Introduction

Occupational science as a discipline holds benefits for the occupational therapy profession in general and for mental health practice in particular. Benefits for occupational therapy practice include the provision of language, stimulation of occupation-based practice, provision of a theoretical interface platform, revealing of new research directions and pressure for practice development across system levels and practice sectors. For mental health practice, exploration of the function of occupation in identity construction, its primary role in fulfilling a full range of needs and potential to fulfil purpose and/or enhance meaning in life are obvious advantages.

Zemke (1996, p. vii) introduced occupational science as ‘an academic discipline, the purpose of which is to generate knowledge about the form, the function, and the meaning of human occupation’. Occupational therapists’ concern with occupational behaviour – concretised as participation in work, leisure, play and personal life skills – together with the role it plays in achievement of wellness, has been well debated and documented (Meyer 1922; Pratt et al. 1997; Steward 1997; Strong 1998). The relationship between occupational science and occupational therapy, once much debated, has revealed itself as mutually beneficial and enriching. One important outcome is an increased focus on the development of occupation-based practice. This development has potential to guide the profession in its positioning to better address current and anticipated occupation-related macro influences. In other words, it could provide direction on how to address the negative impact of restrictive environments, which deny opportunities for participation in work, leisure, learning and play.

The character of occupational science

Occupational science is a basic science devoted to the study of the human as an occupational being. As a basic science it is free to pursue the widest and deepest questions concerning human beings as actors who adapt to the challenges of their environments via the use of skill and capacities organised or categorised as occupation (Yerxa 1993, p. 5).

Yerxa (1993, p. 5) introduced occupational science by putting forward the working definition cited earlier. In doing so, she emphasised that it was a basic science and made the point that occupational science could not be ‘constrained in its development by preconceptions of how its knowledge will be applied in occupational therapy clinical practice’. Yerxa identified the following assumptions:

• Skill is an essential capacity of human beings and is a vital component of occupation.
  
• People’s experience of engagement in occupations influences both their satisfaction with performance and intrinsic motivation.
  
• Occupation is engaged in by whole human beings that may not be reduced to cells or organ systems (holism).
  
• The occupational human is a complex living system that interacts with multiple environments.
  
• Occupational science represents an important focus of study and, as such, a legitimate scholarly resource.

Occupational science has shown rapid development. An argument could be made that such development has been predominantly theoretical, with relatively small influence on practice. However, recent work suggests a trend towards occupation-based practice development.

Glover (2009, p. 92) regarded occupational science’s entry into its third decade as a formal discipline a temporal marker and pondered the question ‘how the discipline will shape and be shaped by both its members and the larger world’. The author’s view is that the most exciting and important application of occupational science could be a renewed concern with the use of natural occupations – the understanding and use of occupations that occur within naturalistic contexts (differentiated from constructed occupations that are used within institutional contexts). Natural occupations should increasingly be the focus of occupational therapists because such developments will inform and guide occupation-based practice.

Natural occupations are most often used to address occupation as an end – in other words, occupations that fit into the occupational repertoire of a person. Conversely, constructed occupations, as a means, have traditionally been used to meet particular therapeutic outcomes within occupational therapy practice settings, including hospitals. Interventions designed to enhance the goodness of fit between the natural occupations of people with mental illness and their abilities and needs hold obvious advantages. One example is the placement of persons with psychiatric disability in work, through supported employment, rather than utilising traditional vocational rehabilitation services that predominantly focused on simulated work in rehabilitation units, institutions or hospitals. Importantly, a focus on natural occupation, as opposed to simulated occupation in therapeutic contexts, will lead the development of occupational therapy and occupational science in ways that will meet policy imperatives. Such a focus will direct occupational therapy to meet the real needs of people they work with and harness benefits from the interrelatedness of participation in occupation and the achievement of health and wellness.

Language for practice

What do occupational therapists do? is often asked with an expectation that a ready-made answer to this question exists. Occupational therapists themselves have described their dilemma when trying to capture the essence of occupational therapy. This elusiveness has been attributed to difficulties in delineating the boundaries of professional role and defining occupational therapy in diverse practice setting (van Niekerk 1998). According to Yerxa (1993, p. 4), confusion could be attributed to ‘the uniqueness of occupational therapists ways of perceiving people and their needs and a different way of thinking from that of many other health professionals’. Occupational therapists will recognise that within our profession the reasoning that informs the best course of action for a particular problem at a particular time will necessarily involve a broader range of considerations than is the case with health professions more closely aligned to the medical model orientation. The nature of the occupational therapists’ role is such that a medical condition is only one of many factors that shape decisions about intervention. Although this could be experienced as a challenge, occupational therapists would do well to realise the reasons for this complexity are tied with the imperative and ability to meet the clients’ needs holistically. The complex interplay of influences on the role of occupational therapists results in the profession being shaped through and by this process, allowing for adaptability and responsiveness to need.

The provision of new professional language leads to shifts in practice boundaries and refinement of conceptual terrain; concurrently such practice shifts will allow for further refinement of professional language. As such, the provision and refinement of occupational science language is much needed to direct future practice development. Molke’s (2009, p. 76) advice, grounded in his review of historical influences in occupational therapy and science, was: ‘For those working in occupational therapy and science to maintain an attitude that seeks enlightenment, a continual effort must be made to detail the limits of knowledge, document how this knowledge may foster injustice and work to escape these limits’.

The conceptualisation of concepts or ideas, that could ultimately shape occupational therapy practice, starts with coining a term, which then provides the opportunity for refinement through research and/or debate. Occupational science has shown rapid development in the conceptualisation of concepts that could provide the foundation for occupational therapy reasoning. Examples that are relevant to mental health practice include occupational consciousness (Ramugondo 2012), occupational potential (Asaba & Wicks 2010) and occupational intelligence (Collins 2010). Spin-off advantages could include definitions for occupational concepts that are broadly understood and as such facilitate sharing and understanding across disciplinary and professional boundaries. Such developments will necessarily foreground humans as occupational beings, thus converging diverse theoretical perspectives to promote the occupational engagement of the people occupational therapists work with, instead of this being a secondary focus that follow a concern with disability or impairment. As such, occupational therapy’s identity, as a profession that is concerned with optimising human health and potential through the use of occupation, is fostered, and occupational therapy will continue to be liberated from the medical model that limits its scope and reduces its contribution.