Convergence of Occupational Science and Occupational Therapy: Updates on OTJR's Occupational Science Section.

Established in 2019, OTJR's Occupational Science Section provides a dedicated venue for showcasing empirical occupational science research and fostering translation of that research into occupational therapy practices. In this invited commentary, the first and second Associate Editors of the Occupational Science Section reflect on its early growth, connecting the foci of the Occupational Science Section to topics discussed at selected occupational science and occupational therapy conferences in 2022. The commentary concludes with a discussion of future possibilities for the Occupational Science Section as it moves forward.

Occupational Therapists as Street-Level Bureaucrats: Leveraging the Political Nature of Everyday Practice.

BACKGROUND.: As front-line service providers who often work in systems regulated by governmental bodies, occupational therapists can be conceptualized as "street-level bureaucrats" ( Lipsky, 1980/2010 ) who effect and are affected by policy. PURPOSE.: Drawing on understandings from a study of long-term unemployment, this article proposes that occupational therapists, as street-level bureaucrats, respond to inter-related policies and systems in ways that can perpetuate, resist, or transform opportunities for doing and being. KEY ISSUES.: By highlighting practitioners' everyday negotiation of governmental, organizational, and professional power relations, the notion of street-level bureaucracy illuminates the political nature of practice as well as the possibilities and boundaries that policy can place on ideal forms and outcomes of practice. IMPLICATIONS.: Framing occupational therapists as street-level bureaucrats reinforces practitioners' situatedness as political actors. Mobilizing this framing can enhance awareness of occupational therapists' exercise of discretion, which can be investigated as a basis for occupation-focused and emancipatory forms of practice.

Using Occupational Justice as a Linchpin of International Educational Collaborations.

When designing international educational collaborations, occupational science and occupational therapy educators must consider how occupational justice can be a linchpin for students' learning. This article describes an international collaboration involving 52 undergraduate occupational science students in the United States and 41 undergraduate occupational therapy students in South Africa. The students participated in six synchronous video conferences in 2016, during which they gave group presentations about four occupational science constructs and engaged in general question-and-answer sessions. Forty percent of the students provided feedback about the interactions using a six-item open-ended electronic questionnaire, which we analyzed using directed content analysis. Our findings suggest that the collaboration helped the students develop more nuanced understandings of disciplinary constructs, international peers, and themselves, providing a platform from which to engage with the big idea of occupational justice. Refinements to this collaboration are aimed at drawing on students' increased critical consciousness to further develop their knowledge about occupational justice.

Expanding beyond individualism: Engaging critical perspectives on occupation.

BACKGROUND: Perspectives that individualize occupation are poorly aligned with socially responsive and transformative occupation-focused research, education, and practice. Their predominant use in occupational therapy risks the perpetuation, rather than resolution, of occupational inequities. AIM: In this paper, we problematize taken-for-granted individualistic analyses of occupation and illustrate how critical theoretical perspectives can reveal the ways in which structural factors beyond an individual's immediate control and environment shape occupational possibilities and occupational engagement. METHOD: Using a critically reflexive approach, we draw on three distinct qualitative research studies to examine the potential of critical theorizing for expanding beyond a reliance on individualistic analyses and practices. RESULTS: Our studies highlight the importance of addressing the socio-historical and political contexts of occupation and demonstrate the contribution of critical perspectives to socially responsive occupational therapy. CONCLUSION AND SIGNIFICANCE: In expanding beyond individualistic analyses of occupation, critical perspectives advance research and practices towards addressing socio-political mediators of occupational engagement and equity.

Precarity in the Nonprofit Employment Services Sector.

Drawing on interview and focus group data, this article explores research undertaken as part of a larger research project exploring precarity in the nonprofit employment services sector in a mid-sized Canadian city. We critically survey major legislative changes to Canadian employment and income security policies and programs, including the restructuring of work and labor relations, growth of performance-based contracting-out, erosion of intergovernmental transfers, worker stress, and emotional tolls. Our study's results demonstrate how employment precarity in the nonprofit employment services sector is amplified by top-down and centralized relationships with funding partners and policymaking divorced from the employment experiences of frontline staff. We make the case that it is important to work against rising workplace precarity to strengthen organizational and workplace conditions, as well as build environments more supportive of optimal employment support services. En se fondant sur des entretiens et des données découlant de groupes témoins, cet article présente des explorations entreprises dans une recherche plus large étudiant la précarité dans le secteur des emplois de service dans une ville canadienne de taille moyenne. Nous faisons une revue critique de changements importants intervenus dans la législation portant sur l'emploi au Canada et les politiques et programmes de la sécurité du revenu, incluant la restructuration du travail et des relations de travail, l'augmentation de la privatisation se fondant sur la performance, la diminution des transferts intergouvernementaux, le stress au travail et les conséquences émotionnelles. Les résultats de notre recherche démontrent comment la précarité de l'emploi dans les secteurs des services à but non lucratif est amplifiée par des relations allant du haut vers le bas et centralisée avec des partenaires et des politiques séparés de l'expérience des travailleurs sur le terrain. Nous démontrons qu'il est important de travailler contre la précarisation en renforçant les conditions organisationnelles et de travail, tout en construisant des environnements favorisant une offre de services de l'emploi optimaux.

International Educational Interactions and Students' Critical Consciousness: A Pilot Study.

Online technologies facilitate connections between students around the world, but their impact on occupational science and occupational therapy students' critical consciousness about culture is underexplored. In this article we present research on five groups of occupational science and occupational therapy students across two cohorts at one Midwestern university. We used a pretest-posttest group design and the Multicultural Experiences Questionnaire to investigate the potential influence of students' exposure to international educational interactions on their multicultural experiences and desires. Of 157 students surveyed, those who experienced the greatest number of international educational interactions demonstrated statistically significant increases in their desire to become acquainted with other people of different backgrounds and to explore their own prejudices and biases. Given the transformative potential of international educational interactions, future research must assess the ways in which such interactions affect critical cultural consciousness apart from other educational content and design.

Resource Seeking as Occupation: A Critical and Empirical Exploration.

Occupational therapists and occupational scientists are committed to generating and using knowledge about occupation, but Western middle-class social norms regarding particular ways of doing have limited explorations of survival occupations. This article provides empirical evidence of the ways in which resource seeking constitutes an occupational response to situations of uncertain survival. Resource seeking includes a range of activities outside formal employment that aim to meet basic needs. On the basis of findings from 2 ethnographic studies, we critique the presumption of survival in guiding occupational therapy documents and the accompanying failure to recognize occupations that seem at odds with self-sufficiency. We argue that failing to name resource seeking in occupational therapy documents risks alignment with social, political, and economic trends that foster occupational injustices. If occupational therapists truly aim to meet society's occupational needs, they must ensure that professional documents and discourses reflect the experiences of all people in society.

Justice and U.S. Occupational Therapy Practice: A Relationship 100 Years in the Making.

At 99 years old, occupational therapy is a global health care profession with a growing orientation toward justice. Because much of the occupational justice discourse has developed outside the United States, parallels between the profession's ethos and its current focus on justice must be examined more closely in this country. Although occupational therapy practitioners in the United States are better equipped than their predecessors with language and theories that explicitly emphasize justice, the potential for bringing that focus to bear depends on practitioners' willingness to think differently about their practices. We argue that a focus on justice can be naturally integrated with curriculum standards by emphasizing the link between cultural humility, client-centeredness, and embodied habits of "seeking out unknown others." Outside formal education, practitioners can be encouraged to think of justice as something that already intersects with practice, not something that practitioners must choose whether to take up.

Translating Occupational Justice Education Into Action: Reflections From an Exploratory Single Case Study.

There is a growing body of scholarly literature about occupational justice, human rights, and power redistribution ready to be integrated into occupational science and occupational therapy education. As students around the world become familiar with the concepts and intents underlying occupational justice, it will be important to investigate their translation of occupational justice understandings into actions outside the classroom. This exploratory single case study describes curricular, university, and regional factors related to one former student's engagement in social protests following her occupational justice education. Based on her reflections, we emphasize the need to provide classroom opportunities where students can apply and critically reflect on (a) knowledge about occupational justice and (b) unintended consequences and potential professional tensions that may arise in relation to pursuing occupational justice. Future research will benefit from broader comparative studies that analyze personal, contextual, and programmatic differences among instances of occupational justice education and students' engagement in occupational reconstructions.

U.S. and Swedish Student Learning Through Online Synchronous International Interactions.

There is a continued need to communicate global perspectives in occupational therapy education, but the literature addressing how to incorporate firsthand global experiences into campus learning environments is scant. This article describes how course-based synchronous interactions between U.S. undergraduate occupational science students and Swedish undergraduate occupational therapy students occur via online technology. In a 2014 pilot study, we thematically analyzed students' open-ended survey responses to discern what students learned through the interactive sessions. We also performed a content analysis of four audio-recorded interactive sessions to understand the content and nature of students' learning. Our findings suggest that course-based online synchronous interactions provide a positive way for students to learn about other cultures and global differences in occupational therapy practice. The findings also highlight needs for improvement relative to the structure and aims of the interactive sessions. We relate these findings to the global availability of technology and occupational therapists' cultural competence.

Developing occupational therapy students' practice habits via qualitative inquiry education.

BACKGROUND: Accreditation standards and practice competencies underscore the importance of research for occupational therapy practice, but they do not guide how occupational therapy education addresses research. Despite the prominence of qualitative research in the health professions, there exists a need to articulate how and why qualitative inquiry is taught in occupational therapy education. PURPOSE: We discuss how qualitative inquiry education can develop habits of reflection and reflexivity, criticality, and active engagement in preparation for occupational therapy practice. KEY ISSUES: We hold that our students' professional abilities to practice in a well-reasoned, ethical, and responsive manner are enhanced by experiences with qualitative inquiry and suggest that there is potential in linking qualitative inquiry experiences to professional habit formation in occupational therapy education. IMPLICATIONS: In addition to teaching research for its own sake, we suggest that educators can adopt a broader view of how qualitative inquiry functions within occupational therapy education.

Empirical lessons about occupational categorization from case studies of unemployment.

BACKGROUND: Scrutiny regarding the typological categorization of occupation (e.g., occupation as work, rest, or leisure) has prompted interest in experiential categories as a less exclusionary alternative. Empirical research can extend the dialogue about categorization by demonstrating how people in particular situations apply and generate occupational categories. PURPOSE: This article explores how adults without work utilized typological and experiential categorizations when discussing their occupations. METHOD: Data were generated via a secondary analysis of interview transcripts from three ethnographic case studies. FINDINGS: Study consultants gravitated toward experiential rather than typological categorizations, emphasizing the social, chosen, purposeful, and temporal qualities of their occupational engagement. IMPLICATIONS: Occupational therapy practitioners and researchers must explicitly state how and why they categorize occupations with clients and research participants. Whereas typological categories can be used to initiate discussions about occupation, open questions paired with consultant-generated experiential categories may better capture occupational engagement and reveal potential injustices in situations like unemployment

"It's hard to plan your day when you have no money": discouraged workers' occupational possibilities and the need to reconceptualize routine.

OBJECTIVE: This paper presents daily routine as a justice-related concern for unemployed people, based on an ethnographic study of discouraged workers. PARTICIPANTS: Four women and one man who wanted to work but had ceased searching for jobs, and 25 community members whose jobs served the unemployed community, participated in the study. METHODS: Ethnographic methodology--including participant observation, semi-structured and unstructured interviews, and document reviews--and the Occupational Questionnaire were used to gather data for 10 months in a rural North Carolina town. Data analysis included open and focused coding via the Atlas.ti software as well as participant review of findings and writings. RESULTS: Routines need to be seen as negotiated, resource-driven products of experience rather than automatic structures for daily living. Scholars and practitioners must acknowledge that the presence or absence of routine not only relates to resource use but also influences unemployed people's occupational possibilities. CONCLUSIONS: To address unjust expectations about unemployed people's occupational possibilities, scholars must examine the uncertain, negotiated nature of daily routine and its function as a foundation for occupational engagement. Thus, it may be helpful to view routine as both a prerequisite of occupation and a way that existing occupations are organized.

A review and critique of well-being in occupational therapy and occupational science.

Scholars in occupational therapy and occupational science often reference well-being when discussing treatment goals or occupational engagement, but the various meanings of this reference remain unexamined in current literature. This paper reports the results of a literature review of five journals and five monographs in the occupational therapy and occupational science literature. The purpose of this review was to understand and critique how scholars in the profession and the discipline conceptualize well-being, guided by broader philosophical perspectives on the subject. The review revealed inconsistent definitions and uses of "well-being" throughout the literature, illuminating the need to reconsider this concept's purpose within the profession and the discipline. Based on these results and building on current theoretical trends, the author advocates a more nuanced and considered use of well-being that acknowledges the uncertainty faced by occupational therapists, occupational scientists, and the people with whom they practice or research.

Moving to a continuing care retirement community: occupations in the therapeutic landscape process.

The process of transitioning into, and living in, a retirement community can be usefully examined with the concept of 'therapeutic landscapes.' While underutilized in anthropology and gerontology, the concept offers a combination of geographical and cultural views on the place and well-being relationship. The inclusion of an occupational science perspective, wherein occupations (or everyday activities of meaning) are seen as a crucial part of the person-place relationship, should enhance the therapeutic landscape perspective of older persons and their retirement communities. We present a case study analysis that attempts to combine these perspectives and examine the role of occupation in the lives of older people who moved to a Continuing Care Retirement Community (CCRC). 116 movers completed pre- and post-move questionnaires about their levels of engagement in 20 activities. Frequency distributions, paired t-tests, and logistic regression analyses performed on the data indicate that while overall levels of activity did not change from pre- to post-move, patterns of engagement did change in the course of the move to the CCRC. Some social and cultural activities (e.g., parties, concerts, movies, meetings) increased in frequency, and some maintenance chores (e.g., grocery shopping, housekeeping) and communication (email) decreased in frequency. Moreover, total activity engagement after the move was associated with residential satisfaction in the CCRC. Even with their limitations, the data and analytical findings suggest that occupations are an important part of the CCRC therapeutic landscape process.