Michael A. Pizzi, Lorie Gage Richards; Promoting Health, Well-Being, and Quality of Life in Occupational Therapy: A Commitment to a Paradigm Shift for the Next 100 Years. Am J Occup Ther 2017;71(4):7104170010. https://doi.org/10.5014/ajot.2017.028456
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© 2020 American Occupational Therapy Association
Since the inception of the profession of occupational therapy a century ago, a clarion call to link health with occupation and occupational engagement has been heard. For decades, leaders in the profession have emphasized the need for prevention and health promotion as well as for development of assessments and models linking health with occupation. This article addresses the need for an increased presence of occupational therapy in health and wellness, emphasizing participation over performance, to optimize the health, well-being, and quality of life of individuals, communities, and populations.
We are a profession possessing knowledge that is particularly necessary to maintain the health of people. To move from therapist to health agent demands us to change but to change in a forward, positive way. We do not have to give up what we know, rather, we must instead be willing to know more. (Finn, 1972, p. 66)
Our conception of man is that of an organism that maintains and balances itself in the world of reality and actuality by being in active life and active use. . . . It is the use that we make of ourselves that gives the ultimate stamp to our every organ. (p. 1)
Health is created and lived by people within the settings of their everyday life; where they work, learn, play and love. . . . Health is created by caring for oneself and others, by being able to make decisions and have control over one’s life circumstances. (World Health Organization [WHO], 1986, p. 4)
Individuals, communities, and populations strive to optimize their health, well-being, and QOL.
Health, environments, and occupational performance have a dynamic influence on QOL and well-being.
Health behavior change can occur when clients become aware of a need for such change.
Participation in daily activities that are meaningful promotes a positive health trajectory for daily living.
Health is a resource used daily to pursue and participate in important and meaningful activity in life (WHO, 1986).
Use of time for an individual, community, or population in meaningful, culturally relevant, and socially appropriate daily activities can be health promoting.
Interprofessional collaboration facilitates clients’ health, well-being, and QOL.
The promotion of health, well-being, and QOL can and should be included in every client’s intervention plan to firmly establish the role of occupational therapy in health care.
A focus on health, and not only on occupational performance and participation, is imperative to move the profession forward.
Having a health focus includes addressing the physical, social, mental and emotional, and cultural aspects of doing, being, becoming, and belonging, which facilitates QOL and well-being.
A paradigm shift in occupational therapy academic institutions and in practice is mandated to carry forward the vision of promoting health, well-being, and QOL.
An expansive opportunity exists for occupational therapy research focused on health, well-being, and QOL to help meet societal needs.
Having both a model and assessments linking health and occupational participation directly, practitioners can begin to substantiate Vision 2025 for occupational therapy, which states, “Occupational therapy maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living” (AOTA, 2017, p. 1).
Occupational therapy has not merely added knowledge to its stockpile over the past decades, but has undergone profound shifts in its most fundamental orientations and in its clinical technologies. . . . Such a paradigm must recommit itself to the early principles of the paradigm of occupation. (p. 46)
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