Transforming values into action: Advocacy as a professional imperative.

BACKGROUND: The goal of enabling meaningful occupation for all requires occupational therapy to become a more socially and politically responsible discipline. PURPOSE: This paper argues that occupational therapy's dominant individualist perspective is too narrow to meet this goal. It presents an argument for integrating advocacy into occupational therapy identity and discusses why we should advocate at political and public levels. KEY ISSUES: Although the dominant paradigm and political climate pose challenges, there must be a realignment of the balance between helping individuals who are facing disruptions in their occupational lives and addressing systems and structures that prevent them from moving forward. Adopting a broader sociopolitical approach involves engaging in advocacy as a key strategy. Indeed, advocacy is a professional imperative for occupational therapy. IMPLICATIONS: Advocacy must become part of the process of professional socialization. A new set of competencies is needed in our educational programs and in our professional development, accompanied by a sense of self-confident idealism.

Exploring the occupations of homeless adults living with mental illnesses in Toronto.

BACKGROUND: The nature of occupational engagement for homeless people living with mental illnesses is not well understood, and there are few studies to date that examine the occupational lives of these individuals. PURPOSE: This research study seeks to understand how this group of individuals engages in occupations. The central question is "What is the nature of occupational engagement by homeless adults living with mental illnesses in Toronto?" METHOD: A constant comparative method of analysis was used in a secondary analysis of 60 interviews with homeless adults experiencing mental illness. FINDINGS: Four themes emerged that describe the nature of occupational engagement for this group: occupations as enjoyment, occupations as survival/risk, occupations as passing time, and occupations as self-management. Implications. This research informs occupational therapy interventions aimed at optimizing engagement, health, and well-being for homeless adults living with mental illnesses.

Cognitive work hardening for return to work following depression: An intervention study: Le réentraînement cognitif au travail pour favoriser le retour au travail à la suite d'une dépression : étude d'intervention.

BACKGROUND: Work absences due to depression are prevalent; however, few interventions exist to address the return-to-work challenges following a depressive episode. PURPOSE: This mixed-methods study aimed to (a) evaluate the effectiveness of cognitive work hardening in preparing people with depression to return to work and (b) identify key elements of the intervention. METHOD: A single group ( n = 21) pretest-posttest study design was used incorporating self-report measures (Work Ability Index, Multidimensional Assessment of Fatigue, Beck Depression Inventory II) with interviews at intervention completion and at 3-month follow-up. Descriptive statistics, paired-samples t test, and content analysis were used to analyze the data. FINDINGS: Work ability, fatigue, and depression severity significantly improved postintervention. Participants identified structure, work simulations, realism of simulated work environment, support, and education as key intervention elements. IMPLICATIONS: Findings underscore an occupationally focused return-to-work intervention for people recovering from depression with potential for wider adoption and future research.

Occupation-based practices and homelessness: A scoping review.

BACKGROUND: Persons experiencing or at risk of homelessness have occupational needs that are seldom addressed in the Canadian system of care. The lack of documented evidence on occupational therapy practices in this field hinders the development of the profession. PURPOSE: This article identifies current and potential practices that aim to enable or support the occupations of persons experiencing or at risk of homelessness. METHOD: A scoping review was conducted, including evidence from both occupational therapy and non-occupational therapy sources. FINDINGS: One hundred and seventy-eight papers were selected in the areas of occupational performance skills training, enrichment of occupational repertoire, employment/education, physical rehabilitation services, child/family services, community building, occupational transition from homeless to housed, literacy, and disaster relief. IMPLICATIONS: Occupational therapists can build environments and create opportunities that facilitate occupational engagement of individuals experiencing homelessness. Gaps in knowledge include the evaluation of occupational therapy practices, the Canadian context of family homelessness, and the cultural safety of occupational therapy interventions.