Opportunity, Not Prescription: An Exploratory Study of the Experience of Occupational Engagement

Abstract

Occupational therapy practice is based upon the belief that the use of occupation-as-means can promote the health and sense of well-being of individuals with disability. Despite a firm commitment to the construct of occupation by the profession, little empirical evidence has been generated which supports the basic tenets of practice. In the psychosocial literature, no studies could be located which directly investigated the use of occupation-as-means to mental health. An exploratory study was conducted with eight participants of an occupation-based, women's mental health group. In-depth interviews and participant observation were utilized to explore the meaning of occupational engagement for these women. The experience of occupational engagement is presented in the form of a conceptual model named occupational spin-off. Occupational spin-off represents conceptually the experience of occupational engagement for the participants in the research study and describes a process of occupation-as-means to mental health. The processes of affirmation, confirmation, actualization, and anticipation collectively contribute to and maintain occupational spin-off. The process of occupational spin-off contributes to an understanding of why these participants have remained out of hospital, and why they are feeling better. Implications of this process model for clinical practice and future research are suggested.

Factors Influencing Occupational Engagement in Day Centers for People with Psychiatric Disabilities

“…The time spent in extrinsically motivated but still individually meaningful occupations may theoretically impact the attendee's intrinsic motivation over time (Deci & Ryan, 2008;Kielhofner, 2008). This reasoning is in agreement with qualitative studies, showing that doing triggers more engagement, which then leads to a spin-off effect in terms of further activity (Leufstadius, Eklund, & Erlandsson, 2009;Rebeiro & Cook, 1999) and intrinsic motivation (Mee & Sumsion, 2001). In the present study, setting own individual goals was highlighted as important for OE.…”

Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services

“…It should also result in better satisfaction with the day center services and a higher level of engagement, as the intentions with the freedom of choice system in question was to increase the possibilities for matching individuals' preferences with available offers. According to previous research, such a match has been found to be vital for client satisfaction and engagement (Leufstadius, Eklund, & Erlandsson, 2009;Rebeiro & Cook, 1999;Tjörnstrand et al, 2011). Finally, since research has shown that one of the main advantages with attending a day center is an increased number of social contacts (Argentzell et al, 2013) one can also expect a change in that respect.…”

Developing a descriptive framework for “occupational engagement”

“…The meaning of occupational engagement was later explored by Rebeiro and Cook (1999). They presented their findings in terms of a conceptual model named "occupational spin-off" and discuss this in terms of occupation-as-means.…”

“…By coming from the perspective of occupation-as-means, Rebeiro and Cook (1999) acknowledged that occupations do not always contain an element of subjective significance for an individual. Feelings of competence and confidence appear to be described as two features of sustaining occupational engagement (Rebeiro & Cook, 1999).…”

“…Feelings of competence and confidence appear to be described as two features of sustaining occupational engagement (Rebeiro & Cook, 1999). Chugg and Craik (2002) explored the subjective influences on occupational engagement for people with schizophrenia and found both external (physical and social environments) and internal influences (self-efficacy).…”