Occupational Therapy and Imprisoned Adolescents: An Analysis of Professional Practices

The care of adolescents in reclusion has been a field of work for occupational therapists in different parts of the world. The objective of this study was to describe and analyze Brazilian occupational therapists' practices with adolescents in reclusion. Research conducted in Brazil, identifying 56 professionals, invited to answer a questionnaire (n = 43); participate in discussion groups (n = 9); and interview (n = 4). Professionals reported different visions that guide their practices, including the identification of individual skills and the profession's possibilities for social action. Occupational therapists have specificities to work in these institutions, highlighting the possibilities of acting with a focus on social change. Practices in occupational therapy can lead to social change if focused on social issues. Social occupational therapy offers theoretical and methodological elements that inform the profession. Reflections on the practice carried out, according to a critical perspective, enable a performance in occupational therapy that intends social change.

"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.

Drawing on critical disability and universal design perspectives within occupational therapy

BACKGROUND

Critical perspectives which focus on socio-political influences on occupation have gained increased attention within the occupational therapy profession. Critical disability studies (CDS) question prevailing assumptions about disability and how disabling ideologies and practices are perpetuated in society. Universal Design (UD) is a design approach that aims to operationalise issues of inclusion and justice.

AIM

To identify and discuss how the tenets of CDS and UD can contribute to occupational therapy practice and research.

METHODS AND RESULTS

Drawing on the writings of leading scholars within CDS, UD and occupational therapy, we demonstrate the intertwined barriers faced by disabled children, youth, and adults who have participated in our studies and provide ideas on how practice can be guided by the tenets of CDS and UD to promote social equity.

CONCLUSIONS

Incorporating CDS and UD perspectives in occupational therapy practice and research requires a change in mindset and ways of working. Occupational therapy knowledge needs to be expanded to scrutinise disabling hindrances hidden within social and structural spaces, and implemented in services. We recommend working with disability communities to raise awareness and combat disabling barriers at various level of society, as mandated by policy.

Exploring the Role of Occupational Therapy and Forced Migration in Canada

BACKGROUND.

In response to increasing forced migration across the globe, Canadian occupational therapists are returning to the profession's social justice roots by exploring this emergent area of practice. Purpose. This research explores occupational therapy practices with forced migrants in a Canadian context. Method. Grounded in critical epistemologies, the researchers conducted 12 semi-structured interviews with occupational therapists, students, and researchers connected to displacement. Data were analyzed using thematic analysis. Findings. Four themes describe current occupational therapy practices related to forced migration: 1) engaging clients in new environments, 2) translating the everyday, 3) connecting and networking, and 4) advocating for occupational justice. Implications. This research contributes to the advancement of occupational therapy and forced migration by documenting the diverse and fluid nature of occupational therapy roles. Further, the paper outlines promising reflexive practices while forwarding advocacy priorities for (occupational) justice.

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.

The Concept of Oppression and Occupational Therapy: A Critical Interpretive Synthesis

Background. Occupational therapy and occupational science literature include growing attention to issues of justice, marginalization, and rights. In contrast, the concept of oppression has scarcely been employed. Purpose. This paper investigates how adding the concept of oppression may enhance occupational therapy approaches to injustice, prioritizing a focus on structural causes, and facilitating conscientious action. Method. A critical interpretive synthesis explored insights from authors who name oppressions in occupational therapy and occupational science literature. In total, a sample of 28 papers addressing oppression, ableism, ageism, classism, colonialism, heterosexism, racism, and/or sexism was selected for inclusion. Findings. Four themes were identified: oppression and everyday doing; effects of structures and power; responding and resisting; and oppression within occupational therapy. Implications. Incorporating oppression within the plurality of social discourse may help occupational therapists to avoid individualistic explanations, attend to relationships between social structures and constrained occupations, frame intersectional analysis, and engage in praxis.

Enacting social transformation through occupation: A narrative literature review

BACKGROUND

In occupational therapy and occupational science there is a drive to confront social and health injustices through occupation-based practices with social transformation as a goal. However, scholars acknowledge a lack of theory to support this developing area of practice.

AIM

To explore how occupations have been used to enact social transformation for disadvantaged communities and to elucidate socially transformative outcomes.

METHODS

A narrative literature review was carried out, focussing specifically on arts-based occupations, using seven databases. Thirty-eight items were included.

RESULTS

Three overarching themes emerged: experiences related to giving voice; levels of change and arts-based occupations influence social change.

CONCLUSIONS

Art forms as a means of expression can support people to make demands for change. This was true whether the art form was adopted at grass roots level, or via formalized projects run by researchers or Non-Government Organizations. Whilst personal change and small scale social change outcomes were achievable, larger scale structural change was not evident. Unintended outcomes in the form of risks to participants were reported. How and why change came about was not clearly articulated; leaving a need for further exploration of the mechanisms and contexts supporting change in the growing field of social transformation through occupation.

Occupational Therapists as Street-Level Bureaucrats: Leveraging the Political Nature of Everyday Practice

Background.

As front-line service providers who often work in systems regulated by governmental bodies, occupational therapists can be conceptualized as “street-level bureaucrats” ( Lipsky, 1980/2010 ) who effect and are affected by policy.

Purpose.

Drawing on understandings from a study of long-term unemployment, this article proposes that occupational therapists, as street-level bureaucrats, respond to inter-related policies and systems in ways that can perpetuate, resist, or transform opportunities for doing and being.

Key Issues.

By highlighting practitioners’ everyday negotiation of governmental, organizational, and professional power relations, the notion of street-level bureaucracy illuminates the political nature of practice as well as the possibilities and boundaries that policy can place on ideal forms and outcomes of practice.

Implications.

Framing occupational therapists as street-level bureaucrats reinforces practitioners’ situatedness as political actors. Mobilizing this framing can enhance awareness of occupational therapists’ exercise of discretion, which can be investigated as a basis for occupation-focused and emancipatory forms of practice.