Occupation Emerges in the Process of Therapy

Abstract

OBJECTIVE. The current literature offers no cohesive definition of occupation-based practice. Current definitions emphasize intervention forms and contexts, which do not reflect the complexity of practice. This article demonstrates that the therapeutic relationship and the meanings that are created in the therapy process are central aspects of occupation-based practice. Occupation, as an idea that emerges in the therapeutic process, has aspects of both doing and becoming. METHOD. The authors conducted observation sessions and interviews with an occupational therapist, Nancy, who used multiple therapeutic strategies with one child, Hannah, as they worked toward Hannah’s goals of going to preschool and becoming a friend. RESULTS. Strategies include changing therapeutic conditions, using cognitive strategies, bridging the person–task–social context, pushing participation, and engaging in narrative micronegotiations. CONCLUSION. Occupation emerged in the therapeutic processes as the occupational therapist and client co-created meaning about the client moving toward or away from who she wanted to become.

Mother becoming: Learning to read Mikala's signs

“…The findings presented in this study stem from a continuation study (13,14,16) that examines how occupation and occupation-based practices emerge in the practices of peer-nominated, experienced occupational therapists. This study combines interviews with Erin and Carmen and observations of their therapy process with Mikala in order to reveal both of their reflections on and interpretations of the therapy actions and interactions that occurred between them.…”

“…Erin did not ask Carmen a lot of questions about their culture or their family life and routines, yet Erin seemed to glean this information from observing and interacting with Carmen and Mikala. As the interpretation will illustrate, Erin tacitly tacked between procedural reasoning (31) and narrative reasoning (14,16,18,22). She employed procedural reasoning when she fostered Carmen's acquisition of competence by systematically teaching her how to feed Mikala given Mikala's functional problems.…”

“…As Carmen and Mikala learned to read and respond to each other's signs, they developed a foundation for the Mikala to enter family life. Generic feeding became occupation as it became imbued with personal meaning (13,14,16,18). Carmen engaged in a learning process with Erin that enabled her to acquire competence in managing and advocating for Mikala's biomedical and disability issues as well as develop mutual affection with Mikala and confidence in parenting her.…”

“…This article will describe the therapy process between Erin, a NICU therapist, and Carmen and her infant, Mikala (all pseudonyms), to help them become a family. The interpretations in this article are derived from an ongoing study (13,14,16) of occupational therapists who are nominated as and self-espoused to practice from an occupation-based perspective. Erin worked in a tertiary NICU of a large, metropolitan hospital with children who were teetering between living and dying, requiring her to use hands-on approaches to teach parents to competently perform parenting co-occupations (11,12).…”

The Role of Occupational Therapy in Community-Based Programming: Addressing Childhood Health Promotion

“…The initial interviews showed that occupational therapy programming for this population was warranted and that the topics they (Price & Miner, 2007). By matching the participants' needs and preferences, the occupation-based program was relevant, meaningful, and useful in relation to each participant's life goals and aspirations.…”