Focusing on “what matters”: the Occupation, Capability and Wellbeing Framework for Occupational Therapy

Abstract

Introduction: Critical occupational therapists have challenged models from the Global North that have dominated occupational therapy and informed ableist practices focused on appraising dysfunctions, classifying deviations from bodily “norms”, and remedying individuals’ “deficits” in performing three occupations (selfcare, productive, leisure). This indicated the need for a new conceptual framework; one grounded in research evidence derived from a diversity of people and contexts. Objectives: To outline the imperative for, and genesis and features of an evidenceinformed conceptual framework for occupational therapy, centred on occupations, capabilities and wellbeing. Methods: This paper draws from the work of critical occupational therapists; outlining the conception and process of building a flexible framework by linking concepts identified through extensive review of multidisciplinary research from both the Global South and North. Results: Building on evidence that occupation is a determinant of wellbeing, the Occupation, Capability and Wellbeing Framework for Occupational Therapy (OCWFOT, Hammell, 2020a) encourages a strengths-based approach to occupational therapy: assessing and building on individual, collective and community assets, abilities and resources; focusing on occupations that “matter most”; and fostering a relational view of people as interdependent and embedded within families and communities. Conclusion: Focused unequivocally on the wellbeing needs and aspirations of individuals, families, groups, communities and populations that are met or unmet by current patterns of occupational engagement; on both abilities and opportunities; and on occupation as a human right, the OCWFOT is theoretically defensible, provides conceptual clarity, and has utility as an evidence-informed structure around which future research and practices may be oriented.