Personal dimensions of spirituality are important but insufficient for understanding the full transformative potential in spirituality. Communities which extend equal respect and opportunities to people of differing abilities and characteristics create an energizing interconnectedness based on a community spirituality of inclusiveness. This paper offers a critical analysis of inclusiveness as a community dimension of spirituality. Inclusiveness emerged as an implicit yet practical component of everyday practice during an ethnographic study of occupational therapy in adult, mental health day programmes. There were no explicit goals to foster a spirituality of community inclusiveness, yet occupational therapists continually emphasized the worth of everyone's contributions to chores and other occupations which turn day programmes into inclusive communities. Nevertheless, occupational therapy is constrained by organizational processes which control what can be done in everyday practice. Two organizational constraints, medical classification and individualized accountability, are highlighted and shown to interact with risk management, confidentiality, management information, workload measurement, and other policies which form a ruling apparatus that emphasizes the safe management of individual cases or patients. In light of this analysis, occupational therapists are encouraged to make spirituality, inclusiveness and community activism an explicit and accountable part of practice.
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