What is Occupational Therapy in Diverse Settings ?

The Royal College of Occupational Therapists (2017, p.vii) define diverse settings as “working in settings or roles where occupational therapists traditionally have not worked”.

This definition focuses on the setting and it is important that the role should NOT be referred to as diverse occupational therapy but IS occupational therapy in a diverse setting, using core skills and philosophy grounded in occupation-focused practice. Examples include charities, voluntary or private organisations but may also include traditional settings where the role involves the development of the existing service, for example facilitation of service user engagement in meaningful leisure activities on acute medical wards to maintain and enhance well-being whilst an in-patient.

At a time when health and social care contexts are rapidly changing within the UK, and Government drivers are focusing on well-being, enablement, health promotion, reducing inequalities, sustainability, active ageing, integrated services, primary and community care, there is an increasing move for occupational therapists away from medically orientated institutions towards community based, co-ordinated, independent and voluntary services that focus on health promotion, well-being and function (Withers and Shann 2008, Molineux and Baptiste 2011).

These trends are congruent with occupational therapy philosophy which believes that humans have an intrinsic need to be engaged in meaningful occupations and activities and considers the absence of occupation as disruptive to health (Wilcock 2006). Occupation is the means through which humans meet their needs, develop their sense of self and contribute to society (Wilcock 2006). This is reflected in a definition provided by Creek (2003, p32) who suggests that occupation is a “synthesis of doing, being and becoming that is central to the everyday life of every person”. Occupational therapists recognize the need for occupational balance in areas of self-care, productivity and leisure and value occupation’s role in providing mental and physical stimulation, structure, organization and meaning in an individual’s life. Therapists not only focus on improving occupational performance but also address issues of deprivation, occupational engagement and social and environmental restrictions where these are seen to impact on a person’s well-being, growth and development (Creek 2003, Watson and Fourie 2004, Whiteford and Wright-St Clair 2005, Wilcock 2006). Creek and Cook (2017), for example, highlight how issues such as racism, sexism, ageism and poverty marginalize certain individuals in society, creating occupational inequalities and subsequent ill-health and well-being.

In light of this philosophy it is clear that occupational therapists have a role to play in helping to achieve the Government’s agenda of healthy and productive communities, promoting their role and the benefits of occupation-focused practice in new and diverse settings. Literature suggests that practitioners and students are increasingly using their core skills, knowledge and attributes to promote the benefits of occupation-focused practice in new and diverse settings (Clarke 2014, Creek and Cook 2017, Gerlach 2015, Sakellariou and Pollard 2017).

Further useful references and texts are provided for you in the resources pages of this website. Please do let us know if you have written anything or find anything useful to add.


Clarke C (2014) Role emerging placements: a useful model for occupational therapy? A literature review. International Journal of Practice-based learning in health and social care. DOI: 10.11120/pblh.2014.00020

Creek J (2003) Defining occupational therapy as a complex intervention. London: College of Occupational Therapists

Creek J, Cook S (2017) Learning from the margins: Enabling effective occupational therapy. British Journal of Occupational Therapy, 80(7), 423-431.

Gerlach A.J (2015) Sharpening our critical edge: Occupational therapy in the context of marginalized populations: Canadian Journal of Occupational Therapy, 82(4), pp.245–253.

Molineux M, Baptiste S (2011) Emerging occupational therapy practice: Building on the foundations and seizing the opportunities. In M Thew, M Edwards, S Baptiste, M Molineux, eds. Role emerging occupational therapy: maximising occupation-focused practice. Chichester: Wiley-Blackwell.

Royal College of Occupational Therapists (2017) Professional Standards for Occupational Therapy Practice. London: RCOT.

Sakellariou D, Pollard N eds (2017) Occupational therapies without borders: integrating justice with practice. Edinburgh: Elsevier

Watson R, Fourie M (2004) Occupation and occupational therapy. In: R Watson, L Swartz, eds. Transformation through occupation. London: Whurr Publishers. 19-32

Whiteford G, Wright St-Clair V (2005) Occupation and practice in context. Sydney: Churchill Livingstone.

Wilcock AA (2006) An occupational perspective of health. 2nd ed. Thorofare, NJ: Slack Incorporated

Withers C, Shann S (2008) Embracing opportunities: stepping out of the box. British Journal of Occupational Therapy, 71(3), 122-124.