Introduction to Context and Occupational Justice

Contextual Factors in the Occupational Therapy Process

• Context Components (OTPF:4): Context is comprised of Environmental Factors and Personal Factors.

• Environmental Factors:

  • Natural and Human-made changes: Animate and inanimate elements of the environment.

  • Products and technology: Natural or manufactured systems and equipment.

  • Support and relationships: People or animals providing physical or emotional assistance.

  • Attitudes: Customs, practices, ideologies, and beliefs held by others.

  • Services, systems, and policies: Structured programs and regulations provided by societal institutions.

Social and Structural Ecology

• Ecological Layers:

  • Individual: Personal knowledge, attitudes, and skills.

  • Interpersonal: Social networks and relationships.

  • Organizational: Environment and ethos of specific institutions.

  • Community: Cultural values and norms.

  • Public Policy: Broad regulations and societal structures.

Occupational Justice Concepts

• Core Definition: The right of individuals and groups to access, choose, and participate in meaningful occupations that support health and social inclusion.

• Fundamental Rights (Townsend & Wilcock, 2004):

  • Right to experience occupation as meaningful and enriching.

  • Right to develop through participation for health and inclusion.

  • Right to exert autonomy through occupational choice.

  • Right to benefit from fair privileges for diverse participation.

• Relationship to Social Justice: While rooted in social justice and human rights, occupational justice specifically emphasizes the right to engage in life-giving and purposeful occupations.

Forms of Occupational Injustice

• Occupational Alienation: Feeling disconnected from meaningful occupation; lack of control over one's own occupations.

• Occupational Deprivation: Prolonged prohibition from participation in meaningful occupations due to external factors.

• Occupational Marginalization: Unequal access to opportunities, resources, and privileges.

• Occupational Imbalance: Obligation to participate in occupations that are not willingly chosen or meaningful, leading to a lack of variety.

Frameworks for Research and Practice

• Conceptual Review (Durocher, Gibson, & Rappolt, 2014):

  • Method: Scoping review of 13 relevant publications from the years 2000–2012 across 6 databases.

  • Findings: Concepts are evolving but lack clarity and application guidance; more robust models are required for practice and policy.

• Evolving Theory (Stadnyk et al., 2010): A three-part theory illustrating how structural and contextual factors influence occupational outcomes (positive or negative).

• Participatory Occupational Justice Framework (Whiteford & Townsend, 2011): Includes six enablement processes: raising consciousness, collaborative engagement, mediating agreements, strategizing funding, supporting implementation/evaluation, and advocating for sustainability.

Questions & Discussion

• Question: What is context?

• Response: It involves environmental and personal factors that influence occupational performance.

• Question: How does context influence how we move our clients through the OT Process?

• Response: Context is a critical consideration during the Profile, Analysis of Occupation, Intervention, and Outcomes stages to ensure occupational justice and supportive engagement.

Context consists of Environmental and Personal Factors, influencing occupational performance.

• Environmental Factors:

  • Natural and Human-made changes: E.g., a quiet park versus a noisy urban street affecting outdoor activities.

  • Products and technology: E.g., adaptive tools like reachers or smart home devices enhancing independence.

  • Support systems: E.g., family members or friends assisting in daily tasks or emotional support.

  • Attitudes: E.g., community stigma towards disability impacting participation in social activities.

  • Services, systems, and policies: E.g., healthcare policies that affect access to therapeutic services.

Social and Structural Ecology encompasses layers from individual traits to public policy, shaping dynamics in occupational engagement.

• Ecological Layers:

  • Individual: A person’s skills, like cooking or time management.

  • Interpersonal: Relationships with peers that encourage or discourage participation in group activities.

  • Organizational: School environments promoting inclusion versus ones that do not.

  • Community: Cultural views on work-life balance influencing occupational participation.

  • Public Policy: Legislation supporting accessibility in public spaces.

Occupational Justice is about the right to engage in meaningful occupations, with fundamental rights emphasizing autonomy, meaningful participation, and fair privileges.

• Fundamental Rights:

  • E.g., the right of persons with disabilities to access public venues.

  • E.g., supporting children’s access to play in safe environments.

Occupational injustices manifest as alienation, deprivation, marginalization, and imbalance.

• Forms of Occupational Injustice:

  • Occupational Alienation: A senior feeling disconnected from activities after losing mobility.

  • Occupational Deprivation: An individual unable to participate in social events due to lack of transportation.

  • Occupational Marginalization: Lower income families having limited access to recreational facilities.

  • Occupational Imbalance: Overwhelming work obligations preventing time for family or self-care.

Research frameworks highlight evolving concepts and the need for clarity in practice and policy. Key theories address the influence of structural factors on outcomes and propose participatory processes for justice advocacy.

• Participatory Occupational Justice Framework:

  • E.g., engaging community members in the design of accessible public spaces to ensure sustainable participation in local events.