Joanne Valiant Cook

Opportunity, Not Prescription: An Exploratory Study of the Experience of Occupational Engagement:

Occupational therapy practice is based upon the belief that the use of occupation-as-means can promote the health and sense of well-being of individuals with disability. Despite a firm commitment to the construct of occupation by the profession, little empirical evidence has been generated which supports the basic tenets of practice. In the psychosocial literature, no studies could be located which directly investigated the use of occupation-as-means to mental health. An exploratory study was conducted with eight participants of an occupation-based, womens mental health group. In-depth interviews and participant observation were utilized to explore the meaning of occupational engagement for these women. The experience of occupational engagement is presented in the form of a conceptual model named occupational spin-off. Occupational spin-off represents conceptually the experience of occupational engagement for the participants in the research study and describes a process of occupation-as-means to mental health. The processes of affirmation, confirmation, actualization, and anticipation collectively contribute to and maintain occupational spin-off. The process of occupational spin-off contributes to an understanding of why these participants have remained out of hospital, and why they are feeling better. Implications of this process model for clinical practice and future research are suggested

I'm Doing As Much As I Can: Occupational Choices of Persons with a Severe and Persistent Mental Illness

Abstract Competitive employment is important for meeting many needs that contribute to health. For persons with a mental illness, entering or re‐entering the workforce is often an unattainable goal. Despite rehabilitation efforts, unemployment rates remain very high. This study used in‐depth, long interviews and member checking to explore what persons with a severe and persistent mental illness do in the absence of competitive employment. The study was designed to discover what supported or hindered their evolving occupational life paths. The major findings of this study were that persons with a mental illness make choices constrained by fear of relapse and socio‐economic realities, to engage in occupations that will maintain or enhance their social connections, and most importantly, their health.

Client-Centred Care Means that I am a Valued Human Being

Canadian occupational therapists have increasingly adopted a client-centred approach to practice. Interpretation of what “client-centred” means has been diverse and varied. Professionals have written about the characteristics of this approach to care but no reported studies could be found that examined the clients perspective. The omission of the client perspective is puzzling when partnership, client involvement in decision making, and client empowerment are thought to be fundamental elements of this approach to practice. A qualitative research approach, using focus groups was employed to explore the opinions and perspectives of individuals with experience of mental illness and the mental health service delivery system. Seventeen individuals participated in three focus groups to discuss the meaning of a client-centred approach to practice. Participants assessed the inadequacies of past and present practices and recommended needed changes. Their central message was the need for individuals with mental illness to be viewed as valuable human beings by service providers and by society.