"Making change by shared doing": An examination of occupation in processes of social transformation in five case studies.

BACKGROUND: As social and health inequalities deepen around the world, scholarship in occupational therapy and occupational science has increasingly emphasised the role of occupation as a powerful tool in transformative processes. OBJECTIVE: To explore how opportunities for everyday doing together may contribute to processes of social transformation by identifying ways occupation is being taken up in socially-transformative practice. MATERIAL AND METHODS: A generic descriptive qualitative case study design was utilised in order to describe current practice examples and identify ways occupation was being taken up in five initiatives working towards social transformation located in Canada, Germany, South Africa and the United Kingdom. RESULTS: Focussing on the positioning of occupation within the initiatives, three themes were developed: The intentionality of the process, the nature of occupation within the initiatives, and the role of occupation within the processes of social transformation. CONCLUSIONS AND SIGNIFICANCE: Providing examples of agency on the micro level and of engagement with socioeconomic, political and cultural power structures at the societal level, this analysis raises important considerations in addressing how occupational therapy practice can move in socially responsive and transformative directions.

Occupational alienation and the mental health of university students / Alienação ocupacional e a saúde mental de estudantes universitários

Abstract Mental health, especially in the youth, has been a prevailing concern in recent years. University students are a particularly high-risk population for mental health problems. Changing perspectives in the field of mental health present the opportunity to explore this concept through an occupational justice lens - specifically that of occupational alienation. Through a brief review of relevant literature, this critical essay will explore the relationship among the concepts of alienation from both a sociology and occupational science perspective, and consider the insights that may be obtained through application of this concept to understanding the mental health of university students. The use of an occupational justice lens provides an opportunity for an alternative perspective when considering factors potentially contributing to the mental health problems in this population.

Resumo A saúde mental, especialmente na juventude, tem sido uma preocupação predominante nos últimos anos. Os estudantes universitários são uma população particularmente de alto risco para problemas de saúde mental. A mudança de perspectivas no campo da saúde mental apresenta a oportunidade de explorar esse conceito através de uma lente da justiça ocupacional - especificamente a da alienação ocupacional. Tendo por base uma breve revisão da literatura, este ensaio crítico explora a relação entre os conceitos de alienação tanto na perspectiva da sociologia quanto da ciência ocupacional, e considera as contribuições que podem ser obtidas por meio da aplicação desse conceito para entender a saúde mental de estudantes universitários. O uso de uma lente de justiça ocupacional oferece uma oportunidade para uma perspectiva alternativa ao considerar fatores potencialmente contribuintes para os problemas de saúde mental nesta população.

Collective occupation in public spaces and the construction of the social fabric: L'occupation collective dans les espaces publics et la construction du tissu social.

BACKGROUND: Contemporary research is expanding understandings of occupation beyond that of the individual's doing, including the shared and social nature of occupation. The concept of collective occupation has been introduced to capture this broader understanding. PURPOSE: This study aimed to explicate the concept of occupation in a Greek town. METHOD: Ethnographic methodology was used and primary data were collected through observation, participation, and informal interviews. Analysis involved a hermeneutic process to develop a narrative of occupation in the town, including action, setting, and plots. FINDINGS: Occupation, a dynamic and multidimensional process, served to maintain the self, family, and social fabric and balance between and within them. Collective occupation maintained the social fabric through three forms: informal daily encounters in public spaces, organization and associations, and celebration and commemoration. IMPLICATIONS: Occupational therapists may consider engaging with the potential power of such collective occupation when working toward social change to enable just and inclusive societies.

A teachable moment for the teachable moment? A prospective study to evaluate delivery of a workshop designed to increase knowledge and skills in relation to alcohol brief interventions (ABIs) amongst final year nursing and occupational therapy undergraduates.

The perceived value of Alcohol Brief Interventions as a tool to address alcohol misuse in Scotland has supported the establishment of a Health Improvement, Efficiency, Access and Treatment, HEAT: H4 Standard to deliver ABIs within certain health care settings. This requires that nursing, medical and allied health professionals are appropriately skilled to deliver these interventions. This study explores the knowledge and attitudes regarding alcohol misuse and related interventions among two cohorts of final year nursing and occupational therapy undergraduate students before, during and following participation in a workshop devoted to ABI delivery. While relatively good knowledge around recommended limits for daily consumption was evident, this did not translate into competence relating to drink unit content. Although there was overwhelming agreement for the role of each profession in ABI delivery, less than half of students in each cohort at the outset of the workshop agreed that they had the appropriate knowledge to advise patients about responsible drinking. In both cohorts, at the three month follow-up stage, this percentage had almost doubled. Newly qualified practitioners perceived a wider role for motivational interviewing, and endorsed interactive delivery of alcohol education throughout all levels of the curriculum.

Participatory citizenship: Critical perspectives on client-centred occupational therapy.

BACKGROUND/AIMS: This article aims to discuss client-centred practice, the current dominant approach within occupational therapy, in relation to participatory citizenship. Occupational therapists work within structures and policies that set boundaries on their engagement with clients, while working with complex, multidimensional social realities. METHODS: The authors present a critical discussion shaped by their research, including a survey, discussions at workshops at international conferences, and critical engagement with the literature on occupational therapy, occupation, and citizenship. CONCLUSION: A focus on citizenship suggests reframing professional development based on the participation in public life of people as citizens of their society. While occupational therapists often refer to clients in the context of communities, groups, families, and wider society, the term client-centred practice typically represents a particular view of the individual and may sometimes be too limited in application for a more systemic and societal approach. SIGNIFICANCE: The authors question the individual focus which has, until recently, been typical of client-centred occupational therapy. Placing citizenship at the core of intervention is a transformative process that assumes all people are citizens and conceives of health as a collective issue, influencing the way we educate, do research, and practise.

"Doing" social inclusion with ELSiTO: empowering learning for social inclusion through occupation.

OBJECTIVES: The European partnership ELSiTO aimed to develop understanding of the nature and processes of social inclusion for persons experiencing mental illness. PARTICIPANTS: Partners were from Belgium, Greece and The Netherlands with over 30 members including mental health service users, occupational therapists and other staff. APPROACH: A knowledge-creation learning process was used during four international, experiential, visits and local meetings, which included visiting and describing good practice, telling stories of experiences, reflection and discussion. RESULTS: The partnership developed understandings of the nature and process of social inclusion, including both subjective and objective aspects interrelated with the doing of daily activities in the community. Members' work-related experiences, illustrated through their stories, depict the subjective aspects of social inclusion as they are shaped and framed by the objective conditions within a variety of work opportunities. Experiences in paid work, supported employment and voluntary work may both threaten and enhance mental health. Features of successful (voluntary) work experiences are identified. CONCLUSIONS: The importance is revealed of looking critically at current understandings of work and to move beyond a narrow focus on paid work in order to provide a range of work opportunities that will empower the individual's potential and promote inclusive communities.