Canadian Journal of Occupational Therapy 2014, Vol. 81(5) 289-297 DOI: 10.1177/0008417414540129
Article
Empirical lessons about occupational categorization from case studies of unemployment
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Lec¸ons empiriques sur la cate´gorisation des occupations a` partir d’e´tudes de cas sur le choˆmage
Rebecca M. Aldrich, Caroline Harkins McCarty, Brian A. Boyd, Caitlin E. Bunch, and Cathrine B. Balentine
Key words: Classifications of occupations; Experiences; Occupational science; Qualitative research; Work. Mots cle´s : classifications des occupations; expe´riences; recherche qualitative; science de l’occupation; travail.
Abstract Background. Scrutiny regarding the typological categorization of occupation (e.g., occupation as work, rest, or leisure) has prompted interest in experiential categories as a less exclusionary alternative. Empirical research can extend the dialogue about categorization by demonstrating how people in particular situations apply and generate occupational categories. Purpose. This article explores how adults without work utilized typological and experiential categorizations when discussing their occupations. Method. Data were generated via a secondary analysis of interview transcripts from three ethnographic case studies. Findings. Study consultants gravitated toward experiential rather than typological categorizations, emphasizing the social, chosen, purposeful, and temporal qualities of their occupational engagement. Implications. Occupational therapy practitioners and researchers must explicitly state how and why they categorize occupations with clients and research participants. Whereas typological categories can be used to initiate discussions about occupation, open questions paired with consultant-generated experiential categories may better capture occupational engagement and reveal potential injustices in situations like unemployment. Abre´ge´ Description. L’examen approfondi de la cate´gorisation typologique de l’occupation (p. ex., occupation en tant que travail, repos ou loisir) a suscite´ l’inte´reˆt pour une solution de rechange moins exclusive, soient les cate´gories expe´rientielles. La recherche empirique peut permettre d’e´largir le dialogue sur la cate´gorisation en de´montrant comment les personnes se trouvant dans des situations particulie`res utilisent et cre´ent des cate´gories d’occupations. But. Cet article explore la fac¸on dont des adultes sans travail utilisaient des cate´gorisations typologiques et expe´rientielles pour discuter de leurs occupations. Me´thodologie. Des donne´es ont e´te´ produites a` l’aide d’une analyse secondaire des transcriptions d’entrevues tire´es d’e´tudes de cas ethnographiques. Re´sultats. Les consultants des e´tudes gravitaient autour des cate´gorisations expe´rientielles plutoˆt que des cate´gorisations typologiques, en mettant l’accent sur les qualite´s sociales, choisies, utiles et temporelles de leur engagement occupationnel. Conse´quences. Les the´rapeutes et les chercheurs doivent e´noncer explicitement comment et pourquoi ils utilisent des cate´gories d’occupations avec les clients et les participants a` la recherche. Lorsque les cate´gories typologiques peuvent eˆtre utilise´es pour amorcer les discussions au sujet de l’occupation, des questions ouvertes, combine´es aux cate´gories expe´rientielles cre´e´es par les consultants peuvent permettre de mieux saisir l’engagement occupationnel et de mettre en relief d’e´ventuelles injustices dans des situations comme le choˆmage.
Funding: No funding was received in support of this work. Corresponding author: Rebecca Aldrich, Saint Louis University, Department of Occupational Science and Occupational Therapy, 3437 Caroline Street, AHP Room 2020, Saint Louis, MO 63104, USA. Telephone: (314) 977-8577. E-mail: [email protected]
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program completed individual ethnographic case studies under the first author’s guidance between 2010 and 2011. Study recruitment occurred through convenience sampling and was advertised via community bulletins, virtual forums, or word of mouth. The students treated participants as consultants per the terms of collaborative ethnography (Lassiter, 2005), a methodological approach that is increasingly used to teach ethnographic research (Lassiter & Campbell, 2010). A collaborative ethnographic approach aims to rectify problematic power differentials that traditionally exist in research. By using the term consultants, students aimed to signal participants’ centrality in knowledge generation and partnership in the research process. Following a potential consultant’s expression of interest, each student explained the parameters of study participation and secured informed consent. Consultants were required to be between 18 and 65 years of age, by their own definition not retired or currently employed, and fluent in spoken English. The university’s institutional review board (IRB) exempted the class project as well as the secondary analysis of three cases from that project from review.
n the pursuit of clarity, occupational therapists and occupational scientists have developed categories to differentiate occupations. Adolf Meyer’s ‘‘Big Four’’ typology of work, rest, play, and sleep was the primary basis of such efforts until scholars recognized its culturally specific, individualistic, non-empirical (Hammell, 2009a), and potentially exclusionary (Hammell, 2009b) nature. Research has affirmed the restricted applicability of this traditional typology for certain social groups (e.g. Beagan et al., 2012), life-span stages (e.g. Weinblatt, Ziv, & Avrech-Bar, 2000), and non-Western experiences (e.g. Kantartzis & Molineux, 2011). Such findings underscore the need for empirically derived and broadly relevant categories (Ellegard, 2006) that are based on alternative factors, such as experiential elements or intrinsic needs (Hammell, 2009a, 2009b; Jonsson, 2008). However, without questioning how, why, or to what end any categorization is employed, therapists and scholars will lack a clear rationale for continuing to use or refine occupational categories. This article problematizes occupational categorization by using examples from case studies of joblessness. Work is often viewed as an occupation that constitutes everyday life; its absence can therefore illuminate taken-for-granted assumptions about categories of occupation. Since the landmark Marienthal study (Jahoda, Lazarsfeld, & Zeisel, 1933/2002), sociologists and psychologists have examined nonworking adults’ activities relative to ‘‘categories of experience’’ (cf. Haworth & Ducker, 1991; McKee Ryan, Song, Wanberg, & Kinicki, 2005). Such scholarship focuses on themes of loss (Blustein, Kozan, & Connors-Kellgren, 2013) and other negative psychological consequences (Wanberg, 2012) as they are experienced in everyday life. However, that scholarship has provided a framework that has no regard to occupation per se, historically omitting the more mundane occupations that make up everyday experience (Wallman, 1979). Understanding how occupational categorization generates knowledge about unemployment is thus relevant to occupational science specifically and scholarship on joblessness generally. Research shows that a lack of work does not equate to a lack of multifaceted everyday experiences (Cottle, 2001; Engbersen, Schuyt, Timmer, & van Waarden, 1993). Especially following the 2008 recession, the millions of people living without paid employment deserve to have their everyday occupations better understood. Occupational scientists have redoubled their efforts to understand joblessness from an occupational perspective (Aldrich & Callanan, 2011; Aldrich & Dickie, 2013; Laliberte Rudman, 2013), and this study furthers that endeavour by exploring how adults without work categorize their occupations.
Method This secondary analysis drew upon data from a class project that investigated the occupations of adults without paid employment. Seven female students in a master’s of occupational therapy Canadian Journal of Occupational Therapy
Data Collection Steeped in a Deweyan ontological and epistemological framework—which holds that knowledge should start from (Boisvert, 2007) and be adequate to (Pappas, 2008) experience—the original project used methods that privileged real-world knowledge about unemployment (O’Leary, 2005). In accordance with Dewey’s support for multiple forms of knowledge (Johnson & Onwuegbuzie, 2004), the case studies combined a questionnaire with interviews and observations to yield in-depth descriptions via a multiple representative case study approach (Creswell, Hanson, Clark Plano, & Morales, 2007). The case studies began with an initial intake interview and administration of the Occupational Questionnaire (OQ; Smith, Kielhofner, & Watts, 1986). Per the guidelines listed on the OQ, the student researchers asked their consultants to list a ‘‘typical’’ weekday’s activities on the preformatted OQ spreadsheet. The spreadsheet documented activities in half-hour increments between 5:00 a.m. and midnight and required consultants to link each activity to one of the following categories: work, daily living work, recreation, or rest. The OQ guidelines also required consultants to rate each activity in terms of importance, personal aptitude, and personal enjoyment. The OQ served to focus students’ interview questions for ethnographic data generation; it was not used for quantitative analysis due to the small sample size of the project. Following the initial interview and OQ, each studentconsultant pair collaborated to identify and describe the consultant’s daily occupations. Students specifically asked consultants to comment on the ease or difficulty of completing the OQ, including the need to categorize occupations. Instead of relying on a predetermined question for that purpose, students used general prompts as appropriate, such as, ‘‘If you’re having trouble deciding where an activity fits, then talk me through why.’’ Subsequent participant observations and
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Canadian Journal of Occupational Therapy 81(5) interviews about occupation took place over four to six visits and lasted from 1 to 3 hours. Each student personally collected, transcribed, and de-identified her data, iteratively analyzing and generating data until saturation was reached or participants were no longer available for the study.
291 shared their findings with their respective consultants to seek feedback regarding the appropriateness of their representations and analyses. As a final step for this secondary analysis, those same authors individually assessed the faithfulness of the first and second authors’ findings relative to the original interview and observation experiences.
Data Analysis Upon IRB approval of this secondary analysis, the second author (one of the original student researchers) gathered electronic copies of each student’s data and imported it into Atlas.ti software for analysis. The following question guided this secondary analysis: ‘‘What similarities and differences exist in the occupational categories discussed by people who are unemployed?’’ Because our question had the potential to encompass both OQ typological categories and situation-specific experiential categories, we did not apply a preexisting theoretical framework to our analysis. Such a decision is appropriate for descriptive analysis of qualitative data (O’Leary, 2005) and supportive of the coding process suggested by Charmaz (2006). Of the seven original student researchers, six made their cases available for this secondary analysis. Of those six, one case was excluded due to missing transcripts and another was excluded due to a general lack of clarity in the data. The first and second authors individually began analyzing the remaining four cases via open coding of the interview transcripts, seeking in vivo descriptions of occupation relative to the OQ typological categories as well as other descriptors of occupations. The authors initially coded individual cases and did not at first utilize or compare codes across cases. This approach followed a common analytic strategy in multiple case study design, where preliminary identification of the issues within each case occurs prior to assessing commonalities across cases (Creswell et al., 2007; Yin 2003). The first and second authors had repeated e-mail and phone conversations during this phase of analysis to facilitate discussions of analytic convergence and divergence. After 3 months of open coding, the first and second authors met in person to refine codes and discuss strategies for focused analysis. At that meeting, the authors excluded one additional case from focused coding due to a lack of content specifically related to occupational categorization. For the three remaining cases, the first and second authors individually assigned descriptive labels across the cases to data that referenced occupational categorization. The first and second authors then electronically traded and compared their codebooks and met in person one final time to discuss themes. While generalizability is not an appropriate goal for case study findings, transferability to similar situations is possible even with a small number of cases. Findings across wellchosen representative cases—such as the ones used for this secondary analysis—may be reported as lessons learned that can illuminate shared experiences and indicate areas for further investigation (Creswell et al., 2007). In addition to their transferability, the three case studies selected for this secondary analysis are also authentic and trustworthy. During the original project, the second, fourth, and fifth authors of this article
Participants At the time of the original study, Mac was in his 50s, lived with his wife, and had been a town manager until he was laid off from his position. The occupations he identified as most important were caring for his family and volunteering with his church. His days were organized primarily by the priorities identified by his wife, family, pastor, and church members for what needed to be done that day. He was searching for work at the time of the study and anticipated that he would eventually find another job in the same field. Judith was in her 40s, lived with her husband and two sons, and voluntarily left her job within the field of technology to be a fulltime mother. The occupations she emphasized as most important to her related to mothering, community building, and ecological sustainability. Her days were organized primarily around the needs and schedules of her husband and children. She was planning a return to work in a different field, working for herself or in partnership with other women making ecologically sustainable products. Diane was in her 40s, lived with her two dogs, and left her job as a teacher due to a progressive disability. The occupations she emphasized as most important to her related to walking her dogs, spending time with others, and giving back to her community. Her days were organized primarily around caring for her dogs, volunteering, and her frequent doctor’s visits. Due to the permanence of her disability, she did not anticipate a return to work. All three consultants were Caucasian, previous members of the middle socioeconomic class, and residents of North Carolina in the United States. Each consultant had been unemployed for a period greater than 1 year: Mac for 12 months, Judith for 18 months, and Diane for 5 years. Their education levels ranged from undergraduate (Mac and Diane) to master’s (Judith) degrees. For consistency, each section of the findings will discuss the consultants in the order they have been presented here.
Findings This secondary analysis explored the ways in which adults without traditional paid employment categorized their occupations. As noted in the Method section, each consultant was initially asked to label his or her occupations using one of the four categories listed on the OQ. Those categories—clear derivatives of Meyer’s Big Four—proved to be problematic for most of the consultants, who often used personally generated descriptors as alternatives to OQ categories. As the following findings demonstrate, although the traditional OQ categories were useful starting points for student-consultant discussions, the categories failed to encompass the social, chosen, purposeful, and temporal qualities that
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consultants described as central to their occupational engagements. Given that the consultants largely abandoned using OQ typological categories in favour of experiential categories, the themes below problematize the typological categories within discussions of consultant-identified experiential categories.
Social: Staying Connected One prominent feature of Mac’s, Judith’s, and Diane’s descriptions was the way in which occupation connected them to others. Volunteering, caregiving, and being part of the community were important to each of the consultants, respectively, and to some degree, collectively. While in some cases, consultants framed an occupation as social because it meant doing or being in connection with others, in other cases, consultants framed occupations as deliberate vehicles for creating and maintaining community. Each person’s connection to his or her own humanity or other humans was often linked to a need to redefine normalcy in the absence of paid employment. For Mac, each day was structured by his social relationships: He decided how to spend his time based on the needs of his wife, adult children, granddaughter, and church. Staying connected to others was an important part of the occupation he named ‘‘volunteerism.’’ When asked if any of his occupations did not fit within the categories provided by the OQ, he noted, Well, like the thing that you’ve got here is it talks about work, daily living, recreation, or rest. Um, I put a lot of stuff in daily living that’s not work and it’s not recreation, and I guess it’s considered as daily living work, but like when I do volunteer work at the church, it’s volunteer work. It’s not work, and it’s not something that I have to do to eat, and breathe, and live. It’s volunteerism.
Mac’s inherently social occupation of volunteerism did not have any place within the existing categories of occupation: It was in a category all its own. For Mac, volunteerism was especially important—and easier to achieve—in the absence of work: Because I’m out of work, they can call me from the church if something’s going on or someone needs something. I can help with that. We went over and helped stuff bulletins today. Things that I wouldn’t do if I was working.
Mac ultimately classified helping others as daily living work when the student researcher asked him to choose an OQ category. However, he preferred to use his own term of volunteerism or the phrase ‘‘doing what needs to be done’’ to frame such occupations. For Judith, staying connected meant establishing connections with her community through participation and volunteering. She remarked that social connectedness was particularly important to her because of her experience as a stay-at-home mother: For a full time, stay-at-home mom . . . either your needs get met or the kids’ needs get met. There are just not enough resources, time resources, for everybody’s needs to get met . . . and so stay-at-home moms are very isolated women.
One social part of Judith’s daily routine was time at the YMCA, which she categorized as ‘‘community recreation,’’ noting, Canadian Journal of Occupational Therapy
‘‘I consider this activity to be recreation for sure . . . so my 2 hours at the Y are great. It’s community, I know people there.’’ Judith specified that this was community recreation to indicate the social nature of this occupation; in addition to being enjoyable and contributing to her wellness, time at the YMCA provided an opportunity to build relationships and socialize. Judith also sought community to support her sustainability values. Having been unsuccessful in locating a community that promoted sustainability, Judith created such a community by volunteering with her neighbourhood garden. She organized events with farmers to educate children about local food, to build community and connection with others, and to build sustainable farming skills that she might need in the future. This occupation was not visible on Judith’s OQ—perhaps because it was not a daily event—but she described it repeatedly in her interviews as highly important, collaborative, and social. Similar to Mac, volunteering linked Judith to the world outside her home and helped her build connections within her community. Although both Mac and Judith used work-like descriptors when discussing their occupations, they also foregrounded the social nature of those occupations in subsequent conversations and employed self-generated labels in place of those offered by OQ categories. Staying connected was also important to Diane. She emphasized the social aspect of walking her dogs with neighbours and volunteering to tutor her neighbour’s children. Similar to Judith, Diane experienced increased isolation after leaving the workforce, and her isolation was compounded by her disabilities, her adult children leaving home, and the dissolution of her marriage. Diane observed that most of her sameage peers were at work during weekdays and that dog walking became a purposeful way for her to connect with her neighbours in her new situation. She noted, I guess there are people my age, but if you have a job, you’re so wrapped up in that and the time it takes to get home and cook or clean or whatever. Almost all my really good friends are dog walkers, because you know we are all doing the same thing.
In the absence of paid employment, it was the shared occupation of dog walking that allowed Diane to meet and spend time with others. She eventually formed close friendships with the dog walkers in her neighbourhood, and walking her dogs became multifaceted and particularly meaningful. It was both something she had to do every day for her dogs and something she enjoyed doing because it helped her stay connected. On the topic of categorization, Diane remarked, Walking my dogs is definitely recreation. Another way to describe it is a time to get out and be social, a time to—you know you’re going to—I try to, I say hi to everybody I see everywhere, period.
Control: ‘‘It Depends on Whether I’m Having Fun or Not’’ The second commonality between Mac’s, Judith’s, and Diane’s accounts was that each person described occupations in terms of the things they enjoyed and wanted to do versus the things
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Canadian Journal of Occupational Therapy 81(5) they had to do. Each consultant experienced changes in control over how he or she used time and selected occupations in the absence of paid employment. For Mac, increased control over his time changed his enjoyment of certain occupations: The great thing about being unemployed is that it’s not the same everyday. So, the great thing is there’s no monotony. I can work out in the yard a day and that’s fine, that’s wonderful. But I don’t have to do it everyday. So it doesn’t get tiresome. . . . Do some volunteer work at the church, it’s something I can do, but if it gets to be too, uh, overbearing, I can go, no, I want to do something else for a day or so.
Being able to set his own schedule and choose how he spent his time increased Mac’s enjoyment of some occupations, such as working around the house and volunteering at his church. This in turn impacted the way he categorized and described those occupations, which moved from ‘‘things I need to do’’ to ‘‘things I enjoy doing,’’ mimicking a move from the category of work to one of recreation. This shift was particularly evident in Mac’s efforts to categorize volunteerism because his experience of volunteering contrasted with his understanding of work. Mac explained, ‘‘A lot of it is almost recreation. It’s, it’s daily living work [sighs, as if it is a hard choice] because when we are doing things at church we are doing things ’cause something needs to be done.’’ His difficulty categorizing volunteering illustrates the tension between Mac’s experience of volunteering, which he enjoyed and labelled recreation because he had more control over his time and because of his perception of that occupation’s purpose, which was productive and thus associated with daily living work. Similarly, Judith noted that her enjoyment of an occupation—‘‘if I’m having fun or not’’—determined the way that she categorized the occupation. For example, she initially categorized all parenting occupations as work, yet subsequent reflection led Judith to articulate different categorizations for specific aspects of parenting. She noted, I would consider taking care of my children work. Although . . . there’s times when it’s work and there’s times when it’s recreation. Like, [if] I’m at the park with them, it might be recreation. It depends on if I’m having fun or not, I guess. So, I mean, I think that [pauses] . . . being with the children includes everything except for resting. Because there is no rest.
Judith categorized playing with her sons at the playground (which she enjoyed) as recreation, but she categorized playing with her younger son indoors (which she did for his benefit but did not enjoy as much) as work. For Diane, the contrast between enjoying an occupation and its perceived purpose also made categorization difficult. Diane found it most difficult to categorize occupations related to caring for her dogs. After much reflection, Diane highlighted that her enjoyment of these occupations played a central role in how she considered them: Having dogs is certainly not as much work as having children, but we [dog owners] all talk about it. It is a lot of work. But I enjoy it because of all the comfort they offer me, the unconditional
293 love, and everything . . . that’s why I don’t even want to call it work. They require a lot of attention, is a better way to put it.
Diane rejected work as a label for caring for her dogs because the term did not capture her experience of enjoyment, comfort, and love, even as she acknowledged the effort and attention required to engage in those occupations.
Purpose: ‘‘It Gives Me a Purpose to My Day, Not Just a Day of Monotonous Tasks’’ The notion of purpose was a unifying thread throughout the consultants’ discussions of occupation. Each person identified occupations that ‘‘give me purpose’’ or brought a sense of ‘‘satisfaction’’ to their lives. This sense of purpose stemmed from participating in occupations that upheld personal values. For Mac, volunteering through his church gave meaning to his days: There’s not a whole lot of way to make a job out of doing volunteer work at the church. There’s not a whole lot of a way to make a job out of taking folks back and forth to the hospital, and doing things like that. But there is a satisfaction that I get out of it.
He often compared his volunteering activities to working, as if they served as a replacement for the feeling of being helpful or useful via paid employment: I’ve signed up to go on the mission trip this summer. I’m gonna go to Nashville and they’ve got still that flooding stuff over there. That’s one of the ways. [My wife] and I went over and put the church directory together, that’s another way that we can be helpful. . . . A lot of different things like that, that the usefulness is different.
In contrast to Mac, Judith expressed relative satisfaction with the OQ categories, saying that although she had to make some choices about how she categorized parts of her daily routine, with enough deliberation, she could make all of her occupations fit within the OQ. As the only consultant who had intentionally left the workforce, Judith’s circumstances may have made it easier for her to relate to the OQ categories than it was for Mac or Diane. In all her conversations, Judith compared caring for her children to full-time employment in terms of its importance. Because she had quit her job to become a full-time mother, she may have more easily framed parenting occupations as work in connection with her sense of purpose. For Diane, tutoring her neighbour’s children provided purpose to her days. She said, ‘‘I don’t charge to tutor [my neighbour’s daughter], it’s just good for me to have that. And it gives me a purpose to my day, not just a day of monotonous tasks.’’ She emphasized, ‘‘I always get the most satisfaction from giving . . . I get the most pleasure from helping others,’’ later noting that ‘‘doing that just makes me feel good, and the tutoring is a purpose and gives me a fulfilling sense of well, I’m not just wasting my days away.’’ This sense of purpose led Diane to use the label of volunteering more readily than any of the existing categories from the OQ.
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Temporal: ‘‘It’s Not the Way It Used to Be’’ Time was also a significant feature of consultants’ conversations about occupation. Mac, Judith, and Diane compared their current occupations to the way things ‘‘used to be’’ and couched occupations within hopes and plans for the future. Mac noted a different experience of time in his nonworking life as compared to his working life. He had more control over time and could prioritize valued or preferred occupations. In thinking about the future, Mac wondered how he would maintain his present occupations: When I go back to work, I don’t know how I’m going to get stuff done, because I’ve had a list. For this last 9, 10 months, my wife and I have gone from one project to the next . . . and the list is still, I erase off one and she puts three more on. . . . When I go back to work, I don’t know how I’m going to get the grass mowed on time, how I’m going to get all the leaves up.
Although he sought further employment and did not wish to remain out of work, Mac remarked that he would particularly miss helping his family and volunteering at his church when he resumed paid employment. Thus Mac actively planned for the future by networking and exploring work possibilities while also contemplating how he would accomplish his meaningful occupations after returning to the workforce. Unlike Mac, Judith did not experience any perceived increase in time upon leaving the workforce. Contrasting her past paid employment with caring for her children, she remarked, I was paid to work 30 hours a week, and then a year ago I retired from working outside the home. So I’m a full-time mom, and it’s a lot harder than going to work. Going to work is like going on vacation.
Judith additionally emphasized the lack of sick leave and vacation time for stay-at-home mothers in contrast with her experience of paid employment. In addition to comparing her present occupations with the past, Judith also spoke about achieving a desired future through her occupations. Dissatisfied with the amount of community in her life, Judith pursued her sustainable business and the possibility of an intentional living community as a means to the future she envisioned for her family. Diane often described her experience of time by contrasting her past life as a mother and teacher with her present life as a single, retired woman. For example, in reference to her morning routine, Diane noted, An interesting thought about it, eating, why do I eat cereal every day? Because when I worked, I would see my whole family, my ex-husband and the children, enjoying cereal, and I didn’t have time to sit and eat breakfast. I was the one running around, making sure they had a lunch or they had lunch money, getting myself ready for work, drinking coffee while I do my hair, and so I said to myself, the day I retire I’m going to eat cereal every day [laughs].
The occupation of dining was central to Diane’s comparison of the past to the present. She noted the adjustments she had made as her employment and family makeup shifted: Canadian Journal of Occupational Therapy
I find that from having been a wife and a mother, eating by myself is very lonely, and watching TV helps with that. I always made a point of everybody eating dinner together every night, and the children talking about their days, I’d talk about mine. So anyway, that helps with that and I always try to find something on about dogs, or training. . . . I love watching stories about children overcoming adversities.
Discussion The data illuminated four qualities relative to consultants’ categorization of occupation during unemployment. Social connectedness, suggested in both Jonsson’s (2008) and Hammell’s (2009b) experience-based categories, proved to be a fundamentally important aspect of Mac’s, Judith’s, and Diane’s respective occupations. Control, another important quality, appeared to exist in a complex relationship with personal enjoyment, extending Jonsson’s (2008) category of ‘‘basic’’ occupation and Hammell’s (2004) discussion regarding control. All three consultants also highlighted a sense of purpose in their social occupations, reinforcing Hammell’s (2009b) assertion that Western culture values occupations that have social benefits. Finally, all three consultants contrasted the things they used to do with their present engagements. The ability of occupational categories to encompass past, present, and future occupational engagement is not addressed in available literature aside from Hammell’s (2009b) brief statement that occupations allow people to connect with the past and future. Comparison to the past may be especially salient to nonworking adults because the transition from working to unemployment is a significant experiential marker; thus, categorization schemes ought to attend to the continuity (or lack thereof) of experience. Given that the experiential elements of social connectedness, control, purpose, and continuity were much more prevalent in consultants’ discussions than the labels that framed the OQ categories, the findings support a move away from typological categorizations of occupation. As noted in the introduction, typological categories sort occupations based on an unstated assumption of universal everyday occupational types. Such an assumption overlooks the situated and variable qualities of occupational engagement and can lead to the exclusion of many of life’s most meaningful occupations (Hammell 2009a, 2009b). This secondary analysis suggests an additional difficulty with typological categories: When people talk about their occupations, their descriptions can contain overlapping qualities of occupation that may disappear with forced categorization. An occupation that fits one occupational type might shift into an entirely different category depending on circumstance, and it is important to illuminate that shift more deftly than typological categories appear to allow. Despite consultants’ apparent preference for experiencebased categorization, we found that typological categories are not wholly without utility. In these case studies, the OQ categories gave student researchers a way to initiate discussions about occupations, even if from a reference point that viewed work as an assumed part of everyday life. In fact, beginning their discussions with the OQ categories may have helped
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Canadian Journal of Occupational Therapy 81(5) students highlight problematic assumptions and omissions associated with typological categories. When utilized for the purposes of starting conversations and problematizing assumptions, typological categories can thus lead therapists and researchers down an interesting path. If therapists and researchers continue to use the OQ in such a manner, we suggest they utilize Scanlan and Bundy’s (2011) Modified Occupational Questionnaire (MOQ). The MOQ was published after Mac, Judith, and Diane’s case studies had been completed (hence we did not use it in our analysis), and its added ratings for meaningfulness, typology of ‘‘worklikeness,’’ and items regarding the reason for doing an occupation may prevent some of the difficulties our consultants encountered with categorization. The most significant lesson learned from this secondary analysis is the need to explicitly state the purpose of using occupational categories. In determining the utility of occupational categorization, therapists and researchers may find guidance in the following question: Is the aim of categorization to fit people’s occupations within normative expectations, challenge prevailing assumptions, or generate alternate understandings? While the OQ categories—or even the Big Four—may not be used universally, the need to identify and justify an aim for their use can help therapists and researchers avoid unintentionally marginalizing occupations that do not fit within normative categorization schemes. It is equally important for therapists and researchers to consider when not to use (or ask people to use) occupational categories: If the goal is to honour a person’s own perception and experience of occupation, then socially referenced typological categories or previously generated experiential categories may not be appropriate. Honouring personal experiences may instead call for beginning with an open-ended question, such as ‘‘Tell me about your daily routine,’’ and following it with open questions based on people’s self-generated qualitative descriptions. Open questions leave room for a person to describe occupations in his or her own terms rather than imposing potentially restrictive predefined categories. Such questions may include ‘‘What do you enjoy doing in your daily life?’’ ‘‘What do you do that gives you purpose (or meaning)?’’ ‘‘What do you do to be with others?’’ and ‘‘Is there anything you used to do that you would like to get back to doing?’’ Direct exploration of occupational categorization can also facilitate justice-focused critiques when paired with appropriate open questioning. The collaborative ethnographic orientation of the student projects laid a foundation for the critical approach that increasingly characterizes occupational science and occupational therapy research (see Njelesani, Gibson, Nixon, Cameron, & Polatajko, 2013). Although students’ direct discussion of the OQ categories revealed potential occupational alienation (see Townsend & Wilcock, 2004) and occupational deprivation (see Whiteford, 2000) for Judith and Diane, that potential was not explored in the original study. Open questions, such as ‘‘Is there anything you cannot do that you would like to do?’’ or ‘‘What do you think is keeping you from doing things that you would like to do?’’ would have targeted those topics more specifically. Despite not providing detailed information on justice-related topics, this secondary analysis demonstrates that even a small number of cases can illuminate
295 social issues and highlight needs to improve data collection for critically focused explorations.
Limitations Although this study generated novel findings that support and extend discussions of occupational categorization, some limitations related to transferability must be noted. Given that all the consultants for this study were unemployed, our findings about categorization may not resonate with people who are not jobless. In addition, the variety of reasons underlying our consultants’ lack of paid employment may have yielded different approaches to categorization that this secondary analysis could not detect. Finally, our consultants all hailed from a middle-class socioeconomic background, and their financial supports may have helped them access occupations that would not be present in situations of less financial security. Future studies that have consultant pools with different features may vary in their findings from the themes discussed in this article. However, as the introduction shows, other studies uphold the general idea that experiential categorization is preferable to typological categorization; thus these particular limitations regarding transferability do not undermine the relevance of the findings.
Conclusion Although typological categories can provide a starting point for discussing occupation, the findings described in this article support Jonsson’s (2008) and Hammell’s (2009a, 2009b) advocacy for experiential categories as well as Scanlan and Bundy’s (2011) modification of the typological categories in the OQ. Furthermore, given that occupations can represent transactions with exceptionally uncertain situations, such as unemployment, static categories may not ‘‘get at’’ people’s ever-changing, situated occupational engagement as successfully as open-ended questions. For both therapists and researchers, open questioning based on knowledge of both typological and experiential categories may provide the clearest picture of occupation and related potentials for injustice. Therefore, therapists and researchers must explicitly consider how, why, and whether or not they ask people to categorize occupations. This imperative is especially applicable when talking with people in marginalized situations, such as unemployment, which norm-referenced typological categories inherently exclude. Further research is needed to understand what experiential qualities apart from the social, chosen, purposeful, and temporal nature of occupations characterize such situations, including how those qualities illuminate injustices that typological categories may hide.
Key Messages Occupational therapists and occupational scientists should consider the purpose of using occupational categories with clients and research participants.
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Aldrich et al. Typological and experiential categories may be useful for select practice and research aims, but the relevance of such categories for experiences such as unemployment cannot be assumed and warrants further research. Reliance on any categorization scheme necessarily limits what knowledge can be gained from interactions with others; such reliance may also inhibit critical, justice-focused analyses.
Acknowledgements We would like to thank the three consultants for participating in the original case studies that generated data for this secondary analysis. We would also like to thank Laurie Pearman, Alicia Matthews, and Abigail Owens for enhancing our understanding of qualitative research by participating in the research seminar that generated the case studies. Finally, we would like to thank the reviewers and the editor for providing helpful comments that strengthened this manuscript.
References Aldrich, R., & Callanan, Y. (2011). Insights about studying discouraged workers. Journal of Occupational Science, 18, 153–166. doi:10.1080/14427591.2011.575756 Aldrich, R., & Dickie, V. (2013). ‘‘It’s hard to plan your day when you have no money’’: Discouraged workers’ occupational possibilities and the need to reconceptualize routine. Work: A Journal of Prevention, Assessment, and Rehabilitation, 45, 5–15. doi:10.3233/WOR-131596 Beagan, B. L., De Souza, L., Godbout, C., Hamilton, L., MacLeod, J., Paynter, E., & Tobin, A. (2012). ‘‘This is the biggest thing you’ll ever do in your life’’: Exploring the occupations of transgendered people. Journal of Occupational Science, 19, 226–240. doi:10. 1080/14427591.2012.659169 Blustein, D. L., Kozan, S., & Connors-Kellgren, A. (2013). Unemployment and underemployment: A narrative analysis about loss. Journal of Vocational Behavior, 82, 256–265. doi:10.1016/j.jvb. 2013.02.005 Boisvert, R. D. (2007). John Dewey: Rethinking our time. Albany: State University of New York Press. Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage. Cottle, T. J. (2001). Hardest times: The trauma of long-term unemployment. Westport, CT: Praeger. Creswell, J. W., Hanson, W. E., Clark Plano, V. L., & Morales, A. (2007). Qualitative research designs: Selection and implementation. Counseling Psychologist, 35, 236–264. doi:10.1177/0011000006287390 Ellegard, K. (2006). The power of categorization in the study of everyday life. Journal of Occupational Science, 13, 37–48. doi:10.1080/ 14427591.2006.9686569 Engbersen, G., Schuyt, K., Timmer, J., & van Waarden, F. (1993). Cultures of unemployment: A comparative look at long-term unemployment and urban poverty. Boulder, CO: Westview Press. Hammell, K. W. (2004). Dimensions of meaning in the occupations of daily life. Canadian Journal of Occupational Therapy, 71, 296– 303. doi:10.1177/000841740407100509
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Hammell, K. W. (2009a). Sacred texts: A skeptical exploration of the assumptions underpinning theories of occupation. Canadian Journal of Occupational Therapy, 76, 6–13. doi:10.1177/ 000841740907600105 Hammell, K. W. (2009b). Self-care, productivity, and leisure, or dimensions of occupational experience? Rethinking occupational ‘‘categories.’’ Canadian Journal of Occupational Therapy, 76, 107–114. doi:10.1177/000841740907600208 Haworth, J. T., & Ducker, J. (1991). Psychological well-being and access to categories of experience in unemployed young adults. Leisure Studies, 10, 265–274. doi:10.1080/02614369100390241 Jahoda, M., Lazarsfeld, P. F., & Zeisel, H. (1933/2002). Marienthal: The sociography of an unemployed community. Edison, NJ: Transaction. Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33 (7), 14–26. doi:10.3102/0013189X033007014 Jonsson, H. (2008). A new direction in the conceptualization and categorization of occupation. Journal of Occupational Science, 15, 3–8. doi:10.1080/14427591.2008.9686601 Kantartzis, S., & Molineux, M. (2011). The influence of Western society’s construction of a health daily life on the conceptualization of occupation. Journal of Occupational Science, 18, 62–80. doi:10.1080/14427591.2011.566917 Laliberte Rudman, D. (2013). Enacting the critical potential of occupational science: Problematizing the ‘individualizing of occupation.’ Journal of Occupational Science, 20, 298–313. doi:10. 1080/14427591.2013.803434 Lassiter, L. E. (2005). The Chicago guide to collaborative ethnography. Chicago, IL: University of Chicago Press. Lassiter, L. E., & Campbell, E. (2010). What will we have ethnography do? Qualitative Inquiry, 16, 757–767. doi:10.1177/1077800410374444 McKee-Ryan, F. M., Song, Z., Wanberg, C. R., & Kinicki, A. (2005). Psychological and physical well-being during unemployment: A meta-analytic study. Journal of Applied Psychology, 90, 53–76. doi:10.1037/0021-9010.90.1.53 Njelesani, J., Gibson, B. R., Nixon, S., Cameron, D., & Polatajko, H. J. (2013). Towards a critical occupational approach to research. International Journal of Qualitative Methods, 12, 207–220. O’Leary, Z. (2005). Researching real-world problems: A guide to methods of inquiry. Thousand Oaks, CA: Sage. Pappas, G. F. (2008). John Dewey: Democracy as experience. Bloomington: Indiana University Press. Scanlan, J. N., & Bundy, A. C. (2011). Development and validation of the modified occupational questionnaire. American Journal of Occupational Therapy, 65, e11–e19. doi:10.5014/ajot.2011.09042 Smith, N. R., Kielhofner, G., & Watts, J. H. (1986). The relationships between volition, activity pattern, and life satisfaction in the elderly. American Journal of Occupational Therapy, 40, 278– 283. doi:10.5014/ajot.40.4.278 Townsend, E., & Wilcock, A. (2004). Occupational justice and clientcentered practice: A dialogue in process. Canadian Journal of Occupational Therapy, 71, 75–87. doi:10.1177/000841740407100203 Wallman, S. (1979). Introduction. In S. Wallman (Ed.), Social anthropology of work (pp. 1–24). London, UK: Academic Press.
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Canadian Journal of Occupational Therapy 81(5) Wanberg, C. R. (2012). The individual experience of unemployment. Annual Review of Psychology, 63, 369–396. doi:10.1146/annurevpsych-120710-100500 Weinblatt, N., Ziv, N., & Avrech-Bar, M. (2000). The old lady from the supermarket: Categorization of occupation according to performance areas. Is it relevant for the elderly? Journal of Occupational Science, 7, 73–79. doi:10.1080/14427591.2000.9686468 Whiteford, G. (2000). Occupational deprivation: Global challenge in the new millennium. British Journal of Occupational Therapy, 63, 200–204. Yin, R. K. (2003). Case study research: Design and methods (3rd ed.). Thousand Oaks, CA: Sage.
Author Biographies Rebecca M. Aldrich, PhD, OTR/L, is Assistant Professor, Department of Occupational Science and Occupational Therapy, Saint Louis University, Saint Louis, MO, USA. At the time of the study, Dr. Aldrich was a doctoral student in the Division of Occupational Science and Occupational Therapy at the University of North Carolina–Chapel Hill. Caroline Harkins McCarty, MS, OTR, is Doctoral Candidate, Department of Allied Health Sciences, Division of
297 Occupational Science and Occupational Therapy, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA. At the time of the study, Ms. McCarty was a master’s student in the Division of Occupational Science and Occupational Therapy at the University of North Carolina–Chapel Hill. Brian A. Boyd, PhD, is Assistant Professor, Department of Allied Health Sciences, Division of Occupational Science and Occupational Therapy, University of North Carolina–Chapel Hill, Chapel Hill, NC, USA. Caitlin E. Bunch, MS, OTR/L, is Occupational Therapist, Therapeutic Solutions of NC, Durham, NC, USA. At the time of the study, Ms. Bunch was a master’s student in the Division of Occupational Science and Occupational Therapy at the University of North Carolina–Chapel Hill. Cathrine B. Balentine, MS, OTR/L, is Occupational Therapist, Piedmont Health SeniorCare, Elon, NC, USA. At the time of the study, Ms. Balentine was a master’s student in the Division of Occupational Science and Occupational Therapy at the University of North Carolina– Chapel Hill.
Book Review Law, Mary, and MacDermid, Joy (Eds.). (2014). Evidence-based rehabilitation: A guide to practice (3rd ed.). Thorofare, NJ: Slack. 429 pp. US$57.95. ISBN: 978-1-61711-021-4 DOI: 10.1177/0008417414562202
This 2014 edition is timely in a context of rapidly evolving means to access scientific knowledge and the increasing necessity to support the development of clinical reasoning and professional expertise through the consultation of carefully selected evidence. It is a comprehensive textbook providing excellent guidance to students and practitioners for their mastery of evidence-based practice (EBP). More than knowledge and skills, this compelling work is also designed to instill the set of attitudes required for such an endeavour. As in the previous editions, the text is supported by an abundant amount of figures, diagrams, and tables. It is supplemented by several hundred online resources to support learning and implementation of EBP strategies. The chapter ‘‘Becoming an Evidence-Based Practitioner’’ is more factual and includes a new section on theories and strategies for the
teaching of EBP. Readers will also appreciate the new case examples and the addition of the ‘‘knowledge translation taxonomy to move knowledge to action.’’ Compared to other existing resources, the distinguishing feature of this Law and McDermid textbook is the number of chapters dedicated to implementing evidence. The authors are also making a strong call to readers and consumers of research to participate in the knowledge exchange and dissemination process. For instance, there is a detailed presentation of the process of writing critically appraised topics (CATs) along with suggestions regarding their publication. This textbook will appeal to beginners wishing to develop a better grasp of EBP as well as seasoned practitioners wishing to attain exemplary practice. The sheer number of examples, solutions, and models provided will support readers in defining an optimal process to conduct EBP in their milieu. This book is convincing in its demonstration of the importance of EBP for continuing professional development as well as for the advancement of the profession.
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Julie Lapointe
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Empirical lessons about occupational categorization from case studies of unemployment
ª CAOT 2014 Reprints and permission: sagepub.com/journalsPermissions.nav www.cjotrce.com
Lec¸ons empiriques sur la cate´gorisation des occupations a` partir d’e´tudes de cas sur le choˆmage
Rebecca M. Aldrich, Caroline Harkins McCarty, Brian A. Boyd, Caitlin E. Bunch, and Cathrine B. Balentine
Key words: Classifications of occupations; Experiences; Occupational science; Qualitative research; Work. Mots cle´s : classifications des occupations; expe´riences; recherche qualitative; science de l’occupation; travail.
Abstract Background. Scrutiny regarding the typological categorization of occupation (e.g., occupation as work, rest, or leisure) has prompted interest in experiential categories as a less exclusionary alternative. Empirical research can extend the dialogue about categorization by demonstrating how people in particular situations apply and generate occupational categories. Purpose. This article explores how adults without work utilized typological and experiential categorizations when discussing their occupations. Method. Data were generated via a secondary analysis of interview transcripts from three ethnographic case studies. Findings. Study consultants gravitated toward experiential rather than typological categorizations, emphasizing the social, chosen, purposeful, and temporal qualities of their occupational engagement. Implications. Occupational therapy practitioners and researchers must explicitly state how and why they categorize occupations with clients and research participants. Whereas typological categories can be used to initiate discussions about occupation, open questions paired with consultant-generated experiential categories may better capture occupational engagement and reveal potential injustices in situations like unemployment. Abre´ge´ Description. L’examen approfondi de la cate´gorisation typologique de l’occupation (p. ex., occupation en tant que travail, repos ou loisir) a suscite´ l’inte´reˆt pour une solution de rechange moins exclusive, soient les cate´gories expe´rientielles. La recherche empirique peut permettre d’e´largir le dialogue sur la cate´gorisation en de´montrant comment les personnes se trouvant dans des situations particulie`res utilisent et cre´ent des cate´gories d’occupations. But. Cet article explore la fac¸on dont des adultes sans travail utilisaient des cate´gorisations typologiques et expe´rientielles pour discuter de leurs occupations. Me´thodologie. Des donne´es ont e´te´ produites a` l’aide d’une analyse secondaire des transcriptions d’entrevues tire´es d’e´tudes de cas ethnographiques. Re´sultats. Les consultants des e´tudes gravitaient autour des cate´gorisations expe´rientielles plutoˆt que des cate´gorisations typologiques, en mettant l’accent sur les qualite´s sociales, choisies, utiles et temporelles de leur engagement occupationnel. Conse´quences. Les the´rapeutes et les chercheurs doivent e´noncer explicitement comment et pourquoi ils utilisent des cate´gories d’occupations avec les clients et les participants a` la recherche. Lorsque les cate´gories typologiques peuvent eˆtre utilise´es pour amorcer les discussions au sujet de l’occupation, des questions ouvertes, combine´es aux cate´gories expe´rientielles cre´e´es par les consultants peuvent permettre de mieux saisir l’engagement occupationnel et de mettre en relief d’e´ventuelles injustices dans des situations comme le choˆmage.
Funding: No funding was received in support of this work. Corresponding author: Rebecca Aldrich, Saint Louis University, Department of Occupational Science and Occupational Therapy, 3437 Caroline Street, AHP Room 2020, Saint Louis, MO 63104, USA. Telephone: (314) 977-8577. E-mail: [email protected]
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program completed individual ethnographic case studies under the first author’s guidance between 2010 and 2011. Study recruitment occurred through convenience sampling and was advertised via community bulletins, virtual forums, or word of mouth. The students treated participants as consultants per the terms of collaborative ethnography (Lassiter, 2005), a methodological approach that is increasingly used to teach ethnographic research (Lassiter & Campbell, 2010). A collaborative ethnographic approach aims to rectify problematic power differentials that traditionally exist in research. By using the term consultants, students aimed to signal participants’ centrality in knowledge generation and partnership in the research process. Following a potential consultant’s expression of interest, each student explained the parameters of study participation and secured informed consent. Consultants were required to be between 18 and 65 years of age, by their own definition not retired or currently employed, and fluent in spoken English. The university’s institutional review board (IRB) exempted the class project as well as the secondary analysis of three cases from that project from review.
n the pursuit of clarity, occupational therapists and occupational scientists have developed categories to differentiate occupations. Adolf Meyer’s ‘‘Big Four’’ typology of work, rest, play, and sleep was the primary basis of such efforts until scholars recognized its culturally specific, individualistic, non-empirical (Hammell, 2009a), and potentially exclusionary (Hammell, 2009b) nature. Research has affirmed the restricted applicability of this traditional typology for certain social groups (e.g. Beagan et al., 2012), life-span stages (e.g. Weinblatt, Ziv, & Avrech-Bar, 2000), and non-Western experiences (e.g. Kantartzis & Molineux, 2011). Such findings underscore the need for empirically derived and broadly relevant categories (Ellegard, 2006) that are based on alternative factors, such as experiential elements or intrinsic needs (Hammell, 2009a, 2009b; Jonsson, 2008). However, without questioning how, why, or to what end any categorization is employed, therapists and scholars will lack a clear rationale for continuing to use or refine occupational categories. This article problematizes occupational categorization by using examples from case studies of joblessness. Work is often viewed as an occupation that constitutes everyday life; its absence can therefore illuminate taken-for-granted assumptions about categories of occupation. Since the landmark Marienthal study (Jahoda, Lazarsfeld, & Zeisel, 1933/2002), sociologists and psychologists have examined nonworking adults’ activities relative to ‘‘categories of experience’’ (cf. Haworth & Ducker, 1991; McKee Ryan, Song, Wanberg, & Kinicki, 2005). Such scholarship focuses on themes of loss (Blustein, Kozan, & Connors-Kellgren, 2013) and other negative psychological consequences (Wanberg, 2012) as they are experienced in everyday life. However, that scholarship has provided a framework that has no regard to occupation per se, historically omitting the more mundane occupations that make up everyday experience (Wallman, 1979). Understanding how occupational categorization generates knowledge about unemployment is thus relevant to occupational science specifically and scholarship on joblessness generally. Research shows that a lack of work does not equate to a lack of multifaceted everyday experiences (Cottle, 2001; Engbersen, Schuyt, Timmer, & van Waarden, 1993). Especially following the 2008 recession, the millions of people living without paid employment deserve to have their everyday occupations better understood. Occupational scientists have redoubled their efforts to understand joblessness from an occupational perspective (Aldrich & Callanan, 2011; Aldrich & Dickie, 2013; Laliberte Rudman, 2013), and this study furthers that endeavour by exploring how adults without work categorize their occupations.
Method This secondary analysis drew upon data from a class project that investigated the occupations of adults without paid employment. Seven female students in a master’s of occupational therapy Canadian Journal of Occupational Therapy
Data Collection Steeped in a Deweyan ontological and epistemological framework—which holds that knowledge should start from (Boisvert, 2007) and be adequate to (Pappas, 2008) experience—the original project used methods that privileged real-world knowledge about unemployment (O’Leary, 2005). In accordance with Dewey’s support for multiple forms of knowledge (Johnson & Onwuegbuzie, 2004), the case studies combined a questionnaire with interviews and observations to yield in-depth descriptions via a multiple representative case study approach (Creswell, Hanson, Clark Plano, & Morales, 2007). The case studies began with an initial intake interview and administration of the Occupational Questionnaire (OQ; Smith, Kielhofner, & Watts, 1986). Per the guidelines listed on the OQ, the student researchers asked their consultants to list a ‘‘typical’’ weekday’s activities on the preformatted OQ spreadsheet. The spreadsheet documented activities in half-hour increments between 5:00 a.m. and midnight and required consultants to link each activity to one of the following categories: work, daily living work, recreation, or rest. The OQ guidelines also required consultants to rate each activity in terms of importance, personal aptitude, and personal enjoyment. The OQ served to focus students’ interview questions for ethnographic data generation; it was not used for quantitative analysis due to the small sample size of the project. Following the initial interview and OQ, each studentconsultant pair collaborated to identify and describe the consultant’s daily occupations. Students specifically asked consultants to comment on the ease or difficulty of completing the OQ, including the need to categorize occupations. Instead of relying on a predetermined question for that purpose, students used general prompts as appropriate, such as, ‘‘If you’re having trouble deciding where an activity fits, then talk me through why.’’ Subsequent participant observations and
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Canadian Journal of Occupational Therapy 81(5) interviews about occupation took place over four to six visits and lasted from 1 to 3 hours. Each student personally collected, transcribed, and de-identified her data, iteratively analyzing and generating data until saturation was reached or participants were no longer available for the study.
291 shared their findings with their respective consultants to seek feedback regarding the appropriateness of their representations and analyses. As a final step for this secondary analysis, those same authors individually assessed the faithfulness of the first and second authors’ findings relative to the original interview and observation experiences.
Data Analysis Upon IRB approval of this secondary analysis, the second author (one of the original student researchers) gathered electronic copies of each student’s data and imported it into Atlas.ti software for analysis. The following question guided this secondary analysis: ‘‘What similarities and differences exist in the occupational categories discussed by people who are unemployed?’’ Because our question had the potential to encompass both OQ typological categories and situation-specific experiential categories, we did not apply a preexisting theoretical framework to our analysis. Such a decision is appropriate for descriptive analysis of qualitative data (O’Leary, 2005) and supportive of the coding process suggested by Charmaz (2006). Of the seven original student researchers, six made their cases available for this secondary analysis. Of those six, one case was excluded due to missing transcripts and another was excluded due to a general lack of clarity in the data. The first and second authors individually began analyzing the remaining four cases via open coding of the interview transcripts, seeking in vivo descriptions of occupation relative to the OQ typological categories as well as other descriptors of occupations. The authors initially coded individual cases and did not at first utilize or compare codes across cases. This approach followed a common analytic strategy in multiple case study design, where preliminary identification of the issues within each case occurs prior to assessing commonalities across cases (Creswell et al., 2007; Yin 2003). The first and second authors had repeated e-mail and phone conversations during this phase of analysis to facilitate discussions of analytic convergence and divergence. After 3 months of open coding, the first and second authors met in person to refine codes and discuss strategies for focused analysis. At that meeting, the authors excluded one additional case from focused coding due to a lack of content specifically related to occupational categorization. For the three remaining cases, the first and second authors individually assigned descriptive labels across the cases to data that referenced occupational categorization. The first and second authors then electronically traded and compared their codebooks and met in person one final time to discuss themes. While generalizability is not an appropriate goal for case study findings, transferability to similar situations is possible even with a small number of cases. Findings across wellchosen representative cases—such as the ones used for this secondary analysis—may be reported as lessons learned that can illuminate shared experiences and indicate areas for further investigation (Creswell et al., 2007). In addition to their transferability, the three case studies selected for this secondary analysis are also authentic and trustworthy. During the original project, the second, fourth, and fifth authors of this article
Participants At the time of the original study, Mac was in his 50s, lived with his wife, and had been a town manager until he was laid off from his position. The occupations he identified as most important were caring for his family and volunteering with his church. His days were organized primarily by the priorities identified by his wife, family, pastor, and church members for what needed to be done that day. He was searching for work at the time of the study and anticipated that he would eventually find another job in the same field. Judith was in her 40s, lived with her husband and two sons, and voluntarily left her job within the field of technology to be a fulltime mother. The occupations she emphasized as most important to her related to mothering, community building, and ecological sustainability. Her days were organized primarily around the needs and schedules of her husband and children. She was planning a return to work in a different field, working for herself or in partnership with other women making ecologically sustainable products. Diane was in her 40s, lived with her two dogs, and left her job as a teacher due to a progressive disability. The occupations she emphasized as most important to her related to walking her dogs, spending time with others, and giving back to her community. Her days were organized primarily around caring for her dogs, volunteering, and her frequent doctor’s visits. Due to the permanence of her disability, she did not anticipate a return to work. All three consultants were Caucasian, previous members of the middle socioeconomic class, and residents of North Carolina in the United States. Each consultant had been unemployed for a period greater than 1 year: Mac for 12 months, Judith for 18 months, and Diane for 5 years. Their education levels ranged from undergraduate (Mac and Diane) to master’s (Judith) degrees. For consistency, each section of the findings will discuss the consultants in the order they have been presented here.
Findings This secondary analysis explored the ways in which adults without traditional paid employment categorized their occupations. As noted in the Method section, each consultant was initially asked to label his or her occupations using one of the four categories listed on the OQ. Those categories—clear derivatives of Meyer’s Big Four—proved to be problematic for most of the consultants, who often used personally generated descriptors as alternatives to OQ categories. As the following findings demonstrate, although the traditional OQ categories were useful starting points for student-consultant discussions, the categories failed to encompass the social, chosen, purposeful, and temporal qualities that
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consultants described as central to their occupational engagements. Given that the consultants largely abandoned using OQ typological categories in favour of experiential categories, the themes below problematize the typological categories within discussions of consultant-identified experiential categories.
Social: Staying Connected One prominent feature of Mac’s, Judith’s, and Diane’s descriptions was the way in which occupation connected them to others. Volunteering, caregiving, and being part of the community were important to each of the consultants, respectively, and to some degree, collectively. While in some cases, consultants framed an occupation as social because it meant doing or being in connection with others, in other cases, consultants framed occupations as deliberate vehicles for creating and maintaining community. Each person’s connection to his or her own humanity or other humans was often linked to a need to redefine normalcy in the absence of paid employment. For Mac, each day was structured by his social relationships: He decided how to spend his time based on the needs of his wife, adult children, granddaughter, and church. Staying connected to others was an important part of the occupation he named ‘‘volunteerism.’’ When asked if any of his occupations did not fit within the categories provided by the OQ, he noted, Well, like the thing that you’ve got here is it talks about work, daily living, recreation, or rest. Um, I put a lot of stuff in daily living that’s not work and it’s not recreation, and I guess it’s considered as daily living work, but like when I do volunteer work at the church, it’s volunteer work. It’s not work, and it’s not something that I have to do to eat, and breathe, and live. It’s volunteerism.
Mac’s inherently social occupation of volunteerism did not have any place within the existing categories of occupation: It was in a category all its own. For Mac, volunteerism was especially important—and easier to achieve—in the absence of work: Because I’m out of work, they can call me from the church if something’s going on or someone needs something. I can help with that. We went over and helped stuff bulletins today. Things that I wouldn’t do if I was working.
Mac ultimately classified helping others as daily living work when the student researcher asked him to choose an OQ category. However, he preferred to use his own term of volunteerism or the phrase ‘‘doing what needs to be done’’ to frame such occupations. For Judith, staying connected meant establishing connections with her community through participation and volunteering. She remarked that social connectedness was particularly important to her because of her experience as a stay-at-home mother: For a full time, stay-at-home mom . . . either your needs get met or the kids’ needs get met. There are just not enough resources, time resources, for everybody’s needs to get met . . . and so stay-at-home moms are very isolated women.
One social part of Judith’s daily routine was time at the YMCA, which she categorized as ‘‘community recreation,’’ noting, Canadian Journal of Occupational Therapy
‘‘I consider this activity to be recreation for sure . . . so my 2 hours at the Y are great. It’s community, I know people there.’’ Judith specified that this was community recreation to indicate the social nature of this occupation; in addition to being enjoyable and contributing to her wellness, time at the YMCA provided an opportunity to build relationships and socialize. Judith also sought community to support her sustainability values. Having been unsuccessful in locating a community that promoted sustainability, Judith created such a community by volunteering with her neighbourhood garden. She organized events with farmers to educate children about local food, to build community and connection with others, and to build sustainable farming skills that she might need in the future. This occupation was not visible on Judith’s OQ—perhaps because it was not a daily event—but she described it repeatedly in her interviews as highly important, collaborative, and social. Similar to Mac, volunteering linked Judith to the world outside her home and helped her build connections within her community. Although both Mac and Judith used work-like descriptors when discussing their occupations, they also foregrounded the social nature of those occupations in subsequent conversations and employed self-generated labels in place of those offered by OQ categories. Staying connected was also important to Diane. She emphasized the social aspect of walking her dogs with neighbours and volunteering to tutor her neighbour’s children. Similar to Judith, Diane experienced increased isolation after leaving the workforce, and her isolation was compounded by her disabilities, her adult children leaving home, and the dissolution of her marriage. Diane observed that most of her sameage peers were at work during weekdays and that dog walking became a purposeful way for her to connect with her neighbours in her new situation. She noted, I guess there are people my age, but if you have a job, you’re so wrapped up in that and the time it takes to get home and cook or clean or whatever. Almost all my really good friends are dog walkers, because you know we are all doing the same thing.
In the absence of paid employment, it was the shared occupation of dog walking that allowed Diane to meet and spend time with others. She eventually formed close friendships with the dog walkers in her neighbourhood, and walking her dogs became multifaceted and particularly meaningful. It was both something she had to do every day for her dogs and something she enjoyed doing because it helped her stay connected. On the topic of categorization, Diane remarked, Walking my dogs is definitely recreation. Another way to describe it is a time to get out and be social, a time to—you know you’re going to—I try to, I say hi to everybody I see everywhere, period.
Control: ‘‘It Depends on Whether I’m Having Fun or Not’’ The second commonality between Mac’s, Judith’s, and Diane’s accounts was that each person described occupations in terms of the things they enjoyed and wanted to do versus the things
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Canadian Journal of Occupational Therapy 81(5) they had to do. Each consultant experienced changes in control over how he or she used time and selected occupations in the absence of paid employment. For Mac, increased control over his time changed his enjoyment of certain occupations: The great thing about being unemployed is that it’s not the same everyday. So, the great thing is there’s no monotony. I can work out in the yard a day and that’s fine, that’s wonderful. But I don’t have to do it everyday. So it doesn’t get tiresome. . . . Do some volunteer work at the church, it’s something I can do, but if it gets to be too, uh, overbearing, I can go, no, I want to do something else for a day or so.
Being able to set his own schedule and choose how he spent his time increased Mac’s enjoyment of some occupations, such as working around the house and volunteering at his church. This in turn impacted the way he categorized and described those occupations, which moved from ‘‘things I need to do’’ to ‘‘things I enjoy doing,’’ mimicking a move from the category of work to one of recreation. This shift was particularly evident in Mac’s efforts to categorize volunteerism because his experience of volunteering contrasted with his understanding of work. Mac explained, ‘‘A lot of it is almost recreation. It’s, it’s daily living work [sighs, as if it is a hard choice] because when we are doing things at church we are doing things ’cause something needs to be done.’’ His difficulty categorizing volunteering illustrates the tension between Mac’s experience of volunteering, which he enjoyed and labelled recreation because he had more control over his time and because of his perception of that occupation’s purpose, which was productive and thus associated with daily living work. Similarly, Judith noted that her enjoyment of an occupation—‘‘if I’m having fun or not’’—determined the way that she categorized the occupation. For example, she initially categorized all parenting occupations as work, yet subsequent reflection led Judith to articulate different categorizations for specific aspects of parenting. She noted, I would consider taking care of my children work. Although . . . there’s times when it’s work and there’s times when it’s recreation. Like, [if] I’m at the park with them, it might be recreation. It depends on if I’m having fun or not, I guess. So, I mean, I think that [pauses] . . . being with the children includes everything except for resting. Because there is no rest.
Judith categorized playing with her sons at the playground (which she enjoyed) as recreation, but she categorized playing with her younger son indoors (which she did for his benefit but did not enjoy as much) as work. For Diane, the contrast between enjoying an occupation and its perceived purpose also made categorization difficult. Diane found it most difficult to categorize occupations related to caring for her dogs. After much reflection, Diane highlighted that her enjoyment of these occupations played a central role in how she considered them: Having dogs is certainly not as much work as having children, but we [dog owners] all talk about it. It is a lot of work. But I enjoy it because of all the comfort they offer me, the unconditional
293 love, and everything . . . that’s why I don’t even want to call it work. They require a lot of attention, is a better way to put it.
Diane rejected work as a label for caring for her dogs because the term did not capture her experience of enjoyment, comfort, and love, even as she acknowledged the effort and attention required to engage in those occupations.
Purpose: ‘‘It Gives Me a Purpose to My Day, Not Just a Day of Monotonous Tasks’’ The notion of purpose was a unifying thread throughout the consultants’ discussions of occupation. Each person identified occupations that ‘‘give me purpose’’ or brought a sense of ‘‘satisfaction’’ to their lives. This sense of purpose stemmed from participating in occupations that upheld personal values. For Mac, volunteering through his church gave meaning to his days: There’s not a whole lot of way to make a job out of doing volunteer work at the church. There’s not a whole lot of a way to make a job out of taking folks back and forth to the hospital, and doing things like that. But there is a satisfaction that I get out of it.
He often compared his volunteering activities to working, as if they served as a replacement for the feeling of being helpful or useful via paid employment: I’ve signed up to go on the mission trip this summer. I’m gonna go to Nashville and they’ve got still that flooding stuff over there. That’s one of the ways. [My wife] and I went over and put the church directory together, that’s another way that we can be helpful. . . . A lot of different things like that, that the usefulness is different.
In contrast to Mac, Judith expressed relative satisfaction with the OQ categories, saying that although she had to make some choices about how she categorized parts of her daily routine, with enough deliberation, she could make all of her occupations fit within the OQ. As the only consultant who had intentionally left the workforce, Judith’s circumstances may have made it easier for her to relate to the OQ categories than it was for Mac or Diane. In all her conversations, Judith compared caring for her children to full-time employment in terms of its importance. Because she had quit her job to become a full-time mother, she may have more easily framed parenting occupations as work in connection with her sense of purpose. For Diane, tutoring her neighbour’s children provided purpose to her days. She said, ‘‘I don’t charge to tutor [my neighbour’s daughter], it’s just good for me to have that. And it gives me a purpose to my day, not just a day of monotonous tasks.’’ She emphasized, ‘‘I always get the most satisfaction from giving . . . I get the most pleasure from helping others,’’ later noting that ‘‘doing that just makes me feel good, and the tutoring is a purpose and gives me a fulfilling sense of well, I’m not just wasting my days away.’’ This sense of purpose led Diane to use the label of volunteering more readily than any of the existing categories from the OQ.
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Temporal: ‘‘It’s Not the Way It Used to Be’’ Time was also a significant feature of consultants’ conversations about occupation. Mac, Judith, and Diane compared their current occupations to the way things ‘‘used to be’’ and couched occupations within hopes and plans for the future. Mac noted a different experience of time in his nonworking life as compared to his working life. He had more control over time and could prioritize valued or preferred occupations. In thinking about the future, Mac wondered how he would maintain his present occupations: When I go back to work, I don’t know how I’m going to get stuff done, because I’ve had a list. For this last 9, 10 months, my wife and I have gone from one project to the next . . . and the list is still, I erase off one and she puts three more on. . . . When I go back to work, I don’t know how I’m going to get the grass mowed on time, how I’m going to get all the leaves up.
Although he sought further employment and did not wish to remain out of work, Mac remarked that he would particularly miss helping his family and volunteering at his church when he resumed paid employment. Thus Mac actively planned for the future by networking and exploring work possibilities while also contemplating how he would accomplish his meaningful occupations after returning to the workforce. Unlike Mac, Judith did not experience any perceived increase in time upon leaving the workforce. Contrasting her past paid employment with caring for her children, she remarked, I was paid to work 30 hours a week, and then a year ago I retired from working outside the home. So I’m a full-time mom, and it’s a lot harder than going to work. Going to work is like going on vacation.
Judith additionally emphasized the lack of sick leave and vacation time for stay-at-home mothers in contrast with her experience of paid employment. In addition to comparing her present occupations with the past, Judith also spoke about achieving a desired future through her occupations. Dissatisfied with the amount of community in her life, Judith pursued her sustainable business and the possibility of an intentional living community as a means to the future she envisioned for her family. Diane often described her experience of time by contrasting her past life as a mother and teacher with her present life as a single, retired woman. For example, in reference to her morning routine, Diane noted, An interesting thought about it, eating, why do I eat cereal every day? Because when I worked, I would see my whole family, my ex-husband and the children, enjoying cereal, and I didn’t have time to sit and eat breakfast. I was the one running around, making sure they had a lunch or they had lunch money, getting myself ready for work, drinking coffee while I do my hair, and so I said to myself, the day I retire I’m going to eat cereal every day [laughs].
The occupation of dining was central to Diane’s comparison of the past to the present. She noted the adjustments she had made as her employment and family makeup shifted: Canadian Journal of Occupational Therapy
I find that from having been a wife and a mother, eating by myself is very lonely, and watching TV helps with that. I always made a point of everybody eating dinner together every night, and the children talking about their days, I’d talk about mine. So anyway, that helps with that and I always try to find something on about dogs, or training. . . . I love watching stories about children overcoming adversities.
Discussion The data illuminated four qualities relative to consultants’ categorization of occupation during unemployment. Social connectedness, suggested in both Jonsson’s (2008) and Hammell’s (2009b) experience-based categories, proved to be a fundamentally important aspect of Mac’s, Judith’s, and Diane’s respective occupations. Control, another important quality, appeared to exist in a complex relationship with personal enjoyment, extending Jonsson’s (2008) category of ‘‘basic’’ occupation and Hammell’s (2004) discussion regarding control. All three consultants also highlighted a sense of purpose in their social occupations, reinforcing Hammell’s (2009b) assertion that Western culture values occupations that have social benefits. Finally, all three consultants contrasted the things they used to do with their present engagements. The ability of occupational categories to encompass past, present, and future occupational engagement is not addressed in available literature aside from Hammell’s (2009b) brief statement that occupations allow people to connect with the past and future. Comparison to the past may be especially salient to nonworking adults because the transition from working to unemployment is a significant experiential marker; thus, categorization schemes ought to attend to the continuity (or lack thereof) of experience. Given that the experiential elements of social connectedness, control, purpose, and continuity were much more prevalent in consultants’ discussions than the labels that framed the OQ categories, the findings support a move away from typological categorizations of occupation. As noted in the introduction, typological categories sort occupations based on an unstated assumption of universal everyday occupational types. Such an assumption overlooks the situated and variable qualities of occupational engagement and can lead to the exclusion of many of life’s most meaningful occupations (Hammell 2009a, 2009b). This secondary analysis suggests an additional difficulty with typological categories: When people talk about their occupations, their descriptions can contain overlapping qualities of occupation that may disappear with forced categorization. An occupation that fits one occupational type might shift into an entirely different category depending on circumstance, and it is important to illuminate that shift more deftly than typological categories appear to allow. Despite consultants’ apparent preference for experiencebased categorization, we found that typological categories are not wholly without utility. In these case studies, the OQ categories gave student researchers a way to initiate discussions about occupations, even if from a reference point that viewed work as an assumed part of everyday life. In fact, beginning their discussions with the OQ categories may have helped
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Canadian Journal of Occupational Therapy 81(5) students highlight problematic assumptions and omissions associated with typological categories. When utilized for the purposes of starting conversations and problematizing assumptions, typological categories can thus lead therapists and researchers down an interesting path. If therapists and researchers continue to use the OQ in such a manner, we suggest they utilize Scanlan and Bundy’s (2011) Modified Occupational Questionnaire (MOQ). The MOQ was published after Mac, Judith, and Diane’s case studies had been completed (hence we did not use it in our analysis), and its added ratings for meaningfulness, typology of ‘‘worklikeness,’’ and items regarding the reason for doing an occupation may prevent some of the difficulties our consultants encountered with categorization. The most significant lesson learned from this secondary analysis is the need to explicitly state the purpose of using occupational categories. In determining the utility of occupational categorization, therapists and researchers may find guidance in the following question: Is the aim of categorization to fit people’s occupations within normative expectations, challenge prevailing assumptions, or generate alternate understandings? While the OQ categories—or even the Big Four—may not be used universally, the need to identify and justify an aim for their use can help therapists and researchers avoid unintentionally marginalizing occupations that do not fit within normative categorization schemes. It is equally important for therapists and researchers to consider when not to use (or ask people to use) occupational categories: If the goal is to honour a person’s own perception and experience of occupation, then socially referenced typological categories or previously generated experiential categories may not be appropriate. Honouring personal experiences may instead call for beginning with an open-ended question, such as ‘‘Tell me about your daily routine,’’ and following it with open questions based on people’s self-generated qualitative descriptions. Open questions leave room for a person to describe occupations in his or her own terms rather than imposing potentially restrictive predefined categories. Such questions may include ‘‘What do you enjoy doing in your daily life?’’ ‘‘What do you do that gives you purpose (or meaning)?’’ ‘‘What do you do to be with others?’’ and ‘‘Is there anything you used to do that you would like to get back to doing?’’ Direct exploration of occupational categorization can also facilitate justice-focused critiques when paired with appropriate open questioning. The collaborative ethnographic orientation of the student projects laid a foundation for the critical approach that increasingly characterizes occupational science and occupational therapy research (see Njelesani, Gibson, Nixon, Cameron, & Polatajko, 2013). Although students’ direct discussion of the OQ categories revealed potential occupational alienation (see Townsend & Wilcock, 2004) and occupational deprivation (see Whiteford, 2000) for Judith and Diane, that potential was not explored in the original study. Open questions, such as ‘‘Is there anything you cannot do that you would like to do?’’ or ‘‘What do you think is keeping you from doing things that you would like to do?’’ would have targeted those topics more specifically. Despite not providing detailed information on justice-related topics, this secondary analysis demonstrates that even a small number of cases can illuminate
295 social issues and highlight needs to improve data collection for critically focused explorations.
Limitations Although this study generated novel findings that support and extend discussions of occupational categorization, some limitations related to transferability must be noted. Given that all the consultants for this study were unemployed, our findings about categorization may not resonate with people who are not jobless. In addition, the variety of reasons underlying our consultants’ lack of paid employment may have yielded different approaches to categorization that this secondary analysis could not detect. Finally, our consultants all hailed from a middle-class socioeconomic background, and their financial supports may have helped them access occupations that would not be present in situations of less financial security. Future studies that have consultant pools with different features may vary in their findings from the themes discussed in this article. However, as the introduction shows, other studies uphold the general idea that experiential categorization is preferable to typological categorization; thus these particular limitations regarding transferability do not undermine the relevance of the findings.
Conclusion Although typological categories can provide a starting point for discussing occupation, the findings described in this article support Jonsson’s (2008) and Hammell’s (2009a, 2009b) advocacy for experiential categories as well as Scanlan and Bundy’s (2011) modification of the typological categories in the OQ. Furthermore, given that occupations can represent transactions with exceptionally uncertain situations, such as unemployment, static categories may not ‘‘get at’’ people’s ever-changing, situated occupational engagement as successfully as open-ended questions. For both therapists and researchers, open questioning based on knowledge of both typological and experiential categories may provide the clearest picture of occupation and related potentials for injustice. Therefore, therapists and researchers must explicitly consider how, why, and whether or not they ask people to categorize occupations. This imperative is especially applicable when talking with people in marginalized situations, such as unemployment, which norm-referenced typological categories inherently exclude. Further research is needed to understand what experiential qualities apart from the social, chosen, purposeful, and temporal nature of occupations characterize such situations, including how those qualities illuminate injustices that typological categories may hide.
Key Messages Occupational therapists and occupational scientists should consider the purpose of using occupational categories with clients and research participants.
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Aldrich et al. Typological and experiential categories may be useful for select practice and research aims, but the relevance of such categories for experiences such as unemployment cannot be assumed and warrants further research. Reliance on any categorization scheme necessarily limits what knowledge can be gained from interactions with others; such reliance may also inhibit critical, justice-focused analyses.
Acknowledgements We would like to thank the three consultants for participating in the original case studies that generated data for this secondary analysis. We would also like to thank Laurie Pearman, Alicia Matthews, and Abigail Owens for enhancing our understanding of qualitative research by participating in the research seminar that generated the case studies. Finally, we would like to thank the reviewers and the editor for providing helpful comments that strengthened this manuscript.
References Aldrich, R., & Callanan, Y. (2011). Insights about studying discouraged workers. Journal of Occupational Science, 18, 153–166. doi:10.1080/14427591.2011.575756 Aldrich, R., & Dickie, V. (2013). ‘‘It’s hard to plan your day when you have no money’’: Discouraged workers’ occupational possibilities and the need to reconceptualize routine. Work: A Journal of Prevention, Assessment, and Rehabilitation, 45, 5–15. doi:10.3233/WOR-131596 Beagan, B. L., De Souza, L., Godbout, C., Hamilton, L., MacLeod, J., Paynter, E., & Tobin, A. (2012). ‘‘This is the biggest thing you’ll ever do in your life’’: Exploring the occupations of transgendered people. Journal of Occupational Science, 19, 226–240. doi:10. 1080/14427591.2012.659169 Blustein, D. L., Kozan, S., & Connors-Kellgren, A. (2013). Unemployment and underemployment: A narrative analysis about loss. Journal of Vocational Behavior, 82, 256–265. doi:10.1016/j.jvb. 2013.02.005 Boisvert, R. D. (2007). John Dewey: Rethinking our time. Albany: State University of New York Press. Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage. Cottle, T. J. (2001). Hardest times: The trauma of long-term unemployment. Westport, CT: Praeger. Creswell, J. W., Hanson, W. E., Clark Plano, V. L., & Morales, A. (2007). Qualitative research designs: Selection and implementation. Counseling Psychologist, 35, 236–264. doi:10.1177/0011000006287390 Ellegard, K. (2006). The power of categorization in the study of everyday life. Journal of Occupational Science, 13, 37–48. doi:10.1080/ 14427591.2006.9686569 Engbersen, G., Schuyt, K., Timmer, J., & van Waarden, F. (1993). Cultures of unemployment: A comparative look at long-term unemployment and urban poverty. Boulder, CO: Westview Press. Hammell, K. W. (2004). Dimensions of meaning in the occupations of daily life. Canadian Journal of Occupational Therapy, 71, 296– 303. doi:10.1177/000841740407100509
Canadian Journal of Occupational Therapy
Hammell, K. W. (2009a). Sacred texts: A skeptical exploration of the assumptions underpinning theories of occupation. Canadian Journal of Occupational Therapy, 76, 6–13. doi:10.1177/ 000841740907600105 Hammell, K. W. (2009b). Self-care, productivity, and leisure, or dimensions of occupational experience? Rethinking occupational ‘‘categories.’’ Canadian Journal of Occupational Therapy, 76, 107–114. doi:10.1177/000841740907600208 Haworth, J. T., & Ducker, J. (1991). Psychological well-being and access to categories of experience in unemployed young adults. Leisure Studies, 10, 265–274. doi:10.1080/02614369100390241 Jahoda, M., Lazarsfeld, P. F., & Zeisel, H. (1933/2002). Marienthal: The sociography of an unemployed community. Edison, NJ: Transaction. Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33 (7), 14–26. doi:10.3102/0013189X033007014 Jonsson, H. (2008). A new direction in the conceptualization and categorization of occupation. Journal of Occupational Science, 15, 3–8. doi:10.1080/14427591.2008.9686601 Kantartzis, S., & Molineux, M. (2011). The influence of Western society’s construction of a health daily life on the conceptualization of occupation. Journal of Occupational Science, 18, 62–80. doi:10.1080/14427591.2011.566917 Laliberte Rudman, D. (2013). Enacting the critical potential of occupational science: Problematizing the ‘individualizing of occupation.’ Journal of Occupational Science, 20, 298–313. doi:10. 1080/14427591.2013.803434 Lassiter, L. E. (2005). The Chicago guide to collaborative ethnography. Chicago, IL: University of Chicago Press. Lassiter, L. E., & Campbell, E. (2010). What will we have ethnography do? Qualitative Inquiry, 16, 757–767. doi:10.1177/1077800410374444 McKee-Ryan, F. M., Song, Z., Wanberg, C. R., & Kinicki, A. (2005). Psychological and physical well-being during unemployment: A meta-analytic study. Journal of Applied Psychology, 90, 53–76. doi:10.1037/0021-9010.90.1.53 Njelesani, J., Gibson, B. R., Nixon, S., Cameron, D., & Polatajko, H. J. (2013). Towards a critical occupational approach to research. International Journal of Qualitative Methods, 12, 207–220. O’Leary, Z. (2005). Researching real-world problems: A guide to methods of inquiry. Thousand Oaks, CA: Sage. Pappas, G. F. (2008). John Dewey: Democracy as experience. Bloomington: Indiana University Press. Scanlan, J. N., & Bundy, A. C. (2011). Development and validation of the modified occupational questionnaire. American Journal of Occupational Therapy, 65, e11–e19. doi:10.5014/ajot.2011.09042 Smith, N. R., Kielhofner, G., & Watts, J. H. (1986). The relationships between volition, activity pattern, and life satisfaction in the elderly. American Journal of Occupational Therapy, 40, 278– 283. doi:10.5014/ajot.40.4.278 Townsend, E., & Wilcock, A. (2004). Occupational justice and clientcentered practice: A dialogue in process. Canadian Journal of Occupational Therapy, 71, 75–87. doi:10.1177/000841740407100203 Wallman, S. (1979). Introduction. In S. Wallman (Ed.), Social anthropology of work (pp. 1–24). London, UK: Academic Press.
Downloaded from cjo.sagepub.com at EMORY UNIV on April 19, 2015
Canadian Journal of Occupational Therapy 81(5) Wanberg, C. R. (2012). The individual experience of unemployment. Annual Review of Psychology, 63, 369–396. doi:10.1146/annurevpsych-120710-100500 Weinblatt, N., Ziv, N., & Avrech-Bar, M. (2000). The old lady from the supermarket: Categorization of occupation according to performance areas. Is it relevant for the elderly? Journal of Occupational Science, 7, 73–79. doi:10.1080/14427591.2000.9686468 Whiteford, G. (2000). Occupational deprivation: Global challenge in the new millennium. British Journal of Occupational Therapy, 63, 200–204. Yin, R. K. (2003). Case study research: Design and methods (3rd ed.). Thousand Oaks, CA: Sage.
Author Biographies Rebecca M. Aldrich, PhD, OTR/L, is Assistant Professor, Department of Occupational Science and Occupational Therapy, Saint Louis University, Saint Louis, MO, USA. At the time of the study, Dr. Aldrich was a doctoral student in the Division of Occupational Science and Occupational Therapy at the University of North Carolina–Chapel Hill. Caroline Harkins McCarty, MS, OTR, is Doctoral Candidate, Department of Allied Health Sciences, Division of
297 Occupational Science and Occupational Therapy, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA. At the time of the study, Ms. McCarty was a master’s student in the Division of Occupational Science and Occupational Therapy at the University of North Carolina–Chapel Hill. Brian A. Boyd, PhD, is Assistant Professor, Department of Allied Health Sciences, Division of Occupational Science and Occupational Therapy, University of North Carolina–Chapel Hill, Chapel Hill, NC, USA. Caitlin E. Bunch, MS, OTR/L, is Occupational Therapist, Therapeutic Solutions of NC, Durham, NC, USA. At the time of the study, Ms. Bunch was a master’s student in the Division of Occupational Science and Occupational Therapy at the University of North Carolina–Chapel Hill. Cathrine B. Balentine, MS, OTR/L, is Occupational Therapist, Piedmont Health SeniorCare, Elon, NC, USA. At the time of the study, Ms. Balentine was a master’s student in the Division of Occupational Science and Occupational Therapy at the University of North Carolina– Chapel Hill.
Book Review Law, Mary, and MacDermid, Joy (Eds.). (2014). Evidence-based rehabilitation: A guide to practice (3rd ed.). Thorofare, NJ: Slack. 429 pp. US$57.95. ISBN: 978-1-61711-021-4 DOI: 10.1177/0008417414562202
This 2014 edition is timely in a context of rapidly evolving means to access scientific knowledge and the increasing necessity to support the development of clinical reasoning and professional expertise through the consultation of carefully selected evidence. It is a comprehensive textbook providing excellent guidance to students and practitioners for their mastery of evidence-based practice (EBP). More than knowledge and skills, this compelling work is also designed to instill the set of attitudes required for such an endeavour. As in the previous editions, the text is supported by an abundant amount of figures, diagrams, and tables. It is supplemented by several hundred online resources to support learning and implementation of EBP strategies. The chapter ‘‘Becoming an Evidence-Based Practitioner’’ is more factual and includes a new section on theories and strategies for the
teaching of EBP. Readers will also appreciate the new case examples and the addition of the ‘‘knowledge translation taxonomy to move knowledge to action.’’ Compared to other existing resources, the distinguishing feature of this Law and McDermid textbook is the number of chapters dedicated to implementing evidence. The authors are also making a strong call to readers and consumers of research to participate in the knowledge exchange and dissemination process. For instance, there is a detailed presentation of the process of writing critically appraised topics (CATs) along with suggestions regarding their publication. This textbook will appeal to beginners wishing to develop a better grasp of EBP as well as seasoned practitioners wishing to attain exemplary practice. The sheer number of examples, solutions, and models provided will support readers in defining an optimal process to conduct EBP in their milieu. This book is convincing in its demonstration of the importance of EBP for continuing professional development as well as for the advancement of the profession.
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Julie Lapointe
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