, instant messaging and video calling applications stood out, which facilitated the development of collective practices, thus minimizing the impacts of physical distance. Conclusion Social media platforms are powerful resources to maintain collective action and occupational reconstruction processes.

Terapia ocupacional e o direito à cidade

Resumo Este ensaio tem como objetivo apresentar reflexões sobre a terapia ocupacional na garantia do “direito à cidade” como um direito humano e social fundamental, diretamente relacionado com as ocupações humanas. Iniciamos este debate com as ocupações coletivas enquanto determinantes na construção do espaço social das cidades. Em seguida, focalizamos as assimetrias do poder e as desigualdades territoriais, frutos da mercantilização da propriedade urbana, que implicam injustiças e privações no envolvimento ocupacional no cotidiano dos sujeitos. Sumarizamos possibilidades teórico-metodológicas, novas e outras já conhecidas, que trazemos à luz das questões urbanas, e que aproximam a terapia ocupacional do campo dos estudos urbanos e das políticas públicas de urbanização. Defendemos que a terapia ocupacional é uma área de significativas contribuições na defesa e garantia do direito à cidade.

Estratégias de participação social em leituras comunitárias de municípios brasileiros: aproximações da terapia ocupacional com a política urbana

Resumo Introdução Há um abismo técnico e epistêmico sobre a produção de informações a respeito da gestão democrática no planejamento das cidades. Isso implica prejuízos na participação social, enquanto envolvimento ocupacional coletivo, na condução do Plano Diretor Participativo, em especial na etapa diagnóstica da leitura comunitária, como prevê o Estatuto da Cidade. Objetivo Identificar as abordagens metodológicas da leitura comunitária dos Planos Diretores Participativos de municípios brasileiros e aproximar as suas informações à área de terapia ocupacional. Método Foi conduzida uma pesquisa documental, hipotético-dedutiva, exploratória e de natureza quali-quantitativa. Elegeu-se como variáveis de análise o conjunto de estratégias metodológicas e categoria profissional. Resultados Foram levantados 42 documentos que compreendem cinco etapas na condução da leitura comunitária: Divulgação, Mobilização, Capacitação, Diagnóstico e Pactuações. Em cada etapa, estratégias são criadas ainda sob perspectivas tradicionais e hegemônicas, conduzidas, majoritariamente, por profissionais da Arquitetura, Geografia e Engenharia. Com isso, a ação interdisciplinar é insuficiente e a participação é tratada como um “ato de aderência populacional” na construção da política urbana. Conclusão Os municípios brasileiros encontram dificuldades para implementar a política urbana, sobretudo a etapa da leitura comunitária, a qual se considera fundamental para a participação social da população. Com isso, este estudo aproxima as questões do planejamento urbano da área de terapia ocupacional, em especial ao fornecer contribuições relativas às tecnologias de participação e ao direito à cidade, enquanto direitos humano e social intrínsecos à cotidianidade de diversas populações.

Can we talk about it? A qualitative study exploring occupational therapists’ decision making in judging when to ask an older person about drinking alcohol

Older people now currently drink alcohol more frequently than previous generations, indicating a need to understand how this influences health and wellbeing in older adults. However, knowledge and awareness of the changing role alcohol plays in the lives of older people is not necessarily widely understood by allied health professionals in acute hospital contexts. In turn, conversations about drinking alcohol in later life may not be routinely addressed as part of practice, limiting an older person's choice to make informed decisions about their drinking. This paper qualitatively examines when occupational therapists (N = 17) in an acute hospital setting will initiate a conversation with older people (65+ years) about their drinking, guided by a theoretical lens that encompasses both person-centredness and collective occupation. Adopting a qualitative methodology, this study illustrates a typology of reasoning describing how, and in what circumstances, therapists ask older people about their alcohol use. Three themes were generated that provide further insight into the typology, these being ‘hesitancy in practice’, ‘failure to link life transitions to alcohol use’ and ‘challenges of focusing on healthfulness’. These findings provide a potentially useful tool for therapists, services and organisations to self-assess their approach to asking older people about alcohol use; a necessary element of professional health-care practice as social trends in alcohol use continue to increase.

Transcending the individual: The promise and potential of collectivist approaches in occupational therapy

BACKGROUND

In a globalised world, with injustices and inequities, occupational therapists have a moral and ethical obligation to use their knowledge and skills to work at a collective level with groups, communities, and populations rather than focus solely on individualistic approaches.

OBJECTIVES

To review the literature exploring the question: What do occupational therapists do in their everyday practice that could be characterised as having a collectivist orientation?

METHOD

A scoping review with searches on Web of Science, Scopus and CINAHL databases with the keywords 'occupational therapy' AND collectiv*.

RESULTS

161 articles were found and after screening of abstracts and/or full text, 19 were included. Articles were published in English (13) and Portuguese (6), in 12 different journals and one book, from 1988 to 2018. They were categorised as focussing on: social welfare - collectivism (n = 2); collective occupations (n = 11); and collective oriented practices (n = 6).

CONCLUSION

A clear definition of collectivist approaches in occupational therapy practice was not found. What was evident, however, was a focus on experiential accounts of working with groups of people and the methods and processes utilised. It is argued that occupational therapy needs to further develop knowledge and practices aimed at injustices grounded in a collectivist epistemology.