Bridging critical gaps in occupational justice and social justice in occupational therapy practices

Congratulations on a tremendous accomplishment! The Brazilian Journal of Occupational Therapy is promoting international dialogues on critical gaps in occupational justice and social justice in occupational therapy practices. This is a golden opportunity to celebrate the five Guest Editors, 50 Authors, and the publisher of this Special Issue. I see the great accomplishment for this Journal and everyone involved as being the publication of 15 diverse papers that transport us beyond the early Western writings and research on occupational justice (Davis & Malfitano, 2017). Consider the geographic breadth from nine countries, 50 authors who have expressed ideas about occupational justice and social justice from Southern – Northern, Western - Eastern hemispheres (listed alphabetically): Australia (2 authors, 1 paper), Brazil (10 authors, 5 papers), Canada (14 authors, 1 paper), Chile (10 authors, 3 papers), France (2 authors, 1 paper), Ireland (2 authors, 1 paper), the Philippines (2 authors, 1 paper), South Africa (5 authors, 1 paper), and Spain (3 authors, 1 paper). The Special Issue presents a wide range of theoretical-methodological research in 9 research articles, one literature review, one experiential report, and four reflection articles.

As I was thinking about writing this Editorial, I was reflecting on the ongoing transformation of occupational therapy. I started working as an occupational therapist in 1968 in a children’s rehabilitation centre that served the rocky coasts and fishing towns on the Atlantic Ocean in and around St. John’s, Newfoundland, Canada. I did not know how to explain why we were called occupational therapists; I and my contemporaries lacked the language and ideas that are emerging today to explain occupation-focused practices. Ideas of justice and human rights were always very important to me. But I had no language to express or understand and actually use such ideas in my institutional and community-based practices. Without a justice and human rights theoretical framework, I was like other occupational therapists – using problem solving to reduce daily life struggles from challenges that could be environmental (e.g., inaccessible schools), mental (e.g., emotional disturbances), and/or physical (e.g., movement limitations from cerebral palsy). Since then, I have been privileged as a white English/Scottish educator, researcher, and practitioner in this profession. One of my great privileges has been to name and explore the concept of occupational justice from my Canadian standpoint with Ann Wilcock in Australia. We shared our mutual need to name an occupational perspective of injustice and justice (Wilcock & Townsend, 2000). It was exciting to discover through our workshops and writings that the concept of occupational justice attracted interest around the world.

Many questions remain, however, for our profession to bridge critical gaps in using occupational justice and social justice in practice. I still wonder, as many people do: Can professionals actually enable occupational justice? (Townsend & Marval, 2013). On a related note, I am thrilled with Brazil’s work on social occupational therapy, referring to occupational therapy without medical funding, to address occupational injustice. Critical gaps to understand and use the concept of occupational and social justice in social occupational therapy are raised in the book (originally in Portuguese) now in English: Social Occupational Therapy: Theoretical and Practical Designs (Lopes & Malfitano, 2021). In addition to the book, it’s important to highlight the article by Malfitano et al. (2019), based on a vast literature review that addressed two issues: “do occupational justice concepts inform occupational therapists’ professional actions?” and “how are occupational justice concepts connected to Brazilian ideas about social occupational therapy?” The conclusion is that we have some approaches that can connect occupational justice and social occupational therapy (Malfitano et al., 2019).

In this Special Issue, I believe that the 15 papers will do what Gerlach (2015) described as “[...] sharpening our critical edge in the context of marginalized populations”. We can think of the critical gaps with reflection of Walley-Hammell’s (2021, p. 369) critique of occupational therapy’s structure. She wrote that “[...] it is essential for occupational therapy students and practitioners to understand how inequitable social structures determine the range of occupations that are realistically available to individuals and communities”. There are so many critical gaps to fully understand how occupational justice differs from and overlaps with social justice. We need to know how practices are structured and how these concepts might be expressed in various languages. With these thoughts, let us consider how the papers in this Special Issue can guide our thinking on theories and practices for considering occupational justice and social justice.

The six papers from Ireland, Spain, France, South Africa, Canada, and the Philippines display occupational therapy concerns for /and with many populations. The authors from Ireland present research on socially disadvantaged youth/adolescents. They used standardized measures, including a measure of adolescent strengths and difficulties, as a basis to test an occupation-focused intervention with socially disadvantaged youth. Asking “Who is safe at work?”, the authors from Spain problematized employment volatility from the experiences of workers during the 2008 to 2018 Spanish socioeconomic crisis. The paper from France explores the perception of needs for enacting health promotion services for occupational therapists working in disadvantaged community settings. Occupational alienation and the mental health of university students in the Philippines is the topic of a reflective, critical essay drawing on both sociology and occupational science perspectives. One reflective paper is on conceptualizing and operationalizing the term resilience in occupational therapy and occupational science literature from a Canadian perspective. The paper from South Africa examines two objectives from a case study on centering a decolonial praxis in a community development curriculum at the University of Cape Town.

Two papers offer an occupational perspective on the end of life with chronic diseases. From Australia, there are insights on an evidence-based education package for promoting occupational justice with adults in palliative End of Life Care. From Chile, we gain insights on adults with Terminal Chronic Kidney Disease who are undergoing hospital hemodialysis. This paper examines occupational repercussions caused by hospital hemodialysis treatment and how public policies, specifically Explicit Health Guarantees, actually address (or not) the needs of this population.

Four contemporary occupational perspectives are offered on immigration (Chile and Brazil), violence against women with disabilities (Chile), and COVID-19 (Brazil). One perspective from Chile uses a moral and normative framework for social intervention with migrant citizens using the critical perspectives of social justice by Fraser and Honneth. This paper presents migration as a current social phenomenon, and as the basis for developing an occupational justice intervention. Another perspective on immigration is from Brazil in a paper on African immigrant university students. To illustrate the thrust of this paper, here are two of the themes drawn from qualitative data: “Culture, identity and daily life: crossing the Black Atlantic”, and “The house belongs to the other: institutional support/helplessness and coping strategies”. One paper from Chile presents qualitative data collected between 2015 and 2020 that tells a story of the violence experienced in health contexts by women with disabilities. The research raises attention to “[...] various forms of violence: physical, psychological, sexual, obstetric, and symbolic-institutional”. The paper also raises attention to the experiences for this population to “[...] claim their human rights through processes of emancipation, resistance and construction of practices that transform their violation”. The paper on COVID-19 is on gender expressions in the prevention and care by occupational therapists. Mixed methods research includes reports, field diaries, participation in all phases of the field research, questionnaires, interviews, and conversation circles. The analysis points to the “[...] unequal place occupied by men and women in household/family relationships and the different manifestations of sexism in issues related to the changes in daily life caused by physical distance and isolation at home.”

Of special note, three papers record ongoing research on Brazil’s signature contributions to the world of occupational therapy: social occupational therapy and social participation. One reflective paper examines social participation as a possible way forward to address occupational and social justice by occupational therapy students in Brazil. The authors discuss how 65 collaborators who work in teaching, research, and assistance carry out social participation both in their theoretical and practical work. Another reflective paper from Brazil is on social occupational therapy, social justice, social participation, and Brazil’s LGBTQIA+ population. The authors used the conceptual production of social justice developed by Nancy Fraser to recognize that this population does not wish to be considered “vulnerable”. Rather their “[...] experiences go beyond gender and sexuality norms, and include situations of violence and oppression, different forms of social injustice, and neglect of social rights”. Also on social occupational therapy is an essay that contributes to the debate on “anti-oppression and freedom in the revolution of/in everyday life.” The authors problematize the role of occupational therapists, asking whether or not an occupational therapist can be a “mediator/articulator” rather than an oppressor with individuals who seek to revolutionize (humanize, liberate) everyday life.

May we treasure this innovative and timely Special Issue. We have a collection of excellent papers to advance global thinking on critical gaps in occupational justice and social justice in occupational therapy theories and practices.

• How to cite: Townsend, E. (2022). Bridging critical gaps in occupational justice and social justice in occupational therapy practices. Cadernos Brasileiros de Terapia Ocupacional, 30(spe), e30202201.https://doi.org/10.1590/2526-8910.ctoED302022012

References

• Davis, J. A., & Malfitano, A. P. S. (2017). Supporting research dissemination across languages and cultures. Canadian Journal of Occupational Therapy, 84, 204-205. http://dx.doi.org/10.1177/0008417417745843
  » http://dx.doi.org/10.1177/0008417417745843
• Gerlach, A. J. (2015). Sharpening our critical edge: occupational therapy in the context of marginalized populations. Canadian Journal of Occupational Therapy, 82(4), 245-253. http://dx.doi.org/10.1177/0008417415571730
  » http://dx.doi.org/10.1177/0008417415571730
• Lopes, R. E., & Malfitano, A. P. S. (2021). Social occupational therapy: Theoretical and practical designs Philadelphia: Elsevier.
• Malfitano, A. P. S., de Souza, R. G. M., Townsend, E. A., & Lopes, R. E. (2019). Do occupational justice concepts inform occupational therapists’ practice? A scoping review. Canadian Journal of Occupational Therapy, 86(4), 299-312. http://dx.doi.org/10.1177/0008417419833409
  » http://dx.doi.org/10.1177/0008417419833409
• Townsend, E., & Marval, R. (2013). Can professionals actually enable occupational justice? Cadernos de Terapia Ocupacional da UFSCar, 21(2), 229-242.
• Walley-Hammell, K. (2021). Social and structural determinants of health: exploring Occupational Therapy’s structural (In)competence. Canadian Journal of Occupational Therapy, 88(4), 365-374. http://dx.doi.org/10.1177/00084174211046797
  » http://dx.doi.org/10.1177/00084174211046797
• Wilcock, A. A., & Townsend, E. A. (2000). Occupational terminology interactive dialogue: occupational justice. Journal of Occupational Science, 7(2), 84-86. http://dx.doi.org/10.1080/14427591.2000.968647
  » http://dx.doi.org/10.1080/14427591.2000.968647

Publication Dates

• Publication in this collection
  08 June 2022
• Date of issue
  2022