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Discuss the term occupation in occupational therapy

The American Occupational Therapy Association (AOTA) describes occupational therapy as skilled treatment that helps individuals achieve independence in all facets of their lives. (AOTA, 2005) One of the most important tenets of occupational theory is that there is a occupation is central in achieving health and well-being. (Wilcock, 1993; CAOT, 1997) This paper will help to define the term occupation in occupational therapy, discuss the different forms and functions of occupation, and briefly describe the profession of occupational therapy.

As a discipline, occupational therapy was first seen in the early 20th century when it used participation in daily occupations to restore the health and function of soldiers injured in World War I and persons with mental illness. (Driver, 1998) The term occupational therapy came from the observation that occupation, health, and well-being are intrinsically bound. (Atwood, 1907; Barton, 1915)

Christiansen and Baum have described occupations as goal-directed pursuits that typically extend over time, have meaning to the performer, and involve multiple tasks. (Christiansen, 1997) The concept of occupational performance forms the basis for occupational therapy models. Occupational performance encompasses tasks, roles and activities; as such, it connects the person to the environment. (Reed, 1999)

One such model, the PEOP model, has four major components. (Christiansen, 2005) These four elements include what people need or want to do in their lives (occupations); performance, or the actual act of doing; the person, which includes physiological, neurobehavioral, cognitive, psychological, and spiritual factors; and the person's environment, or the place where the occupations take place. All of these factors influence occupational success.

Central to the PEOP model is the concept of human agency, which states that people are naturally motivated to explore their world and demonstrate mastery within it. Individuals are said to be competent if they have the ability or skills to do what they must in order to meet their personal needs. Doing this requires the effective use of personal, social, and material resources in the environment. Individuals who possess both emotional maturity and problem-solving skills are able to identify and achieve goals that lead to life satisfaction.

Another belief that is central to this model is that people feel good about themselves when they experience success. Through their daily occupations, people develop their identities. Fulfillment comes when people establish goals that have personal meaning and are able to fulfill them. Over time, this process gives people a sense of who they are and what their place is in the world. Nelson defined occupation as the relationship between occupational form and occupational performance. The role of the occupational therapist is to create occupational forms "objective circumstances with physical and sociocultural dimensions--that elicit or guide a person's occupational performance" what they do or how they behave. When the person becomes engaged in the occupational form, they are successful in the occupational performance. (Nelson, 1996)

Turner et al. describes concepts that arise when occupational therapists use the term occupation. Occupations are the fabrics of doings of people's lives; they are driven by people's needs, aspirations, and environments; they relate to the purposeful use of time as defined by the individual; and they are the means through which people control the balance of their lives. (Turner, 2002)

Occupation is considered therapeutic when it results in a positive change in a person's sensorimotor, cognitive, or psychosocial abilities. Occupational performance can have an impact on a number of occupational forms such as how a person makes his or her bed or how he or she prepares a meal.

Plants in a nursing or convalescent home lobby are an example of an occupational form. They can represent an opportunity for a patient who is recovering from a hip fracture, for example, to become mobile enough to reach the hallway and perform the necessary activities such as watering and tending to the plants. One problem that occupational therapists often face is that they do not have access to real home-based and community-based settings. Therefore, they must rely on simulations of everyday settings, such as the patient's hospital room or the OT kitchen. An occupational therapist may use 1-pound weights as substitutes for household items, and ask patients to place them on shelves and reorganize the kitchen cabinets. However, these simulations will only be effective if the patient finds meaning in them.

Actions that comprise occupational performance are referred to as skills., observable, goal-directed actions that a person is performing. (Kielhofner, 1992) Three types of skills have been described: motor skills, process skills, and communication and interaction skills. Actions such as bending one's body or listing, manipulating, or transporting objects are considered motor skills. Process skills refer to actions like choosing and organizing objects in space as well as initiating and terminating steps in a performance. Gesturing, speaking, engaging in physical contact and collaborating with others are examples of communication and interaction skills.

In recent years, professionals in the field of occupational therapy have been involved in an active debate over the fundamental principles guiding the profession and how they should be carried out. Although the debate is continuing, some key concepts have emerged. For example, it has now been stated that occupational therapy is concerned with the key elements of occupational performance: individuals and the roles, occupations, and relationships that people have in the environments they inhabit. The aim of occupational therapy is to enable and empower people to be competent and confident performers in their daily lives, and thereby to enhance well-being and minimize the effects of dysfunction or environmental barriers. (Hagedorn, 2004)

The role of occupational therapists has also been more closely defined. Occupational therapists are called upon to encourage individuals to actively engage in the processes of therapy and to become partners in designing and directing this process. Occupational therapists are also called upon to use tasks and activities therapeutically and creatively to help the person to achieve goals that are relevant to his or her life. A core belief of occupational therapists is that occupational performance depends on a complex interaction between an individual and his or her environment. A person's sense of well-being is directly related to the quality of this interaction. (Hagedorn, 2004)

Occupational therapy, a blend of medical and social science, is a changing profession designed to help people achieve greater health and well-being. By creating opportunities for people to perform meaningful occupations, occupational therapy can make a positive difference in peoples' lives.

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