Please find in the additional pages a cue sheet to use in initial assessments! I developed this whilst I was a student and it helped a lot!
Wilcock (1998) stated that occupation was “a synthesis of doing, being and becoming” that is central to the everyday life of each individual and their health and wellbeing (p. 249). Wilcock (1998) further proposes that doing, being and becoming is integral to the philosophy of occupational therapy, the process and each outcome, as it epitomises occupation.
The first part of this essay will describe doing, being and becoming and health and well being, then occupational form and performance, therapeutic strategies and the meaning and place occupation has in society. Then through an exploration of pottery as a purposeful activity, each of these elements brought forward through several articles discussed, will be synthesised into an occupation critique to provide an in depth discussion of pottery as an occupation.
Doing has been described as the purposeful, goal orientated, observable, active doing of an occupation, the physical performance in initiating meaningful and purposeful occupations and a mechanism for social interaction and growth (Whalley Hammell 2004; Wilcock, 1998). Being, as a concept, encompasses the inner experience of the doer, the self discovery and flow experience (Lyons et al, 2002; Wilcock, 1998). Csikszentmihalyi (1975, cited in Emerson 1998) describes a flow experience as a subjective psychological state one experiences when immersed or absorbed within an activity. Wright et al (2007) discussed the importance of challenge and skill in flow; one must utilise their skills and the occupation must be a challenge for the optimal flow experience to occur. Becoming is the next natural step in the doing, being, becoming process where the doer becomes competent and realises their potential, transforms, grows and self actualises (Wilcock, 1998).
Wilcock (1998) provided this framework for occupational therapists to fully comprehend the complexities of occupation and through this framework, enable occupational therapists to enable health through occupation. Occupational therapists must ensure a dynamic balance between these three elements in their client’s occupational lives (Lyons et al, 2002).
Nelson (1988) aimed to define occupation and its relationship with occupational forms and occupational performance, and the meaning and purpose of occupations. Occupation is the dynamic relationship between the occupational form and occupational performance with subjective meanings and purposes (Kramer et al, 2003; Nelson, 1988; Wu and Lin 1999). The occupational form is an objective, multidimensional set of circumstances which is external to the doer that structures, guides or elicits human occupational performance (Kramer et al, 2003; Nelson, 1988). The occupational performance is the actions taken in response to the occupational form (Nelson, 1988). The meaning of occupational forms lies heavily on the individuals own developmental structure, meaningful occupation is subjective as ones meaningful occupation may not be that of another (Nelson, 1988). Occupation has to be purposeful, and this is the goal orientation of the person with a link between the developmental structure and occupational performance (Nelson, 1988).
McLaughlin Gray (1998) addresses the difficulties of keeping occupation at the centre of the occupational therapists practice in each of their therapeutic strategies, and discussed component driven practice and the professional pressures occupational therapists can encounter. McLaughlin Gray (1998) discussed occupation as ends and occupation as means. Occupational as ends is the over-arching goal of occupational intervention (McLaughlin Gray, 1998). Occupation as means is the use of a therapeutic occupation as a therapeutic strategy to improve
occupational outcomes (McLaughlin Gray, 1998).
Persson et al (2001) provided a structure to introduce value as a prerequisite for meaning of occupation. Three dimensions of this were discussed, concrete, symbolic and self reward values. Persson et al (2001) discussed the macro, meso and micro components to categorise singular occupations. They proposed that all occupations are meaningful if they relate to a persons’ occupational continuity, but that the relationship between the three components determine their unique meaningfulness.
The occupation of pottery as a meaningful and purposeful therapeutic medium will now be discussed and related back to the articles discussed. Engagement in occupations that are meaningful and purposeful to an individual provides a sense of worth and meaning (Whalley Hammell, 2004). The use of pottery as a therapeutic intervention would have to ensure a subjective sense, meaning and purpose; meaning being the person’s interpretation of the occupation form, with this achieved, purpose can be possible, where the person subjectively decides their goal and intention (Nelson, 1997).
The occupational form of pottery can consist of the materials such as the clay, knife and apron, the environment of the art centre and group room; the human context in form of the participants and the banter; the temporal context and the socio-cultural reality, which in the experience encountered within this module included the friendship circles and the university institution (Nelson, 1988). The occupational performance consists of the gross motor movements required to pick up the clay and the fine motor skills to manipulate it into the desired outcome, speech when interacting with group members, ocular movements when interacting with the clay and the covert experience by thinking how one will manipulate the clay to shape the desired outcome (Nelson, 1988). This is the doing of doing, being, becoming as it is the action performed in
relation to the occupational form. The client may experience being throughout the therapeutic intervention through enjoying the occupation and reflecting and experiencing flow by being absorbed into the occupation. Becoming would take place when the client had learned from the occupation and acquired skills and mastery in the occupation at hand; in this example it would be pottery (Wilcock, 1998). The occupational form can be divided into three constructs; imagery based occupations, materials based occupations and rote exercise (Wu and Lin, 1999). The occupational form for pottery is centred upon material based occupation where the doer may manipulate the clay to form a desired object. The occupational form can take on differing meanings to each participant; meanings can involve the affective meanings, perceptual meanings and also the symbolic meanings (Kramer et al, 2003). Meanings are individual and each person interacting with an occupational form will assign their meanings that are unique to their own developmental structure (Kramer et al, 2003).
Occupational therapists can design an occupation form in collaboration with their client to enhance the therapeutic process to meet goals; this is cited as occupational synthesis (Nelson, 1996). Through occupational synthesis, the occupational therapist can provide therapeutic interventions that challenge their developmental structure appropriately (Nelson, 1996). Occupational synthesis is also cited as a “helping process” (Nelson, 1997). An occupational therapist may provide pottery in a group environment as a therapeutic intervention with a client who experiences a lack of social skills. The purpose of such an intervention would involve a sense of extrinsic purpose from the participant, as the occupational form would be external to the purpose of social interaction and inclusion, whereas, intrinsic purpose would involve the participant interacting with the
occupational form for the purpose of interest or exploration (Kramer et al, 2003). Through providing pottery as a therapeutic intervention that was both meaningful and purposeful, the occupational therapist would be providing occupation as means as it would increase client outcomes (McLaughlin Gray, 1998). Occupation as means links into being, in doing, being and becoming. The participant in the activity may enter a flow experience where enjoyment in the activity would take place (Wilcock, 1998). Occupation as ends would be enabling the client to utilise the therapeutic use of pottery to meet the over-arching goal of social participation and inclusion (McLaughlin Gray, 1998). Occupation as ends may
then mirror the becoming stage of doing, being becoming as the ends may enable self actualisation and transformation in the participants circumstances (Wilcock, 1998). Blanche (2007) discussed that creativity and the use of creative occupations can enable self actualisation and heighten self awareness. Self actualisation, through doing, being and becoming must, therefore, increase health and wellbeing (Wilcock, 1998).
Gilbert (1996) discussed the importance of Quichua pottery to the communities of Equador. Pottery has meaning and purpose in this community, in the shape of culture and financial gain (Gilbery 1996). Meaning is multidimensional, and can be shaped by a variety of influences, the cultural environment and our own social environment can be contributors to the shaping of this meaning (Hannam, 1997). The purpose or goal directed perspective revolves around the financial gain associated with Quichua pottery, while the meaning often revolves around the
cultural environment. This links into pottery having value and meaning within society as it can serve a means to financial profit and provide communities with the tools to shape their culture. Occupation that is both meaningful and purposeful would work as a motivator for enhanced health and wellbeing (Lin et al, 1997; Wilcock, 1993). The use of pottery in this context provides meaning and purpose and by utilising pottery as a means of profit, to sustain one’s present life and survival, and by utilising it in one’s socio-cultural environment positively impacts on the Eduadorian potter’s health and wellbeing (Wilcock, 1993).
To determine the value of an activity for clients, occupational therapists should initiate activity analysis to examine the therapeutic benefits of that particular activity to a client (Swee-Hong and Yates, 1995). The activity of pottery would be analysed through activity analysis to determine this and to sequence the task at hand (Creek, 1996). Activity analysis is a process whereby the occupational therapist breaks down an activity into its component elements and task sequences to identify its therapeutic potential and skills for performance then adapting it to enhance potential (Creek, 2003). The occupational therapist would analyse pottery as a therapeutic activity by analysing the performance skills required as well as the physical and human requirements, including space and equipment, structure and purpose, meaning and value (Creek, 2003). These are a select few and the occupational therapist would analyse on a much deeper level whilst analysing pottery as an activity.
Occupation is complex. Occupation has many component parts explaining the nature of it. These include occupation as a process of human interaction with their environment, as influenced by habits, knowledge and skills. These same interactions can involve self-care, productivity and leisure, all with an over-arching relationship with meaning (Lambert, 1998).
Participation in meaningful and purposeful occupations are vital to humans as it builds skills and develops experience, and enhances our social participation amongst communities and groups in society (Law, 2002). Occupation clearly has a positive influence on health and wellbeing and these are cited to be “inseparable” (Law et al, 1998; Wilcock, 2007). Occupational therapists are equipped with the professional skills to ensure health and wellbeing through participation and adaptation of activities that are meaningful and purposeful to their clients as occupation is the core of occupational therapy (Lambert, 1998; Law et al, 1998).
McLaughlin Gray (1998) discussed component-driven practice, its relationship with the medical model and the deprivation of meaning and purpose to enhance benefits to outcomes of therapy. Providing occupations that are meaningful and purposeful to the individual would improve outcomes and enhance health and well being through occupation (Law et al, 1998; McLaughlin Gray, 1998). Baum (1997, cited in McLaughlin Gray, 1998) points out that occupational therapists must keep an occupational perspective in each of their contacts with their clients and must feel positive and nurture the use of meaningful and purposeful occupations to ensure that we meet our client’s needs. The use of pottery as an occupation would be a beneficial activity to utilise if meaningful and purposeful to the participant in the activity. The therapeutic use of activity is indeed a core skill of occupational therapy (COT 2006) and occupational therapists should embrace this skill in their practice to increase outcomes of therapeutic occupational therapy.
Wilcock (1998) proposed that occupation was much more than just doing, but it was a “synthesis of doing, being and becoming” (p. 249). Its premise is on meaning, rather than purpose and goal directed purposes (Whalley-Hammell, 2004). However, Whalley-Hammell (2004) discussed the recent research by Roberio et al (2001) who brought “belonging” to this occupation focused theory. Roberio et al (2001, cited in
Whalley-Hammell 2004) proposed that belonging comprised the necessary social support networks to occupational performance and satisfaction in life. Belonging can promote a sense of meaning and increase the pleasure of doing (Whalley-Hammell, 2004).
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