1. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 42 Emerging Theories Debra Tupe

2. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Learning Objectives After reading this chapter you will be able to: 1.Identify key OT trends, issues, and concepts that contribute to emerging theory. 2.Describe the contributions of systems theories, cultural approaches, and transdisciplinary frameworks in understandings of occupational performance, social participation, and civic engagement. 3.Describe the role and application of social entrepreneurship and service learning in novel and community-based OT contexts.

3. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction Emerging ideas can evolve as trends or have a long- lasting or dramatic impact on society, the ways we think, and everyday experiences Emerging theory communicates the need for a profession to rethink conceptual constructs or assess practice OTs are thinking about global change agents such as: –profession’s conceptual constructs; –practice beyond traditional borders; and –emerging professional roles

4. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Discussion Point How can practice provoke revisions of outdated perspectives, reconfigure conceptual constructs, or produce new and emerging approaches?

5. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Impact of Globalization on Practice and Theory The global world requires new methodologies and conceptual approaches that (a) inform, (b) describe, (c) evaluate, and (d) advance understandings of occupation Efforts needed to understand cultural, political, social, and economic environments impacts: –on occupational choices; –that support access to occupation; and –facilitate or restrict full social participation

6. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Impact of Globalization on Practice and Theory (Continued) As OT interfaces with changing global community, existing theories may not adequately address deficiencies and advances

7. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins The Need for New Theoretical Perspectives New theories, frameworks, and models are required to demonstrate a wide skill set and how OTs think differently about illness, disability, and social exclusion (Thew, Edwards,Baptiste, & Molineux, 2011) Theories grounded in complexity and embedded in cultural and political analysis may lead OT to new insights on occupation, agency, culture, and human rights (Galheigo, 2011b)

8. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Complexity Theory Complexity theory: –is grounded in the principles of systems theory; –expands systems theory to include the interactional components within environments or contexts; –holds that no action occurs in isolation – individuals and processes interact to form complex systems

9. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Transactionalism Based on Dewey’s concept of transaction Transaction addresses the nature of phenomena (individuals, occupation, or context) as related to other phenomena Transactionalism (like complexity theory) moves away from linear models of understanding occupation approaches differ on: –in the location of occupation within the model: and –relationships between occupation and the actor

10. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Occupational Systems (OS) Approach An OS considers influences of the individual on occupation and addresses external factors on the production of occupation –with systems theory, OS views the occupational actor and the context as integrated

11. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Occupational Systems (OS) Approach (Continued) OS aims to advance theory beyond the level of the individual –focuses on collective occupations that are produced, shared, and enacted among multiple individuals at group, community, and population levels

12. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Sociocultural Approaches (SA) Culture is reconfigured as an emergent phenomenon growing out of interactional moments within the therapeutic session SA holds that culture (as related to theory and OT practice) should be understood from the perspectives of clients’ contextualized reality Kawa Model provides an exemplar of this approach

13. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Social Field (SF) Approaches SFs are dynamic and structured –organized in networks (members taking on different roles) The dispositions of individuals acquired through socialization and life experiences The social space produces and disputes issues and assigns capital and power Within this view, capital is conceptualized as being: (a) social, (b) cultural, (c) political, and (d) symbolic

14. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Social Entrepreneurship (SE) SE (variation of business entrepreneurship) foci on social mission rather than generating wealth (Katzenstein & Chrispin, 2011) The social entrepreneur establishes and sustains relationships that supports: –needs of the target population; and –success of the program

15. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins The Modified Instrumentalism in Occupational Therapy (MIOT) MIOT – developed to empower individuals and communities in addressing social challenges through occupational performance (Ikiugu, 2011) MIOT: –guides empowerment and sensitization of individuals and communities – enables positive influence on individual and global events –underscores the complexity in OT and draws attention to social and cultural aspects of community practice

16. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Addressing Complexity in Research The complex nature of occupation and OT practice has also led to an acknowledgement of the limitations of quantitative research studies Research Pyramid fosters a more comprehensive integrated approach that values qualitative procedures in informing judgment-based decision making

17. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Service Learning (SL) Service learning: –is a form of experiential learning; –puts the needs of the community first; and –allows students to apply classroom theory to community social issues

18. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Application: See case studies 42.1 & 42.2 What are the contextual factors that restrain, support or influence the client’s occupational participation? Identify emerging theories or approaches that are useful in understanding the client’s occupational performance and social participation in the particular context? How may the selected theoretical approach influence intervention priorities and goals?