Read Full Text: Belonging, occupation, and human well-being: An exploration (Available in ProQuest via NBCOT)
Journal: Canadian Journal of Occupational Therapy (Impact Factor 1.098)
Author: Karen R. Whalley Hammell
Year Published: 2014
Ranked 30th on our 2014-2019 list of the 50 most influential articles
Big-picture article breakdown for OTs
If you’ve ever gone into a patient’s room and been asked to come back later because they have visitors (which you probably have) you probably have a sense of what this article is talking about.
You might have wondered why they’d want to visit with family and friends versus engaging in your “meaningful ADL occupations.” Presumably, it’s because in that moment, connection was more important to them than independence.
Perhaps this is a case of us not fully understanding the occupations that patients feel are most meaningful!
This article argues that the way we currently conceive of occupations—as being divided into the three categories of “ADLs, work, and play” —misses out on one of the most fundamental motivators of human activity: belonging. After all, connecting with others through reciprocal care is the heart of what we do.
This is the first article in the Club that comes directly from an occupational therapy journal, and it is the first one that specifically addresses OT theory. So it is one that should hit home for many of us, and I’m really excited to hear your thoughts.
What OTs need know about the details
There has been lots of critique of our current understanding of occupation.
This article does not hold back on sharing the critiques of our current understanding of occupation. Here are some of the words you will see in this article to explain our current understandings of occupation:
- Simplistic
- Value-laden (in a bad way)
- Decontextualized
- Insufficiently descriptive of subjective experience
- Flimsy
- Fuzzy
The author argues that our current triad (ADL, work, and play) puts too much emphasis on doing and independence, and feeds into a cultural script that simply does not represent how people and our world actually function.
There are lots of great details in this article about what belonging can entail, so I encourage you to read the whole thing! As a teaser, I will say that belonging is not confined to family and friends, but can also extend to nature, ancestors, and culture at large.
There have also been new models proposed—but they have not been readily adopted.
As good problem-solving OTs, where there have been critiques, there have also been new models offered. Ann Allart Wilcock wrote a paper Reflections on doing, being and becoming, which proposed a new model—followed by an even more fleshed-out model in An occupational perspective of health in 2006.
Wilcock’s basic model is this:
Doing + being, becoming, and belonging = survival and health
Throughout the article, Michale Iwama is also mentioned for his work in pushing for more culturally relevant theories, especially his 2003 article, Toward Culturally Relevant Epistemologies in Occupational Therapy. The Kawa Model, which is also Iwama’s work, is highlighted in this article, as well.
Takeaways for OT Practitioners
(These are my personal takeaways, and were not mentioned in the article.)
I expect that future occupational therapy practitioners will (rightly) conceive of occupation differently than I was taught.
Creating our own language and categories around occupation was likely an essential step in validating ourselves as a unique profession. But now, as an established profession, it is my belief that we should be shifting into a new phase. We need to start re-examining some of the language that we use—and aligning it more closely with the latest research (along with the language used by other professions).
I’m not totally sure what this will look like, but after reading this article, I fully expect that future occupational therapy practitioners will have a much more holistic understanding of occupation than what I was taught.
An underlying vibe of this article is that a new understanding of occupation will bring us in closer alignment with other professions and organizations.
This article draws heavily on research from the fields of anthropology, sociology, and psychology. One of the basic arguments is that continuing to use outdated descriptors and categories of occupation/human functioning will hold our profession back. Not only will it keep occupational therapy siloed as a profession, but it will also prevent us from forming critical common ground with other professions.
I needed a lot more Brene Brown in this article 
I was thinking about Brene Brown the whole time I was reading this article.
For me, she has popularized much of the research about Belonging, and her work would be one of my recommended resources for anyone who is interested in the topic of belonging. Her 2010 TED Talk The Power of Vulnerability and her book, Braving the Wilderness: The Quest for True Belonging and the Courage to Stand Alone are two pieces of content I would recommend.
I’ve found a lot of benefit from her work in my personal life, and now it seems time to start thinking about how it applies to my professional life.
Listen to my takeaways in podcast form:
Find other platforms for listening to the OT Potential Podcast here.
