Midterm Flashcards
What is occupation?
to be occupied is to use and even seize control of time and space (or place) as a person engages in a recognizable life endeavour
(Christiansen & Townesend, 2004)
What is occupational therapy?
the art and science of enabling engagement in everyday living through occupation, enabling people to perform the occupations that foster health and well-being, and enabling a just and inclusive society so that all people may participate to their potential in the daily occupations of life
(Townsend & Polatajko, 2007)
What is occupational science?
the study of humans as occupational beings, including the need for and capacity to engage in and orchestrate daily occupations in the environment over the lifespan
(Yerxa et al., 1989)
What are the 4 components of the occupational perspective?
- doing
- being
- becoming
- belonging
Describe the structure of daily occupations.
see notes
What are some challenges in establishing OTs in some scenarios?
- building trust
- going against traditional ways
- lack of funding
- no preceptors in some regions for students to learn from
UBC MOT Curriculum Model
What are the components of the model?
health, occupation, social justice, occupational therapy
- advocate, professional, scholar, enabler of occupation, change agent, communicator, researcher
see notes
UBC MOT Curriculum Model
What is the vision of the model?
health and participation for all
UBC MOT Curriculum Model
What is the purpose of the model?
create, inspire, and uphold a scholarly community that contributes to the health of individuals and communities through research on occupation and education programs for occupational therapy students, health professionals, and scientists
UBC MOT Curriculum Model
What are the values of the model?
community, compassion, curiosity, equity, excellence, inclusion, innovation
UBC MOT Curriculum Model
What is a change agent?
someone who advocates on behalf of the client, as well as the occupation
What is the Person-Environment-Occupation (PEO) Model of Occupational Performance?
model that emphasizes occupational performance shaped by the interaction between person, environment, and occupation
- sometimes occupation is very separate from the person and environment, and you want to bring it closer together – each component does not have to be completely symmetrical
- see notes
What are the aspects of the person to consider in the Person-Environment-Occupation (PEO) Model of Occupational Performance?
intrinsic factors
- health
- cognition
- sensory abilities
- interests
- attitudes
What are the aspects of the environment to consider in the Person-Environment-Occupation (PEO) Model of Occupational Performance?
- physical
- cultural
- institutional
- social
- economic (ie. transportation costs)
- societal
Give an example of how to consider occupation in the Person-Environment-Occupation (PEO) Model of Occupational Performance?
ie. balance between school and work – rent prices can affect how much you need to work, and therefore affect which classes you can take
How might social determinants of health affect occupation
can restrict participation
What can environmental and place-specific limitations on occupation lead to?
can lead to restrictions in social participation, marginalization, and social exclusion
What does ‘place’ provide?
a shared context for people and their occupational engagement
What is the central focus of occupational therapy?
reengagement with occupation
What professional view is occupational therapy influenced by?
influenced by the reductionist view of the medical profession (ie. medical model of disability)
- micro – focused on physical abilities only
- looks only at the issues of the individual and not considering other factors (ie. social model of disability)
What are the 4 core assumptions of the current paradigm of occupational therapy?
- humans have an occupational nature
- humans may experience occupational dysfunction (ie. occupational deprivation)
- occupation can be used as a therapeutic agent
- occupation may be idiosyncratic (one time/unique)
What is the WFOT International Advisory Group’s definition of occupational therapy?
a profession concerned with promoting health and well-being through occupation
- the primary goal of OT is to assist people to participate in the activities of everyday life
- but we are imposing our values on individuals we are working with
- but activities in everyday life are different for everyone (choice factor)
What are the two approaches of OT practice?
- occupation-based approach
- collaborative-relational approach
What is the occupation-based approach?
within OT, you are focusing on occupations
- ie. physiotherapists work with clients with a focus on the physical component – improve ability to do certain exercises/movements
- ie. occupational therapists work with people on functioning to do a certain activity – focus on tasks such as cooking, dressing, using the washroom, mobility
What is the collaborative-relational approach?
- working with different people to find the best approach
- working with/between different sectors to see how they work together
- interdisciplinary
- building goals together between client and therapist – not using the same baseline for everyone
What approach are occupational therapists moving away from?
client-centred approach
- client may be having difficulty with something due to the structural context that is affecting the client’s ability, not because of their own fault
- focuses/pressurizes the individual, putting responsibility on the client
- therapist is imposing their values and knowledge onto their client
What are the 3 key stages of OT practice?
- assessment – report, observation, structured interview, diagnosis, etc.
- therapeutic planning
- implementation and evaluation
What are the two approaches to OT?
- improve/maintain client’s capacities and capabilities
- modify occupation and/or environment(s)
(these are along a continuum)
What are the various practice areas of OTs? (7)
- SCHOOL: support students with disabilities, ensure school is accessible for physical disabilities
- MENTAL HEALTH: help people do occupations they want to do, simplify self-care and hygiene tasks, destigmatize personal beliefs
- ACUTE: (usually see client only one time, then client moves on) hospital setting, post-surgery education, stroke and TBI neuro assessment, concussion
- REHABILITATION: assessment and intervention
- COMMUNITY: home visits, outpatient programs (client returns to community centre or hospital to meet OT and work on things together)
- PRIVATE: consultation services, mental health, autism clinic
- WORK: ergonomics, pain management and intervention, return-to-work
What does transdisciplinary?
when two disciplines start to overlap and work together (ie. PT and OT), do each other’s jobs
What is the focus of occupational science?
using an occupation perspective
- humans are viewed as occupational beings – have a need to engage in occupation in order to thrive
Describe how OS and OT are a basic and applied science, respectively.
- OS: basic science – interdisciplinary (includes many different professions)
- OT: applied science – does not include many different disciplines, but can work with other disciplines
- OTs are now moving beyond distinguishing the two
- ie. anatomy is a basic science, while chiropractic is an applied science
What does occupational science do
- provides the essential foundational knowledge for occupational therapy – gives clinicians the ability to provide better service – evidence-informed practice
- declares a unique professional perspective – gives a way to differentiate OTs from other therapists and professions in healthcare system
-articulates an occupational framework for research and evidence-based practice – helps OT looking at social problems, systemic problems, and injustices - sharpens practitioners’ occupational lens on clients and society – looks critically at occupation
Occupational science makes occupation central. What does this do?
- expands thinking beyond a biopsychosocial to an occupational perspective
- expands practice beyond the therapeutic use of activity to enabling occupation
What is a biopsychosocial perspective?
embedded in the person – reducing individuals to their components – biological, psychological, social
- impairment and disability
What is an occupational perspective?
occupation and participation focused
- assess and address occupational performance and occupational justice
- social injustice
Flow State
What is the ‘Just Right’ challenge?
- balance of person and environment (shows individuality) – need to have the skills and the setting
- things are different for different people
- experience of occupation is beyond observed behaviour (internal)
What are some qualitative and quantitative methodologies for occupational science research? (4)
- experiential elements of occupation – people experience and perform occupations differently
- connections between occupation and identity – can establish how people perceive us, and how we perceive others
- occupation is situated in time – lifespan approach, minute-by-minute, occupational deprivation
- occupation is related to health and well-being – shows relationship between OS and OT
What is the differenCE between OS and OT?
- OS focuses on occupation and humans as occupational beings
- OT focuses more on health and well-being – using therapeutic intervention with occupation
What triggered the ‘turn’ in occupational science?
“…recognition of an urgent need…characterized by growing inequalities and increasing individualization of social issues…”
- move away from the individual and onto the context
Describe the relationship between OS and OT.
- under development and in negotiation – think about transformation of OS beyond
- closely related
- each share ‘occupation’ as a central construct
One concern is dualistic thinking in occupational science and occupational therapy. What does that mean?
separation of basic and applied science and seeing them as absolutes rather than acknowledging the tensions as the possibilities for integration and overlap
How does ‘questioning the status quo’ play a role in occupational science research?
moving “beyond socially sanctioned occupations within dominant social groups” and being critical of the dominant narratives embedded in our society
What is space?
location, physical space, and physical geography
What is place?
what gives a space meaning, ‘personality,’ and a connection to a cultural or personal identity
What are the 3 types of space?
- conceived space
- perceived space
- lived space
What is conceived space?
representation of space reflecting codes and discourses of the powerful elite
- powerful elite include policy makers, architects, etc.
- good for OTs to be involved, as they think about accessibility when it is not often considered in universal design standpoints
- ie. makes sense to have a screen at the front of the classroom, facing the students
- ie. someone fights for a crosswalk to be made
What is perceived space?
production and reproduction of spatial practices shaping how society engages with and uses space – people’s rapport with, and understanding of, space
- ie. no one told a professor they have to stand at the front, but it makes sense to do so
- ie. someone knows that they should be using a crosswalk
What is lived space?
space of representation in which daily life challenges other forms of space
- ie. someone chooses to J-walk instead of using a crosswalk
What does the spatiality of occupation allow us to explore?
allows us to explore the concept of space, while integrating a critical aspect and the concept of occupation in daily life
What is place-making?
what agency people have in the place-making process – ongoing process
- ie. decorations in your bedroom, who you invite into the room
What is place belongingness?
sense of being ‘at home,’ where individuals build an attachment to place over time
- largely an individual process
- draw from memories
- sense of belonging can be shaped by social dynamics
- ie. sports team practice areas, bedrooms,
What are politics of belonging?
processes of socio-spatial inclusion and exclusion
- social process
- can become more complicated when exclusivity is discriminatory (ie. recent ‘whites only’ kids groups in Vancouver)
- ie. unwritten rules
- ie. ‘read the room’
- ie. places for seniors only, daycares for young children only
Processes of Inclusion and Exclusion
how can people be explicitly and implicitly included/excluded from place
- places can be exclusive, but can become more inclusive
- ie. more gender-neutral bathrooms
Forms of Resistance
how can places be made more welcoming
- ie. visible signage indigenous artwork on display
- ie. flex-use spaces (venues) can be used for multiple things such as sports games or concerts
What is the mobilities paradigm?
practices in and through which mobilities are produced and productive of relations of movement… with some groups moving, some not, some privileged, some displaced, some experiencing a burden of mobility, some brutally emplaced – an uneven relational landscape of mobilities
- ie. based on economic status – affording connecting flights, accessible flights
- ie. what community services families are accessing – location of the service and their home can determine whether or not they will commute
- ie. living on campus vs. being a commuter
- ie. unable to access places in own city due to tourism taking up lots of spaces and creating private spaces
What are the 3 types of identity?
- social identity
- personal identity
- ego identity
(these categories are not exclusive – aspects of cultural identity may be shown socially)
What is social identity?
reflects social location, appearance, and can be gleaned by others at a glance
- markers include gender, age, race
- influences how people are perceived
- ie. clothing – casual day vs. at work, different professions/departments
What is personal identity?
gleaned through social interaction and not solely derived from appearance
- people tend to manage how they want to be perceived
- cultural identity – ie. favourite foods
- ie. taste in music, political views
What is ego identity?
core aspects of the self – unlikely to vary over time
- ie. impatient, punctual
What is structure?
structures and forces external to human agency, that go beyond the individual’s control – ie. social systems and institutions, healthcare
What is the interaction field?
social interaction in situations of face-to-face contact
- ie. healthcare professional and client meeting for the first time – client may be approaching the situation based on how another health professional has treated them previously, healthcare professional may be making assumptions based on patient demographics
- interaction field has changed as a result of technology – not all situations are face-to-face now (ie. carefully crafting emails professionally for professors)
What is agency?
individual’s capacity to recognize their situation, monitor their actions, etc.
What is identity?
- overarching concept that shapes, and is shaped by, relationships with others
- closely tied to what people do and their interpretations of those actions in the context of their relationships with others
- important to self-narratives and life stories that provide coherence and meaning for life and everyday events
How are occupation and identity linked?
- contextual and temporal relationship between occupation and identity
- emphasis upon impact of illness, injury, disability
- attention paid to intersectionality of identity markers (ie. age, class, culture, gender, race, sexuality, etc.)
What is occupational identity?
- (Unruh, 2002) conceptualized as the expression of the physical, affective, cognitive and spiritual aspects of human nature, in an interaction with the institutional, social, cultural and political dimensions of the environment, across the time and space of a person’s life span, through the occupations of self-care, productivity and leisure
- (Howie, 2003) development and maintenance of a sense of self through occupational engagement
- (Kielhofner, 2004) the composite sense of who one is and wishes to become as an occupational being, which is generated from one’s history of occupational participation
What are some factors that contribute to occupational identity?
- spatial contexts (ie. where you live)
- temporal contexts – relationship between occupation and identity over time (ie. continuity in an occupation may result in the occupation becoming part of your identity)
- what is expected of someone in a social/cultural space that may influence their decision making
- hobbies and culture play a large role in upbringing
What is intersectionality?
tool to examine perpetuation of a single-axis framework when approaching anti-discrimination law and politics
What is the relevance of intersectionality for occupational science and occupational therapy?
- limitation of single-axis frameworks – if we limit a single axis, we are marginalizing people’s identities and putting them into one box
- marginalization outside prototypical identities – people are often put into categories (disabled, female, gay, etc.), we may not be looking at people’s identities holistically
- interrelated (rather than additive or compounding)
- social positions