Matthew Molineux

The Influence of Western Society's Construction of a Healthy Daily Life on the Conceptualisation of Occupation

This article proposes that the current conceptualisation of occupation within the dominant Anglophone literature reflects central elements of Western societys construction of a ‘healthy’ daily life, the ‘ideal’ and expected way to live. Contemporary theories of social action are used to describe the structuring influence of social institutions on daily activity. Four of the commonly identified characteristics of occupation, that it is active, purposeful, temporal and meaningful, are discussed in relation to Western institutions and related aspects of daily life. It is not intended to provide a comprehensive account of the socio-historical construction of the concept of occupation, but rather to illustrate the coherence of characteristics of occupation with those of Western daily life. The implications of this for understandings of occupation amongst groups and communities with alternative constructions of daily life are discussed. Some examples are offered, particularly from Greece, as a Christian Orthodox, non-industrialised, largely collectivistic society.

Prisons: From occupational deprivation to occupational enrichment

Abstract Whilst prisons and prison life are never far from the attention of the popular media, many dimensions of prison life and the incarceration process itself remain poorly understood. The concept of occupational deprivation, recently developed in the occupational science literature, is one that has been applied to understanding the phenomenon of inmates’ restricted occupational engagement in traditional penal settings. This article explores occupational deprivation as a feature of prison life and considers how penal policies create or inadvertently reinforce this situation. In contrast, occupational enrichment is posited as an approach that could be adopted in penal environments to better meet the needs of inmates and society at large.

The experiences of mothers of children with autism: Managing multiple roles

Abstract Background Mothers of children with autism experience poorer health and wellbeing compared to mothers of children with other disabilities or typically-developing children. This qualitative phenomenological study aimed to explore the daily life experiences of mothers of children with autism, and the strategies they use to manage their roles, their emotions, and their childs behaviours. Method In-depth interviews were conducted with 7 mothers and the data were analysed using interpretative phenomenological analysis. Results Findings revealed that the mothers were challenged by the demands of their multiple roles while dealing with the paradox of accepting their child for who they were, and at the same time also desiring their typical growth and development. However, the mothers reported various strategies they used to manage their roles, their emotions, and their childs behaviours. Conclusions The findings indicate that health professionals working with these families must support mothers in managing various aspects of their lives, including those not directly related to their child with autism.

Storied Approaches to Understanding Occupation

Abstract Occupation is a complex and multifaceted phenomenon, one that truly tests the range of research methodologies available to occupational scientists. In recent times there has been a resurgence of the use of personal stories as a research method in a wide range of disciplines and occupational scientists have begun to recognise their particular value in furthering our understanding of occupation and humans as occupational beings. There are many types of personal stories and these include life story, life history, and oral history. The boundaries between these are becoming increasingly blurred and so researchers are beginning to take a more eclectic approach to their use. There is, however, little doubt that stories are well suited to the study of occupation as they permit an exploration of personal meaning, temporality, occupational historicity, and the wider contextual dynamics that impact on occupational engagement. When combined with narrative methods of analysis, oral history provides a powerful method for making sense of what people do. Research which employs oral history and narrative analysis produces field and research texts which both further our understanding and appreciation of the occupational nature of humans and their experience of illness.

The Care Home Activity Project: Does introducing an occupational therapy programme reduce depression in care homes?

The primary aim of the study was to test the hypothesis that depression severity in care homes for older people would be reduced by an occupational therapy programme. This was a feasibility study for a cluster randomised controlled trial and involved four intervention and four control homes in northern England. In each intervention home a registered occupational therapist worked full-time for one year delivering an individualised programme to participants. Pre- and post-intervention data for the Geriatric Mental State–Depression Scale (primary outcome measure) were obtained for 143 participants. Secondary outcomes included dependency and quality of life. No significant intervention effects were found in any of the quantitative outcome measures, though qualitative interviews showed the intervention was valued by many participants, staff and relatives. Therapist ratings and qualitative interviews suggested that the intervention was beneficial to some participants but no distinctive characteristics were found that might enable prediction of likely benefit on initial assessment. This exploratory study provides no evidence that this intervention produced benefits in terms of depression, dependency or quality of life. Lack of prior power calculations means these are not definitive findings; but numbers were sufficient to perform the required analyses and data did not suggest effects that would have reached statistical significance with a larger sample. This study highlights issues for consideration in providing such services in care homes.

Role Emerging Occupational Therapy: Maximising Occupation Focused Practice

Acknowledgements. Preface. Notes on contributors. Part I: Background to OT, and philosophy of OT and emergence/re-emergence of occupation focussed practice. 1 Emerging occupational therapy practice: Building on the foundations and seizing the opportunities (Matthew Molineux & Sue Baptiste). 2 Models of role emerging placements (Mary Edwards & Miranda Thew). Part II: Current examples of emerging practice for occupational therapists. 3 Successful role emerging placements: It is all in the preparation (Yvonne Thomas & Sylvia Rodger0. 4 The student experience of a role emerging placement (Philippa Gregory, Lydia Quelch & Elisha Watanabe). 5 Promoting well-being in a large organisation: Challenges and opportunities (Miranda Thew). 6 An occupational perspective of a disability-focused employment service (Sally Hall). 7 Promoting occupational therapy in a community health centre (Barry Trentham & Lynn Cockburn). 8 Occupational therapy: Can it make a difference in community cardiac failure? (Emma Brown & Barbara Gurney). 9 Community development (Deborah Windley). Part III: Part Three Future of the profession. 10 Using policy and government drivers to create role emerging opportunities (Lori Letts & Julie Richardson). 11 The way forward? (Sue Baptiste & Matthew Molineux). Index.

True to Our Philosophy? Sexual Orientation and Occupation

Occupational science and occupational therapy suggest that people engage in occupations that are meaningful and relevant to them on personal and cultural levels. Sexual orientation is one theme of meaning in a persons life which influences his or her choice of occupations and the meaning and relevance those occupations hold. Sexual orientation, as it is conceptualised here, encompasses far more than a persons choice of sexual partner and is, therefore, an important area for an occupational therapist to consider. It is, however, an often neglected area in both curricula and the literature. This paper presents the results of a qualitative study which investigated the perspectives of basic grade occupational therapists regarding working with clients of gay, lesbian or bisexual sexual orientation. Six basic grade occupational therapists were interviewed using a semi-structured format and four themes emerged. The findings included that the basic grade occupational therapists interviewed did not consider occupation in its complexity and so did not appreciate how sexual orientation might be expressed in a persons occupations. The interviews also indicated that the subject of sexuality is still taboo in occupational therapy.

Contemporary occupational therapy practice: the challenges of being evidence based and philosophically congruent

Several authors have written of the need to embrace occupation and use it to energise our practice, research and education for the benefit of the profession, individual occupational therapists and ultimately, and most significantly, our clients. However, Wilcock (1999) best summarises the issues and the work that must be done, calling for the profession to adopt a consistent professional philosophy. This approach is entirely congruent with the paradigm approach proposed by Kielhofner (2009). Reinforcing the ideas of Doris Sym, Wilcock (p. 192) states that ‘the first essential for each individual in any profession is the acceptance of a philosophy that is the profession’s keystone.’ Wilcock is clear that such a philosophy should not be adopted and enacted in a rigid way, but it should be dynamic so as to enable the profession to respond to research and theories, and changes in the world. In essence, a professional philosophy should guide research, education and practice and be a touchstone when considering potential changes to practice. It is our suggestion that occupational therapists, individually and collectively, need to use our occupational philosophy, currently best operationalised by the Contemporary Paradigm, to inform EBP. In conclusion, we again find ourselves at a cross road for the profession with the occupational philosophy of the Contemporary Paradigm at times challenged by the adoption of research evidence into practice. We would encourage all occupational therapists to engage in EBP but do so ever mindful of its complexity. We would suggest that evidence-based decision making is viewed through the lens of the occupational therapy philosophy, with occupational therapists critically questioning whether or not the ‘procedure’ for which there is evidence is consistent with the Contemporary Paradigm. This is a complex matter, with many remaining issues to be explored. We would encourage all occupational therapists to interrogate the ways in which they implement EBP and consider the extent to which the profession’s philosophy guides practice decisions.

HIV/AIDS: A New Service Continuum for Occupational Therapy

The first cases of what is now known as AIDS were reported in the USA in June 1981. The first article on occupational therapy for people with HIV/AIDS was published 6 years later in July 1987. Since that time, much has been written about the work of occupational therapists with people affected by HIV or AIDS. This article presents some of the material published on this area of work, and suggests that occupational therapy has much more to offer this group of people than is described in the literature. A new continuum of service provision is outlined and discussed. This includes practice that falls outside what might be considered the traditional role of occupational therapists. Although this article is specific to HIV/AIDS, many of the issues raised are applicable to other areas of practice.

Occupation to Maintain the Family as Ideology and Practice in a Greek Town

Discussions of the cultural relativity of occupation and the potential hegemony of Western conceptualisations have included increasing awareness of a dominant focus on the individual and individual agency. Recognition of the importance of understanding occupation in diverse contexts led to an ethnographic study exploring occupation in a Greek town. A transactional perspective underpinned the emergent understanding of occupation as a multidimensional and fluid process occurring within and between individuals, the family and the community, from each moment to across the life-span. This paper presents part of the findings of that study, focusing on the family as ideology and as practice. Values and beliefs around the ideal family, occupation for the maintenance of the household, and the network of family occupation, transacted in an ongoing process that constructed and reconstructed each element. Family was embedded in memories and stories, the embodied experience of growing up in the town and in the ongoing family occupation that predominated throughout the days and weeks. Family was part of who one was, but also an inextricable part of what one did. The study supports expanding conceptualisations of occupation beyond the individual to include the family as an important part of everyday life.