Championing evidence in occupation-based practice

Occupation as a therapeutic medium has been the core of occupational therapy since the profession’s inception. The centrality of occupation predominates in the literature, from the philosophical base (Meyer, 1922) to Eleanor Clarke Slagle lectures (Clark, 1993; Fisher, 1998; Gillen 2013; Reilly, 1962) to the theories and models guiding practice (Dunn et al., 1994; Kielhofner & Burke, 1980; Law et al., 1996; Wilcock & Hocking, 2015). The health benefits of occupation-based approaches are further supported by several systematic reviews conducted through the American Occupational Therapy Association’s (AOTA’s) Evidence-Based Practice Project (n.d) as well as AOTA’s Choosing Wisely® campaign (2022) recommending evidence-based approaches, which are aligned with occupation-based practice.

The push to use occupation in practice is clearly articulated and supported, yet it continues to be difficult to do in light of the myriad barriers to using occupation therapeutically. Across studies, researchers have found similar barriers that reflect professional obstacles, client expectations, and the practice context. Examples of barriers include professional training, practitioner beliefs and experience with occupation, administrative support, a pervasive exercise culture, client expectations of exercise, logistical obstacles related to documentation and billing, and the physical practice environment, specifically space and equipment (Colaianni & Provident, 2010; Psillas & Stav, 2021; Stav & Herman, 2022).