F E AT U R E
Theory to Practice in Action: A Research and Program Commitment at Griffith University Louise Gustafsson, Michelle Bissett and Matthew Molineux, Griffith University
T
he unique contribution of occupational therapy is the profession’s occupationcentred approach to promoting health and well-being. However, change has been slow following the renaissance of occupation and a theory-to-practice gap persists within clinical practice. We believe research holds an important role in supporting changes to occupational therapy practice consistent with the following three core constructs of the contemporary paradigm: occupation is inextricably linked to health and wellbeing, humans can experience dysfunction in their occupations, and occupation-based practice. At Griffith University (GriffithOT) we are committed to supporting the profession to bridge the theory-to-practice gap through research partnerships with all stakeholders. Our research agenda aims to: • Demonstrate the value of occupation and occupational therapy practice to health and well-being • Build evidence-based approaches to support student occupational therapists and practitioners to integrate theory into practice
In this article we summarise some of our key work, findings, and implications for the profession. Through doing so, we aim to
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inspire other occupational therapy researchers and clinicians to consider how they can contribute to the theory-to-practice evidence base and bridge the theory-to-practice gap.
Occupation in Practice
Our research has identified that occupationbased practice is valued by the profession and satisfaction is high for consumers1,2. We found that clinicians working in an acute paediatric setting recognised the power of occupation and the benefits of an occupation-based approach, and incorporated these in practice, albeit inconsistently3. The clinicians identified barriers external to themselves such as working within the medical model, workplace expectations, and multidisciplinary team understanding. However, scoping reviews from other practice settings suggest that a common problem is the disconnect between the planned outcomes and the interventions that we implement. For example, occupationbased interventions are often implemented within a residential setting but the key outcomes are often measured at a person level4–or within hand therapy settings, the push of a biomedical culture and pull of an occupational perspective means there is often an expectation that component level
interventions will directly translate into improved occupational engagement 5,6. While these findings suggest the intent, and attempts, to work within the contemporary paradigm, they also challenge the profession to make the occupational perspective explicit. Supervision and/or professional development to refresh knowledge and skills in occupational therapy conceptual practice models—and to support integration of occupation throughout all of the practice process—can assist. One of our current projects involves working alongside occupational therapists in an acute setting to coach and strengthen occupation-centred practice. Intentionally increasing knowledge, skills, and confidence for implementing occupation-based practice and the changes required for documentation and intervention protocols is not only important for the profession, but also to outwardly demonstrate this perspective to the interprofessional team. Language is a powerful tool that can be used to support occupational therapists who often feel unable or unsure of how to engage in occupation-based practice. As one example, the term ‘function’ is often used interchangeably with ‘occupation’ and used variably by the interprofessional team. A conscious decision to change language and documentation to include terms such as occupation, occupational performance and engagement, and enabling occupation is a simple but powerful step to prioritising occupation in practice.
