Open-access Occupational therapy and work: historical-temporary categorization of Brazilian academic productions

Abstract

Introduction  Throughout history, Brazilian occupational therapists have intervened with workers. However, academic publications have not always focused on work as a determinant of problems.

Objective  To analyze Brazilian academic publications in occupational therapy in the field of work, in light of their historical and temporal contexts.

Method  This is an exploratory, descriptive study with a qualitative approach, situated within the modality of bibliographic research or literature review. The descriptor "Work" was used in the three specific Brazilian scientific journals currently in operation.

Results  After applying the inclusion/exclusion criteria at each stage of reading, 157 publications remained. Three historical and temporal periods were developed and named to group the publications and reflect upon them: the period of institutionalization of occupational therapy (1950-1990); the period of development and implementation of public and social policies in favor of workers and the expansion of occupational therapy practices (1991-2017); and period influenced by technological revolutions, setbacks in workers' rights, and theoretical-practical reflections from/on occupational therapy (2018-2024).

Conclusion  The themes and debates in Brazilian productions in the field are intertwined with historical events. Occupational therapists have transformed their theoretical and practical interests in the field of work over time, and current productions problematize contemporary issues through a diversity of themes. It is recommended that future research utilize this database for more in-depth productions on the subject, including studies on the epistemologies of the field.

Keywords:
History; Occupational Therapy; Work; Occupational Health

Resumo

Introdução  Em diferentes momentos históricos, os terapeutas ocupacionais brasileiros realizaram intervenções junto aos trabalhadores. Contudo, nem sempre as condições e processos de trabalho eram pautadas enquanto determinantes das problemáticas.

Objetivo  Analisar as produções acadêmicas brasileiras de terapia ocupacional no campo do trabalho, à luz de seus contextos histórico-temporais.

Método  Estudo exploratório, descritivo e de abordagem qualitativa, situado na modalidade de pesquisa bibliográfica ou revisão de literatura. Foi utilizado o descritor "Trabalho" nos três periódicos científicos específicos brasileiros que estão atualmente em funcionamento.

Resultados  Ao final da aplicação dos critérios de inclusão/exclusão em cada etapa de leitura, restaram 157 publicações. Foram elaborados e nomeados três períodos histórico-temporais para agrupar as produções e refletir sobre elas: período de institucionalização da terapia ocupacional (1950-1990); período de elaboração e implementação das políticas públicas e políticas sociais a favor dos trabalhadores e ampliação das práticas da terapia ocupacional (1991-2017); e período influenciado por revoluções tecnológicas, retrocessos nos direitos dos trabalhadores e reflexões teórico-práticas a partir/da terapia ocupacional (2018-2024).

Conclusão  As temáticas e debates realizados nas produções brasileiras do campo estão entrelaçados aos fatos históricos. Os terapeutas ocupacionais transformaram seus interesses teóricos e práticas no campo do trabalho ao longo do tempo e as produções atuais problematizam questões contemporâneas através de uma diversidade de temáticas. Recomenda-se que futuras pesquisas utilizem este banco de dados para produções mais aprofundadas sobre o tema, incluindo estudos sobre as epistemologias do campo.

Palavras-chave:
História; Terapia Ocupacional; Trabalho; Saúde do Trabalhador

Introduction

At different historical moments, Brazilian occupational therapists have developed academic works on labor and reflected on their interventions with workers. As examples, one can mention publications and practices in physical rehabilitation that took place after the war and helped consolidate the profession in the United States in 1917, as well as the occupational therapy productions and practices carried out in Brazil in the 1950s, which targeted workers injured on the job, and later the studies and practices developed in Brazil in the 1990s, centered on public health and social security, and guided by public policy directives aimed at workers (Monzeli et al., 2019; Lancman et al., 2003; Lancman, 2004). Before the creation of the Unified Health System (SUS) in Brazil, professionals worked with this group mainly through theoretical foundations and approaches from physical rehabilitation, focusing on stimulating and recovering motor components, without reflecting on the work activity that caused the injury or the conditions for returning to work (Lancman, 2004).

Considering this, theoretical and methodological influences from different fields of knowledge have been incorporated into the field of labor, consequently modifying the thematic scope of academic productions as well as the theoretical understanding of work and its implications for the profession, as previously mentioned by Rodrigues et al. (2020).

In this sense, one can mention the incorporation of interdisciplinary knowledge related to biomechanics and physical rehabilitation; historical materialism as a possibility for reflection, analysis, and production of new realities; ergonomics; the psychopathology and psychodynamics of work; the Social Model of Disability and ontological reflections on disability proposed by the Philosophy of Difference; Solidarity Economy; and the Psychosocial Care Model (Rodrigues et al., 2020; Morato & Lussi, 2016; Lancman, 2004; Souza & Lussi, 2022).

Moreover, the socio-historical and political developments related, for example, to changes in forms of labor, labor legislation, and approaches to worker interventions both globally and in Brazil, have also influenced the field of labor and the thematic and epistemological choices of research (Monzeli et al., 2019).

Considering this, we understand that to advance this debate it is essential to map the thematic scope of academic productions (their titles, abstracts, central themes, methods, and publication venues), in light of historical events (the year of publication), in order to begin outlining pathways for strengthening and marking the transformations within what we call here the field of labor.

Regarding the use of the term “field of labor,” Rodrigues et al. (2020) and Rodrigues & Souza (2023) identify as belonging to occupational therapy in the field of labor those academic productions that emphasize the centrality of labor in the lives of individuals and in society and/or that address the need for attention and care for workers in the face of their various work-related demands.

By clarifying this, the intention now is to describe the historical and temporal milestones within the field of labor. After a long period during which Brazilian professionals published studies related to psychiatry and grounded their practices in the influences of moral treatment and the mechanistic paradigm, criticisms began to emerge in Brazil regarding a limited practice based on illness or the prescription of occupations that served more to control than to include (Shimoguiri & Costa-Rosa, 2017; Monzeli et al., 2019).

Considering this critical movement, the social struggles that occurred in Brazil in the 1970s – focused on the democratization of health and the achievement of labor rights – culminated in the emergence of Public Policies (later laws) such as the Unified Health System (SUS) in 1990 and Social Security in 1991. These movements expanded the theoretical bases and practices of occupational therapy in all fields of practice, including the field of labor (Lancman et al., 2016; Rodrigues et al., 2020).

However, the technological transformations that occurred, especially from the 2000s onward, changed the ways work is organized, managed, and controlled globally. These transformations include both the use of digital platforms to offer and perform different types of work – a process also called the uberization of labor or platform capitalism – and the use of algorithms to monitor and control workers in the digital age (Antunes, 2020).

In Brazil, these transformations – which represent the development of new capitalist tools – were accompanied by labor reforms against workers’ rights, attacks on labor laws under the argument that there were no public funds to provide rights to current workers, social security reforms, and a discourse defending self-employment and freelance work (under the argument of freedom in work) to the detriment of formally contracted professionals with rights and social protection (Krein & Colombi, 2019).

Thus, changes in work processes and in work control continue to pose challenges for Brazilian workers, as the consequences directly affect their lives. Consequently, in order to discuss the field of labor and consider the construction of occupational therapy practices in contemporary times, a critique of the capitalist mode of production and the types of work it offers has been revisited, as the aforementioned movements have imposed new challenges for the integrated care network for these individuals (Souza & Lussi, 2022).

It is evident that there are distinct periods that have influenced the development of academic production in occupational therapy within the field of labor, as well as professional practices with workers in Brazil. In this study, we refer to these periods as historical-temporal processes.

Continuing this reflection, some historical-temporal periods can be cited, such as: the period of institutionalization of the profession in Brazil (1950-1990); the period of implementation of a unified health system and the national social security institute, Brazilian public and social policies that paradigmatically (and broadly) transformed the construction of occupational therapy knowledge and practices (1991-2017); and the period of contemporary labor, influenced by technological revolutions, labor and social security reforms, and the regression of workers’ rights previously achieved in Brazil, understanding that these also influence theoretical and practical reflections in (or from) occupational therapy in Brazil (2018-2024).

The identification of historical and temporal milestones (historical events and the periods in which they occurred) that influence a field of practice is important for characterizing, explaining, and strengthening knowledge production and practices within the field. This process provides a kind of timeline of production and offers clues for the future of studies and interventions.

However, considering that occupational therapists in Brazil can work in the health, education, social assistance, and social security sectors, and understanding that labor-related issues and workers’ challenges are present across all these sectors and care facilities, identifying academic productions in occupational therapy within the field of labor becomes a challenge. It is understood that academic production on labor in Brazil is dispersed across different areas of occupational therapy because it engages in interdisciplinary dialogues with fields such as public health, psychology, medicine, and sociology (Rodrigues & Souza, 2023).

This epistemic diversity within the field, along with the complexity and breadth of the topic, means that some occupational therapy researchers who discuss labor or workers (with different focuses) link their academic productions not necessarily to what we define here as the field of labor (or not exclusively to the field of labor), but rather to the fields of mental health, public and primary health care, hospital care, physical rehabilitation/functional health, or the social field.

In occupational therapy, Cardinalli & Silva (2021) have already proposed a study that conducted non-systematic searches “based on the retrieval of key references” with the aim of identifying and discussing academic productions on a specific theme, reflecting on professional knowledge and practices over the years. Galheigo et al. (2018) have also conducted research using primary sources on a given topic, mapping and analyzing productions. This mapping led to the identification of theoretical “movements” or “trends” in occupational therapy over time.

When mentioning the studies above, it appears that there is currently no published academic work that has focused on mapping and grouping academic productions in occupational therapy in the field of labor (understanding this field broadly), considering historical-temporal milestones or trends. It is believed that this study seeks to fill this academic gap on the subject, in the sense of organizing, explaining, and strengthening knowledge production in this field.

In this way, the following research questions were developed in this study: i) What are the academic productions in occupational therapy in the field of labor published in Brazilian scientific journals specific to the area? ii) How can these productions be categorized in a historical-temporal manner, considering the year of publication and Brazilian historical events? iii) What are the possible relationships and influences between historical events over time and the construction of knowledge in occupational therapy in the field of labor in Brazil?

Thus, the general objective of this study was to analyze Brazilian academic productions in occupational therapy in the field of labor, in light of their historical-temporal contexts.

Method

This work is configured as an exploratory, descriptive study with a qualitative approach concerning the characterization of the research. Regarding the sources and data collection, this research falls under the category of bibliographic research or literature review using primary sources, which in this case is the academic production of the area related to the theme of this research.

According to some theoretical understandings, bibliographic research is synonymous with literature review, and although it is a fundamental part of any research, it is also possible to develop studies exclusively based on bibliographic reviews, especially when the researcher needs access to the knowledge already produced on a given topic to design more in-depth studies. Furthermore, bibliographic research is a legitimate type of investigation, even when its objective is to carry out a critical analysis of relevant works on the subject (Gil, 1999, 2008; Brito et al., 2021).

According to Cavalcante & Oliveira (2020), bibliographic research does not necessarily use systematic methods or standardized reference protocols. Through bibliographic research, it is possible to map, describe, and develop non-systematic academic reflections on different themes, producing meaning through the critique of works considered relevant to a given debate.

Through bibliographic research, it is also possible to demarcate the time and place of productions, which allows for a historical update on a debate. However, it should be considered that bibliographic research carried out in a rigorously systematized manner becomes easily reproducible (Cavalcante & Oliveira, 2020).

Specifically in this study, when using electronic databases to access sources, the steps indicated by Brito et al. (2021) for this research modality were followed, which we adopted here as a guiding methodological reference, as follows: I. Definition of the theme/subject (mapping of academic productions in occupational therapy in the field of labor and their organization into historical-temporal categories); II. Definition of the publication period (mapping with no date filter); III. Delimitation of descriptors (labor); IV. Definition of search sources (national occupational therapy journals currently active).

Before detailing the review, it is clarified that both the hypothesis (that there are at least three distinct historical-temporal movements in the field) and the results of the collections carried out in this work were part of a preliminary stage of a scientific initiation project on this topic. In summary, the results presented here are being used to guide the development of a larger, ongoing research project entitled “The theoretical bases of occupational therapy in the field of labor in Brazil: the urgency of a contemporary praxis with critical epistemological contributions,” coordinated by a researcher affiliated with the Department of Occupational Therapy of a Public University in the Northeast region of Brazil.

Regarding the methodological procedures, the descriptor "Labor" was searched in the three currently active Brazilian scientific journals specific to the area: Revista de Terapia Ocupacional da Universidade de São Paulo, Cadernos Brasileiros de Terapia Ocupacional, and Revista Interinstitucional Brasileira de Terapia Ocupacional. The inclusion criteria established were: Brazilian productions that expressed a reflection of/in/for occupational therapy specifically about issues related to the world of work and/or the care of workers. The exclusion criteria were: editorials and productions that presented some type of inaccessibility (data, link, etc.).

First, the titles of the academic productions were read, followed by the abstracts, and finally, the full text of the studies. For each reading phase (title, abstract, and full text), the inclusion and exclusion criteria mentioned were applied.

The tracking was performed manually, without any type of filter (such as date or language). The manual search was carried out because the Boolean operators in the search systems of the journal websites do not have the same precise filtering potential as those in scientific databases and do not allow for the construction of specific search expressions.

The searches began in July 2024 and were completed in October 2024. It is important to highlight that the searches and application of criteria were carried out by three researchers. The researchers conducted a blind reading process of the productions and generated spreadsheets with different colors at each search stage, indicating which articles would be selected or excluded in each phase. In the end, the researchers’ consensus determined whether a production was included or excluded. This consensus, after blind reading, contributed to greater robustness and reliability of the research.

As a tool for collecting data from the returned articles, a table was created in Excel software for organizing the studies, which included the following topics: a) Occupational therapy journal; b) Article title; c) Keywords; d) Article authors; e) Year; f) Objective; g) Method; h) Theoretical and/or theoretical-methodological references.

Not all of these topics were used for reflection in this research, as this is part of a larger study. The occupational therapy journal accessed, the article title, the article authors, the year of publication, and the study method were used. The remaining topics are part of the research agenda of the authors involved in a larger research project on the subject. These topics allowed for the analysis of the thematic scope of the publications (titles, abstracts, themes), the research methods, and the publication venues in light of their historical-temporal contexts.

Results

A total of 1003 academic publications were returned from the search using the descriptor "work" in the three indicated journals. The titles of all works were read, and the previously established inclusion and exclusion criteria were applied. 823 publications were excluded at this stage. Of those excluded, 788 were not on theme (did not articulate occupational therapy and work), 30 were editorials, and 5 were inaccessible.

180 publications remained for the abstract reading and analysis stage. After that, 178 publications were selected, and 2 publications were excluded considering the application of the criteria, since they were not related to the topic.

The 178 publications included after this process had their content read in full (complete work). 21 publications were excluded at this stage after applying the criteria. Of the 21 excluded publications, 18 were not on theme when the complete text was read, and 3 were inaccessible for complete reading. Thus, a total of 157 productions met the established criteria for the complete reading phase (Figure 1).

Figure 1
Flowchart. Source: Authors' own elaboration, 2025.

Based on the 157 publications, three historical and temporal categories were developed from the available literature on the subject and the hypotheses explained in the introduction: 1 - Period of institutionalization of occupational therapy (1950-1990); 2 - Period of development and implementation of public and social policies in favor of workers and expansion of occupational therapy practices (1991-2017); and 3 - Period influenced by technological revolutions, setbacks in workers' rights and theoretical-practical reflections from occupational therapy (2018-2024).

To group a publication into one of the aforementioned categories, the year of publication of each study was taken into account, considering all 157. No articles were included in category 1, 102 articles were included in category 2, and 55 articles fell into category 3. The results below visually demonstrate the distribution of academic publications in each category mentioned. The results and discussion of this work were developed for each theoretical category.

Summary tables were presented in this results section, considering the volume of academic productions. It is possible to access the tables and mapped categories in full through the public link for consultation in Google (2025).

Period of Institutionalization of Occupational Therapy (1950-1990)

It is known that the occupational therapy journals used in the mapping began their publications in 1990, and that some of these issues are available in digital format and were accessed in this research. However, no publications from this year were included in the articles considered at the end of this research, since the oldest publication that remained in the study after applying the inclusion and exclusion criteria was published in 1997. Therefore, no publications were produced in this category.

However, the absence of publications from this period also constituted data for this research, and therefore this category will remain in the discussion topic. Through the findings, it was possible to discuss the absence of the 1990 publications that were included in the research, even though they exist in the journals, and to establish a relationship between the fact that they were excluded during the process and the development of knowledge production in occupational therapy and work.

Period of development and implementation of public and social policies in favor of workers and expansion of occupational therapy practices (1991-2017)

Regarding category 2, referring to the table presented, a total of 102 articles were found. Of these studies, 58 were published in the journal Cadernos Brasileiros de Terapia Ocupacional and 47 were published in the Revista de Terapia Ocupacional da USP. During this period, it was identified that few authors were repeated in the results table. Among those who were repeated are the authors Simonelli et al. (2013, 2016), Alencar (2011, 2015), Lancman (2004) and Lancman et al. (2003, 2016).

Regarding the research method indicated in the table, most studies were qualitative in approach. Regarding the article titles, it is noticeable that the themes generally refer to issues and problems in the physical and mental health of workers, the role of public networks in worker care, and the inclusion of people with disabilities in the workplace. The summarized information can be seen in Table 1 below. The order of the articles in the table follows the order in which they appeared in the journal's filters.

Table 1
Academic productions from the period of elaboration and implementation of public and social policies in favor of workers and expansion of occupational therapy practices (1991-2017).

Period influenced by technological revolutions, setbacks in workers' rights, and theoretical-practical reflections from/on occupational therapy (2018-2024)

In the third category, the articles were published between 2017 and 2024, totaling 55 publications. Of these, 27 were published in the journal Cadernos Brasileiros de Terapia Ocupacional, 21 in the Revista Interinstitucional de Terapia Ocupacional, and 6 in the Revista de Terapia Ocupacional da Universidade de São Paulo. The year with the highest number of publications was 2020, with 17 articles. Regarding the authors who appear repeatedly in this table, Souza et al. (2019, 2020), Rodrigues (2023) and Barros et al. (2022, 2023) stand out.

Regarding the research methodology indicated in the table, most studies use a qualitative approach. Regarding the article titles, it is noticeable that the themes address topics such as: the problems of informal work and the mental health of workers, the aging of the working population, theories of stress and burnout, reflections on gender and on socially vulnerable populations. The summarized information can be seen in Table 2 below. The order of the articles on the table follows the order in which they appeared in the journal's filters.

Table 2
Academic productions of the period influenced by technological revolutions, setbacks in workers' rights, and theoretical-practical reflections from/on occupational therapy (2018-2024).

Discussion

Period of Institutionalization of Occupational Therapy (1950-1990)

No publications were found that could be included in the first historical-temporal category (1950-1990), and this is due to several factors, such as the year of publication of the first editions of the journals used for the search and the criteria established for the selection of articles, which include the subject matter of the publications.

The oldest journals used in the search for this review were launched in 1990, namely the Revista de Terapia Ocupacional da Universidade de São Paulo and the Cadernos de Terapia Ocupacional da UFSCar, the latter of which was renamed in 2017 as Cadernos Brasileiros de Terapia Ocupacional. In 2017, the first edition of the Revista Interinstitucional de Terapia Ocupacional (Revisbrato) was also published, making it the most recent of all the scientific journals consulted, with less than a decade of existence. However, publications from 1990 could have been included since two of these journals had already published numbers, and some are available online. However, these studies were excluded following the criteria applied during the process, and this will be explained in the following paragraphs of this section.

Beyond the year of establishment of the journals, in the 1990s, when consulting the first search results of the research, it was evident that articles from 1990 appeared in the screenings but were excluded during the review stages. These articles were excluded because they did not fit the theme of this research. Considering this, it is worth reflecting on the publications from 1990 that were excluded.

Upon retrieving the excluded articles from the search, it is clear that the productions published in 1990 were excluded because they were not directly related to the theme of the present study. They focused on topics such as: physical rehabilitation; the need for the deinstitutionalization of users in the mental health field; academic training and professional identity; all of which were unrelated to the construction of knowledge and practices focused on work or workers (Barros, 1990a, 1990b; Castro & Silva, 1990; Silva, 1990; Ferrigno, 1990; Fridman, 1990; Kielhofner, 1990; Lopes, 1990; Mângia, 1990; Mângia et al., 1990; Marques, 1990; Nascimento, 1990; Oliver, 1990; Pinto & Ferrari, 1990; Souza, 1990).

It is important to note that the issues addressed in the 1990 studies are closely related to historical events that influenced the early stages of the profession both globally and in Brazil, which may justify the interest of researchers at the time specifically in the aforementioned themes.

Considering that in 1990, Law 8.080 was enacted, establishing the Sistema Único de Saúde (SUS), and understanding that publications take time to be written and subsequently published in journals, the academic productions that were actually published during this period (considering the times of this process) relate to issues and problems that preceded this law.

Regarding this first historical-temporal moment, it is important to make some considerations. The arrival of occupational therapy in Brazil occurred around the 1950s, and the polio epidemic was a milestone in the history of the profession, as it led to an increase in infant mortality and childhood disability. This consequently led to a rise in the number of children's hospitals and physical rehabilitation centers in the country (Monzeli et al., 2019), influencing the production of knowledge about physical rehabilitation and the development of practices to meet the demands of this need.

Between the 1950s and 1960s, the Hospital das Clínicas of the University of São Paulo housed one of the first occupational therapy services, with the objective of helping injured workers using physical rehabilitation techniques focused on traumatic-orthopedic knowledge, which did not aim to reflect on work but rather on the rehabilitation of injuries (Lancman, 2004). During this period, the first professional training programs in occupational therapy also emerged. The first course in Brazil was established in 1956 and was linked to the Associação Brasileira Beneficente de Reabilitação (ABBR) (Monzeli et al., 2019).

In the 1970s, Brazil experienced the implementation of the military dictatorship. The coup of April 1st was supported by U.S. imperialism, the conservative sectors of the Catholic Church's high hierarchy, the international and national bourgeoisie (industrial and financial sectors, and large landowners). This historical event hindered the progress of popular forces, which had been increasingly organized and mobilized around struggles for fundamental reforms (Lara & Silva, 2015), such as democratizing health care and renewing professional practices that were centered on the biomedical health model and did not address the determinants of diseases.

In 1977, the National Institute of Social Security Medical Assistance (INAMPS) was created, responsible for providing health assistance to its members. Health assistance under INAMPS benefited only formal sector workers, those with signed employment contracts, and their dependents, meaning it was not universal (Brasil, 2002). Moreover, it focused on rehabilitation related to work-related illnesses, primarily physical health issues, demands that were later absorbed by the SUS.

However, despite the repression during the Brazilian military dictatorship (1964-1985), there were many intellectual and popular movements during this historical moment advocating anti-capitalist causes, anti-asylum struggles, the right to health, and better working conditions. These movements and discussions culminated in both the drafting of a new Brazilian constitution in 1988 and the creation and implementation of a public health system, which would be realized in the second half of 1990.

In 1988, with the end of military rule in Brazil, a new constitution was promulgated, consolidating labor rights and affirming the right to health for the entire Brazilian population, regardless of employment status. In 1990, through Law 8.080, the Sistema Único de Saúde was established, the result of discussions and movements in intellectual, social, and popular spheres that had taken place in previous decades.

The aforementioned facts provide clues to understand the themes of articles published up to 1990, explaining why they were not centered on issues of work and practices with workers but rather focused on the occupational therapist's professional role in physical rehabilitation, treatment offered to people with mental suffering (and the issues between the psychiatric model and the need for a psychosocial approach), the need to reconsider practices based on a holistic understanding versus a disease-centered one, academic training in occupational therapy (curriculum, academic implementation, and professional legitimation globally and nationally), and professional identity (therapeutic activity as a myth and the debates on activity and occupation as possible central concepts of the profession). As mentioned earlier, the publications from 1990 that were excluded, despite being published in a historical moment when significant reforms in professional practices and new reflections on workers' issues occurred, likely refer to issues from years and decades prior.

Period of development and implementation of public policies and social policies in favor of workers and expansion of occupational therapy practices (1991-2017)

In the second historical-temporal category (1991-2017), most of the articles came from the journal Cadernos Brasileiros de Terapia Ocupacional. During this period, a large number of articles were selected for addressing the role of occupational therapy with individuals who needed to be (re)integrated into work due to mental health issues and with public health policies regarding workers' health, emerging from SUS, reflecting on work and workers. These publications are believed to be the result of reflections initiated by social and popular movements from the previous period and the first professional experiences at the beginning of the health sector's redemocratization.

The 1990s began after significant debates about the need to deinstitutionalize people with mental illness and reintegrate them into society. In the "asylum" treatment, which predominated the health assistance scenario until the 1980s, the proposal was to educate, correct, and change the will of the individual (Vechi et al., 2017).

After recognizing the need for deinstitutionalization, work became a way to reintegrate individuals into society. Social inclusion through work began to be presented as a strategy for social emancipation, promoting self-knowledge, self-realization, and independence. Articles on this subject also strongly advocated for the establishment of a new work society, one that is more inclusive and conscious of social issues (Morato & Lussi, 2016; Vechi et al., 2017).

Discussions regarding the work of institutionalized individuals in the 1990s and the need for their (re)integration into productive activities outside asylums had SUS and the Psychosocial Care Network (implemented in 2011) as strong allies in caring for this population and questioning the types of work offered in capitalist society. These discussions are present in many of the articles, with topics related to deinstitutionalization, income generation, solidarity economy, and social inclusion through work (Morato & Lussi, 2016).

The emergence of the National Network for Workers' Health Care (RENAST), published as a public policy in 2004 and reformulated in 2017, is pointed out as fundamental in establishing support and care for workers within services with a community-oriented perspective, aiming at promotion, education, assistance, and workers' health surveillance (Brasil, 2017).

This proposal for a workers' health network in the SUS arose as a result of a critical review of the reference centers and workers' health programs, which did not establish stronger links with the organic health structures, remaining isolated and marginalized (Leão & Vasconcellos, 2011). With SUS, the Centers for Reference in Workers' Health (CEREST) emerged, which directly served the worker, initially working in a supportive way and, later, transitioning to acting as a reference service that contributes to analyzing work conditions and their modifications with the goal of promoting workers' health through health education.

In 2017, the new labor reform came into effect, modifying the CLT (Consolidation of Labor Laws) in more than 100 points, directly affecting the number of informal workers in Brazil. The justifications provided by the government were based on the idea that, to offer more job opportunities, there should be a reduction in labor rights costs (Souza & Lussi, 2022).

Thus, it is clarified that this category presented studies derived both from the reflections of the late 1980s (which were published starting in 1991) and from productions that already reflected on new practices incorporated from the implementation of a public health system in Brazil, a new Social Security system, and a paradigmatic transformation in the practices within the field of labor.

Period influenced by technological revolutions, setbacks in workers' rights, and theoretical-practical reflections from occupational therapy (2018-2024)

The third category (2018-2024) was the only one in which publications were found in all three journals, especially because Revisbrato published its first edition in 2017. This category presented publications referring to professional reflections that address broader issues related to work in Brazil, particularly the existence of reforms that further harmed working conditions and workers' rights in the country.

It is believed that the historical context brought more diversity to the themes of the publications precisely because of the need to question labor in a context where care for the worker and their rights were regressing.

From 2017, Brazil experienced the consequences of the labor reform, such as the precariousness and weakening of labor relations mentioned earlier. In 2019, a new reform known as the pension reform was enacted, which changed laws regarding social security, such as the contribution time and the minimum retirement age under the National Institute of Social Security (INSS).

In this context, it is pointed out that between 2018 and 2024, the world underwent intense transformations stemming from technological development and its influence on the work society, with consequences for workers' lives. Digital platforms, the use of algorithms, and the ongoing presence of artificial intelligence, for example, modified the ways in which work is organized and managed (Antunes, 2020).

With the labor reforms that permanently weakened formal labor relations and workers' rights in Brazil, and with the valorization of a neoliberal governmental discourse on "entrepreneurship" – which advocates for "freedom" and contractual flexibility to the detriment of formal labor contracts – platform-based work and those controlled/managed by algorithms and artificial intelligence became an increasingly legally accepted reality in the country, but socially unprotected in terms of labor rights and social protection for workers.

Still, in 2020, with the onset of the COVID-19 pandemic, which lasted for two years, there was a race to develop a vaccine that could be produced, tested, and assured for the population as quickly as possible. While the pharmaceutical industry sought a vaccine, hospitals were full, and mortality rates were a concern for the population. Also, during this period, workers were put at risk, and much was discussed about the impacts of work in this context on workers' lives (Barroso et al., 2020).

It should also be considered that different vulnerable populations (such as women, the elderly, children, people with disabilities, gender and sexual minorities, black people) organized and highlighted their issues related to the world of work, which currently makes the profession reflect on this and bring these issues into knowledge production (Santamaria & Almeida, 2023; Silva & Surjus, 2021; Almeida & Costa, 2019).

Galheigo et al.'s (2018) study identified that from 2018, there was an intense movement in the field of research in occupational therapy, leading to a theoretical-conceptual and methodological diversification in knowledge production. The authors conducted a survey in 2018 through the Directory of Research Groups in Brazil by the National Council for Scientific and Technological Development (CNPq), and found a significant increase in the number of groups coordinated by occupational therapists. In 2003, only 16 groups were identified.

This study by Galheigo et al. (2018) also reported that from 2018, Brazilian occupational therapy began to use a variety of concepts and theoretical frameworks, as well as plural practices with different populations in various contexts, including services, equipment, projects, and actions in domiciliary, community, territorial, institutional, and private settings.

In this review, it is clear that this movement impacts knowledge production in the field of labor. In the third historical-temporal category, it is possible to identify this movement through a diversity of themes present in the studies, which, for example, address work and feminism, informality, homeless populations, and working youth. Furthermore, during this period, researchers and professionals have been advocating for work with populations made vulnerable by contemporary labor situations, reaffirming an ethical and political role in defending dignified work and confronting inequalities caused by current capitalism (Barros & Raymundo, 2021; Ferreira-Marante & Veiga-Seijo, 2023; Prado et al., 2020; Pinho et al., 2019; Souza & Lussi, 2022).

Although some productions are still linked to reflections specifically on the conditions of workers' illness and their possibilities of rehabilitation and reintegration into work – without necessarily highlighting the issue of labor setbacks and precariousness from the movements mentioned earlier – it is reiterated that these productions, despite being inserted in different historical periods, undergo processes of theoretical-practical and theoretical-political transition. However, it is noted that the lack of reflections more incisively addressing setbacks in workers' rights and forms of control and management of labor in contemporary capitalism may indicate a gradual adaptation of the analytical frameworks in the field.

Some notes on the journals and the methodology of the analyzed productions

The journals used in this research are specific to occupational therapy, primarily in Brazil. The existence of these journals is of utmost importance for strengthening the identity of the profession and the production of specific knowledge. At the end of this research, it was observed that the journal Cadernos Brasileiros de Terapia Ocupacional has the largest number of publications. Revista de Terapia Ocupacional da USP has a smaller number of publications but features older articles.

Revista de Terapia Ocupacional da USP is mostly present in the third historical-temporal category and published an average of three editions per year until 2019. However, starting in 2020, only one publication was made per year. In 2021, no editions were published. This lack of publications could be related to the COVID-19 pandemic, which began in 2020 and peaked in 2021, which also seems to have affected Cadernos Brasileiros de Terapia Ocupacional, where only one edition is available for the year 2021, even though the journal typically had an average of four publications per year, something that has not occurred since 2020.

The mentioned journals accept articles that address interdisciplinary issues or those related to other professions. The objective of this research was not to analyze the specific theoretical-methodological frameworks of occupational therapy used in academic productions but rather to map publications that interface between the profession and issues of work and workers.

Thus, it is believed that it is possible for the articles to present discussions that do not necessarily have specific theoretical foundations in occupational therapy, although they present relevant discussions for the profession. New studies are needed that specifically analyze the theoretical and/or theoretical-methodological frameworks of the articles, in order to provide reflections on the specificity of occupational therapy in the field of labor in the Brazilian context.

Furthermore, the identification of the increase in occupational therapy knowledge production indicates that these journals have increasingly been considered important vehicles for disseminating the profession's specific knowledge, contributing to the strengthening of occupational therapy knowledge (Folha et al., 2019).

Regarding research methods, it is noted that during the period 1990-2017, a significant number of case studies, experience reports, and theoretical essays were published. In the period from 2017-2024, the production of various types of review studies and theoretical essays was highlighted. In both periods, qualitative research predominates, and quantitative research appears sporadically among the publications. Although qualitative research is important for in-depth understanding of certain realities, it is stated that the development of quantitative studies is important for constructing knowledge in a field, particularly for understanding realities from larger samples, generalizing data, and making precise measurements (Lamattina et al., 2021).

Conclusion

This research mapped the academic productions of occupational therapy in the field of labor that were published in active national journals specific to the area. In this study, it was possible to identify that the occupational therapy production, which reflects on and considers practices for workers and about work, is connected to the historical context of the profession and the political and social situation in the world of labor in Brazil over the decades. It was also noted that in each identified time period, there could be a gradual adaptation of the analytical frameworks of the field. While differences are already evident in the production between one period and the next, there are also productions that maintain debates from earlier periods, which is common in this process of theoretical-practical, theoretical-political, and reflective transition.

From this mapping, it was possible to identify that the themes of Brazilian productions are intertwined with historical, political, and social facts that occurred in three distinct periods, established during the organization of the research results. In this way, it was possible to understand that researchers and professionals transformed their practices with workers over time. In recent years, the productions have increasingly questioned labor and reflected on the need to transform these realities, including the social reality itself, and not just treat illnesses related to them.

Through preliminary studies like this, which focus on the themes of the articles, future research can be conducted on the theoretical or theoretical-methodological paths and practices (knowledge and practices) that have been pursued, constructed, and valued in what we are calling occupational therapy in the field of labor. This tracking of academic productions allowed for the documentation of academic paths in this field.

It is also identified that the current moment calls for the development of studies and practices that can reflect and address the gaps in care for workers in the current world of labor, considering their counter-reforms, scarcity of rights, and the multiplicity of contracts that affect workers' lives and present challenges to previously established care networks.

The limitations of the research include: not consulting interdisciplinary journals or broader databases; not accessing physical copies of older journals in the field; and not considering access to books published during the established period. It is understood that in the three categories mentioned in the results, important works on occupational therapy and labor were published in book format, which certainly constitute important sources for knowledge production in the field and for the historical influences that both relate to and explain the choices made by the authors of these productions.

However, the recovery and analysis of books and other materials of relevance to the field are part of a larger research agenda on the topic. Finally, considering a digital mapping across all national journals, specific to the field and with currently active issues, which resulted in over a thousand productions and allowed for the analysis of 157 productions, we still have an important historical-temporal mapping and categorization of knowledge production in occupational therapy in the field of labor within Brazil.

  • How to cite:
    Silva, G. C., Rodrigues, D. S., Monzeli, G. A., & Souza, M. B. C. A. (2025). Occupational therapy and work: historical-temporary categorization of Brazilian academic productions. Cadernos Brasileiros de Terapia Ocupacional, 33, e4100. https://doi.org/10.1590/2526-8910.cto416341002
  • Data Availability
    The data supporting the results of this study are available from the corresponding author upon request.

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Edited by

  • Section editor
    Profa. Dra. Roseli Esquerdo Lopes

Data availability

The data supporting the results of this study are available from the corresponding author upon request.

Publication Dates

  • Publication in this collection
    12 Jan 2026
  • Date of issue
    2025

History

  • Received
    28 Apr 2025
  • Reviewed
    07 July 2025
  • Accepted
    20 Aug 2025
Creative Common - by 4.0
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E-mail: cadto@ufscar.br
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