Occupation-Centered Practice: Providing Opportunities for Becoming and Belonging

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Pollie Price
article description
Although occupation has been the central heuristic for occupational therapy practice since its inception, until recently, scholars have not examined how occupation emerges in practice. The paper will present findings of a study that examined forms of occupation and occupation-centered processes of two experienced occupational therapists who were nominated by peers and self-espoused as occupation-centered. Each therapist selected two infants or children and their parents to participate. Observations and interviews were conducted as the therapists interacted with the children and parents over the course of service. Narrative analysis (Mattingly, 1998, Reissman, 1991) and micro-analytic strategies (Mattingly, 1998) were employed to closely examine the therapeutic processes as they emerged and unfolded over time, yielding several findings. First, both therapists thought of occupation as social; their processes enabled attachment, social connectedness and participation (Lawlor, 2003) as outcomes, placing less emphasis on developing skills for discreet occupational performances. Second, occupation as an idea emerged in the therapeutic processes as meaning was co-created about what the therapy experiences meant for who the child and/or family were becoming in their social worlds; generic activities became occupational. Finally, the paper will elaborate on analysis that highlighted numerous micro-processes embedded in the therapeutic relationships, and how the therapists tacitly synthesized the particulars of the situations to improvise and maneuver subsequent actions as they moved toward the desired outcome. Doing with (Jackson, 1998; Lawlor, 2003; Mattingly & Fleming, 1994; Peloquin, 1990, 1995) created an intra-personal context in which transformations happened that otherwise could not have. All efforts made by the children, therapists and mothers enabled them to move forward on a narrative trajectory (Corbin & Strauss, 1988; Mattingly, 1991, 1994) to who they were becoming in their social worlds. Finally, therapists mentored parents to achieve peripheral legitimate participation (Lave & Wenger, 1999, Wenger, 1998) in the social practices, and acquire competence in advocating for and confidence nurturing their child; parents helped their child generalize their adaptiveness into new social arenas.The findings will stimulate participant discussion about the therapeutic aspects of context, activity, process and relationship, and implications for studying and teaching occupation-centered practice.