A critical approach to the foundations of occupational therapy: contributions to an Alternative Occupational Therapy

Abstract

This essay addresses, from a critical perspective of the Global South, what has been called the foundations of occupational therapy. It argues that these so-called foundations rely on certain constitutive categories that form the basis of the construction of concepts, theories, and frameworks with which the discipline operates, including mainly the notion of occupational nature, the concept of the individual, among others. These categories that support what has been referred to as the foundations of our work primarily derive from the world-system in which scientific disciplines have been produced, including occupational therapy, and correspond to the rationality of the modern Western, North Eurocentric project. The purpose of this essay is to critically analyze and reflect upon the fundamental categories of occupational therapy from a critical position of the Global South, which will open up the possibility of producing an occupational therapy radically different from those of the modern Western world-system. We will refer to it as “alternative occupational therapy,” which is based on a radical rupture from the central categories of the profession. As an introduction, we propose other categories that promote a historically situated, decolonized understanding of the discipline oriented towards recognition and a South-South praxis that fosters intercultural dialogues breaking away from the universalism, monotopism, and monoculturalism of occupational therapy.

Keywords:
Occupational Therapy; Critique; Knowledge

Resumen

El ensayo aborda, desde una perspectiva crítica Sur, lo que se ha llamado «los fundamentos» de la terapia ocupacional. Se plantea que estos disponen de ciertas categorías constitutivas que están en la base de la construcción de conceptos, teorías y marcos de trabajo en los que actúa la disciplina. Algunos de estos fundamentos primordiales son el de la naturaleza ocupacional, el concepto de individuo, entre otros. Estas categorías que sostienen nuestro quehacer devienen, primariamente, del sistema mundo en el cual se han producido las disciplinas científicas—entre ellas la terapia ocupacional—y que corresponden a la racionalidad del proyecto moderno occidental nor-eurocéntrico. El objetivo de este ensayo es analizar y reflexionar críticamente las categorías fundamentales de la terapia ocupacional desde una posición crítica Sur, la que permitirá abrir la posibilidad de producir una terapia ocupacional radicalmente diferente a las del sistema mundo moderno occidental. A esta la llamaremos una terapia ocupacional Otra, que se fundamenta en una ruptura radical de las categorías centrales de la profesión, para lo cual proponemos, a modo introductorio, otras categorías que promuevan una comprensión histórica, situada, de orientación descolonial de la disciplina, orientada al reconocimiento y a una praxis Sur-Sur que promueva diálogos interculturales que rompan con el universalismo, el monotopismo y monoculturalismo de la terapia ocupacional.

Palabras clave:
Terapia Ocupacional; Critica; Conocimiento

Resumo

Este ensaio aborda, a partir de uma perspectiva crítica do Sul, o que tem sido chamado de fundamentos da terapia ocupacional. Argumenta-se que os chamados fundamentos dispõem de certas categorias constitutivas que estão na base da construção de conceitos, teorias, estruturas de trabalho, com as quais a disciplina atua, sendo uma das principais a noção de natureza ocupacional, o conceito de indivíduo, entre outras. Essas categorias que sustentam o que foi chamado de fundamentos de nosso trabalho derivam principalmente do sistema-mundo no qual as disciplinas científicas foram produzidas, incluindo a terapia ocupacional, e que correspondem à racionalidade do projeto moderno, ocidental, norte-eurocêntrico. O objetivo deste ensaio é analisar criticamente e refletir sobre as categorias fundamentais da terapia ocupacional a partir de uma posição crítica do Sul, a qual possibilitará produzir uma terapia ocupacional radicalmente diferente daquelas do sistema do mundo ocidental moderno. Vamos chamá-la de terapia ocupacional Outra, que se baseia em uma ruptura radical das categorias centrais da profissão, para a qual propomos, como introdução, outras categorias que promovam uma compreensão histórica, situada, descolonizada da disciplina, orientada para o reconhecimento e uma práxis Sul-Sul que promova diálogos interculturais que rompam com o universalismo, o monotopismo e o monoculturalismo da terapia ocupacional.

Palavras-chave:
Terapia Ocupacional; Crítica; Conhecimento

Introduction

Initiating a critique of what is commonly referred to as original, conventional, traditional, Anglo-Saxon or hegemonic¹ occupational therapy—predominantly located in the five wealthiest countries: the United States, Canada, the United Kingdom, Australia and New Zealand, which represent about 5% of the world’s population—highlights a geopolitical trend towards epistemic domination and global cognitive imperialism (Sousa, 2019). We suggest that considering “alternative” locations implies primarily making a stand before modern Western occupational therapy and questioning its foundational principles.

The reflection we propose involves analyzing some fundamental categories supporting the epistemic, theoretical, and methodological rationality of modern Western non-Eurocentric occupational therapy² . This reflection opens the possibility of moving away from these traditional foundations and predominant categories. Instead, we propose an initial ethical, political, and theoretical framework, geopolitically located from/to the South. This framework would result in an alternative occupational therapy approach rooted in the central categories of radical historicism³ , decoloniality⁴ , and humanism⁵ .

We aim not to determine which approach is superior, correct, or more validated by evidence. Instead, we aim to foster communication between various perspectives and world-systems (hence, different occupational therapies) without subordinating anyone. We operate under the assumption that no single location or foundation dictates the practice of occupational therapy (Ochoa, 2019).

We present a reflection of what we identify as the foundations⁶ of the central categories⁷ sustaining modern scientific reasoning. This reasoning, or logos, mirrors that of modern Western rationality—a world-system and a specific historical experience of reality. It holds a totality of meaning and truth in its propositions, serving as the bedrock on which scientific disciplines are based and evolve. This logos manifests in the theories, theoretical systems, and conceptual frameworks developed within each respective field.

This logos of modernity has materialized in occupational therapy. Within its unique position in the social field, occupational therapy is a product of the rationality of the society that produces it. It is a concrete expression in the world in which it unfolds. The rationality, as a historically and socially produced construct, sustains the modern North-Eurocentric world in general and North-Eurocentric science in particular (Guajardo, 2014). This rationality serves as the primary foundation upon which occupational therapy builds its categories.

We will delve into the most relevant categories underlying occupational therapy, including the primary notions of nature, individual, realism, atomism, and reductionism.

Critique of Fundamental Categories of North-Eurocentric Occupational Therapy⁸

The notion of nature

Official and institutional occupational therapy assumes the rationality of modernity. Ontologically, it is grounded on the idea of the “natural”, experienced broadly as “nature”. This implies an order, a reality that is beyond human will and action, yet it shapes us. This reality possesses an established, regular organization and structure devoid of contradictions; instead, it showcases regularity, balance, stability, and functionality. Such a system can be understood and investigated through science and its operational procedure - the scientific method. Accordingly, nature is guided by general laws that shape it and can be discerned, thus enabling the generation of taxonomies. The foundation of this rationality of occupational therapy, as an expression of the modern Western world-system, adopts this notion of nature as a primary category. In North-Eurocentric modernity, the existence of nature is a given, not a matter of belief. Its existence is undoubted because it is a way of life. This understanding is reflected in the foundations of occupational therapy, manifest in the contemporary paradigm of occupation: “the occupational nature of human beings” (Kielhofner, 2006, p. 66). Another expression is “occupation is the main activity of the human being in all its aspects, the result of an evolutionary process culminating in the development of their biological, psychological, and social needs" (Santos del Riego, 2005, p. 1) [...]. Thus, “occupation as inherent to human beings” (p. 9). Likewise, “experts in understanding the occupational nature of humans should focus, as soon as possible, on how people can reach their creative potentials” (Wilcock, 2011, p. 21).

All theoretical structures, systems, and conceptual frameworks rest on this assumption. The assumption becomes plausible through the rationality in which the notion of nature is a central dimension. This nature is fused with the technicality of the trade; the primacy is given to human nature, aligning with the occupational language of the profession ⁹ . Human nature is seen to have a specificity that only we can perceive: the occupational aspect.

Nature is the beginning of everything. It has its own movement, laws, and regularity. It is substance and cause. Motivation is intrinsic and manifests as a phenomenon (its nature) observable in occupation. The individual and the occupation or individual and their spirituality are interconnected, as are the individual and the environment, mediated by the occupation.

Thus, the notion of nature is intertwined with realism. There is an external reality that can be known and investigated. We can state that an individual and a reality exist. This reality can be studied as a natural entity (in occupational therapy: the cultural, social, physical environment). Under this rationality, the object of study¹⁰ is established, which is objective, as it exists as a natural entity with its own laws and regularities. This object is positive, observable, and verifiable.

The only path to freedom for human beings—or as occupational therapy, which presumes the notion of nature, would term it, “occupational beings”—is through mastering, understanding, and discovering the nature that governs us. The strategy to achieve this purpose is based on scientific reason, on the rationality that operates under the idea of discovering or understanding—or both—the occupational nature. This mastery allows people to make their occupational choices, with occupational freedom and balance, and for some, under ideals and values of occupational justice.

The analytical-reductionist character

The rationality of occupational therapy fosters a conceptual operating system grounded in the belief that it is possible to classify and order, given that nature possesses regularity, universal laws, which we can discover, simplify, and comprehend. There is a natural, logical order ranging from the simple to the complex, from the inferior to the superior, from the individual to the collective, from the biological to the social. Each of these parts, in turn, is constituted by others. This enables the construction of operational taxonomies to address occupation as the object of study.

Examples can be found in what has been termed models of occupational therapy: models founded on occupation that allow operation based on the occupational nature and under a rationality of analytical-reductive character of parts and mechanisms. For example: individual-occupation-environment; abilities-skills-performance; biological-psychological-social; personal causality-values-interests-volitional process; habits-routines-performance patterns, among many other taxonomies (Kielhofner, 2006; American Occupational Therapy Association, 2020). Also, function, participation, and inclusion are notions that are not confined to the individual but extend to the individual in interaction with social reality (Durocher et al., 2019; Guajardo, 2020).

In this context, North-Eurocentric occupational therapy is also pervaded—as mentioned earlier—by an analytical-reductionist-atomist logic. Analytical in the sense that scientific reasoning—and within it, occupational therapy—considers understanding to involve separation (Pérez, 1998). The whole is the result of an articulation of parts, and this is deemed holistic and integral, as it incorporates all the articulations to understand the whole. The disease is not only biological but also biological-psychological-social, yet this is not sufficient, since the individual with this ailment is integrated into a broader family, cultural, physical system, akin to the different practice frameworks that have been constructed (occupation-individual-environment / person-occupation-environment / occupational beings-justice-occupation-culture). The articulation is usually understood as the whole being more than the sum of its parts, and what is the “more”? It is the interactions between the parts: 1+1+R=everything. The catch is that while a part is a thing, the interaction is a quality. Interestingly, the latter is often treated as a part, as a thing. In some occupational therapy evaluation instruments, people are interviewed to review the quality—for example, meanings—which are subsequently quantified, averaged, used for intervention, re-evaluate, and has assessed for individual progress. Interestingly, this process measures the value, the quality expressed as a number, which involves the objectification of the individual, since the qualities, while understood and interpreted, are treated as a part, as an object that can be measured; for instance, the various performance measures (Simó & Urbanoswki, 2006).

The notion of understanding reality as parts that interact encompasses the idea of mechanism¹¹ . An example is given by Brea’s (2017) identification of forms of action, action itself, the structure of the action, conditioning factors for the action, and sources of energy for the action. Metaphorically, this could be compared to the components of a cell phone: case, screen, memory chip, battery, and a power source (electricity). In occupational therapy, this energy source has been referred to as intrinsic motivation, volition-motivation with its natural biological substrate, or, in a more metaphysical sense, spirituality. Performance, skills, abilities, functionality, and autonomy may exist, but without energy, nothing functions.

The notion of individual

Within the matrix that has been developed thus far, incorporating elements of naturalism, realism, and an analytical-reductive procedure, society is society is perceived as a primary product of the individual, who possesses an inherent ontological quality and serves as the root of all reality. As previously highlighted, occupational therapy not only harbors a notion of occupation but also an understanding of the individual engaged in the occupation. This individual inherently has a nature and, collectively with others, constitutes society. An individual evolves in the Darwinian manner, demonstrating progress, adaptation, established routines and habits, equilibrium with the environment, and functionality in meeting expected societal demands. “What varies the potential of the different occupational individualities is the result of their inherited genetic capacities and the expression and execution of the occupation learned and modified by the ecosystem and sociocultural environment where they live” (Wilcock, 2006, as cited in Schliebener, 2014, p. 5).Such an individual is intrinsically free, equipped with an autonomous awareness distinct from others, and the capacity to make choices according to personal interests and motivations. This individual possesses abilities and talents to develop, revealing an omnipresent entrepreneurial capacity. This notion of individuality underpins the liberal society within which North-Eurocentric occupational therapy is embedded. Like an indelible mark, we encounter Smith’s (1996) premise of individuals’ natural tendency to produce objects (occupations), which they subsequently exchange with others. The individual is always a free subject in relation to their needs. Smith argues that “the self-interest of each individual leads to the general welfare.” Therefore, the issue of occupational choices becomes of significant importance.

Beyond North-Eurocentric Occupational Therapy

North-Eurocentric occupational therapy should be understood as a spectrum, just like a beam of light. It exhibits internal variations, with a diversity of developments and nuances, yet they all originate from the same source: the individual, occupational nature and the understanding of function as liberal participation in the social realm to engage in meaningful occupations (Townsend & Wilcock, 2004). As an embodiment of the modern North-Eurocentric Western world-system, it presents itself monoculturally¹² , according to Tamayo (2019), guided by metonymic reasoning (universalism and globalization). Becoming an occupational therapist is only feasible under the rubrics of naturalistic, realistic, factual, Darwinian, Cartesian, individual, functionalist, analytical, reductionist, and atomist rationality. This could be referred to as the intrinsic nature of North-Eurocentric occupational therapy, its essence.

Thus far, we have developed what we perceive as the foundation of North-Eurocentric occupational therapy. But could there be alternative locations or realms that reflect a different rationality, another idea of occupational therapy, a new foundation emerging from diverse forms and ways of life that materialize as other perspectives?

Proposing occupational therapy from an alternative foundation, under a historically situated understanding, requires a decolonization process inspired by the utopian vision of a different world-system. This entails a critical examination the essence of occupational therapy. The potential for an alternative occupational therapy cannot emerge externally but should stem from its intrinsic foundation. The possibility of an Alternative occupational therapy cannot emerge externally but should stem from its intrinsic foundation. From the dialectical perspective, it implies a negation of its current essence. This process, in our opinion, has been gradually evolving in peripheral regions, with various practical and theoretical expressions centered around critical, political, ethical, and social ideas, resulting in the recognition of a South-South praxis. This negation movement, in the dialectical sense, has positioned itself on the periphery of essence, constituting itself, in our view, as an alternative interpretation of occupational therapy. This has been referred to as critical, social, political, and ethical occupational therapies (Díaz-Leiva & Malfitano, 2021; Galheigo, 2020; Lopes & Malfitano, 2023; Rojas, 2016; Alburquerque et al., 2016; Bottinelli et al., 2016; Pino & Ulloa, 2016; Testa et al., 2016; Guajardo & Galheigo, 2015).

However, if the modern North-Eurocentric Western project is grounded on the denial of human life (dehumanization), a dialectical negation of this project is required, that is, the negation of negation. As long as occupational therapy itself, along with its alternatives, does not discard the modern rationality that shaped them, a truly distinct model, that is, an Alternative occupational therapy, will not materialize. This alternative model, as an ethical and utopian ideal, would promote different rationalities that envision the possibility of diverse worlds through disciplinary praxis. This implies a historically situated understanding that encourages a South-South praxis, leading to decolonizing actions expressed in intercultural dialogues that break away from the universalism, monotopism, and monoculturalism of occupational therapy.

Final Remarks

The proposition exposed here is possible to the extent that North-Eurocentric rationality is overcome and the essence of its being is transcended, leading to a formulation of occupational therapy under a socio-historical framework, emerging from a peripheral and subordinate position, and resulting in an Alternative totality. This does not arise from natural principles but instead is a product of concrete, historically situated, pluralistic, and transformative social praxis. Here, reality, the world, knowledge, and knowing is tangible, material, and forms the substantive human history.

This is plausible given our historical location: the periphery, the margins of the world-system, the place that is intended to be civilized, the place where humanity and its territories are denied. It is possible to envisage that Alternative occupational therapy, because this is the historical place of the excluded, of “the oppressed, the condemned of the earth” (Fanon, 2014), of the genocide resulting from colonization, of cultural and racialized ethnic plurality, of poverty and precariousness arising from global patriarchal capitalism. We can envision an Alternative occupational therapy since the social-historical context is not of the modern, Western, North-Eurocentric center, but a different totality. We will refer to this foundational stance as the South Decolonial Position of occupational therapy.

And what composes it? Human history as praxis, as social action, as the production of human life in a particular world-system, in a concrete and material way of life. History as being itself, effective reality, that is, the human activity that produces the world in which we reproduce ourselves. History that manifests in its entirety, in all its cultural, economic, symbolic, technological dimensions, of the human condition itself, of its body and its flesh. There is nothing that is not human history, concrete and substantive activity. The human being as a creator. Not god or nature.

This also implies historicizing occupational therapy, occupation, everyday life and doing as the object of study, to consistently place the individual-individual relationship at the center, since all activity in its concretion (Kosík, 1967) is the individual itself in action, in a concrete everyday life with other individuals (Guajardo, 2016). Similarly, the production of knowledge, its theoretical systems, and practices that are deeply intertwined with the social question and social issues imply infusing meaning into occupational therapy from its concrete time and not in the abstract, in what has been termed radical contextualism (Grossberg, 2016).

To historicize occupational therapy is to decolonize and denaturalize. It is to situate the ways in which the structures of domination of occupational therapy and, within it, the modern colonial Western project, operate in a concrete way through various axes of power of its geopolitics. Meanwhile, decolonizing implies a humanization process that is only possible in the process of liberation from oppression (Farias & Lopes, 2022). Liberation from the denial of humanity and from the denial of North-Eurocentric occupational therapy from its mono-culturality and its epistemology; from the notion of individual, from their role in the modern civilizing project, from their theoretical-methodological proposals. It suggests, from the margins, insurgent practices that fracture the program instituted by official occupational therapy. It also entails, from an Alternative occupational therapy perspective, an existential-ethical-political-theoretical praxis linked to the possibility of hope and directed towards justice, dignity, freedom, and humanization.

An Alternative occupational therapy must understand that humanization is only achievable in the freedom of the individuals, not in their function, performance-balance-choice-participation-justice, all occupational, but in the transformation of the person. In those who have lived in their subjectivity and their body, racialization, patriarchy, poverty, the dehumanization of difference and the oppression of the subordinated of the modern colonial project of which North-Eurocentric occupational therapy is a part. Their liberation is our own liberation as people and professionals. Constructing and weaving new foundations is the next task. Tracing paths from the South in the profession to learn and unlearn in the work of decolonial-oriented occupational therapy, for a feeling-thinking and militant political-theoretical praxis in the possibility of another living, with the horizons of transformation and humanization as an ethical challenge, as the primary foundation. This is the prolegomenon that should challenge us to create new foundations for the possibility of an Alternative occupational therapy. Foundations that will be based on history, the world-system, totality, relationship, otherness, power, colonialism, plurality, the situated and local, difference, intercultural cosmopolitanism, and liberation.

In conclusion, from this critical rationality of the Global South, and with a decolonial orientation, the challenge is to surpass what some might perceive as an academic trend and continue materializing this position in their theories, strategies, and methods of doing, understanding the activity as the concrete and historically situated subject.

• 1
  Occupational therapy can be considered as originating in the United States and the United Kingdom, subsequently expanding and globalizing throughout the rest of the modern Western world system. It can be described as follows: Original: referring to its origins in the United States and the United Kingdom; Traditional: in the sense that it is transmitted, has norms, and a specific culture; Official: when institutionally recognized, Legal: having authorization from other institutions, such as the World Health Organization (WHO); Hegemonic: signifying a form of political and cultural domination and control of knowledge surrounding occupational therapy; Conventional: referring to commonly known and established practices; Anglo-Saxon: primarily linked to English-speaking countries, particularly those that are economically developed.
• 2
  Eurocentric refers to a position described by Grosfoguel as [...] “not merely pertaining to the population of the territory known as ‘Europe’, but rather to a position in a system of racial classification within a global ethno-racial hierarchy in which those classified as ‘European’ are granted privileges and a higher accumulation of wealth compared to those classified as non-Europeans” [...]. This perspective often entails a certain type of fundamentalist-Eurocentric thought that does not recognize other epistemologies as equal and normal, except its own. Consequently, it produces an epistemological racism where only Western knowledge holds truth and justice (and is thus deemed superior), while non-western knowledge is considered inferior. We acknowledge that Eurocentric, as a position in the global world system, can also be interpreted as “a system that unveils the heterarchy of multiplicity of power relations: European/Euro-North American modern/colonial capitalist/patriarchal world-system” (Grosfoguel, 2007, as cited in Montes & Busso, 2007, p. 18). In this essay, we adopt the term “Norh-Eurocentric” to encompass all the aforementioned perspectives (Patiño, 2014).
• 3
  We understand radical historicism as the perspective that views all reality and being as human history, where nothing external, divine, or natural determines it. Human life is fundamentally grounded in the ontological character of the social relations that people establish, forming communities for the production of their existence, and simultaneously constituting the production of being itself (Pérez, 1998). Similarly, the notion of individual does not exist in an abstract or separate manner from history; on the contrary, human life, being history, is the outcome of socially determined relations throughout time (Cancino, 1987).
• 4
  The term decolonial encompasses a set of political, philosophical and theoretical contributions that “question the status and scope of the Western modernity project” (Guajardo Córdoba, 2021, p. 138). It addresses the colonial, capitalist, patriarchal, racist, liberal, Cartesian (egocentric and scientific), and naturalistic world systems. The concept incorporates a series of critical, situated perspectives originating from the Global South (Obarrio, 2013). These perspectives include Anticolonial Thought, Post-Colonial Studies, Subaltern Studies, Latin American Group of Subordinates Studies, Decolonial Thought (Turn), Epistemologies of the South, Decolonial Feminisms, and works of various authors such as Mariátegui, Martí, Fanon, Freire, Dussel, Spivak, Guha, Quijano, Mignolo, Grosfoguel , Castro Gómez, Lugones, Walsh, Segato, Qusicanqui, Ochi Curiel, Paredes, among others (Conti, 2017).
• 5
  This radical ethic of decolonization and recognition refers to a humanism of the other that diverges from the Eurocentric tradition and is based on “the inter-human relationship between oneself and others” (Maldonado-Torres, 2007, as cited in Walsh, 2013, p. 160). This notion implies liberation and decolonization for those who have suffered the colonial wound. Mignolo expresses that “emancipation does not necessarily point to liberation and decolonization. Initially constructed in the bourgeois revolutions, rather than in the Haitian revolution, emancipation later became a motto of the universalized proletariat to express the interests and struggles of the oppressed worldwide, rooted in modernity and the linear trajectory of Western rationality. In contrast, liberation, the term most used by Fanon, is a project and perspective conceived from and oriented by those who have endured the colonial wound. Emancipation and liberation are the two sides of the same coin– the coin of modernity/coloniality. While liberation frames the struggle of the oppressed in the ‘Third World’ and the history of modern coloniality that underscores its history, decoloniality constitutes an even larger project encompassing, in Fanon’s opinion, both the colonized and the colonizer, thereby integrating emancipation and liberation” (Mignolo, 2010, p. 311, as cited in Walsh, 2014, p. 42).
• 6
  The term “foundation” alludes to various meanings that pertain to origin, principle, the underlying reason for something, as well as to the set of statements that support an idea, serving as its a first principle. Some interpretations may relate to a material foundation upon which something is built, akin to a physical base (Ferrater, 2001). Under this premise, the notion of ontological, epistemological, methodological, ethical, and political foundations can be sustained. From the proposal of this text, the idea of foundation is directed towards understanding the world and the rationality of a world-system wherein the epistemological, methodological, and other aspects are built.
• 7
  “Categories” represent the most general and abstract ideas used to understand the world, forming the basis upon which the theoretical concepts and approaches are developed. According to Kant (2003), they encompass concepts such as quantity, reality, uniqueness, among others. For Hegel, they include notions such as history, relationship, necessity, and others (Pérez, 2008). For instance, in the general theory of the classical system, understood as a set of parts that interact to form a whole, fundamental categories include the part, exteriority, and duality (where each part is initially separated from the other). From a perspective originating in the Global South, ideas such as totality, otherness, relationship, and history can be proposed.
• 8
  The North-Eurocentric perspective encompasses a multitude of dimensions: it is considered modern due to its perception of rationality as progress and development; it is liberal in its political principles; it is capitalist, due to its productive principles; it adopts a naturalist/Darwinian/individual approach; it is egocentric with its ontological principles based on the classical Newtonian Cartesian canon within scientific rationality; and it is scientific in its pursuit of knowledge, among other aspects.
• 9
  ”North-Eurocentric” is a neologism used to refer to the overuse of the adjective “occupational”. For instance, terms like occupational balance, occupational deprivation, occupational injustice, occupational rights, occupational dignity, occupational experiences, occupational participation, occupational evidence, occupational choices, occupational renaissance, occupational dream, among others, fall under this category.
• 10
  Another possible critical interpretation of the object of study is to view it as “the problematization of certain aspects of reality that we are interested in investigating, understanding, and contributing to transforming [...]. This object is shaped by the interaction of preexisting political interests, the conceptual perspectives at stake, and the methodologies employed (Duarte, 2013, p. 232). It is an object of reflection—a ‘not-knowing-for-knowing’—constructed to objectify a phenomenon as a social fact” (Cottet, 2006, p. 194).
• 11
  The idea of a mechanism is understood as a set of interconnected parts, pieces or elements working together to form a unified whole, serving a specific function. In philosophical terms, a mechanism represents a doctrine that theoretically explains natural phenomena through the mechanical laws of movement. Those who adhere to mechanistic views are known as mechanists who believe that everything in physical reality follows a structured order, akin to the operation of a machine (Ferrater, 2001).
• 12
  “Boaventura de Sousa Santos designs his original sociology of absences and emergencies. He analyzes the world of the five monocultures: a) monoculture of knowledge, which perceives only rigorous knowledge as valid (epistemicide); b) monoculture of progress, viewing time as linear, with history progressing in one direction – advancement and development belong to the privileged world, while the rest is considered residual and obsolete; c) monoculture of the naturalization of hierarchies, where hierarchies are perceived as innate to nature, making them seem unalterable based on reasons of race, ethnicity, class and gender; d) monoculture of the universal, which is considered the sole valid perspective, regardless of context; anything opposite of the universal, such as vernacular, lacks validity, and the global takes precedence over the local; e) monoculture of productivity, which defines human reality by the criterion of economic growth as an unquestionable rational objective. This criterion is applied not only to human work, but also to nature, treating it as an object of exploitation and depredation. Those who do not produce are branded as lazy” (Tamayo, 2019, p. 21).
• How to cite: Guajardo Córdoba, A., & Malfitano, A. P. S. (2023). A critical approach to the foundations of occupational therapy: contributions to an Alternative Occupational Therapy. Cadernos Brasileiros de Terapia Ocupacional, 31, e3491. https://doi.org/10.1590/2526-8910.ctoARF267634912

• Funding Source

  This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

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Edited by

Section editor

Prof. Daniela Edelvis Testa

Publication Dates

• Publication in this collection
  27 Oct 2023
• Date of issue
  2023

History

• Received
  06 Jan 2023
• Reviewed
  20 Jan 2023
• Reviewed
  18 May 2023
• Accepted
  13 June 2023