How to be an effective occupational therapist through occupational science (Chapter 3 of Occupational Therapy in the Philippines)

Occupation is the focus of occupational therapists (OTs). Not sensory processing, not reflexes, not intersectionality — but occupation. Should we OTs have a good working knowledge of the science behind experimental interventions? Yes, of course! Are we free to use them judiciously? Yup! Should we be aware of how the social determinants of health are affecting our patients? Oh yes! But are these what make OTs effective at producing better patient outcomes in ways that other professionals can’t? According to the evidence, no. 

In this installment of the From Pages to Practice series, we will delve into some occupational science concepts from the book, Occupational Therapy in the Philippines: Theory, Practice, and Stories (Sy, Pineda, & Fischl, 2025). These will help us understand what separates OTs from other helping professionals.

Occupational Science in Daily Practice

According to sound peer-reviewed evidence, the best occupational therapy interventions are those that facilitate improvements at the level of participation in activities that are crucial for the person with disability (PWD) to fulfill his societal roles, which simultaneously remediate his body structures and functions. Hence, for us OTs, occupations are our primary therapeutic modalities, and improvements in the engagement of these occupations are the goal of our treatment programs. Occupational therapy is both rich in spiritual tradition and anchored on the bedrock of evidence-based healthcare. There shouldn’t be any insecurity about what makes our profession different.

Yet we OTs constantly find ourselves getting swept up in the torrents of fads and pseudoscientific approaches. Enough of all the hundreds of thousands of pesos and dollars worth of voo-doo! Let us focus instead on what OTs should be good at: occupation. 

Occupations are simply daily living activities that a person must perform to fulfill his life roles. An occupation has three aspects (Carrasco, et al., 2025):

1. Form - the observable aspects of the activity (i.e., actions, task objects, and environment).

2. Function - the specific goals of the activity that will enable a person to attain better health and well-being.

3. Meaning - the subjective experience of the person who engaged in the activity.

The Means and the Ends

The specifics of these aspects of occupation have a significant impact on an OT’s choice of interventions per client. Let’s consider the activity of posting on social media. As you can see in the examples below, posting on social media can take on different forms, accomplish various functions, and produce different experiences depending on the individual who performs it in his specific contexts. 

The role of an OT is to enable the client to accomplish these activities in the specific form that the client can and must engage in within the parameters of his circumstances. The OT will teach the the specific skills for carrying out daily tasks while remediating and compensating for the impaired body structures and functions through the use of contextually-relevant activities. Hence, occupation is both the “means and the ends” (Fischer, Green, & Lygnegard, 2023). 

The Main Thing

As you can see, there are many scientific occupation-based approaches that OTs can use to improve patient outcomes. But they require an individualized understanding of what the client’s activities are in their contexts.

We may use experimental interventions judiciously. It’s also right for us OTs to be concerned about the inequities that are depriving our patients of opportunities to participate in society. However, we should never disregard well-established occupation-based interventions for ineffective fads that will only waste the clinicians’ and the clients’ resources. We also don’t need to decry every “injustice”, real or imagined, before we can start teaching PWDs important life skills — skills that can help them thrive in life no matter how imperfect the world may be. 

REFERENCES

Carrasco, R., et al. (2025). Occupational science: a basis for understanding Filipino occupations. In M. Sy, R.C. Pineda & C. Fischl (Eds.), Occupational therapy in the Philippines: Theory, Practice, and Stories (pp. 35-48). Routledge.

E. Fischer, D. Green & F. Lygnegård. (2023). Occupation as means and ends in paediatric occupational therapy – A systematic review, Scandinavian Journal of Occupational Therapy, 30:8, 1181-1198, DOI: 10.1080/11038128.2023.2188253