Occupational stewardship and collaborative engagement: a theory grounded in experiences of natural disaster

Abstract

Introduction: Disaster is one of the most pressing global issues of the 21st century in that it compromises human development and economic gains on a global scale and threatens the integrity of the natural environment. The poorest regions of the world, and the most vulnerable groups within them, assume a disproportionate share of the burden. Little is known about what the discipline of occupational therapy may contribute to the field within the medical-rehabilitation sphere and beyond, involving issues of social inequality and change; and specifically, the role of ‘occupation’ in strengthening resilience and promoting recovery across individual and social realms of practice. This thesis explores the relationship of occupation to disaster resilience and recovery through a qualitative study that engaged a culturally diverse group of occupational therapy practitioners involved in the field of disaster. Methods: The study utilised a constructivist grounded theory approach, involving active, in-depth interviews. Findings: Across different situations of disaster the practitioners were confronted with patterns of disconnect between actors and elements within the system that impacted upon the coordination and quality of assistance. In response to these challenges they used occupation to bring people into changing relationships with each other and the environment around them, toward more resilient, collaborative and sustainable relationships and systems. This process is represented by the theory of ‘Occupational Stewardship and the model of Occupational Stewardship and Collaborative Engagement (mOSCE). Conclusion: Occupational Stewardship illuminates the transformative potential of occupation as it is deeply embedded in the social world and lies within a dynamic, emergent, ecological context. The concept and practice holds the potential to contribute to inclusive, community-based approaches and interventions in the field of disaster. Moreover, Occupational Stewardship opens up avenues for the contribution of an occupational perspective to complex global issues and population health concerns related to issues of equity, participation, sustainability and social change.