The World Federation of Occupational Therapists (WFOT) defines occupational therapy as a client-centered health profession concerned with promoting health and well-being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to, need to, or are expected to do or by modifying the occupation or the environment to better support their occupational engagement (WFOT 2012).
Occupational therapy, founded in 1917, has become a well-established profession within the areas of health and rehabilitation with over 95 member countries in the WFOT membership. Occupational therapists use a variety of interventions to foster recovery, modify activities for successful performance, and facilitate or adapt environments to enable persons to improve or regain the ability to participate in meaningful and satisfying activities that are necessary to support everyday living. Occupational therapy is applied at individual, group, community, and population levels (Söderback 2009; Christiansen et al. 2015).
The term “occupation,” as used by occupational therapists, refers to more than paid work; it refers to all manner of meaningful activities and includes activities necessary to care for self and others, education, work, play, leisure, and social participation. The profession holds a number of key values and assumptions. In particular, it views people as occupational beings, believes in the positive relationship between occupation and health, and holds that all people have the need for and right to engagement in meaningful occupation and experience the health and well-being it brings (Townsend and Polatajko 2013; Duncan 2011; Christiansen et al. 2015).
Occupational therapy is an applied discipline with theoretical underpinnings related to occupation and its enablement. The practice of occupational therapy draws from numerous sciences including occupational science and neuroscience, as well as the behavioral, biomedical, psychological, social, and environmental sciences. The integration of knowledge from these diverse sciences and its application to daily life place the profession in a key position to contribute to the translation of science to everyday living to improve the human condition (Carey and Baum 2011).
The Practice of Occupational Therapy
As an applied science, occupational therapy is focused on the role occupation plays in the everyday lives of those who experience difficulties in engaging in the activities they want to do, need to do, or are expected to do. Occupational therapists become involved when the occupations of everyday living are compromised or are at risk of being compromised by health conditions, injuries, or potentially disabling conditions. They help people overcome activity limitations or occupational participation restrictions by identifying barriers to occupational engagement and by evaluating the processes that support it. Occupational therapy interventions are designed to promote engagement, restore function, and enable important activities and occupational participation. Occupational therapists rely on a variety of valid and reliable measurement tools and intervention techniques that assist in their assessment and enablement of engagement in the important occupations of everyday living and promote their unique roles as members of a team supporting a person’s development, recovery, and integration or reintegration in everyday life. Occupational therapy practitioners understand performance and engagement from a holistic perspective and address all aspects of performance when providing interventions.
Occupational therapists use a client-centered approach and conduct a detailed analysis of the fit between a person’s capacity, the occupational demands, and the environment to determine the best approaches to improving capacity and/or modifying occupations and adapting environments to facilitate change and enable performance and engagement (Law et al. 2005; Polatajko et al. 2013; Christiansen et al. 2015). Eriksson, Kottorp, Borg, and Tham describe the limitations to daily occupations caused by disruptions of health and social situation as “occupational gaps,” the gaps that occur between what the individual wants, needs, and is expected to do and what he or she actually does.
Occupational therapy is practiced in a wide range of settings, including hospitals, rehabilitation settings, health centers, mental health centers, community centers, private practices, and primary care sites including physician offices, homes, workplaces, schools, and residences for seniors and those living with chronic and developmental disabilities. Clients are actively involved in the therapeutic process, and outcomes of occupational therapy are measured in terms of occupational performance and engagement, participation, and well-being (WFOT 2012). Occupational therapists bridge between the medical perspective focused on impairment reduction, management, or recovery and the sociocultural perspective focused on the contexts in which people live their lives. Occupational therapists are committed to promoting inclusion, diversity, independence, and safety for all recipients in various stages of life, health, and illness and are guided by an Occupational Therapy Code of Ethics and/or Conduct (American Occupational Therapy Association 2005; College of Occupational Therapists 2015; Canadian Association of Occupational Therapists 2007; Occupational Therapy Board of Australia 2014).
The day-to-day practice of occupational therapy is guided by jurisdictionally relevant bodies; at the international level, it is guided by the self-appointed World Federation of Occupational Therapists (WFOT 2010). All schools worldwide must meet minimum standards established by WFOT. Many countries have additional standards, and some have registration or certification standards that must be met by therapists to practice. There are also national and international bodies, such as the American, Australian, Canadian, British, and Swedish Associations of Occupational Therapists that support and regulate practice.Occupational therapy practice has an established literature supporting the theoretical underpinnings of the profession, its measures, and interventions. The science of occupational therapy contributes to occupational science, neuroscience, and environmental science and furnishes evidence to support recovery and/or adaptive or compensatory strategies that improve the lives of people, support development, or maintain health and well-being.
The Science of Occupational Therapy
The science of occupational therapy provides a unique contribution to the understanding of human occupation and participation in the everyday activities of living. Occupational therapy is based on the premise that humans have a basic need for occupation and health, and well-being is dependent on and can be supported through meaningful and purposeful engagement in occupations. Occupation is a primary source of meaning (Christiansen 1999; Hasselkus 2002) and a determinant of life satisfaction (Eriksson et al. 2009). A number of empirical studies have identified occupational engagement as a determinant of health and well-being (Clark et al. 1997; Glass et al. 1999; Herzog et al. 1998; Horgas et al. 1998; Hultsch et al. 1999). The absence of engagement in occupation may lead to physiological decline and negatively impact health (Kielhofner 2004; Townsend and Polatajko 2013). Importantly, occupation has the potential to be therapeutic.
The science of occupational therapy seeks to understand the mechanisms that support function, activity, participation, and the environmental enablers and barriers that make function, activity, and participation possible. Occupational therapy scientists study the full range of phenomena that is human occupation. From basic mechanisms of body function and structure to sociocultural influences, they address measurement, intervention, and translational and health services research.
References and Further Reading
- British Association of Occupational Therapists and College of Occupational Therapists. (2015). Code of ethics and professional conduct. Retrieved from https://www.rcot.co.uk/practice-resources/rcot-publications/downloads/rcot-standards-and-ethics. Accessed 15 Aug 2018.
- Canadian Association of Occupational Therapists. (2007). Canadian association of occupational therapists code of ethics. Retrieved from https://www.caot.ca/site/pt/codeofethics?nav=sidebar. Accessed 15 Aug 2018.
- Carey, L. M., & Baum, C. (2011). Occupational therapy. In N. P. Azari (Ed.), Encyclopaedia of sciences and religions. Heidelberg: Springer.Google Scholar
- Christiansen, C., Baum, C. M., & Bass-Haugen, J. (2015). Occupational therapy: Performance, participation, and well-being (4th ed.). Thorofare: SLACK.Google Scholar
- Duncan, E. A. (Ed.). (2011). Foundations for practice in occupational therapy. Churchill Livingston/Elsevier Health Sciences.Google Scholar
- Eriksson, G., Kottorp, A., Borg, J., & Tham, K. (2009). Relationship between occupational gaps in everyday scientists study the full range of phenomena that is human occupation. From basic mechanisms of body function and structure to sociocultural influences, they address measurement, intervention, and translational and health services research life, depressive mood and life satisfaction after acquired brain injury. Journal of Rehabilitation Medicine, 41, 187–194.CrossRefGoogle Scholar
- Hasselkus, B. (2002). The meaning of everyday occupation. Thorofare: SLACK.Google Scholar
- Kielhofner, G. (2004). Conceptual foundations of occupational therapy (3rd ed.). Philadelphia: F. A Davis. Authoritative texts on occupational therapy.Google Scholar
- Law, M. C., Baum, C. M., & Dunn, W. (2005). Measuring occupational performance: Supporting best practice in occupational therapy (2nd ed.). Thorofare: SLACK.Google Scholar
- Occupational Therapy Board of Australia. (2014). Code of conduct. Retrieved from http://www.occupationaltherapyboard.gov.au/Codes-Guidelines/Code-of-conduct.aspx. Accessed 15 Aug 2018.
- Polatajko, H. J., Davis, J., Cantin, N., Dubouloz-Wilner, C.-J., & Trentham, B. (2013). Occupation-based practice: The essential elements, Chapter 8. In E. A. Townsend & H. J. Polatajko (Eds.), Enabling occupation II: Advancing an occupational therapy vision for health, well-being and justice through occupation (2nd ed., pp. 203–227). Ottawa: CAOT Publications ACE.Google Scholar
- Söderback, I. (Ed.). (2009). International handbook of occupational therapy interventions (Vol. 1, 1st ed.). New York: Springer.Google Scholar
- Townsend, E. A., & Polatajko, H. J. (2013). Enabling occupation II: Advancing an occupational therapy vision for health, well-being & justice through occupation (2nd ed.). Ottawa: CAOT Publications ACE.Google Scholar
- World Federation of Occupational Therapists. (2012). Definition of occupational therapy. Retrieved from http://www.wfot.org/AboutUs/AboutOccupationalTherapy/DefinitionofOccupationalTherapy.aspx. Accessed 15 Aug 2018.