"Doing" in mental health practice: therapists' beliefs about why it works

Mental Health Clients Confirm the Motivating Power of Occupation

Most occupational therapists, like the founders of the profession, believe that engagement in meaningful occupation is fundamental in helping to overcome the effects of disability. This paper describes the method and one of the resulting themes of a study that investigated the value, related to personal meaning, of occupation from the perspective of people with enduring mental health problems.

Qualitative research methods were used in two mental health day service settings: a workshop, where woodwork was provided as a medium for creative therapy, and a drop-in facility. Clients were asked about their motivation, their occupational experiences and any benefits that engagement in occupation might have had for them. Participant observation was undertaken over 10 sessions and six in-depth interviews were conducted. The findings emerged through content and inductive analysis, as well as analytical triangulation of the data.

Occupation was identified as a means for generating intrinsic motivation. By providing a sense of purpose and a structuring of time, within an empowering environment, engagement in occupation was seen to be of value and had personal meaning for the clients. However, more research needs to be undertaken to augment the findings. Such evidence will support increased provision of occupation for people whose lives have been severely disrupted by mental health problems.

Retired People's Experience of Participation in Art Classes

The role that different activities play in contributing to retired people's wellbeing is not well understood, a situation that needs to be addressed now that a long period of retirement is becoming the norm for millions of people in western societies. Research carried out over the last decade has explored some aspects of participation in various activities, such as exercise, but only a few studies have explored retirees' own perspectives. This qualitative research used phenomenological methods to explore art class activity as experienced by six retired people living in the community. The participants' perspectives were explored using unstructured interviews. The data were analysed using a phenomenological approach, as outlined by Van Kaam (1959, and described by Streubert and Carpenter 1995), and the participants then confirmed the findings.

Painting added a special dimension to the particpants' retirement: it gave satisfaction, challenge, time transformation, a sense of achievement, productivity and a boost to confidence. These results confirm and extend previous studies that link creative activities to wellbeing, including those that reveal how positive emotions contribute to health. Actual attendance at an art class was also seen as valuable, because working in a group was experienced as an inspiration and an opportunity to be encouraged by and to learn from others. The activity and the socialising seemed to be equally important aspects of attending an art class, which supports Wilcock's (2007) latest theories of the benefits of belonging. This research may contribute to the justification for participation in art or craft activity within the community, in occupational therapy practice or in settings such as residential homes, by providing further understanding of its meaning and value for retirees and its potential for promoting their health.

Icelandic occupational therapists' attitudes towards educational issues

The purpose of this study was to assess the readiness of occupational therapists in Iceland to accept a professional as opposed to a technical view of the profession. Most Icelandic occupational therapists were educated in other countries, with little emphasis on liberal arts, sciences and research. The first Icelandic occupational therapy programme, a university-level programme, was founded in 1997. All Icelandic occupational therapists were surveyed. Eighty-seven questionnaires were sent out and 80 (92%) were returned and used for statistical analysis. The results of the study showed that Icelandic occupational therapists valued academic skills over technical skills, emphasizing occupational therapy theory unique to the profession and research to validate practice. More recognition among other health professionals was considered the most needed change in the profession. The results of the study showed that the clinicians' attitudes confirmed in general what is emphasized in the curriculum and in students' fieldwork. Further research is needed to explore whether the Icelandic occupational therapy profession succeeds in promoting research and recognition by other health professions.