Occupational therapy for people experiencing illness, injury or impairment: Promoting occupational participation.

The Preface for the previous edition of this book started with the story of Matthew deciding, when he was 18 years old, to move out of his family home to live by himself. Matthew had not decided to move out because he was unhappy at home but because he just “thought it was about time”. However, it took another 3 years, until he was 21 years old, to make the move into a place of his own. Matthew was diagnosed with cerebral palsy. Matthew used a powered wheelchair to move around, a communication device to talk with people, and physical assistance to accomplish many of his personal care and daily activities. Matthew felt that in making the decision to live on his own he became more confident in making his own arrangements and doing the things he wanted to do the way he liked to do them. He had control of how and when he participated in occupations.

Based on his experiences, Matthew offered the following advice: “You just do not know the possibilities, until you try it. Whatever your disability is, whatever your fear is, whatever your abilities are […] anything is possible”. Cathy, Matthew’s mother and advocate, adds a caveat to Matthew’s statement, explaining, “It took a lot more than Matthew’s great attitude and determination to achieve his goals. It required the support of others, both family and professionals and a context in which supports were available to facilitate his participation. He required people who shared this can-do attitude, shared his vision, believed in him, and were willing to work with him to make his dream a reality. Anything is possible, when people have the right attitude!”

Matthew’s story of moving out on his own, and his and Cathy’s belief that anything is possible, when people have the right attitude, provides an essential lesson for the readers of this book. Although this book has garnered the wisdom of a range of skilled and experienced occupational therapists and other professionals from around the world, and offers readers numerous approaches and strategies that can be used when working with people who have an illness, injury or impairment, all of the content rests on the reader establishing genuine collaborative relationships with the people they work with, and being open to exploring and enacting an openness to expanding their professional horizons to contribute to critical orientations to occupational therapy practice.

Occupational therapists with an openness to critical occupational therapy have a commitment to expanding an individual, group, community, and population’s “opportunities to engage in meaningful occupations that contribute positively to their own wellbeing and the wellbeing of their communities” (Whalley Hammell 2021, p. 7). These occupational therapists have developed critical thinking is essential “to resist conformity, question the assumptions and ideologies that are presented as ‘truth,’ and discern the systems of oppression that shape [people’s] occupational lives” (Whalley Hammell, 2021, p. 8). Moreover, to facilitate well-being, social inclusion and participatory citizenship, occupational therapists must be critically reflexive to consider whether what they think, say, and do is consistent with what we believe (Whiteford et al., 2021). Critical thinking is key to recognising and understanding how power structures and systems “of oppression and domination can negatively affect [the health and wellbeing of people] through restriction of their occupational participation. Such understanding will illuminate the structural determinants of health, thereby opening new pathways for intervention” (Bailliard, 2016, p. 13).

As editors of this book, we trust that readers will approach it as critical thinkers and have the capacity to go beyond existing attitudes, assumptions, practices, and services to meet the needs, desires, hopes and dreams of the individuals, groups, communities, and populations with whom they work. In this way, we invite readers to practice in a way that genuinely promotes occupational participation.