The Occupation Debate – Means vs Ends? or is Occupation Focused, Based and Centered practice enough to claim we are providing true occupational therapy?.

The Occupation Debate – Means vs Ends? or is Occupation Focused, Based and Centered practice enough to claim we are providing true occupational therapy?

Date: 23/06/2015  Host: @GillyGorry

Blog Post  –  Transcript


OTalk 23-062015 hosted by @GillyGorry

As OTs we all know that the profession of occupational therapy is diverse and OTs practice in many different settings: traditional/ non traditional, Generic and role emerging areas of practice, but sometimes there doesn’t seem to be agreement between what is and isn’t practicing occupational therapy, so tonight we’ll debate it.

Firstly I thought it useful to Define the terms:

Occupation as Ends – the outcome of intervention or goal is the ability to perform or engage in occupation, but does not necessarily mean the use of occupation was used directly as an intervention. (Gray, J.1998).

Occupation as Means – using the engagement and performance of occupations as intervention. (Gray, J. 1998).

Occupation Centered –  to put occupation at the centre and view with an occupational lens ( Fisher, A.G, 2013).

Occupation Based – the foundation or base, is fundamental to assessment and intervention and for OTs this relates to Occupation. (Fisher, A.G. 2013).

Occupation Focused – to bring something into focus and concentrate on one aspect of occupation. (Fisher, A.G. 2013).

before we chat I would like you all to take a little pre chat poll https://docs.google.com/forms/d/1F-CX0SEWmIL2jY7aYkY5St3s59_bBGC6qpGg24GBCUI/edit#

Q1. how would you describe ‘true’ or ‘pure’ occupational therapy

Q2. Should OTs been practicing occupation as means only when providing interventions?

Q3. What would an occupation as means only OT profession look like?

Q4. Could all types of service user benefit from a means only profession? or would some miss out?

Q5. If practicing occupation as means only, would we still be holistic professionals?

Q6. Should OTs be using occupation as ends if it is, Occ focused, based and centred?

Q7. Does Generic working fit with being Occ focused, based and centred?

Q8 Does the setting dictate means or ends? does it dictate Occ focus?

Q9. How do you practice? do you see your practice as true occupational therapy?

After the chat could you please take the post chat poll https://docs.google.com/forms/d/1zhb3XmAkT7MrnCMsNGIQSGKWuhKHYz41JTvWI6zhs1c/edit#

My personal opinion on this subject,  is that occupation focused, based and centered practice creates an environment where occupation can happen, whether that be by means or ends and that actually sometimes my ‘ends’ focus, might lead to another OT being able to be ‘means’ focused intervention. This view comes from working in a broad range of settings with people with Physical and Mental health issues.  for many of the people I work with, barriers such as their environment, or a severe physical disability,  would prevent them from participation in occupation as means therapies initially. However, occupation as means is often my ends, but I always keep the occupational goals of the individual at the heart of my practice. I am interested in hearing your thoughts, and views on this topic and I know from experience it usually generates a good debate. Please feel free to add your comments to the blog as well as tweeting on the night.

Gray,J. (1998). Putting occupation into practice: Occupation as ends, occupation as means. American Journal of Occupational Therapy, 52(5)3, 354-364.

Fisher, A.G. (2013) Occupation – Centred, Occupation – based, Occupation – focused: Same, same or different? The Scandinavian Journal of Occupational Therapy, 20: 162-173.

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