The Human Occupation & Wellbeing Journal
Welcome to The Human Occupation & Wellbeing Journal, a publication dedicated to understanding the multifaceted nature of human occupation and how it shapes and is shaped by wellbeing. We invite submissions that explore the diverse ways in which our occupations (daily activities) interplay with our health and wellbeing. Our journal is not only a forum for rigorous academic debate but also a space where critical perspectives and innovative insights can flourish, driving positive change for humanity (Unhu/Ubuntu). At HOWJ, we recognise that academia thrives on the diverse thoughts and experiences of individuals, leading to meaningful contributions to our communities. We are particularly keen to hear from voices that have historically been marginalised in the peer reviewed publishing arena. Whether you are a student with fresh, innovative insights or a scholar from a minoritised ethnic community or an author from the Global South, your unique perspectives are not only welcome but essential to broadening our collective understanding of how our daily occupations shape and are shaped by wellbeing. The HOWJ is founded as a necessary response to the persistent limitations in current occupational science and occupational therapy research. Today’s practices are often constrained by an unyielding adherence to narrow hegemonic practices, outdated methodologies, and an over-medicalisation of wellbeing that too often overlooks the rich and complex tapestry of social, spiritual, cultural, and subjective dimensions of human occupation. Rather than merely taking incremental steps to try and decolonise existing structures and systems as what traditional journals in this space are constantly grappling with, HOWJ is built from an uncolonised perspective, a system that prioritises humanity and cultural humility. The ethos statement and scope of The HOWJ can be found here.
Editotial Board: The Human Occupation & Wellbeing Journal
© 2026 [Author(s)]. This is an open access article distributed under the **Creative Commons Attribution 4.0 International License (CC BY 4.0)**, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Book Review: Olive Growing in Palestine: Stories of Everyday Forms of Resistance, by Juman Simaan.
This review engages critically with Juman Simaan's Olive Growing in Palestine: Stories of Everyday Forms of Resistance, arguing that its contribution extends beyond occupational science into broader conversations on decoloniality, humanity and everyday resistance. Rather than simply documenting occupation under conditions of settler colonialism, the book invites readers to reconsider how meaning, dignity and collective life are sustained amid structural violence. The review also acknowledges inherent tensions of how readers will perceive the everyday resistances from their positions and contexts, suggesting fertile ground for future conceptual dialogue.
Copyright (c) 2026 Dr Chantal Juanita Christopher (Author) https://creativecommons.org/licenses/by/4.0
The Vital Role of Home Health Occupational Therapy During the Prehabilitation Phase of Chemotherapy
While it is well-known that chemotherapy significantly impacts clients physically and emotionally, what tends to be overlooked are the impacts on clients before chemotherapy treatment begins. Prehabilitation in the cancer care continuum, the time after cancer diagnosis, but prior to acute treatment, is a critical, preparatory time. Research indicates that early interventions during prehabilitation benefit clients and improve their functional outcomes, yet no clear standard of care exists. Indeed, occupational therapy is not typically offered during chemotherapy prehabilitation, even though many of the areas impacted fall well within the scope and practice of occupational therapy. This essay details the unmet needs of clients during prehabilitation and provides an in-depth analysis of how home health occupational therapy can play a vital role in filling this gap in care. Specific interventions addressed include precautions in the home, as well as chemotherapy-induced peripheral neuropathy, cognition, chemotherapy-induced alopecia, cancer-related fatigue, pre-existing conditions, and emotional distress.
Copyright (c) 2026 Naomi Bregman (Author) https://creativecommons.org/licenses/by/4.0
Decolonial Schools as Critical Spaces for Healing: An Invitation to Occupational Therapists and Occupational Scientists.
Copyright (c) 2026 Mapheyeledi Motimele (Author) https://creativecommons.org/licenses/by/4.0
Emotional Wellbeing During Occupational Engagement: A Role for Mindful Awareness
Background: Emotional wellbeing reflects the quality and balance of individuals’ everyday emotional experiences and is a key contributor to overall health and quality of life. Engagement in routine occupations plays a central role in supporting wellbeing; however, the factors that influence how individuals emotionally experience these everyday occupations remain insufficiently understood. Mindful awareness has been proposed as a mechanism that may support emotional regulation during occupational engagement. This study examined the relationship between mindful awareness and emotional regulation during completion of daily occupations across two complementary studies. Methods: Two quantitative studies, each employing a descriptive cross-sectional study design, were conducted with healthy adult participants. In Study 1, 141 healthy community-dwelling adults completed the Mindful Attention and Awareness Scale (MAAS), Difficulties in Emotion Regulation Scale (DERS), and Positive and Negative Affect Schedule (PANAS) to assess associations among mindful awareness, emotional regulation, and affect. In Study 2, 92 healthy adults completed the MAAS and the Emotional Experiences in Activities of Daily Living Scale (EEADLs) to explore how mindful awareness relates to emotional experiences during routine occupations. Results: Higher levels of mindful awareness were consistently associated with better regulation of negative emotions. In Study 1, individuals with high mindful awareness demonstrated fewer difficulties in emotional regulation. In Study 2, mindful awareness was associated with reduced experiences of negative emotions, including frustration and overwhelm while engaging in routine occupations. Conclusion: Findings suggest that mindful awareness supports emotional regulation during everyday activities. Assessing emotional experiences during routine occupational engagement may inform occupational therapy interventions aimed at promoting emotional wellbeing and supporting sustained occupational participation across populations.
Copyright (c) 2026 Karen Hebert (Author) https://creativecommons.org/licenses/by/4.0
The Power of a Paradox - Reflecting on the Potential of Occupational Futurity
This spoken word piece reflects on the paradoxes, tensions, and possibilities within the profession of occupational therapy at a pivotal historical moment. Written and performed for the centennial conference of the Canadian Association of Occupational Therapy in Montreal in 2026, the poem emerged from the author’s experiences as an occupational therapist, educator, researcher, and learner navigating the contradictions embedded within contemporary occupational therapy discourse and practice. Positioned at the intersection of celebration and critique, the piece responds to the profession’s 100-year milestone by questioning dominant narratives of progress while simultaneously holding hope for more responsive and relational futures. Through poetic storytelling, the work explores the coexistence of pride and nature within occupational therapy. The poem interrogates professional ideals of holism, inclusivity, and client-centredness alongside the realities of colonialism, ableism, individualism, systemic inequity, and institutional constraint that continue to shape education, research, and practice. Drawing on themes of paradox, positionality, and collective responsibility, the piece invites listeners to move beyond binary thinking and toward a “both/and” orientation that makes space for multiple truths, tensions, and ways of moving forward. The piece engages metaphors of waves, dance, movement, breath, and discomfort to consider what it might mean for occupational therapy to evolve collectively rather than defensively. Rather than offering solutions, the poem centres reflection as an occupational and political act, asking how the profession might better align its sphere of concern with its sphere of influence. Ultimately, the piece argues that embracing uncertainty, contradiction, and discomfort is necessary for occupational therapy to meaningfully respond to contemporary social realities and cultivate more accountable, imaginative, and justice-oriented futures over the next century.
Copyright (c) 2026 Dr Holly Reid (Author) https://creativecommons.org/licenses/by/4.0
OTs in Crisis: A Co-produced Toolkit for Occupational Therapy Practice Across Contexts of Siege, Occupation, Armed Violence, and Humanitarian Emergency
Occupational therapy practice in contexts of siege, military occupation, armed violence, and humanitarian emergency, here termed 'crisis OT', is a domain simultaneously ubiquitous in its demand and marginal in its theoretical development. The knowledge base guiding crisis OT has been produced predominantly by researchers and institutions operating at a safe remove from the realities they seek to address, systematically excluding the practitioners whose experience grounds that knowledge. This submission argues that this scarcity is structural and a product of epistemic injustice, the coloniality of knowledge, and the Global South's positioning as a site of data rather than theory generation. Informed by Fricker’s concept of epistemic injustice, Connell’s Southern theory, Haraway’s situated knowledges, Ubuntu philosophy, and occupational justice, this article proposes a theoretical and ethical framework for the co-production of crisis-related occupational therapy knowledge with, rather than about, practitioners situated in contexts of crisis. The OTs in Crisis Toolkit is introduced as a formative, co-produced resource developed with occupational therapists across multiple contexts of siege, military occupation, and humanitarian emergency, governed by principles of contributor protection, equitable attribution, and shared authorship. This perspective calls the occupational therapy profession to account for who is, and is not, in the room where knowledge is made; using crisis as the sharpest illustration of a structural problem that extends across the discipline. It proposes co-production, occupational justice, and ubuntu as the necessary ground for building differently.
Copyright (c) 2026 Elizabeth A Andare (Author) https://creativecommons.org/licenses/by/4.0
A Risk Worth Taking? Caregiver Perspectives on Risky Outdoor Play for Toddlers with Developmental Disabilities in an Urban U.S. Setting
Background: Risky outdoor play supports autonomy, emotional regulation, and resilience in early childhood, yet little is known about how caregivers of toddlers with developmental delays or disabilities make decisions about such play in urban settings in the United States. The study explored how caregivers in the St. Louis, Missouri metropolitan area perceive the socio-ecological factors shaping their attitudes toward risky outdoor play for children aged 13–47 months with developmental delays or disabilities. Methodology: A mixed methods cross-sectional study design was used. An online survey containing adapted validated items and open-ended questions was distributed through early intervention networks and community organizations. Of 38 surveys initiated, 11 formed the final analytic sample after eligibility and completion exclusions and were analyzed using descriptive statistics and reflexive thematic analysis guided by a socio-ecological model of risk and safety in children’s play. Results: Four themes were identified: (1) recognizing the developmental value of risky outdoor play; (2) negotiating the balance between supervision and independence; (3) navigating external scrutiny and cultural expectations; and (4) managing variability in community infrastructure and institutional support. Conclusion: Results showed caregivers generally valued risky outdoor play but navigated tensions related to developmental readiness, safety concerns, sociocultural expectations, and uneven access to inclusive play environments. Findings highlight the need for equity-focused and disability-informed strategies to promote developmentally meaningful outdoor play experiences.
Copyright (c) 2026 Dr Emily Korte-Stroff, Alethea Jerebine, Katherine Kristensen, Pamela Talero Cabrejo (Author) https://creativecommons.org/licenses/by/4.0
An Educational Program for Residential Staff to Enhance Confidence in Supporting Substance Use Prevention and Reduction Among Foster Youth
Background: Foster youth encounter various challenges such as adverse childhood experiences (ACEs), which increase their prevalence of developing substance use disorders (SUDs). The importance of implementing trauma-informed care techniques and harm reduction approaches in residential settings for foster youth was highlighted. The literature emphasizes a clear need for residential staff and care partners to understand and apply trauma-informed strategies and harm reduction approaches. Implementing these evidence-based strategies while also enhancing foster youth’s protective factors can strengthen resiliency among foster youth, ultimately improving their overall well-being and life outcomes. The impact of stress and burnout among residential staff and care partners of foster youth is also addressed. An educational program for residential staff working with foster youth at-risk for or experiencing SUDs was developed and implemented to address current gaps in care. Methods: A descriptive single-group pretest-posttest approach, integrating quantitative and qualitative data, was used. Eight residential staff participated in a six-week educational program (one, 30–45-minute session each week for six weeks). Sessions included topics such as trauma-informed care (TIC), ACEs, harm reduction, protective factors, resiliency, leisure, sleep, coping skills interventions, and managing staff burnout. Results: Results found participants’ confidence levels increased when implementing TIC, harm reduction techniques, and providing youth with coping skills to utilize in the moment or to add to their repertoire. Conclusion: Foster youth have a higher prevalence of experiencing trauma, resulting in a risk for developing a SUD. Results indicate education on TIC, harm reduction approaches, and coping skills can increase residential staff’s immediate self-reported confidence when assisting youth. Successful integration and continued carryover of these approaches will require ongoing staff support to sustain the program and ensure it can be carried forward by future staff.
Copyright (c) 2026 Allyson Ferraro, Dr. Alexis Morin, Jennifer Anderson (Author) https://creativecommons.org/licenses/by/4.0
The High Cost of Survival: Exploring Financial Pressures in Medical Services and Daily Living for Persons with Spinal Cord Injury from two Selected Study Settings in Rwanda: A Qualitative study
Background: Spinal cord injury causes lasting disability and financial hardship. Individuals in low- and middle-income settings like Rwanda face major barriers to affordable long-term services. Methodology: This study employed a qualitative phenomenological design to gain an in-depth understanding of participants’ lived experiences of financial pressures related to medical services and daily living. Purposive sampling was used to recruit participants, and following thematic saturation, the sample size was 12 participants. Data were gathered through in-depth interviews and analysed using thematic analysis. Results: The study generated two main themes and associated sub-themes. The first theme, financial pressures in daily living, captured the economic strain on family livelihoods, the high cost of daily living, and expensive transportation. The second theme, financial pressures in medical and related services, reflected the high cost of hospitalisation, assistive devices, and other medical services. Conclusion: These findings underscore the multifaceted financial challenges faced by people with spinal cord injury in Rwanda, both in daily living and in accessing medical services. The cumulative burden of unemployment, costly private transportation, limited insurance coverage, and unaffordable rehabilitation services highlights the urgent need for inclusive policies and financial support systems.
Copyright (c) 2026 Joseph Nshimiyimana, Valens Mbarushimana, Potien Uwihoreye, Peter Mooni Nyangezi, Maurice Kanyoni (Author) https://creativecommons.org/licenses/by/4.0
Simulating Intimacy Without Disrobing: Teaching Relational Ethics Through Feeding and Oral Care
Background: At least four and potentially six of the eight basic activities of daily living (ADL) described in the Occupational Therapy Practice Framework involve the patient in a naked or partially-clothed state. Preparing occupational therapy students to assist with intimate ADLs such as bathing, toileting, and dressing poses unique challenges, particularly regarding relational and ethical dimensions of care. While active learning is widely supported in occupational therapy education, little evidence describes high fidelity methods for reproducing these private states. Methodology: This study examined an innovative feeding and oral care lab designed to replicate relational demands of intimate ADL care. The lab required second year students in a Master of Occupational Therapy program to alternate between the roles of therapist and patient while engaging in tasks such as feeding a partner and providing oral hygiene. Following the lab, 106 students across three cohorts submitted reflections which were qualitatively analyzed. Results: Students reported significant emotional complexity in both roles. As student-therapists, they noted discomfort with proximity, bodily functions, and navigating dignity, communication, and consent. As dependent student-patients, they described vulnerability, loss of control, and embarrassment. These reflections underscore core elements of relational ethics in practice, highlighting empathy, professionalism, cultural humility, and therapeutic use of self. This lab successfully simulated the emotional aspects of intimate ADLs in an educationally appropriate, safe environment, supporting self-discovery, emotional processing, and skill development. Conclusion: Findings suggest that high fidelity simulation should emphasize relational authenticity, and this lab experience is recommended for preparing occupational therapy students for the relational and ethical demands of intimate ADLs.
Copyright (c) 2026 Dr. Orli Weisser-Pike, Dr. Stephanie Lancaster (Author) https://creativecommons.org/licenses/by/4.0
The Role of a Non-Immersive Interactive Technology (BITS) in Enhancing Occupational Therapy Outcomes: A Pilot Study
Non-immersive interactive technologies offer cost-effective and engaging tools for rehabilitation, yet limited research has examined occupational therapists’ (OTs) perceptions of their effectiveness and clinical value. This study investigated how OTs view the role of these technologies in enhancing patient outcomes. Licensed OTs (N = 10) from acute care, inpatient, and outpatient settings completed a custom-designed survey assessing perceived benefits, challenges, and satisfaction. Data were analyzed using descriptive statistics and the One-Sample Wilcoxon Signed Rank Test. Results showed significant agreement that non-immersive technologies improve patient motivation (Z = −2.803, p = .005), engagement (Z = −1.990, p = .047), and therapy effectiveness (Z = −2.803, p = .005). However, responses regarding training adequacy (Z = −1.051, p = .293) and promotion of independence (Z = −0.314, p = .753) were more neutral. These findings suggest OTs value non-immersive technologies for supporting therapy but emphasize the need for training and integration strategies. The study highlights therapist perspectives as critical for guiding evidence-based adoption in occupational therapy practice.
Copyright (c) 2026 Jayla Carpenter, Thierry Lienou, Christopher Gaskins (Author) https://creativecommons.org/licenses/by/4.0
Doing, Being, Belonging and Becoming in the Occupation of Dumpster Diving
Background: Dumpster diving refers to the practice of salvaging edible food from commercial or residential waste containers. Although stigmatized and associated with poverty, recent public discourse suggests a shift towards greater visibility and acceptance, particularly in relation to sustainability and food waste reduction. From an occupational science perspective, dumpster diving remains largely unexplored. This scoping review aims to understand how food-related dumpster diving as an occupation can be conceptualized through the dimensions of doing, being, belonging, and becoming. Methodology: Guided by Arksey and O’Malley’s methodological framework, a scoping review was conducted. Data of nine studies representing over 120 individuals engaged in dumpster diving across Europe, North America, and Australia was used and analysed deductively. Findings: Findings portray dumpster diving as a multidimensional occupation. Doing involved planning, executing and activities related to conserving the food. Use of sensory and cognitive skills as well as risk management were highlighted. Being was reflected in identity formation, values, choice, and motivations ranging from food insecurity to activism and enjoyment. Belonging emerged through shared practices, social connections and knowledge exchange, while also shaped by encounters with authority. Becoming incorporated changes in diets, environmental awareness, self-sufficiency, and wellbeing, alongside potential health risks. Conclusion: This review demonstrates that dumpster diving can support meaning, participation, and wellbeing despite its non-normative and sometimes illegal nature. Recognizing dumpster diving as an occupation broadens occupational therapy’s understanding of human engagement and highlights the importance of addressing marginalized and non-sanctioned occupations, discussed here through the lenses of dark side of occupation, occupational justice and ecopation.
Copyright (c) 2026 Tanja Turtiainen MscOT, Anni Pekkanen MScOT, Ella Mutanen OT (Author) https://creativecommons.org/licenses/by/4.0
Perinatal Mental Health Inequalities Affecting Mothers from Ethnic Minority Backgrounds: A Qualitative Study of Occupational Therapy Students' Perspectives from Education to Future Practice
Background: Perinatal mental health inequalities remain a concern in the United Kingdom (UK), particularly for mothers from ethnic minority backgrounds who often face additional social and structural barriers to gaining support. This study aimed to explore how occupational therapy students understand these inequalities and how prepared they feel to work with mothers during the perinatal period. Methodology: A qualitative phenomenological design was used. A purposive sampling strategy was used, and semi-structured interviews were conducted with four occupational therapy students from a UK University. Data were analysed using Braun and Clarke’s six-phase thematic analysis to identify key themes in the participants accounts. Findings: Three themes emerged, pointing to gaps in confidence, understanding, and readiness for culturally responsive work. Students described different levels of awareness of perinatal mental health, with some drawing on placement experience while others relied more on personal or informal knowledge. Students felt that the lack of focused teaching on perinatal mental health and cultural humility sometimes made it harder for them to work out how their academic learning should translate into everyday practice. Conclusion: Overall, the findings suggest that clearer curriculum guidance and more practical learning opportunities may help prepare the future occupational therapy practitioners to deliver safe, fair and more inclusive perinatal mental health care and support.
Copyright (c) 2026 Karlene Ruddock (Author) https://creativecommons.org/licenses/by/4.0
Test-retest reliability and internal consistency of the Occupational Resilience Measure (ORM 1.0)
Background: The Occupational Resilience Measure (ORM 1.0) is a 20-item, multidimensional self-report tool for measuring occupational resilience, a construct defined as an individual’s ability to persist in performing occupations despite barriers. Objective: This study evaluated test-retest reliability and internal consistency and explored the extent to which ORM 1.0 is a reliable measure across a diverse range of activity types. Methods: Ninety-four participants completed the test and retest measurements within a 2- to 3-week period. A total of 202 activities were included in the analysis, grouped into leisure (LE) [94], productivity (PD) [35], and self-care (SC) [73]. Findings: The estimates of test-retest reliability (95% confidence interval [CI] ) for SC, LE, and PD were 0.863 (0.794,0.91), 0.860 (0.793,0.907), and 0.876 (0.771,0.935), respectively, indicating good reliability across the two time points for each of the three categories. The Cronbach’s alphas at time point 1 for SC, LE, and PD were 0.744 (0.666, 0.808), 0.711 (0.63, 0.778), and 0.694 (0.517, 0.818), respectively, suggesting acceptable to good internal consistency. Similarly, the estimates of Cronbach’s alpha at time point 2 for the three occupational categories were: 0.79 (0.725,0.842), 0.766 (0.7,0.82), and 0.775 (0.645,0.866), respectively, indicating good internal consistency at time point 2. Conclusion: The findings suggest that ORM 1.0 has test-retest reliability and internal consistency across leisure, productivity, and self-care activities. Further research is needed to strengthen ORM 1.0 as an evidence-based measure of occupational resilience.
Copyright (c) 2026 Bernard Muriithi, Milan Bimali, Kara Gore (Author) https://creativecommons.org/licenses/by/4.0
Adjustment Disorder, Life Transitions, and Occupational Disruption: Implications for Preventive Occupational Therapy Practice
Background: Adjustment disorder is a prevalent yet frequently underrecognized mental health condition defined as a maladaptive response to an identifiable stressor accompanied by clinically significant distress and functional impairment in social, occupational, or other important domains. Historically regarded as a residual or transient diagnosis, adjustment disorder has often been marginalized in both research and clinical practice. However, emerging evidence suggests that adjustment disorder is associated with sustained functional impairment, disrupted occupational participation, and prolonged difficulties in role performance, particularly during periods of major life transition. Methodology: This paper used a mixed methods approach presenting a narrative evidence synthesis of contemporary interdisciplinary literature through an occupational and wellness lens, supplemented by survey data from adults experiencing recent life transitions to explore perceived impacts on routines, roles, occupational engagement, and awareness of occupational therapy as a potential support. Findings: Findings indicate that adjustment disorder reflects a dynamic and reciprocal process in which occupational disruption and psychological symptoms mutually reinforce one another over time, rather than representing short-lived distress alone. Survey results similarly highlight the extent to which life transitions are experienced as occupationally disruptive, with respondents reporting sustained challenges in maintaining routines, balancing roles, and supporting wellbeing. Despite these challenges, awareness and utilization of occupational therapy were limited, although respondents identified occupation focused support as potentially valuable. Conclusion: By conceptualizing occupational performance and psychological symptoms as mutually reinforcing, this paper positions occupation-centered intervention not only as functional support but as a therapeutic mechanism capable of directly mitigating adjustment-related distress.
Copyright (c) 2026 Dr. Sue Persia (Author) https://creativecommons.org/licenses/by/4.0
Occupations Are Not Neutral: Toward Anti-Caste Occupational Therapy Praxis in India
Occupational therapy is often grounded in theoretical frameworks that conceptualise occupation as an expression of individual choice, motivation, and ability. While such approaches emphasise personal agency and functional performance, they frequently obscure the structural forces that shape occupational possibilities Drawing on occupational science, occupational justice, and anti-caste scholarship, particularly Ambedkarite and Dalit feminist frameworks, this conceptual paper theorises caste as a structural determinant of occupation within the Indian context. It argues that caste produces enduring conditions of occupational marginalisation, alienation, and occupational apartheid by determining access to education, labour, safety, dignity, and social recognition. The paper challenges the dominant assumption of “occupation as choice,” demonstrating how this notion is largely illusory for Caste-oppressed communities whose occupational trajectories are constrained by inherited social location, stigma, and systemic exclusion. In response, the paper offers a theoretical reframing of occupational justice through an anti-caste Ambedkarite lens, advances an epistemic critique of caste neutrality in occupational therapy, and highlights implications for curriculum reform and practice.
Copyright (c) 2026 Preethi Shanmugapriya (Author) https://creativecommons.org/licenses/by/4.0
Our Identity, Promise, and Responsibility: Our Perspective
In this personal reflection, the miscasting of Dian Fossey, the primatologist, conservationist and occupational therapist, in the 1988 movie "Gorillas in the Mist" provides a lens to explore the seemingly enormous challenge of describing one of healthcare’s most important - and most misunderstood - health professions: occupational therapy. This challenge leads directly into longstanding, ongoing debates around defining occupational therapy: who are we, what do we do, and why does that distinction matter, perhaps now more than ever?
Copyright (c) 2025 Professor Gavin Jenkins, Rachel Ashcraft (Author) https://creativecommons.org/licenses/by/4.0
The Lion’s Right to Speak: Historical Erasure, Constitutional Memory, and the Politics of “Progress”
In a world where "progress" is increasingly weaponised as justification for historical erasure, the deliberate suppression of national memory poses a direct threat to democracy, justice, and human rights. This article interrogates how state-led narratives of being "too progressive" or "protecting children" function as strategies of governance that distort constitutional purpose and undermine collective wellbeing. Through comparative analysis of curriculum restrictions and book bans in the United States, the systematic silencing of Gukurahundi in Zimbabwe, and the bureaucratic erasure of the Windrush scandal and Chinese seamen deportations in the United Kingdom, this work argues that the constitutional duty to preserve collective memory is fundamental to safeguarding citizenship, dignity, and rights. Drawing on postcolonial theory, decolonial jurisprudence, feminist epistemology, and queer legal theory, this article argues that historical erasure operates as epistemic violence: a form of structural harm that fractures communities, sustains intergenerational trauma, and undermines the conditions necessary for meaningful democratic participation. The article examines the transformative potential of truth and reconciliation commissions, exploring how societies that confront the past through inclusive, transparent processes more effectively uphold the rights to protest, to speak, and to live with dignity. It proposes a jurisprudence of remembering that recognises memory as a constitutional right essential to both justice and healing. Ultimately, it calls for a re-conceptualisation of constitutional memory as a living archive of dissent and survival, one that guarantees the lion's right to speak, and the state's obligation to listen.
Copyright (c) 2026 Lisa Shoko (Author) https://creativecommons.org/licenses/by/4.0
Exploring Occupational Justice for Black University Students in the United Kingdom: A scoping review
Background: Occupational justice is a core concept within occupational science, concerned with equitable access to meaningful, health-promoting occupations across the life course. Within higher education (HE), occupational injustices may arise through structural racism, discriminatory institutional cultures, exclusionary curricula, and restricted access to academic and social participation. For Black students in the United Kingdom, these injustices shape educational engagement, occupational identity development, mental health, and future life opportunities. This scoping review aimed to systematically map and synthesise existing evidence on occupational injustice experienced by Black university students in the United Kingdom, using an occupational justice lens to illuminate how structural and institutional factors shape participation, wellbeing, and inclusion within higher education. Methods: This scoping review followed Arksey and O’Malley’s methodological framework. A comprehensive search of MEDLINE, APA PsycINFO, and CINAHL Ultimate identified studies published between 2022 and 2025 that explored Black students’ lived experiences within UK HE. Study selection was conducted using explicit inclusion and exclusion criteria. Data were charted systematically and presented in thematic summaries. Results: Five peer-reviewed qualitative studies conducted in England met the inclusion criteria. Three interrelated themes were identified: (1) structural marginalisation and exclusion within higher education; (2) occupational deprivation through restricted access to social, cultural, and institutional capital; and (3) hope, resistance, and possibilities for occupational justice. Conclusions: This scoping review demonstrates that occupational injustices experienced by Black students in UK higher education are deeply embedded within institutional structures and cultures. Applying an occupational justice lens reveals higher education as spaces where inequities are reproduced but also contested. This study necessitates a shift toward decoloniality to address the foundational role of structural racism in shaping the contemporary UK academic landscape.
Copyright (c) 2025 Charmaine Tinarwo, Dr. Blaine Robin (Author) https://creativecommons.org/licenses/by/4.0
Balancing Excellence and Well-being: An Occupational Perspective on Anxiety Among Elite Performers
Background: Elite performers, such as business executives, athletes, and surgeons, face distinctive role demands that contribute to anxiety and psychological stress. Although prior research has explored anxiety within these groups individually, little is known about anxiety among high performers collectively or from an occupational lens. Aims/Objectives: This narrative review synthesizes current evidence on how individuals in high-performance occupations experience anxiety and examines the impact on occupational engagement, role fulfillment, and well-being. Methods: Twenty-eight peer-reviewed articles published between 2015 and 2025 were analyzed from CINAHL, PubMed, and Google Scholar, focusing on executives, elite athletes, and surgeons. Key Findings: Across domains, anxiety emerged as a pervasive and consequential experience shaped by perfectionism, role imbalance, and continual evaluation inherent to high-stakes performance. Effective strategies identified include adaptive coping strategies, such as mindfulness and mastery coping, as well as supportive work environments and engagement in restorative or serious leisure occupations. Conclusions: These findings highlight the potential for occupational therapy to address the contextual and role-based contributors to anxiety, promoting optimal performance and psychological well-being in high-demand professions.
Copyright (c) 2025 Kristen Bowie, Dr. Corey A. Peacock (Author) https://creativecommons.org/licenses/by/4.0
Occupational Resilience (Part 1): Origins and Significance to Health and Well-being
Occupational resilience (OR) is a novel concept emerging in occupational therapy and occupational science, with significant implications for the field. However, its definition is still evolving and needs clarity and consensus. In this article, we offer a definition inspired by the real-life experiences of refugee immigrants who have been resettled in the United States of America (USA). We define OR as the ability to persist in an occupation, where the duration and intensity of engagement are the essential contributors. Therefore, we propose that three elements, occupation, intensity, and duration, constitute the nature of OR and shape how occupation impacts health, either positively or negatively. We argue that OR is both measurable and modifiable, and we draw on the experiences of refugee musicians to gain insights and suggest how to enhance persistence in occupation over extended periods. We believe that OR is relevant to all kinds of human occupations, the various things people do throughout their lives. To support health, measures of OR must be applied judiciously because the link between occupation and health is complex, rarely following simple linear principles. Despite the complexity of the links between OR and health, we argue that the construct is of high significance in clinical practice, experimental research, and epidemiological studies.
Copyright (c) 2025 Dr Bernard Muriithi, Dr. Jyothi Gupta (Author) https://creativecommons.org/licenses/by/4.0
Occupational Resilience (Part 2): Toward a Cross-culturally Relevant Measure of a Novel Construct
Occupational resilience (OR) refers to an individual’s ability to persist in performing an occupation, with the duration and intensity of engagement determining resilience for each occupation. It is a key determinant of both the manner and the extent to which occupations influence health; therefore, it is a promising construct with several potential applications. There are currently no validated OR measures; which problematizes its application. Three considerations were made in designing the Occupational Resilience Measure (ORM 1.0) and evaluating its potential as a cross-culturally relevant measure of OR: 1) the findings of a published study of lived experiences of refugees from non-Western cultures; 2) Western occupational therapy theories, and 3) evaluations of six American occupational therapy scholar-clinicians. The qualitative study identified five factors that produced sustained participation in one occupation [music]. Four of these factors were developed as subscales of ORM 1.0, namely, History, Experience, Benefits, and Adaptation. On evaluating links between these factors and Western theories, we found constructs that closely align with the four factors, which are measurable and/or modifiable variables associated with long-term occupational performance. Lastly, we considered the results of six American scholar-clinicians who evaluated ORM 1.0 via an anonymous survey and supported the tool as valid, clinically relevant, and unique. The high degree of correspondence between the four ORM 1.0 factors and Western constructs suggests strong cross-cultural relevance. We recommend further studies and cross-cultural application and testing of ORM 1.0 in clinical practice and research.
Copyright (c) 2025 Dr Bernard Muriithi, Dr Milan Bimali (Author) https://creativecommons.org/licenses/by/4.0
Occupational Therapy Students’ Confidence in Building Rapport with Clients During Level II Fieldwork
Background: Occupational therapists regard rapport as a critical element to provide quality client-centered care using an intentional and personal therapist-client relationship. This study aimed to describe OT students’ confidence in client rapport-building skills during level II fieldwork. Knowledge of improvement areas with key components to building rapport would inform OT education. Methods: A quantitative, descriptive survey was administered to OT students across the South-eastern United States from winter 2024 to spring 2025. Findings: Results indicate that a variety of factors, including undergraduate background, graduate degree level, and fieldwork experience, influence OT students’ confidence in various areas of rapport building with clients. Of 36 respondents, it was found that, on average, students entering their second level II rotation were 4% more confident in various aspects of client rapport building than students entering their first level II rotation, demonstrating an increase in confidence with continued experience. This 4% difference occurred over a three-month period, on average, indicating early career continued growth in rapport confidence would be substantial. Additionally, rapport building components of empathizing with clients, being on time and prepared, and maintaining professional boundaries with clients were rated highest confidence by respondents. Conclusion: Gaining confidence as an occupational therapy student is important sequentially from didactic learning to experiential learning. Mastering confidence with rapport building, however, is an ongoing learning process throughout an OT career. Continued research on rapport building is needed and foundational to effective, client-centered occupational therapy practice.
Copyright (c) 2025 Taylor Butts, Sydney Hickox, Molly Henkes, Lydia Nobles, Sabrina Rodgers, Anna Stansell, Laurie Vera, MHS, OTR/L, Ryan M. Carrick, PhD, MHS, OTR/L (Author) https://creativecommons.org/licenses/by/4.0
An Occupational Therapy–Led Multifactorial Fall Prevention Program for Community-Dwelling Older Adults: A Pilot Feasibility Study
Background: Falls threaten older adults’ independence and participation in meaningful occupations. From an occupational therapy perspective, fall prevention extends beyond reducing injury risk; it sustains connection, autonomy, and belonging within one’s community. This pilot study examined the feasibility, acceptability, and community impact of an occupational therapy–led, occupation-focused fall prevention program designed to enhance safety, participation, and collective well-being among community-dwelling older adults. Methodology: A quasi-experimental pretest-posttest pilot study was conducted at a community site (seven enrolled; six completed). Six weekly sessions integrated exercise, education, and environmental strategies mapped to the Occupational Therapy Practice Framework, Fourth Edition. Feasibility indicators included recruitment, retention, fidelity, acceptability, and contextual barriers. Secondary outcomes included the Timed Up and Go (TUG), 30-Second Chair Stand, Activities-specific Balance Confidence (ABC) Scale, and Falls Efficacy Scale (FES). Quantitative data were summarized using medians and interquartile ranges and analyzed with Wilcoxon signed-rank tests (α = 0.10); effect sizes (r) estimated the magnitude of change. Results: All feasibility benchmarks were met (86% retention, high attendance, positive feedback). Median TUG improved from 14 to 11 seconds (r = 0.74), indicating a potential signal of improved mobility; other measures showed small, nonsignificant directional changes. Participants described increased confidence, mutual encouragement, and social connection, reflecting a shared commitment to safety and interdependence. Conclusion: An occupation-based, therapist-led fall prevention program was feasible and well received, fostering safe engagement in daily activities and social connectedness. Preliminary directional changes in mobility and confidence suggest potential benefits for future study of effects on participation and wellbeing. Interpreting outcomes through the doing, being, becoming, and belonging lens highlights how mobility practice, confidence, emerging routines, and mutual support can be advanced together in community programs.
Copyright (c) 2025 Dr. Lauren Healy, Dr. Nakia Lynn, Dr. Kristy Meyer (Author) https://creativecommons.org/licenses/by/4.0
“Learning without the fear of failure”: Ungrading as an alternative assessment method in occupational therapy education
Introduction: Mental health concerns among higher education students, especially those in professional graduate programs, have reached a critical level, prompting exploration of alternative pedagogical methods to alleviate stress and enhance learning. This study investigates the potential of ungrading, a system that minimizes or removes traditional grades in favor of frequent, formative feedback, within the context of two first-year entry-level occupational therapy courses. Methods: Through a mixed-methods approach using a survey design followed by a focus group, the authors gathered data from 17 students, examining their perceptions of ungraded assessment versus traditional grading. Findings: Results indicated that if given the option, most students (94%) would choose ungraded classes for learning and retention, citing reduced stress, increased faculty support, and greater comfort in collaborative environments. Qualitative data revealed themes of decreased anxiety, enhanced material comprehension, self-reflection opportunities, and a supportive classroom culture. However, students initially struggled to adjust to the absence of traditional grading, suggesting that structured feedback and consistent check-ins could facilitate the transition. Conclusion: This study contributes to emerging research on ungrading as a viable approach to supporting student mental health and engagement, while aligning with occupational therapy education ideals. Future research should explore the broader applicability of ungrading across health professions and investigate faculty experiences with this assessment model.
Copyright (c) 2025 Dr. Brittany C. Adams, Dr. Alexis M.F. Morin (Author) https://creativecommons.org/licenses/by/4.0
Smartwatches' Influence on Health Behavior Change and Occupational Engagement Among African American Students
Background: African American university students face disproportionate barriers to health and wellness, including elevated stress and limited access to wellness resources. Wearable technologies, such as smartwatches, offer promising tools for promoting health behavior change and occupational engagement in underserved populations. Methods: This cross-sectional study examined the relationship between smartwatch usage and perceived behavior change among 44 African American students. Participants completed a self-administered survey assessing usage frequency, duration, and perceived impact on daily habits. Findings: Pearson correlation analyses revealed a significant positive association between the frequency of smartwatch use and perceived behavior change (r = .302, p = .046), while duration of ownership showed no significant relationship. Conclusion: These findings suggest that consistent smartwatch use may support self-management and meaningful engagement in daily routines, positioning wearable technologies as valuable adjuncts to digital health strategies for minority student populations.
Copyright (c) 2025 Dr Thierry Lienou, Dr Jaleshia Washington, Alain Bagmi (Author) https://creativecommons.org/licenses/by/4.0
COVID-19 and NHS Rationing: Consequences for the Wellbeing and Care of Older Adults
Introduction: This paper critically examines the care of older adults during the early phase of the COVID-19 pandemic (March–June 2020), drawing on social and occupational justice theories. It highlights systemic neglect and advocates for equitable access to meaningful engagement, autonomy, and participation in health-related decision-making for older adults. Methods: A broad review was conducted using peer-reviewed literature, policy documents, UK print media, and international news sources such as CNN, Sky News, Al Jazeera through databases including the Cochrane Library, CINAHL, Medline, and Google Scholar were used. Findings: The analysis offers a contextual critique of NHS and social care resource management in the UK, serving as a benchmark to compare healthcare responses in the United States during the same period. It reveals a moral polarization between rationing and rationalizing elder care and argues that promoting Advance Care Directives risks undermining professional ethical commitments to the sanctity of life. Conclusion & Implications: For occupational therapists, this study provides a framework to examine and address structural determinants affecting older adults’ experiences, especially in crises. It calls for urgent, justice-oriented systemic reform that moves beyond reactive measures toward proactive preparedness. This paper advocates for the adoption of an Occupational Justice Audit Tool to guide equitable system responses, the establishment of mandatory community-based Advance Care Planning hubs and proactive policies to ensure equitable, dignified engagement for aging populations.
Copyright (c) 2025 Dr Regan R. Reid, Dr. Blaine Robin (Author) https://creativecommons.org/licenses/by/4.0
Welcome to The Human Occupation and Wellbeing Journal
Copyright (c) 2025 Dr Tongai F. Chichaya (Author) https://creativecommons.org/licenses/by/4.0
Perceived Outcomes of Intensive Family Therapy or Multi-family Therapy for Adolescents with Anorexia Nervosa and Their Families: A Literature Review
Background: Adolescents aged 15-19 have the highest incident rate for Anorexia Nervosa in the United Kingdom. They lose meaningful occupations which are often replaced with unhelpful occupations, habits and behaviours. Occupational therapists working within a multidisciplinary team can help these individuals navigate the occupational changes. Aims: To identify perceived outcomes of Family Based Therapy for adolescents with a diagnosis of AN and their families and its relevance to Occupational Therapy practice. Methods: A systematic search of EBSCOhost was completed in December 2024. This review included qualitative studies that concerned perceived outcomes of family therapy for adolescents with AN and their families. Six studies met the inclusion criteria and were quality appraised using CASP tool. The themes found were synthesised using the core themes of the Model of Human Occupation (MOHO). Key findings: Four main themes aligning to the MOHO were synthesised that focussed on health and wellbeing of those with eating disorders and their families. Perceived outcomes were mainly self-awareness, motivation and hope. Role changes within families eased guilt and improved relationships. Areas needing further attention were early focus on weight restoration and neglected emotional needs, parents’ preparation for discharge and adolescents’ willingness to work on skills to deal with body image and eating disorder behaviours. Conclusion: Occupational therapists collaborate with individuals and families to identify occupations that serve the eating disorder. They find meaningful alternatives by addressing routines and rituals around food and build skills to deal with emotional distress.
Copyright (c) 2025 Rebecca Scoggie, Preetee Gokhale (Author) https://creativecommons.org/licenses/by/4.0
Reimagining curricula and pedagogy in occupational therapy and occupational science education: Towards epistemic justice, cultural sensitivity and inclusion
Copyright (c) 2025 Dr Dave S.P. Thomas (Author) https://creativecommons.org/licenses/by/4.0