Still confused about occupation

Since the inception of our profession, occupation has confounded definition.  It’s not just a philosophical debate - the lack of clarity on the topic has hamstrung our attempts at advocating for our profession and helping it be better understood.

How can it be that after 100 years we still lack clarity and consistency in our definition and application of occupation?  

Therapists, occupational scientists and scholars have constantly puzzled over this.  As far as I can tell, there seem to be a several key reasons:

  1. Occupation is complex and defies simple description and understanding

  2. Definitions vary and there is lack of consensus

  3. The word occupation is used distinctly in OT and means something else to the general public

  4. Occupation gets confused with concepts like activity, task, skill and function

  5. Occupation is seen both as a process and a product of therapy (means and ends)

  6. Clients often don’t understand the concept of occupation, are not used to thinking occupationally and are not asking for occupation-based approaches

  7. We (as OTs) don’t understand the concept of occupation, don’t practice occupationally and don’t use occupational language enough in practice.

  8. Healthcare decision makers don’t know what we do (because we don’t communicate or advocate it clearly), resulting in OTs practising in ways that are not occupation based and cause further confusion

  9. The wider medical system is mechanistic and reductionist and influences OT (there has been a loss of the use of occupation in OT and a focus on components)

  10. We’re too eager to be gap fillers and Jack/Jills of all trades.

  11. Occupational therapy practice and research often perpetuates incorrect understandings by lumping non-OT interventions under the title of OT.

  12. The general public is not frequently exposed to OT, and when they are it is often not “true” occupational therapy

All of these factors are interrelated and resistant to change. It feels overwhelming to try and solve the problem. But it’s no good to throw up our hands and complain that no one understands us.  We have to work hard and develop a clear and consistent understanding of occupation. That way we can better apply it in practice, describe and demonstrate to others, and better communicate the value.

Wouldn’t it be nice if you didn’t get that sinking feeling in your stomach every time someone asked you to describe OT?  The only person who can change that is you.