Moving Occupation Into Treatment: Clinical Interpretation of “Legitimizing Occupational Therapy’s Knowledge”

This article was acceptedfOr publication june 14, 1996 I f, as Wood (1996) encourages, occupational therapists seize the opportunity to further develop their knowledge and communicate the societal values that are inextricably bound to their practice, they wiJl undoubtedly march into the 21 St century with an excitement and enthusiasm that will revolutionize the scope and depth of occupational therapy. Therapists will be able to work in a greatly expanded range of settings, delivering a wide band of service. In addition to continuing our efforts with persons who are chronically ill, we will intervene with persons who suffer from the chronic problems that result from poverty and being disadvantaged, who confront new kinds of disruptions and displacement due to newly emerging corporate practices (e.g., downsizing and rightsizing, which are quickly making the idea of fUll-time, long-term work obsolete), and who wish to engage in preventive and wellness activity. In these extended roles, we would be focusing our attention on how occupation can be addressed in evaluation, treatment, and measurable outcomes. The recognition that occupational therapists are the keepers of knowledge pertaining to "adaptation through occupation ... [that] has historically constituted occupational therapy's unique domain of concern" (Wood, 1996, p. 626) is both exciting and empowering but also somewhat threatening. As a clinician, I ask myself, "Why have occupational therapists been so unwilling to articulate their core concepts?" The reasons seem to be many. Without question, external factors have impinged on our development of a knowledge base. Certainly, our unlikely partnership within medicine and the hard sciences has stifled our perspective and diverted our attention. Placed in a world where the primary orientation is directed toward solving problems of acute pathology and the reduction of disease through drugs and surgery, our commitment to persons with severe and chronic disabilities has been compromised. Our discomfort with repeatedly addressing issues of fUnction within an environment that has, until recently, shown only nominal interest in the concept has resulted in our taking a backseat to our own knowledge development. Compounding our limited attention to developing an increased understanding of how we promote occupation through adaptation has been a lack of interest in treatment protocols, program development, and research projects from outside interest groups (e.g., administrators, managers, grant and special project officers) that would facilitate the kind of work that would contribute to the fUndamental core of our field. We have been out-