Participatory change
: an integrated approach toward occupational therapy practice development

    Student thesis: Doctoral ThesisDoctor of Philosophy


    The implications of implementing evidence-based change in practice settings are complex and far reaching. Research examining ways to implement professional theory-driven approaches and support occupational therapists to advance their practice is limited. This participatory action research (PAR) study set out to investigate the implementation of an evidence-based occupational therapy conceptual model of practice, the Model of Human Occupation (MOHO) (Kielhofner 2002) across a mental health occupational therapy service. Methods used involved preparatory workshops and twelve months of team-based, monthly group reflective supervision sessions. In addition individual meetings with the occupational therapists took place every six months for the initial twelve months and a further year thereafter.

    The findings present a fusion of theoretical positions which are integrated within a ‘Participatory Change Cycle’. Emphasis is placed upon the development of a communicative space within which critical consciousness-raising occurred. This in turn enabled the therapists to take steps to advance their practice in light of theory. Fundamentally the therapists engaged in a process of re-negotiation of their professional selves in front of colleagues and myself as an external group facilitator and in the context of professional and political structures. The findings examine how learning occurs amongst people, within the contexts in which it holds meaning; I explore how disciplinary learning has occurred via praxis, which served to transform identities and ways of knowing and participating.

    The study concludes with recognition of the need for an inclusive approach to practice development which embraces each individual therapist’s personal stance and professional craft knowledge alongside the contribution of intellectual constructs. It is argued that those involved in practice development initiatives work to develop a sustainable group collective, a community of practitioners who remain committed to their professional development whilst remaining mindful of contextual issues including subtle individualistic efforts to effect change, which are not always visible at face value. Furthermore, practice development initiatives require collaboration between occupational therapists from education and practice to maintain perspective regarding the contribution of both propositional and practical know-how.
    Date of Award2009
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorDeanne Clouder (Supervisor), Kirsty Anne Forsyth (Supervisor) & Angela Browne (Supervisor)

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