Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Aust Occup Ther J. 2021 Oct;68(5):444-453. doi: 10.1111/1440-1630.12760. Epub 2021 Jul 22.
The COVID-19 pandemic, which has disrupted occupations and lives of people around the world, has simultaneously exposed deeply rooted social inequities and structural injustices that have negated the facile claim that "we're all in this together." But the pandemic has also opened up opportunities to imagine other ways of living and doing in the future. This paper imagines some possibilities for shaping occupational therapy's future practices and seeks to illustrate why it is both timely and necessary to re-imagine occupational therapy in 2021.
Drawing from epidemiological research, the paper explores the inequitable impacts of COVID-19, environmental degradation, and multiple social determinants on people's real opportunities for health, wellbeing, and occupational engagement.
Evidence presented in this paper challenges occupational therapy's individualised approach towards wellbeing and contests the limited parameters of occupations "that matter" that are prioritised and promoted within the profession. In response, the paper seeks to expose the specific, political, economic, and ableist ideology that has effectively shaped the occupational therapy profession's assumptions, models, theories, and the practices these inform.
Drawing from the "Build back better" approach to post-disaster recovery-with its dual attentions to wellbeing, equity, and inclusivity and to physical, social, cultural, economic, and environmental vulnerabilities-this paper imagines an occupational therapy for a post-COVID-19 world; an occupational therapy that takes seriously the premise that occupations and people are inseparable from their environments; a profession that no longer colludes in individualising problems that are inherently social or in depoliticising the systemic social and economic inequalities that create stress and illness; an occupational therapy that no longer promotes the values of neoliberal ableism; and an occupational therapy dedicated to expanding people's just and equitable opportunities to engage in meaningful occupations that contribute positively to their own wellbeing and the wellbeing of their communities.
新冠疫情扰乱了世界各地人们的职业和生活,同时也暴露出根深蒂固的社会不平等和结构性不公正,这些不平等和不公正否定了“我们都在一起”这一简单的说法。但这场大流行也为我们提供了想象未来生活和工作方式的机会。本文设想了塑造职业治疗未来实践的一些可能性,并试图说明为什么在 2021 年重新想象职业治疗既是及时的,也是必要的。
本文从流行病学研究中探讨了新冠疫情、环境恶化和多种社会决定因素对人们健康、幸福和职业参与的实际机会的不平等影响。
本文提出的证据挑战了职业治疗对幸福的个体化方法,并对职业治疗中优先和倡导的“重要”职业的有限参数提出质疑。有鉴于此,本文试图揭示有效塑造职业治疗专业假设、模式、理论和这些理论所依据的实践的具体、政治、经济和歧视性意识形态。
本文借鉴了灾后恢复的“重建得更好”方法,该方法同时关注福祉、公平和包容性以及物理、社会、文化、经济和环境脆弱性,设想了一个后新冠疫情世界的职业治疗;一种职业治疗,认真对待职业和人与其环境不可分割的前提;一种不再将本应是社会问题的问题个体化,或不再使造成压力和疾病的系统性社会和经济不平等非政治化的专业;一种不再提倡新自由主义歧视性价值观的职业治疗;以及一种致力于扩大人们参与有意义的职业的公正和平等机会的职业治疗,这些职业对他们自己的福祉和他们社区的福祉有积极贡献。