Summary for OT 1111: October 4th
Article: The environment: a focus for occupational therapy
Author: Mary Law
Focus of Article: Individuals in Canada with a disability encounter environmental
constraints that limit their active participation in the daily life of interacting in a
community.
The Creation of Disabling Environments:
Built Environment: Structures such as buildings, houses, schools, streets, etc have been
designed and constructed by people without a disability. When considering construction
we forget the heterogeneity of individuals. This prevents some people from achieving a
balance between self-care, productivity and leisure activities.
Production of Space: Societal production of households, shopping districts and
transportation networks are created and are not feasible for individuals with disability.
Classification and Normalization: People with disabilities are differentiated as
abnormal versus normal.
Disability as Deviance: There is an importance placed on the “normality” of everyone
that results in a disabled person being seen as a person with a defect.
Power: Professionals are perceived to hold the truth about how to correct disability.
People with disabilities have little political power and are expected to comply with
treatment.
Bureaucracy: This refers to those structures and processes which are used to order
human actions. Professionals are often rewarded for processing and controlling patients,
not for helping them. The primary goal of a bureaucracy is to have rules which ensure
conformity and stability.
Ideas About Occupation:
First: occupation is performed within a context. That context includes societal rules, an
individuals developmental stage and the environment in which the individual lives.
Second: the classification of a specific activity into the areas of self-care, productivity or
leisure is dependent on the purpose of the activity and the context in which it is
performed.
Thirdly: disability often leads to occupational dysfunction.
Concept of Time: time is seen in Western culture as a commodity. There are substantial
differences in the use of time or activity patterns between individuals with a disability
and those with no disability.
Satisfaction with Occupation: Satisfaction = Flow (losing yourself in an occupation)
To achieve flow, there needs to be a balance between the situational challenges posed by
an activity and personal skills. Therapists can work with clients to structure activities so a
balance between challenges and skills is achieved and activities progress towards
increased complexity.
Environment: are defined as those contexts which occur outside the individuals and
elicit responses in them. It is also used to indicate the broad range of environmental
factors which can affect daily occupation. All environmental settings have forces which
support or work against individual’s participation. Environmental intervention has the
potential to make a significant difference in the occupational function of our clients.
Principles for Environmental Intervention in OT:
Goals: Our goals will be our clients goals, based on their needs and values.
Definition of Need: The need for occupational intervention will be based on the right of
people with disabilities to engage in meaningful occupation.
Theoretical Approach: We will recognize the ecological nature of disability, the
interdependence between the individual and the environment.
Context of Intervention: Clients meaningful occupation is based on their cultural,
social, physical and economic environment.
Built Environment: We will support communities which are built based on the right of
full participation for all citizens.
Participation and Power: People will be allowed to actively make choices.
Intervention and Programme Planning: Explore activities which are meaningful to the
client, have a balance of environmental challenge and skill and enable them to experience
flow. Work with people to explore and modify time use to achieve balance across selfcare, productivity and leisure.
We will develop new models of environment intervention.
Role of Occupational Therapist: We will give up power, acknowledge the political
nature of our role and work together with clients and others to resolve environmental
problems.