Professions are socially constructed phenomena. Accordingly, an understanding of what is meant by a profession, with its associated social positioning and how that is interpreted, is governed by historical, temporal, cultural and ideological influences. For occupational therapy, such an understanding can be a real challenge. This is because of a dichotomy between its ontological, person-centred approach and the medically dominated constructs prevalent in the professionalisation of all caring professions and still inherent in health care arenas today (Etzioni 1969, Fairhurst 1981, Rivett 1997, Freidson 2001). As a consequence of this traditionally accepted dominance and the roles ascribed to or enabled by this positioning, the professional identity of occupational therapy can be limited by the politics of power at the organisational level. This can shape how occupational therapy is understood, not only by significant others but also by the profession itself. Professional consistency and cohesion, both inside and outside the profession, could therefore be challenged, unless individual actors, organisational attitudes and social constructs change. There is a need both to confront and to accept the ever-changing nature of professionalism and the meaning of occupation in the postmodern world.

Introduction: Occupational therapists/scientists maintain that achieving occupational balance through participation in ‘doing’ and ‘being’ occupations enhances personal and social wellbeing. However, the influence of paid work on occupational balance is not well researched. The purpose of this study was to explore the influence of workplace cultures on the lived experience of occupational balance for occupational therapists. Method: Two representative workplaces were accessed: one health and one social services setting, both in Wales. Twenty-nine occupational therapists took part, 18 from healthcare and 11 from social services. The study was qualitative in design, using in-depth interviews and interpretative phenomenological analysis. Findings: The study identified a potent link between neoliberal capitalism and occupational imbalance for occupational therapists as a consequence of the pressures of paid work on the rest of life, the social hegemony of paid work, and a sense of individual responsibility for both performance in paid work and success or failure in personal occupational balance. Conclusion: Occupational therapists can live unbalanced lives as a consequence of the pressures of the neoliberal workplace on ‘doing’ and ‘being’ activities outside of paid work. Individuals can experience a sense of personal responsibility about success or failure in work–life balance that can affect their achievement of wellbeing through occupational balance.

The therapeutic use of self is a term used to encapsulate the therapist's role in working consciously with the interpersonal side of the therapeutic relationship to facilitate an optimal experience and outcome for the client. In occupational therapy, although the literature is replete in references to the topic, there is a paucity of current debate and it remains an elusive aspect of practice. This raises an intriguing point: if the therapeutic use of self is as central to the profession as the rhetoric suggests, why does a lack of clarity in its practice remain? The purpose of this opinion piece is to explore these issues, and consider the potential for refocusing on this aspect of our skills set to meet the challenges of contemporary practice.

The involvement of the user in decisions about his or her own health and social care has become a key element of the changes encapsulated in the Government's legislation. Listening to the service user and responding to his or her needs is an integral part of that change. Occupational therapy philosophy has always engendered client-centred practice and, therefore, listening to and valuing the voice of the user. Now, more than ever, occupational therapists have to show that this is an integral part of their everyday practice. Narrative is one method that could be used to explore the lived experiences of users of occupational therapy. This study explored the relevant literature about narrative using qualitative methodology. The emerging themes from the data suggest that narrative, in its varied forms, could be a useful tool in clinical and research-based occupational therapy activity. Also, occupational therapists' own approach and reflexivity within the narrative process are key elements in the effectiveness of this technique.

Child-on-child harmful sexual behaviour at school is highlighted in the literature although very little is known about how teachers experience it. Interpretative Phenomenological Analysis was used to address this gap. Semi structured interviews were conducted with nine teachers from two special schools and one mainstream school. Overarching themes used the proverb of the three wise monkeys as a framework in which to show how HSB was not seen, heard or spoken about. Instead, it was accepted and expected as part of the special school day because it was not recognised and paid little attention to, whilst in the mainstream school it was not recognised due to lack of knowledge and understanding. A lack of training, support and the sharing of information compounded teachers' fears for personal safety, careers and reputation. Implications for teachers and multi-agency professionals are discussed.