Lisette Farias

A Critical Interpretive Synthesis of the Uptake of Critical Perspectives in Occupational Science

An emancipatory agenda is emerging within occupational science, building on the work of scholars who have advocated for a more critical, reflexive and socially responsive discipline. Although several analyses of the disciplines genesis and underpinning paradigms have been presented and there has been an increasing use of critical approaches in recent publications, little is known about how critical perspectives have been taken up in the occupational science literature. This study presents a critical interpretive synthesis, a methodology that enables synthesis of large amounts of diverse qualitative data and facilitates critical engagement with the assumptions that shape and inform a body of research. The study included articles published between 1996 and 2013 in the Journal of Occupational Science that implicitly or explicitly took up critical perspectives. It was conducted in relation to questions regarding: (a) how “critical” has been defined in this literature and (b) how critical perspectives are being utilized to inform occupational science. In addition to describing three “turns” in how critical perspectives have and are being employed, this article discusses the implications of these results in relation to the aim of developing as a socially responsive discipline.

Illustrating the Importance of Critical Epistemology to Realize the Promise of Occupational Justice

This article argues that it is vital to embrace critical reflexivity to interrogate the epistemological beliefs and principles guiding occupation-based scholarship to move away from frameworks that are incongruent with calls for occupational justice. For this purpose, we describe an epistemic tension between the stated intentions to demonstrate that occupation-based work can be a means to create a more just society and the epistemological beliefs that have historically dominated occupation-based scholarship. To exemplify the potential implications of this tension, a critical analysis of Creswell’s social justice/transformative design is presented, illustrating that work that expresses a commitment to social justice while relying on positivist/postpositivist assumptions often risks perpetuating injustices through neglecting their sociopolitical construction. Drawing upon critical social theory, we highlight how engagement with critical epistemological assumptions can facilitate addressing the sociopolitical “roots” of occupational injustices and highlight directions for social transformation

Reclaiming the Potential of Transformative Scholarship to Enable Social Justice

Scholars within critical qualitative inquiry and health sciences are becoming increasingly interested in transformative scholarship as a means to pursue greater justice in society. However, transformative scholarship has been taken up within frameworks that given a lack of consistent alignment with the critical paradigm seem to fall short in this intention. This article aims to reclaim transformative scholarship as an epistemological and methodological space that transforms and challenges the social order, situating social justice at the forefront of inquiry. The article begins by addressing the call for work toward social justice within critical qualitative inquiry. Subsequently, Creswell and Mertens’ frameworks are analyzed as examples of transformative scholarship that has distanced itself from its critical roots. Based on this analysis, we raise three problematics to illustrate the dangers of this distancing. We conclude by proposing to reframe transformative scholarship within the critical paradigm to (re)connect it to political stances and values.

Critical dialogical approach: A methodological direction for occupation-based social transformative work

Abstract Background: Calls for embracing the potential and responsibility of occupational therapy to address socio-political conditions that perpetuate occupational injustices have materialized in the literature. However, to reach beyond traditional frameworks informing practices, this social agenda requires the incorporation of diverse epistemological and methodological approaches to support action commensurate with social transformative goals. Aim: Our intent is to present a methodological approach that can help extend the ways of thinking or frameworks used in occupational therapy and science to support the ongoing development of practices with and for individuals and collectives affected by marginalizing conditions. Method: We describe the epistemological and theoretical underpinnings of a methodological approach drawing on Freire and Bakhtin’s work. Results: Integrating our shared experience taking part in an example study, we discuss the unique advantages of co-generating data using two methods aligned with this approach; dialogical interviews and critical reflexivity. Discussion: Key considerations when employing this approach are presented, based on its proposed epistemological and theoretical stance and our shared experiences engaging in it. Significance: A critical dialogical approach offers one way forward in expanding occupational therapy and science scholarship by promoting collaborative knowledge generation and examination of taken-for-granted understandings that shape individuals assumptions and actions.

Maternal Care in Guatemala: Problematizing Discourses of Development, Transnational Advocacy, and Indigeneity

This chapter focuses on the impact of development discourses of biomedical care and transnational approaches to maternal pregnancy-related care among the indigenous Maya of Guatemala. Despite efforts by the Guatemalan government and collaboration with international advocates, indigenous Maya maternal mortality rates remain a significant concern. Approaches to reducing maternal mortality have been supported by both international and national initiatives focused on “safe motherhood,” and often involve a complex assemblage of caregivers who span both state run and nongovernmental organization (NGO)-based programming. The structures of care are incredibly complicated to navigate, often forcing women and their families to incur hidden costs associated with transportation, medication, and supplies. They serve to reproduce discourses that place indigenous practices in contrast with “modernity,” and ultimately neglect the critical social role of successful home birth for Mayan women. This chapter argues that discourses of development naturalizing childbirth in Western medical settings positions indigenous birthing practices as immoral and uninformed, and obscures the larger structural issues Mayan women and communities face. Constructing Mayan women as not only uniformed but also immoral does not serve the goal of reducing maternal mortality or morbidity.

Consumo problemático de de drogas y terapia ocupacional: componentes ocupacionales evaluados durante el proceso de tratamiento y rehabilitación.

This research topic is framed within the field of occupational therapy and problematic drug abuse. The purpose of this qualitative study is to explore what occupational components occupational therapists assess in the process of treatment and rehabilitation of problematic drug abuse. The study also explores the models and assessments used during this process. The participants were selected out of the list of Treatment and Rehabilitation Centers, that provides Occupational Therapy intervention in an Intensive Outpatient Program. This list was obtained from the database of the National Council for Narcotics Control (CONACE). Data was collected through literature review on the topic and semi-structured interviews with seven Occupational Therapists with experience in the field of Drug Addiction Treatment and Rehabilitation. The interviews focused on the following topics: occupational components that are assessed for occupational therapists during the process of Treatment and Rehabilitation, models or theoretical frameworks and assessments used during this process and occupational components most affected. The results revealed that the majority of occupational therapists evaluate the occupational components of routine / habits, roles, volition, leisure and work history at the stage of admission to Treatment and Rehabilitation Centers. In addition, the results reveal a lack of appropriate and specific models and assessments from the occupational therapy perspective within the field of drug abuse. This study concludes that there is a lack of homogeneity in language, assessment tools and models used between the Occupational Therapists working in the Treatment and Rehabilitation Centers.