OT101

Occupational Engagement

• Doing occupations that fully involves their effort, drive, and attention

nested or embedded

• occupations done simultaneously

multitasking

primary vs secondary

Habits

- Relatively automatic, repetitive patterns of human behavior

- can be useful, impoverished (something they can do before but not now), or dominating (destructive habit)

automaticity

- unconscious triggers that let you something

- reflex reaction

Routines

Habitual repeatable and predictable ways of acting

Lifestyle

longer patterns of routine often influenced by societal and cultural forces

folk taxonomy

• to describe different types of occupations

• to convey the ways in which certain occupations are values

occupation

• means to occupy or seize

• active process of living

• goal directed

• everything people do to occupy their time

Townsend, 1997

according to them: occupation is an Active process of living: from the beginning to the end of life, our occupations are all the active processes of looking after ourselves and others, enjoying life, and being socially and economically productive over the lifespan and in various contexts

basic areas of focus for the science of occupation

• form

• function

• meaning

Form

• action

• directly observed aspects of occupation

function

• purpose

• drive to do the action

• the contributions of and occupation to human development, health, or quality of life

meaning

• why do we do the action

• subjective experience of participating in an occupation

• constructed symbolically with a culture

Yerxa et al., 1989

according to them: occupation is Specific chunks of activity within the ongoing stream of human behavior which are named in the lexicon of the culture...These daily pursuits are selfinitiated, goal-directed (purposeful), and socially sanctioned"

some essential characteristics

1. Self- initiated

2. Goal directed

3. Experiential and behavioral 

4. Socially valued or recognized

5. Constituted with adaptive skills or repertoires 

6. Organized 

7. Essential to the quality of life experiences

8. Processes the capacity to influence health

CAOT

according to them: occupation is "Everything people do to occupy themselves, including looking after themselves (self-care), enjoying life (leisure), and contributing to the social and economic fabric of their communities (productivity)"

Larson et al., 2003

according to them: occupation is "The activities that comprise our life experience and can be named in the culture "

Organizing occupations

1. Activities of Daily Living (ADL)

2. Instrumental activities of daily living (IADL)

3. Health Management

4. Rest and Sleep

5. Leisure

6. Work

7. Social Participation

8. Education

9. Play

context

environmental factors

• Biological

• contextual

• psychological

• temporal & virtual

Biological

 influences on time use

contextual

(physical & social)

• Social – matter to the client’s society

temporal and virtual

stage of life, time of day or year, duration or rhythm of activity, and history

psychological

• Personality, values, beliefs

Occupational development

The gradual change of occupational behavior overtime, resulting from the growth and maturation of  the individual from interactions with the environment

preformationist

• miniature adults 

• popular from the middle ages to latter part of the 18th century, viewed children as miniature adults who acquired all their lifetime characteristics at conception, including body shape and personality

culture

• The integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group.

objectivism

• a rational view in which reality is absolute – that facts are facts, independent of emotions and beliefs.

empiricism

• refers to all knowledge being derived exclusively from personal experiences and observations

maturationist

believed that a person's genes dictated human development

postmodernism

• explains phenomena in connection to other embedded phenomena and objects found in a shared context.

• bridging the gap between self and environment

relativism

• no definite truths

• people believe what they see as real in their own communities

• truth and beliefs are essentially synonymous.

John Stuart Mill

“culture as the cultivation of human mind.”

Matthew Arnold

• Culture “the study of perfection”

• “Culture was a marker of distinction that involves cultivation one’s mind”

Tomoko Kondo

• “culture is everything”

Franz Boas

“every society or group has its own unique historical development and has to be understood in its own context.”

Clifford Geertz

• “culture is a system of inherited conceptions expressed in symbolic forms.

traditional empirical scientific inquiry

Relies on a deductive approach, which reduces phenomena to postulates or plausible explanations for testing and validation.

inductive approach

• Focus on digging deeper into phenomena to derive a richer description.

qualitative inquiry

• A research paradigm that coincides with this inductive worldview.

worldview

how people perceive and make sense of themselves and the world in which they exist.

social indexing

• Gathering and sorting structured data of social interactions

• Enables a better understanding of group dynamics, activities, and trends

• Used to summarize and categorize specific observations.

vertical social indexing

• hierarchical status

• inequality among individuals and households

horizontal social indexing

• dividing people into two groups:

In group

Out group

amae

• “the need for one to be loved and cherished; the right to assume and depend upon the goodwill of another.”

• An emotion with the characteristics of a drive 

• “Japanese interdependency”

culture

bound by time and place

• explores the study of occupation, focusing on understanding its forms, functions, and meaning within the context of the environment.

western view of occupation

the self is considered the center, and the environment external to the self.

japanese view of occupation

 the doer, or self, is not central but rather one element in an overall context. Places nature, the self, and society in an integrated whole.

first mode

epistemology: knowledge is accepted from authority with no question.

• truth is seen as dichotomous (“black and white”)

second mode

epistemology: different perspectives are considered in accepting knowledge.

• truth is seen as subjective (relies on intuition)

third mode

epistemology: knowledge gained from intuition and authority aren’t enough, knowledge must be supported with evidence and must be evaluated

fourth mode

epistemology: truth is relative and is critically viewed (ranges from informal to formal methods of gaining knowledge)

discipline

 group of people that share like mindedness.

paradigm

 a model of how you think about things and understand them.

naturalistic paradigm

•  (qualitative)

• based on the assumption that the world is made up of multiple, overlapping realities that are subjectively experienced, socially constructed, complex, and constantly changing.

positivistic paradigm

• (quantitative)

• based on the assumption that the world is made up of observable, measurable facts.

 Taxonomic Code for Occupational Therapy

• meaning of TCOP

• a method of bringing uniformity to the discussion of occupation.

occupational science

• A basic science concerned with the nature and organization of work

• The link between occupation and health

• An interdisciplinary field that focuses on the study of human occupation

• Aims to understand the roles that occupations play in individuals’ lives and their overall well-being

• This term was originally coined by Dr. Elizabeth J. Yerxa & colleagues

observable aspect of occupation

• Such as the tasks that people perform and the time they spend doing them.

• The goal is to help people perform the activities of daily living

phenomenological aspects of occupation

• The subjective experiences of people as they engage in occupation

• The goal is to understand how occupation contributes to people’s well being

combine the observable and phenomenological approaches

• Used to understand how the physical and social environment can impact people’s experiences of occupation

moral philosophy

• Can help us understand what it means to live a good life and how occupation can contribute this

assessment

• aims to understand which occupations/actions the client needs or wants to engage and evaluate what could help/hinder the occupation.

therapeutic planning

find desired action

Implementation and Evaluation of Occupational Therapy

the plan is implemented and changes as it is implemented

occupational therapy

 is a profession related to health that centers around the clients

occupational therapists

 encourage their clients’ health and well-being through the use of occupation

occupational science

 understanding of the concept of occupations, people, and medicine

• Provides the theoretical and practical development side or the knowledge base to be put into practice in occupational therapy

environmentalist

• originates with john locke from the mid-17th century, who believed that all individuals were born empty of influence (tabula rasa = blank state) and that they developed due to their different life experiences

• children gain knowledge through experiences and environment

interactionist

• most widely accepted perspective

• individuals are involves in a reciprocal interactive relationship with their environment that ultimately delinates human development across the life span

interactional model of occupational development (IMOD)

proposed as a means of describing the interactional nature of the change in human occupation at the micro, meso, and macro levels

micro

occupational competence development; level of the occupation

fundamental aspects:

• intentional actions: driven from goals

• mechanisms for generating occupational behavior

• sociocultural niche: societal expectations

• engagement in occupation 

meso

occupational life course development; level of the individual

• Bidirectional: person responds to change in the environment + person adapts to the environment to suit their needs

• OD = F(POE): Occupations result from an intentional and particular behavior by a particular person in interaction with particular aspects of the environment.

macro

occupational evolutionary development

• development: across the course of human history

• occupations: new ones emerge; some remain throughout

continuity

• Development is a continuous, lifelong process

• Occupations emerge at various points across the life course

• continuity theory

multiple determinicity

• person determinants

• occupation determinants

• environment determinants

• interaction determinants

multiple patternicity

• multiple variation: trajectories vs transitions

• changing mastery

• ages and stages

• where occupational life course is marked by periods of both growth and decline, expansion and contraction, with occupations emerging at various points throughout life.

Continuous

gradually increasing with age (eg. height and weight)

step

increasing in a stop-and-start manner (eg. mobility, cognition)

invered-U

first increasing then reaching a plateau and then decreasing (ex. visual acuity, and coordination)

U-Shaped

first decreasing, then being absent, and the increasing (eg. the step reflex, auditory localization function)

occupational deprivation

• not all people are afforded equal opportunities to participate in occupation

• Ann wilcock

• Prolonged preclusion from engagement: outside the control of individuals 

External Factors

1. social

2. economic

3. environmental

4. geographic

5. historic

6. cultural

7. political

Deprivation

Prolonged and external

Disruption

temporary; internal and external

geographic location

restricted due to location

ex. rural area and lack of opportunities 

Unsatisfactory conditions of employment

1. Unemployment

2. Underemployment

3. Overemployment

Incarceration

deprivation liberty; prisons and detention centers 

Sex-role stereotyping

social judgements; gender inequality

Refugeeism

transitory living, lack of resources, trauma, adjustment, war: people are forced to relocate; ex. natural disaster

disability and occupational deprivation

• more than 15% of world population: over 1 billion people; mostly in developing countries

occupational justice

• townsend and wilcock: everyone should be given the ability to engage in meaningful occupations to promote their health and well-being 

• occupational therapist: meaningful occupations; jack of all trades

• adapt

restorative justice

court

distributive justice

proper distribution of resources in society 

marginalization

• when people are not afforded the opportunity to participate

occupation alienation

• feeling no meaning in the occupation 

Occupational Science

established Britain and United states, 1917

National Society of the Promotion of Occupational Therapy 

• architechs

• nurses

• social workers

• doctors

paradigm

way of looking at something; perspective; set of concepts and standards that outline a certain field of study

Occupational Therapy

• primary goal: assist people to participation in activities of daily life

• enable people to do things that will enhance their ability to participate of by modifying the environment