Background. The generic process of occupational therapy is often described but is rarely the topic of critical analysis. Purpose. To critically reflect on the occupational therapy process within one Assertive Community Treatment team. Methods. Using an instrumental case study approach, we interviewed one occupational therapist-client dyad from an Assertive Community Treatment team monthly over the course of nine months and reviewed occupational therapy chart notes. Data were analyzed for topical concerns and foreshadowed problems related to the process of occupational therapy. Findings. Five topical concerns were identified. These related to the impact of the use of a medical model lens, unarticulated occupational therapy theory, acceptable occupational therapy goals, the complexity of occupational goals, and invisible emotions and unexamined relationships. Implications. Our research method allowed us to critically reflect on the occupational therapy process within one setting. This reflection may have implications for occupation-based, client-centred services in other areas.
American Occupational Therapy Association. (2002). Occupational therapy practice framework. American Journal of Occupational Therapy, 56, 609–639.
2.
BaumC. M., Bass-HaugenJ., & ChristiansenC. H. (2005). Person-Environment-Occupation-Performance: A model for planning interventions for individuals and organizations. In ChristiansenC. H. & BaumC. M. (Eds.), Occupational therapy: Performance, participation and well-being (3rd ed., pp. 372–392). Thorofare, NJ: SLACK.
3.
Canadian Association of Occupational Therapists. (2002). Enabling occupation: An occupational therapy perspective (2nd ed.). Ottawa, ON: CAOT Publications ACE.
4.
ClarkeP. J., BlackS. E., BadleyE. M., LawrenceJ. M., & WilliamsJ. I. (1999). Handicap in stroke survivors. Disability and Rehabilitation, 21, 116–123. doi: 10.1080/096382899297855
5.
EakmanA. (2009). Occupation and social complexity. Journal of Occupational Science, 14, 82–91.
FearingV. G., LawM., & ClarkJ. (1997). An occupational performance process model: Fostering client and therapist alliances. Canadian Journal of Occupational Therapy, 64, 7–15.
8.
HammellK. W. (2009). Sacred texts: A sceptical exploration of assumptions underpinning theories of occupation. Canadian Journal of Occupational Therapy, 76, 6–13.
9.
KielhofnerG., & ForsythK. (2008a). Therapeutic reasoning: Planning, implementing and evaluating the outcomes of therapy. In KielhofnerG. (Ed.), Model of Human Occupation: Theory and application (4th ed., pp. 143–154). Philadelphia: Lippincott, Williams & Wilkins.
10.
KielhofnerG., & ForsythK. (2008b). Therapeutic strategies for enabling change. In KielhofnerG. (Ed.), Model of Human Occupation: Theory and application (4th ed., pp. 185–213). Philadelphia: Lippincott, Williams & Wilkins.
11.
KrupaT, Radloff-GabrielD., WhippeyE., & KirshB. (2002). Occupational therapy and assertive community treatment. Canadian Journal of Occupational Therapy, 69, 153–157.
12.
MatuskaK. M., & ChristiansenC. H. (2008). A proposed model of lifestyle balance. Journal of Occupational Science, 15, 9–19.
13.
NagleS., CookV. J., & PolatajkoH. J. (2002). I'm doing as much as I can: Occupational chocies of persons with a severe and persistent mental illness. Journal of Occupational Science, 9, 72–81.
14.
O'BrienP., DyckI., CaronS., & MortensonP. (2002). Environmental analysis: Insights from sociological and geographical perspectives. Canadian Journal of Occupational Therapy, 69, 229–238.
15.
PetticanA., & BryantW. (2007). Sustaining a focus on occupation in community mental health. British Journal of Occupational Therapy, 70, 140–146.
16.
ReedK. L., & SandersonS. N. (1999). Concepts of occupational therapy (4th ed.). Philadelphia: Lippincott, Williams & Wilkins.
17.
StakeR. E. (1994). Case studies. In DenzinN. K. & LincolnY. S. (Eds.), Handbook of qualitative research (pp. 236–247). Thousand Oaks, CA: SAGE.
18.
SumsionT, & LawM. (2006). A review of evidence on the conceptual elements informing client-centred practice. Canadian Journal of Occupational Therapy, 73, 153–162.
19.
TownsendE. (1997). Good intentions overruled: A critique of empowerment in the routine organization of mental health services. Toronto, ON: University of Toronto Press.
20.
TownsendE. A., BeaganB., Kumas-TanZ., VersnelJ., IwamaM., LandryJ., … BrownJ. (2007). Enabling: Occupational therapy's core competency. In TownsendE. A. & PolatajkoH. J. (Eds.), Enabling occupation II: Advancing an occupational therapy vision for health, well-being, and justice through occupation (pp. 87–134). Ottawa, ON: CAOT Publications ACE.
21.
TownsendE. A., & PolatajkoH. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being and justice through occupation. Ottawa, ON: CAOT Publications ACE.
22.
TownsendE. A., TrenthamB., ClarkJ., Dubouloz-WilnerC-J., PentlandW., DobleS., & RudmanD. L. (2007). Enabling individual change. In TownsendE. A. & PolatajkoH. J. (Eds.), Enabling occupation II: Advancing an occupational therapy vision for health, well-being and justice through occupation (pp. 135–171). Ottawa, ON: CAOT Publications ACE.
