British Journal of Occupational T

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					Current examples of Occupational Science topics from Europe:


Scientific Journals:

British Journal of Occupational Therapy (BJOT)


Mee, J., & Sumsion, T. (2001). Mental health clients confirm the motivating power of occupation.
         British Journal of Occupational Therapy, 64(3), 121-128.
         Most occupational therapists, like the founders of the profession, believe that engagement in meaningful
         occupation is fundamental in helping to overcome the effects of disability. This paper describes the
         method and one of the resulting themes of a study that investigated the value, related to personal
         meaning, of occupation from the perspective of people with enduring mental health problems.

Wikstrom, I., Isacsson, A., & Jacobsson, T. H. (2001). Leisure activities in rheumatoid arthritis: change after
       disease onset and associated factors.
       British Journal of Occupational Therapy, 64(2), 87-92.
       The objective of this investigation was to examine the relationship between leisure-time occupations,
       quality of life and disease activity among patients with rheumatoid arthritis. Fifty patients with
       rheumatoid arthritis - 39 females and 11 males, aged 30-45 years and belonging to functional class I-III
       according to Steinbrocker et al (1949)--were recruited from the register at a hospital clinic and from a
       private outpatient clinic. The participants completed a questionnaire concerning education, occupation,
       pain, morning stiffness, current leisure activities and those pursued before the onset of the disease, and
       including the Quality of Life Scale (QoLS).


Blair, S. E. E. (2000). The centrality of occupation during life transitions.
          British Journal of Occupational Therapy, 63(5), 231-237.
          This article seeks to examine the nature and experience of transitions in life. It explores pertinent
          theoretical underpinning and considers the ways in which people manage and adapt to change. In
          particular, it attempts to synthesise the ideas from the psychology of transition with those from
          occupational science. Throughout, the article is informed by the contributions both from experiential
          workshops over the last 5 years (including one held at the Inaugural United Kingdom Occupational
          Science Symposium in York in 1999) and from students who have chosen an elective level 3 module
          entitled 'Adult Development Life Transitions and Crisis' in a BSc/BSc(Hons) Occupational Therapy
          programme. Among the conclusions from those experiences is the acknowledgement of the centrality
          and personal meaning of occupation at the point of transition.

Evans, R. (2000). The effect of electrically powered indoor/outdoor wheelchairs on occupation: a study of users'
        British Journal of Occupational Therapy, 63(11), 547-553.
        In 1996, the Government provided an allocation of money for National Health Service wheelchair
        services to issue severely disabled people with electrically powered indoor/outdoor wheelchairs
        (EPIOCs). This funding was for 4 years only (NHS Executive 1996). Although further money for
         EPIOCs has been announced (NHS Executive and Department of Health 2000), it has not been ring
         fenced and could therefore be used in other ways. Evidence needs to be gathered in order to justify
         continued spending on EPIOC provision.

Fieldhouse, J. (2000). Occupational science and community mental health: using occupational risk factors as a
        framework for exploring chronicity.
        British Journal of Occupational Therapy, 63(5), 211-217.
        This article offers an overview of Wilcock's theories, from the field of occupational science, and relates
        them to the community care of people with severe mental health problems. Wilcock's occupational risk
        factors - imbalance, deprivation and alienation - are described and are seen to be reinforced both by the
        adaptive nature of this client group's problems and by the difficulties experienced by community-based
        services as they evolve to address the unfolding complexity of clients' needs. The potential for
        chronicity to be compounded and deepened in this way is highlighted, with particular reference to
        vocational and social disability, and the possible implications of a wider acknowledgement of
        occupational risk factors are discussed in relation to day-to-day practice and service configuration.

Fortune, T. (2000). Occupational therapists: is our therapy truly occupational or are we merely filling gaps?
         British Journal of Occupational Therapy, 63(5), 225-230.
         This article is concerned with role identity and its relationship to the professional thinking and action of
         occupational therapists. In this informed viewpoint, the notion that occupational therapists could be
         perceived as gap fillers is explored, based on empirical data that focused on the roles adopted and the
         guiding philosophies enacted by occupational therapists working in child and adolescent mental health.
         Following the presentation of interview data from four occupational therapists, two cogent issues are
         presented and discussed. The first issue posits that a failure to ground practice in occupational
         philosophies contributes to perpetuating an incoherent role identity. The second issue discusses whether
         the recovery of an occupational paradigm in practice can liberate occupational therapists from role
         incoherence and enable them to reclaim their identity as therapists of occupation.

Godfrey, A. (2000). Policy changes in the National Health Service: implications and opportunities for
        occupational therapists.
        British Journal of Occupational Therapy, 63(5), 218-224.
        Recent changes in the philosophy and structure of the National Health Service give greater emphasis to
        the prevention of ill health within locally defined communities. Occupational therapists, by virtue of
        their unique philosophy, have an opportunity to influence primary care strategy and practice by
        highlighting the links between environment, occupation and health. The recent changes in the structure
        of the National Health Service are described and the philosophy of occupational therapy is discussed in
        relation to these changes. This description provides the basis for recommendations as to how
        occupational therapists can work to build a recognition of the fundamental importance of adaptive
        occupation to individual health and, hence, to health at a community and population level. Working at a
        community and population level will require occupational therapists to strengthen links with health
        promotion and public health in order to help promote health through meaningful occupations within
        local settings.

Green, S., & Cooper, B. A. (2000). Occupation as a quality of life constituent: a nursing home perspective.
        British Journal of Occupational Therapy, 63(1), 17-24.
        Occupational therapy, with its core belief in the occupational needs of individuals, facilitates
        independent and meaningful activity. When clients become elderly, frail and subject to multiple
        pathology, they may need the care of a nursing home. Here, through the lack of use of residual abilities,
        a spiral of decline in occupational performance can occur. To increase knowledge of the factors that
        contribute most to enabling occupational performance in nursing home settings, a study was carried out
        in the north-west of England (n=20). Semi-structured interviews were conducted with the matrons to
        determine the philosophy of care, the daily routines and the approach to activity provision for residents.
        The data were analysed using a person/environment/occupation framework. The results indicated that
        the level of function of the residents greatly influenced the amount and types of activity offered. The
        matron's role was, found to be crucial in recognising the therapeutic value of non-traditional activities
        and in maximising the use of staff and resources to enhance quality of life for the residents. Flexibility
        and a creative use of resources were found to have a greater positive influence on the quality of life of
        severely disabled residents than official policy. In these settings, the role of the occupational therapist
        moves from hands-on provider to consultant, primarily to the matron.
         Ilott, I., & Mounter, C. (2000). Occupational science: an impossible dream or an agenda for action?
         British Journal of Occupational Therapy, 63(5), 238-240

Kingsley, P., & Molineux, M. (2000). True to our philosophy?Sexual orientation and occupation'.
        British Journal of Occupational Therapy, 63(5), 205-210

Molineux, M. (2000). Another step in the right direction.
       British Journal of Occupational Therapy, 63(5), 191

Whiteford, G. (2000). Occupational deprivation: global challenge in the new millennium.
        British Journal of Occupational Therapy, 63(5), 200-204.
        Occupational deprivation is a relatively new term which describes a state in which people are precluded
        from opportunities to engage in occupations of meaning due to factors outside their control. As we face
        the new millennium, it seems likely that, due to widespread social and economic change as well as
        increasing civil unrest, occupational deprivation will be experienced by increasing numbers of people
        globally. This article describes the conceptual origins of occupational deprivation, presents definitions
        of the term and discusses specific populations that may be vulnerable to being occupationally deprived.
        Global, contextual issues of economic reform and technological advances are addressed with specific
        reference to these populations. Finally, consideration is given as to how an understanding of
        occupational deprivation is of relevance to occupational therapy and its concern with social and
        occupational justice.

Williamson, P. (2000). Football and tin cans: a model of identity formation based on sexual orientation
        expressed through engagement in occupations.
        British Journal of Occupational Therapy, 63(9), 432-439.
        Occupational therapy is grounded in the use of purposeful activity. Current practice standards insist that
        such activity be meaningful for the participant. What makes an activity meaningful is a combination of
        an individual's identity, life experiences, intrinsic characteristics and the physical, social and cultural
        environments in which the person finds himself or herself. Sexuality is one of the frameworks that
        provide scaffolding for identity formation, developed alongside and because of engagement in
        occupations. This paper presents a six-stage model, developed by a psychologist in Australia, of identity
        formation based on sexual orientation. This model is illustrated using the oral history of a gay man. The
        influence of occupation at crucial moments in the developmental stages for this individual is illustrated.
        The meaning of this model for occupational therapy practice, education and theory is discussed.

Yerxa, E. J. (2000). Confessions of an occupational therapist who became a detective.
        British Journal of Occupational Therapy, 63(5), 192-199.
        This life history of an occupational therapist traces her evolution from a biomedical technician to a
        'detective', who searches for new ideas that will support clinical practice and enable the profession to
        achieve its potential contribution to humankind. These ideas focus on 'homo occupacio', the
        occupational human: an agent who sets goals, makes choices and becomes competent through
        engagement in occupation. Concepts such as motivation, self-organisation, skill development, resource
        reclamation, brain evolution, repertoires of daily routines, environmental management and defining
        health as the capacity to achieve one's valued goals illuminate occupation. The contexts in which people
        carry out their rounds of occupation also require study in order for occupational therapists to pose a 'just
        right' level of environmental challenge, enabling people to make an adaptive response in user-friendly
        environments. Recommended sources for new ideas are, first, self-reports of people who live with
        impairments and, second, literature from non-medical disciplines that share occupational therapy's
        holistic, integrated and optimistic view of people. The writings of people who live with chronic
        conditions reveal that they are not being served well by the current biomedical system. In contrast,
        scholarly detective work could foster occupational therapy that enhances satisfaction in daily living,
        influences health, reclaims resources and enables equality of capability for myriads of the world's
        populations. A keynote address, given on 8 September 1999 at the Inaugural United Kingdom
        Occupational Science Symposium, held at the College of Ripon and York St John, York.

Chard, G. (1999). Sharing a vision of occupation.
        British Journal of Occupational Therapy, 62(10), 443

Wilcock, A. A. (1999). The Doris Sym Memorial Lecture: developing a philosophy of occupation for health.
        British Journal of Occupational Therapy, 62(5), 192-198.
        The Third Caledonian Health Lecture, held on 3 March 1999, was dedicated to the memory of Doris
        Sym, MBE, Fellow of Glasgow Caledonian University, and founder and first Principal of the Glasgow
        School of Occupational Therapy. Professor Gordon Dickson, Dean of the Faculty of Health at Glasgow
        Caledonian University, hosted the event, which was attended by a wide range of people including
        Doris's family, friends, ex-colleagues, practising occupational therapists, retired occupational therapists
        and academics from other disciplines within the Faculty of Health. In 1997, the year of the diamond
        jubilee of occupational therapy education in Scotland, I had the honour of presenting Doris Sym for the
        award of honorary fellow of Glasgow Caledonian University. Resplendent in her academic robes, Doris
        gave a feisty speech recalling the challenges involved in setting up a new educational establishment and
        looking forward to her future participation in University events. Her death early in 1998 came as a
        shock to us all. The University was pleased and honoured to welcome Dr Ann Wilcock, founding editor
        of the Journal of Occupational Science: Australia and historian of the College of Occupational
        Therapists, to give her lecture--'Developing a philosophy of occupation for health'--in memory of a
        pioneer and visionary woman who led the development of her profession and established the school
        teaching it in the West of Scotland. Ann Carnduff, Head, Division of Occupational Therapy, Glasgow
        Caledonian University.


Brewer, P. (1998). Efficacy and the self.
        British Journal of Occupational Therapy, 61(5), 198-202.
        Psychoanalytic theory concerning efficacy is reviewed from a historical perspective together with the
        work of the more recent writers, Daniel Stern and Joseph Lichtenberg. The contribution of the early
        caregiver and the impact of upbringing on the experience of efficacy is considered. Some
        psychoanalytic ideas are applied to the practice of activity-based therapy.

Crabtree, J. L. (1998). Occupational therapy: building skills or transforming selves?
         British Journal of Occupational Therapy, 61(11), 504-508.
         This paper addresses the claim that there is increasing disparity between the profession's philosophical
         beliefs and core concepts and its clinical practice and research. The author of this claim, Mocellin,
         maintained that occupational therapy's assumptions about occupation are false and have serious
         consequences for the profession. He proposed that 'occupation' be replaced with 'teaching skills' as the
         focus of intervention. To address his criticism and solution, this paper critiques what its author
         understands to be Mocellin's assumptions about competence and teaching/learning skills and offers
         reasons why his underlying assumptions of the competence model do not work. These are that the
         competence model limits therapists' and patients' resources to available skills; it neglects the spiritual
         elements of humans; it neglects the rich and influential context of the therapeutic situation; and,
         contrary to Mocellin's assertions, the founders of occupational therapy placed no special value on
         competence over occupation. Further, it is proposed that meaning making is the essential nature of
         human beings and that meaning making through occupation describes a more viable model of the ideal
         human condition. To support this thesis, a concise definition of occupation is offered and the
         therapeutic use of occupation, based on this definition, is contrasted with Mocellin's notions of
         teaching/learning skills.

Golledge, J. (1998). Distinguishing between occupation, purposeful activity and activity, part 2: why is the
        distinction important?
        British Journal of Occupational Therapy, 61(4), 157-160.
        Part 2 of this article stresses the importance of noting the distinctions between the terms occupation,
        purposeful activity and activity. Both occupational therapists and occupational therapy students need to
         be able to articulate to others exactly what they do in their individual work settings. This includes
         acknowledging both shared core skills and unique core occupational therapy skills. It is important that
         occupational therapists employ these unique core skills in their day-to-day work to highlight their
         distinction from other health care professionals, who may legitimately use activity within their own
         interventions. Additionally, if purchasers are negotiating contracts for services from multidisciplinary
         teams, they need to be able to discern the differences between the input of the different health care
         professionals. In light of this, current political influences within health care and professional concerns
         are briefly explored.

Golledge, J. (1998). Distinguishing between occupation, purposeful activity and activity, part 1: review and
        British Journal of Occupational Therapy, 61(3), 100-105.
        Part 1 of this article explores how occupational therapists use the terms occupation, purposeful activity
        and activity. A literature review of the topic is presented, followed by a personal reflection and
        definition. It is hoped that this will provide an illustrative example of how the terms could be used and
        may assist occupational therapy students and occupational therapists to appreciate the potential
        differences. It is suggested that the terms occupation and purposeful activity should be used to reflect
        more accurately what occupational therapists do in their professional practice.

Lambert, R. (1998). Occupation and lifestyle: implications for mental health practice.
        British Journal of Occupational Therapy, 61(5), 193-197.
        Occupation is central to the concept of occupational therapy. However, the definition and use of the
        term occupation have been through many stages. This paper considers some of these stages. It then
        discusses the role of lifestyle and the emergence of what has become known as lifestyle medicine.
        Lifestyle is an important area for occupational therapy to explore because it influences both the
        individual's perception and his or her experience of health. The suggestion is made that lifestyle
        provides both occupational form and occupational performance. Occupational synthesis can be
        achieved through the use of a therapeutic intervention promoting lifestyle change. Research evidence is
        presented relating to two specific lifestyle factors, caffeine and general fluid intake, examining their
        potential effect on mental health. Case studies demonstrate how a lifestyle approach can provide a
        beneficial early intervention strategy. The discussion resulting from the case studies illustrates how the
        approach can be used in a number of different ways to influence the outcome of therapeutic
        interventions positively.

Richards, S. E. (1998). The Casson Memorial Lecture 1998: occupation for health -- and wealth?
        British Journal of Occupational Therapy, 61(7), 294-300

Wilcock, A. A. (1998). Occupation for health.
        British Journal of Occupational Therapy, 61(8), 340-345

Yeoman, S. (1998). Occupation and disability: a role for occupational therapists in developing countries.
       British Journal of Occupational Therapy, 61(11), 523-527.
       Disability issues are rarely priorities for action in developing countries. Prejudicial attitudes against
       disabled people among the wider community are common and opportunities for empowerment are few.
       As a result, disabled people are frequently marginalised within their communities and have limited
       access to education and employment. Farming is a basic means of livelihood for many people in
       developing countries and for disabled people, unlikely to be able to secure other employment, farming
       is of particular relevance. Yet disabled people are often excluded from opportunities to develop farming
       skills, resulting in further disadvantage and reinforcing the notion of dependence on others. A
       qualitative study was carried out in the Brong Ahafo Region of Ghana in 1996 to examine the position
       of disabled people in local society, particularly in relation to the range of occupations available to them.
       The research highlighted a number of pressing needs for disabled people in Ghana. Analysis of these
       needs showed that, through application of basic occupational therapy philosophy and skills,
       occupational therapists have a unique contribution to make in improving the quality of life of disabled
       people in developing countries.

Finlayson, M., & Edwards, J. (1997). Evolving health environments and occupational therapy: definitions,
descriptions and opportunities.
         British Journal of Occupational Therapy, 60(10), 456-460.
         Over the past 20 years, the world has seen a slow but steady shift in thinking about illness and wellness
         and about what constitutes health and health care. Concepts such as primary health care, disease and
         injury prevention, disability postponement, health promotion and population health are the focal points
         of this shift. In order to contribute in this evolving health environment, occupational therapists need to
         understand this terminology and make the link between these concepts and their philosophy and skills
         in enabling health through occupation. To contribute to this understanding, the objectives of this paper
         are to review the history of occupational therapy as it relates to recent shifts in thinking about health
         and health care, to define and describe briefly the relevant health and health care terms and concepts,
         and to illustrate the existing and potential links between the practice of occupational therapy and these
         health and health care concepts.

Paterson, C. F. (1997). Rationales for the use of occupation in 19th century asylums.
          British Journal of Occupational Therapy, 60(4), 179-183.
         The use of occupation was a key aspect of moral treatment, the reformed management of the "mad" in
         the late 18th and 19th centuries. Physicians observed that the lack of occupation exacerbated symptoms,
         and held the philosophical and religious beliefs that occupation was intrinsically good and that patients
         should be encouraged to become useful members of society. They propounded that occupation could
         divert or provide respite from the patients' delusional or painful thoughts; could counteract symptoms
         by stimulating the withdrawn, calming the excited and channelling the activity of the obsessive; could
         be used to strengthen underdeveloped mental faculties or improve existing ones; and, finally, could
         provide bodily exercise which induced tranquil and refreshing sleep. Some American authors have
         already explored the links between moral treatment and occupational therapy. This article attempts to
         identify the rationales for occupation in a British context.


Kaur, D., Seager, M., & Orrell, M. (1996). Occupation or therapy? The attitudes of mental health professionals.
         British Journal of Occupational Therapy, 59(7), 319-322.
         A questionnaire study of mental health staff on a psychiatric unit investigated their views about
         occupational therapy. The study evaluated the attitudes to the role of the occupational therapist, the
         referral and assessment process, the importance of therapeutic activities, and communication and
         feedback between occupational therapists and other disciplines. Sixty-four out of 89 staff responded
         (72%). Most respondents thought that occupational therapy should start within a week of admission,
         even through many referrals took much longer than this to arrive. There was some confusion over who
         was responsible for getting the patient to attend occupational therapy. Although occupational therapy
         was felt to increase people's confidence, some staff suggested that patients should not attend until they
         had gained confidence. There was uncertainty about who should decide on a patient's suitability for
         occupational therapy. In addition, there was a blurring of roles between occupational therapists and
         other disciplines. Many staff were well able to recognise the main functions of occupational therapy.
         However, they were not confident about this and did not fully apply this knowledge in their clinical
         practice. Occupational therapists were generally seen in a positive light. This study emphasises the
         importance of better communication between occupational therapists and the other professions and, in
         particular, the need to raise the profile of occupational therapy within local teaching programmes.

Breines, E. B. (1995). Understanding "occupation" as the founders did.
         British Journal of Occupational Therapy, 58(11), 458-460.
         The term "occupation" is both ambiguous and encompassing. This term was adopted by the founders of
         the profession as a means of incorporating a variety of perspectives on the profession. Interrelating
         concepts deriving from pragmatism and the mental hygiene movement offer a rationale for
         understanding occupation. Terms used to describe occupation are egocentricity (mind/body elements),
         exocentricity (time/space elements) and consensuality (social elements). The integration of these
         aspects in occupation offers an explanation for the holism advanced by the profession at its outset and

Webber, G. (1995). Gentle teaching, human occupation and social role valorisation.
        British Journal of Occupational Therapy, 58(6), 261-263