As with other health professionals, occupational therapists adhere to different schools of thought for the planning of treatment. There are, however, basic philosophical premises underlying occupational therapy, which foster a sense of professional identity and guide practice.
The concept of occupation is central to occupational therapy. Nevertheless, the term itself has been used in the literature in various, sometimes ambiguous ways. It is best to stand with the position of AOTA (Assembly of the American Occupational Therapy Association) that occupations involve mental abilities and skills but do not always include an associated observable or physical behavior. In the OT process, one of the ultimate goals of treatment is the developing, nurturing and restoring of occupations.
Three major, closely related themes are prevalent in occupational therapy literature. The first is the use of purposeful activity that includes activities that have personal and cultural meaning and provide a basis for "exploration and learning, practicing and achieving mastery" (Hopkins & Tiffany, 1988, p. 94)
A second theme in occupational therapy is the premise of occupational perform...
Yerxa, following the humanistic-phenomenologic perspective stated, "Occupational Therapy's use of 'meaningful and purposeful' activity places upon the patient's view of meaning" (Bing, 1987, p.27)
A second theme in occupational therapy is the premise of occupational performance, which is the "accomplishment of tasks related to self-care/self-maintenance, work/education, play/leisure, and rest/relaxation (Christiansen & Baum, 1991, p. 855). The relationship between purposeful activity and occupational performance is both practical and philosophical.
On a practical level, occupational therapists use purposeful activities as treatment methods to improve patient's performance of self-care, work and leisure skills. On a philosophical level, there is a belief that purposeful activities positively influence an individual's occupational performance.
This was expressed by Reilly, who stated that "man, through the use of his hands as they are energized by the mind and will can influence the state of his own health" (Acquaviva, 1992, p. 2), an rephrased by Barris, Kielhofner and Watts: "The fundamental occupational therapy hypothesis is that people can become competent and confident through what they do" (Mocellin, 1988, p.7). Central to both purposeful activity and occupational performance is the concept of "doing".
The third theme in occupational therapy is the interaction with the environment. The conceptualization of the environment as significant in the OT process can be found in the historical writings of the profession and in every major frame of reference used in occupational therapy.
Based on systems thinking and the extensive influence of the model of human occupation, the term