Occupational Science

Society, Inclusion, Participation

Gail E. Whiteford, Clare Hocking, Gail E. Whiteford, Clare Hocking

• Publisher: Wiley-Blackwell
• Year: 2011
• ISBN:
  9781118281574
• Edition: 1
• Topic: Medizin
• Subtopic: Beschäftigungstherapie

Occupational Science: Society, Inclusion, Participation is the must have resource for occupational therapists, occupational scientists, students and researchers. The book begins with a comprehensive review of the current literature and the knowledge generated to date. Reasons for the field's limited impact are proposed, including its focus on individuals rather than groups and communities, its psychological view of occupation, and its narrow focus on socially approved occupations. Global realities such as poverty, anti-social behaviour and ageing populations are discussed and implications for action are considered.

The second section of the books comprises a series of chapters that address the philosophical, theoretical and scientific bases that underpin and inform everyday decision making in occupational therapy practice. This is followed by a section on methodological and structural considerations. The concluding chapter offers a critical reflection on methods, strategies, values and relationships for the future, to achieve a relevant science that makes a difference to current occupational realities. Written by an internationally renowned team of contributors, this book offers a truly comprehensive critique of the field.

Features
• Internationally renowned Editors and contributors
• First comprehensive text on occupational science
• Fully up to date with the latest thinking and research
• Links theory to practice

Part I

Introduction

Chapter 1

Introduction to critical perspectives in occupational science

Clare Hocking and Gail E. Whiteford

Introduction

Occupational Science: Society, Inclusion, Participation advances an emancipatory agenda in which we stress the power of occupation to address global population inequities. The agenda is informed by a suite of initiatives undertaken by local governments, non-government organizations and individual citizens working to improve the lives of vulnerable people. Such initiatives include, amongst others, those aimed at income creation for persons excluded from labour markets, developing safe environments following natural disasters, and reducing the impact of infectious diseases including AIDS, tuberculosis and malaria through community-based education programmes.

As occupational scientists, we have framed the ideas presented in this book relative to such global initiatives in explicitly occupational terms. Examples of populations with occupational needs include people excluded from education and work that would ensure their survival and provide the means to rise out of poverty, people participating in antisocial and self-destructive occupations, and those forced into degrading and life-threatening occupations (e.g., slave labour, forced prostitution). Examples of phenomena cast in occupational terms include:

Environmental degradation caused through patterns of occupational participation that are inappropriate to their specific context;

The disruption of traditional occupations in discrete communities and the corollaries of this;

The increasing burden of caregiving in communities at one end of the spectrum affected by population diseases such as HIV/AIDS, and at the other end because of increased life expectancy;

The continued occupational deprivation experienced by populations affected by natural disasters and conflicts;

The mobilization of oppressed and marginalized groups into civic action as a response to the exclusions and occupational injustices they have experienced.

Our hope, in assembling the collection of critical essays presented here, has been to stimulate the development of a more critical and reflexive science of occupation. Through the examination and illumination of the ontological biases and assumptions that currently limit our science, we challenge the reader to re-think what may be taken for granted in their own work. Such a reflexive stance enables the possibility of a more socially responsive discipline which in turn is able to make robust and relevant contributions to societal reform, inclusion and participation. To achieve this admittedly ambitious aim, we assembled a range of critical perspectives that would inspire, guide and inform knowledge development salient to an active engagement with pressing societal issues of an essentially occupational nature.

Chapter authors were invited to address the underlying societal structures and the occupational injustices that prevent inclusion and participation, from the perspective of their own practice, research and scholarship. Our hope is that their ideas set new parameters and directions for the development of occupational science into the future. With this objective in mind, the book begins with Magalhães' exposition on oppression and liberation in which she invokes the wisdom of her Brazilian mentor, Paulo Freire. Her reflection problematizes the very nature of occupational science, highlighting attendant tensions between an essential humanism and an at times positivist epistemology. Pointing to issues of language, science and power, Magalhães' interrogates the risk of accepting the reductionist and individualistic perspective of biomedical science, rather than the emancipatory and collectivist agenda that Freire advanced. Set in a real-world context that acknowledges the personal costs of activism, her lively contribution reminds us of the necessity of theorizing social action in order to understand the purposes it ultimately serves.

Understanding occupation, the second section of the book, presents an ontological grounding for the ways occupational scientists might best conceptualize people's engagement in occupation. Citing the predominance of an individualist perspective in occupational science research, even in studies that investigated group-based occupations, Cutchin and Dickie examine the limitations of a science that conceptualizes humans as individual agents responsive to their own needs and meanings. Informed by Dewey's understanding of human experience as embedded in particular situations, they firmly place human endeavours within a transactional framework that supports improvement in people's lives by reconstructing established customs and institutions. In advocating Dewey's pragmatist attitude, Cutchin and Dickie focus on three dimensions of action: habits – which restrict the participation of people living in restricted circumstances, context – which contains multiple possibilities for action, and creativity – which is required to inquire into and reconfigure habits that will enable the growth of individuals and communities for the common good. As Cutchin and Dickie emphasize, the process of engaging with the world is always a shared inquiry.

Furthering that work, Kantartzis and Molineux critique the genesis and development of occupational science. It is, they assert, predominantly anglophonic in its orientation, and thus informed by the religious, economic, political and educational ideas that have shaped the Western world. Invoking Foucault's warning that the context from which knowledge emerges has important consequences for the possibilities it might envisage, they remind us that uncritiqued understandings generally represent and reinforce individualized experiences of reality. Consequently, the assumptions about the patterns, norms and meanings of daily occupations that are familiar to people in the English-speaking world do not align with other world views and cultural constructions. Such a disjunction, they suggest, limits the relevance and expansion of occupational science in the future. Illustrating their argument, Kantartzis and Molineux draw from an ethnographic study of daily life in a small Greek village. Their work reveals a flexible interweaving of familial, social and productive occupations inconceivable in post-industrialized settings in which work as a basis of identity construction and social location is more common.

Reflecting further on the limitations of Eurocentric perceptions of the nature of occupation, Hocking picks up and extends previous critiques of occupational science as being essentially individualistic in orientation, emphasizing individual experiences of everyday occupations rather than the ways they shape and are shaped by groups and communities. Occupational scientists' narrow focus on socially sanctioned occupations and a feminized lens on occupations of significance are also critiqued as ontological perspectives that constrain the field's contribution to critical scholarship and processes of social change.

Kinsella's account of occupational scientists as an epistemic community opens the third section of the book, Ways of knowing occupation. Drawing on Kuhn's assertion that scientists make judgements about the utility of theories based on shared epistemic values, Kinsella describes how theory choice, and thus knowledge development, in occupational science is determined by perceptions of the accuracy, simplicity, scope, fruitfulness and consistency of the theories it adopts and rejects. Since individuals might make different judgements, even in relation to the same criteria, it is the shared judgement of the community that effectively decides the field's theoretical direction. These considerations are important, because such values influence the possibilities for and approaches taken to knowledge generation. On that basis, Kinsella urges the adoption of technical, practical and emancipatory knowledge paradigms and diverse criteria for knowledge claims in occupational science.

The implicit judgement behind this book is the necessity of a critical perspective on occupational science, which is the focus of Sellar's discussion. Characterizing the field's current critical stance as Marxian, he argues that theorists have pitted the natural occupational predispositions of humans against unjust societal practices and policies that alienate people from their needs. That is, occupational science has separated ‘natural laws’ (the biological needs and drives that underpin health) from human beliefs and values (which obscure what people need and give rise to injustices). Sellar argues that rather than merely extending that critique, occupational scientists should embrace understandings more suited to occupational science's perspective on human existence. In so doing, they would be freed to consider what it really means to be critical and what critical practices make possible.

One critical perspective proposed by Laliberte Rudman explores how expectations and possibilities for occupation are shaped by social and political processes. To inform her argument, Laliberte Rudman draws on both critically informed life course perspectives and governmentality theory, which draw attention to complex contextual influences on the ways in which entrée into patterns of occupational participation are made easier for dominant groups whilst excluding or marginalizing others. In addressing the ways occupation is governed, her critical analysis points to cultural, political and structural causations. While acknowledgement of the importance of context is not new, most occupational science research continues to overlook the social processes and mechanisms through which occupational injustices are created and become entrenched as taken for granted practices. Laliberte Rudman maps out a critical approach intended to open up possibilities for dialogue and action towards human flourishing.

Of course, there are also discourses which delimit human flourishing. Dennhardt, in a chapter written in partnership with Laliberte Rudman, introduces risk as such a discourse and explores it from an occupational perspective, a relatively new contribution to the occupational science literature. How occupational scientists frame risk and relate it to occupation will inform possible actions and solutions in relation to occupations deemed as high risk and with respect to at-risk populations. As Dennhardt and Laliberte argue, however, risk is connected to power, in that defining risk pre-empts the responses viewed as rational and possible. Risk, they argue, is alternately framed as an objective hazard that can be quantified, predicted and controlled by rational agents acting on expert advice, or as unanticipated, uncontrollable and socially constructed, albeit with real impacts on individuals and society. Given the pervasive nature and impacts of the risk discourse, and the hegemonic practice that often accompanies it, an occupational science research agenda in this area seems requisite.

Following on from these discussions of the nature of occupation and the perspectives from which it might be viewed, the fourth section of the book addresses more practical concerns; Ways of doing in occupational science. The first consideration in endeavouring to understand the complexity of vulnerable people's occupations and occupational needs, and the occupational justice issues affecting people internationally, is the choice of research methodology. As Wright-St. Clair argues, how we might come to know occupation in its fullness and determining how human occupation ought to be measured are challenging questions. Underpinning those questions are considerations of the meaning of being a science, what counts as occupational science research, and whether the field is best served by unconstrained organic growth or more focused exploration of pressing social questions. Espousing the value of multiple research methodologies to address different kinds of research questions, Wright-St. Clair also points out that science encompasses the development and application of theory and identification of phenomena of interest.

One phenomenon of interest, in relation to equity of access and occupational justice, is the occupational choices people perceive as being open to them. Galvaan's study, which involved young adolescents in a marginalized community in Cape Town, South Africa, employed critical ethnographic methods of inquiry. Against the backdrop of forced relocation into racially segregated communities in the 1970s, that are now characterized by poverty, unemployment, overcrowding, violenc...