Occupational Science: What can it do for the practice of Occupational Therapy

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Occupational Science What can it do for the
practice of Occupational Therapy?

• Zofia Kumas-Tan, OTReg(NS), MScOT Student
• Dr. Elizabeth Townsend

OT Atlantic 2003, Western Shore, Nova
Scotia September 27, 2003
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Learning objectives

• To consider two occupational therapy vignettes
  from an occupational science perspective
• To discuss the relationship between occupational
  science and occupational therapy
• To consider how occupational science can inform
  practice

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What is occupational science?
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What is occupational science?

• A basic science dedicated to the study of human
  occupation
• An interdisciplinary science
• Qualitative and quantitative research
• The term was coined by Yerxa and her colleagues
  at USC in the late 1980s

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What is occupational science?

• What are occupations? How do we conceptualize
  occupations? Why are occupations associated
  narrowly with work?
• What do various occupations mean to various
  groups of people? How do occupations compare
  amongst women and men in similar and different
  cultural groups?
• How do we learn to engage in occupations?
• How do occupations affect our lives? How do they
  affect our health and well-being?
• What determines whether occupations are valued
  economically or socially?

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Vignette 1

• Sally has a new job working with clients with
  multiple sclerosis. She is searching the library
  databases for information that will support her
  practice.
• She finds medical, occupational therapy and
  occupational science resources.

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Vignette 1

• Medical journals Botulinum toxin treatment of
  painful tonic muscle spasms in multiple
  sclerosis (Restivo et al., 2003)
• Occupational therapy journals The effectiveness
  of physical, psychological, and functional
  interventions in treating clients with multiple
  sclerosis a meta-analysis (Baker, 2001)
• Occupational science journals Storymaking and
  storytelling Making sense of living with
  multiple sclerosis (Valerie Wright-St.Clair,
  2003)

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Vignette 1

• Storymaking and storytelling Making sense of
  living with multiple sclerosis
• What is the impact of MS on self, life,
  relationships?
• storymaking and storytelling as ways of making
  sense of illness and managing its place in the
  lived world
• metaphors as a potent means to communicate
  understanding when everyday language seems
  otherwise insufficient

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Vignette 1

• symbolic interactionism women who live with
  multiple sclerosis seem to look through the eyes
  of their illness at themselves, as a way of
  making sense of how their illness is towards them
  and what they do
• multiple sclerosis as an aggressor, saviour,
  partner, guest, adversary
• On the whole, the women experienced their
  illness privately.

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Vignette 1

• Sallys new understandings
• from medical sources disease process, medical
  treatments
• from occupational therapy sources assessments,
  interventions for multiple sclerosis
• from occupational science sources the experience
  of living with and making sense of multiple
  sclerosis, the impact of multiple sclerosis on
  occupations

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Vignette 1

• How Sally might apply her new knowledge
• Encourage clients to share, describe their
  experiences of MS
• Encourage clients to use metaphor as a means of
  telling their stories
• Validate and normalize clients experiences by
  describing other peoples experiences

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Discussion

• In groups of 2 to 4, think about your clients,
  and brainstorm questions about their occupations
• WHO
• WHAT
• WHEN
• WHERE
• WHY
• (Polatajko, 2004)

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Vignette 2

• Joe works in private practice (auto insurance),
  assessing and intervening with clients injured in
  MVAs. Most of his clients are on leave from
  their jobs or have lost their jobs because of
  their injuries.
• Joe has gained a better understanding of how
  injuries affect the occupational lives and
  occupational wellbeing of workers by reading a
  recent article Workers without work Injured
  workers and wellbeing (Sharon Dale Stone, 2003)

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Vignette 2

• But Joe is still having difficulty relaying this
  information to insurance adjusters, and is unsure
  how to go about advocating for his clients.
• A few days ago, he came across another article
  Enhancing occupational opportunities in
  communities Politics Third Way and the concept
  of the Enabling State (Gail Whiteford, 2003)

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Vignette 2

• This article outlines a new political movement
  (the Third Way) and model of governance (the
  Enabling State)
• Whiteford explores whether these represent a
  model through which new occupational
  opportunities can be created in communities in a
  bottom up manner to enhance levels of
  occupational participation. She highlights
• Community led solutions
• Enabling the poor to do more
• Acknowledging space crossing boundaries

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Vignette 2

• How might Joe use these concepts to advocate for
  his clients?
• How might Joe use these concepts to shape his
  practice?

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Vignette 2

• Joe might
• invite his clients to a brainstorming session,
  drawing on the Workers without work paper to
  stimulate discussion about occupational needs,
  barriers, opportunities, etc.
• advocate for implementation of new programs or
  modification of existing ones, which clients
  identify as necessary to occupational wellbeing
• articulate the need for a new rehab/auto
  insurance approach in todays changing times
• collaborate with other occupational therapists,
  health professionals, business/financial
  analysts, academics, researchers, etc. in these
  endeavours

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Some final thoughts

• Occupational science may support occupational
  therapists in their practice by informing
  professional reasoning and evidence-based
  practice.

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• The Canadian Society
• of Occupational Scientists
• www.dal.ca/occscience

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Discussion

• Why does occupational therapy need (or not need)
  occupational science?
• Any other thoughts? comments? questions?