Clinical Reasoning Used by Occupational Therapists to Determine the Nature of Spiritual Occupations in Relation to Psychiatric Pathology

Abstract

Introduction:

In this exploratory study, the clinical reasoning process followed by occupational therapists in determining whether their clients' spiritual occupations were health promoting or manifestations of a psychiatric illness is described. There has been limited investigation in this regard in existing literature.

Method:

A qualitative multiple case study design was used. Five occupational therapists working in different mental health care settings were interviewed using semi-structured interviews. Review of relevant documents and field-notes also provided important data sources.

Findings:

Three themes emerged from thematic analysis, namely ‘Clinical Reasoning: complex, dynamic and multi-layered’; ‘Multiple resources: people as key’; and ‘Rewarding and challenging experience’. ‘Underground practice’ emerged as a strategy that helped participants to navigate around contextual barriers in order to ensure client-centredness when addressing spiritual occupational needs within a mental healthcare setting.

Conclusion:

Spiritual occupational engagements should be examined in conjunction with individual clients' own process of meaning-making, implications for health to the client and others within the healthcare setting, and by taking the broader occupational narrative of the person, as well as relevant cultural norms and expectations, into consideration.