A narrative inquiry of dyslexic post graduate healthcare students: presentation of the model of occupational potential and possible selvesAbstract
Introduction The occupational potential and possible selves of dyslexic students is not well understood.
Objective This research explored the narratives of dyslexic post graduate healthcare students to elucidate the participants temporal lived experiences of barriers and facilitators of occupational potential and possible selves. This research presents The Model of Occupational Potential and Possible Selves.
Method Temporal narratives were gathered via 24 semi structured interviews with nine participants. Data from five participants are presented here as a constructed act and two scenes of a play using narrative inquiry, thematic analysis and performance ethnography.
Results Themes were organised into Act One, ‘Congruent and Incongruent Environments, Occupational Potential and Possible Selves’. This act is separated into Two scenes which explore experiences of diagnosis and implications on education and potential: Scene One, “It would say if it wasn’t!” and Scene two, “I think you’ve got a problem”. Together the act and scenes provide insight into the complex experiences of diagnosis, terminologies used, impact on identity, potential and future possibilities.
Conclusion The findings indicate the interconnected and interdependent nature of occupational potential and possible selves. These findings led to the construction of a model which encapsulates the process of achieving desired possible selves through a transitionary cycle of reaching occupational potential. This model can be a useful tool in occupational therapy and education.
Keywords:
Activities of Daily Living; Research; Occupational Therapy; Dyslexia; Education; Students
Resumo
Introdução O potencial ocupacional e os “eus” possíveis de estudantes com dislexia não são bem compreendidos.
Objetivo Esta pesquisa explorou as narrativas de estudantes de pós-graduação em saúde com dislexia para esclarecer as experiências vividas temporalmente pelos participantes em relação às barreiras e facilitadores do potencial ocupacional e dos “eus” possíveis. Esta pesquisa apresenta o Modelo de Potencial Ocupacional e de “Eus” Possíveis.
Método Narrativas temporais foram coletadas por meio de 24 entrevistas semiestruturadas com nove participantes. Os dados de cinco participantes são apresentados aqui como um ato construído e duas cenas de uma peça, utilizando investigação narrativa, análise temática e etnografia performática.
Resultados Os temas foram organizados no Ato Um: “Ambientes Congruentes e Incongruentes, Potencial Ocupacional e ‘Eus’ Possíveis”. Este ato é dividido em duas cenas que exploram as experiências de diagnóstico e suas implicações na educação e no potencial: Cena Um, “Diria se não fosse!” e Cena Dois, “Acho que você tem um problema”. Juntos, o ato e as cenas fornecem insights sobre as complexas experiências do diagnóstico, as terminologias utilizadas e os impactos na identidade, no potencial e nas possibilidades futuras.
Conclusão As descobertas indicam a natureza interconectada e interdependente do potencial ocupacional e dos “eus” possíveis. Essas descobertas levaram à construção de um modelo que encapsula o processo de alcançar os “eus” possíveis desejados por meio de um ciclo transitório de realização do potencial ocupacional. Esse modelo pode ser uma ferramenta útil na terapia ocupacional e na educação.
Palavras-chave:
Atividades Cotidianas; Pesquisa; Terapia Ocupacional; Dislexia; Educação; Estudantes
Introduction
Occupational therapists help people, populations, and communities reach their potential through occupation. Indeed, Yerxa described occupational therapists as search engines for potential (Yerxa, 1998). Yet the concept of occupational potential appears to be overlooked within contemporary occupational therapy and occupational science literature as well as within models of practice. Despite Wicks (2001) request for further conceptual exploration and development of occupational potential, a search found only 2 papers published on occupational potential within the last 10 years (e.g. Lindsay et al., 2018; Murphy & Stevenson, 2019).
This article presents the Model of Occupational Potential and Possible Selves which was constructed during this research following the analysis phase as a way of conceptualising the complexity of the findings. Findings (additional acts and scenes, including data from all nine participants) from this research are also presented separately in Murphy (2017) and in a doctoral thesis available online (Murphy, 2017). This model can be used within occupational therapy and education and adds to the range of models available to inform both. It provides a lens through which to view the complexities of practice and education, adding to the lexicon [of models] available. It contributes to the unique perspective of occupational therapy and adds to the ‘uncommon sense’ (Turpin & Iwama, 2011) the profession provides.
A model seeks to depict a phenomenon through a visual interpretation of a theory (Taff et al., 2024). Whilst occupational therapy models have generally been aligned to biomedical (Occupational Performance Model - OPM), biopsychosocial (Occupational Performance Model Australia - OPMA; Occupational Adaptation - OA; Person, Environment, Occupation, Performance - PEOP; Person, Environment, Occupation - PEO), socioecological (Ecology of Human Performance - EHP; Kawa model), biopsychosocial (Canadian Model of Occupational Performance and Engagement - CMOP-E; Model of Human Occupation - MOHO) models of health, this model sits alongside the other models and contributes an additional layer of potentiality to professional reasoning through an ecological perspective. It emphasises the interconnectedness of the person and the environment and considers the value of an occupational therapy community of practice which keeps potentiality in mind.
Occupational Potential
Occupational potential originates from the link between occupation and health (Wilcock, 1998) and sits conceptually under an occupational perspective. Wilcock (1998) initially defined it as “future capability, to engage in occupation towards needs, goals and dreams for health, material requirement, happiness and wellbeing” (p. 257). This definition provides a connection between occupation and potential as well as linking occupations to what people wish to pursue, do, and aim to be in the future. The exploration and development of occupational potential was also taken up by Wicks (2001, 2005) who retrospectively explored the occupational potential of older age Australian women. She defined it as “[…] people’s capacity to do what they are required and have the opportunity to do, to become who they have the potential to be” (Wicks, 2005, p. 130). This again indicates that the capacity for potential resides within the individual yet acknowledges that this is influenced by opportunities within environments. Wicks later referred to occupational potential as “[…] a fluid phenomenon that evolves, as human capacities are exercised at different stages of the life course and is shaped by environmental and personal influences” (Asaba & Wicks, 2010, p. 121) indicating temporal dynamic change and an overall potential which is influenced by environmental factors.
Asaba (2005) positions the loci of potentiality as shifting and emergent through interaction with occupation and draws from humanism and potentiality. He claims humans strive to develop potential in creative and constructive ways, with meaningful relationships and striving to be the people they wish to be. Further, Asaba & Wicks (2010, p. 121) acknowledge potential means some future event will occur as “some transformation or change” but also that potentiality has to do with bringing into reality something which “exists in latency” and is realised through dynamic interaction with occupations. Writing collaboratively on the topic, Asaba & Wicks (2010) avoid a static definition and welcome further exploration of occupational potential.
Occupational potential is highly temporal and dynamic as it changes the more occupations are engaged in and as capacities and performance evolve. It is therefore a concept which instils hope and creates a consideration for occupational therapists to go beyond the norm and consider possibilities that are not restricted by circumstances but by what is possible for individuals and communities.
Possible Selves
The term ‘possible selves’ was developed within the field of cognitive psychology in the 1980’s by Paula Markus and Hazel Nurius. It represents individuals’ ideas of, “What they might become, what they would like to become and what they are afraid of becoming” (Markus & Nurius, 1986, p. 954). As humans we draw from representations of the self in the past and our possible selves include representations of the self in the future (Markus & Nurius, 1986). The concept builds upon and is a natural extension of the self-concept, a system of affective-cognitive structures, theories or schemas. They are made salient by an individual’s particular sociological, cultural and historical context (Markus & Nurius, 1986). They have the potential to reveal the inventive and constructive nature of the self but also reflect the extent to which the self is socially determined and constrained (Markus & Nurius, 1986).
Possible selves play an important role in identity formation processes, with a strong relationship with identity and occupational exploration. They are informed by social context, including past and anticipated experiences, influencing motivation and behaviour (Markus & Nurius, 1986; Cross & Markus, 1991). Hoped for possible selves act as goals for life changes and significant life roles (Oyserman, 2008). For example, they support commitment to identity formation as a process where personal investments are made (Cross & Markus, 1991). Often, they involve experimentation and employment of actions which elucidate and augment possible selves and sometimes a change of life direction (Fernan, 2021).
In relation to dyslexic people, little is known about how perceptions of future selves may be influenced by the complex, sometimes hostile and alienating environments participants inhabit (MacDonald, 2012) as they grow up and experience education. While occupational potential helps in the consideration of occupations and potentiality, possible selves is useful in its consideration of how the self is viewed temporally and this perspective is (to my knowledge) unique to this research.
Therefore, the aim of this research was to explore the temporal experiences of postgraduate dyslexic students in healthcare education and to propose a conceptual model which can be employed in occupational therapy and education.
Research Design
Clandinin & Connelly’s (2000) narrative inquiry was employed with sociality (personal and social), temporality, and spatiality positioned alongside occupational potential and possible selves to provide a lens through which to interpret the storied experiences of growing up and studying with dyslexia.
Following ethical approval, 24 face-to-face interviews were conducted with nine healthcare (physiotherapy, occupational therapy, osteopathy) students (up to three interviews each) with an age range of 21-40 (findings presented here are from five participants). An interview crib sheet was used to explore 1) educational and personal experiences growing up with dyslexia 2) facilitators and barriers experienced in education and personal and social lives. Recorded data were listened and re-listened to before being transcribed verbatim. Transcripts were checked carefully by the researcher, shown and discussed with research supervisors between interviews and earlier interviews informed later interviews. Data saturation was noted when repeated themes or plots were noted by the researcher. Care was taken to allow participants to tell their stories through a dialogical exchange to uncover latent meanings (Levitt et al., 2017). Whilst the process of double hermeneutics was integral, the participants’ voices and stories remained central, important and valued throughout.
Once data collection was completed, participants were offered the transcripts for member checking, but none participated in his process. A coding framework was constructed to capture the ‘analytic take’ (Braun & Clarke, 2022, p. 35) of temporality, spatiality, personal and social interactions (Clandinin & Connelly, 2000), occupational potential and possible selves (Table 1. Data analysis framework). This was a cyclical process of distillation guided by Braun & Clarke’s (2022) 6 phases of thematic analysis while paying attention to latent meanings contingent upon the theoretical lenses (occupational potential and possible selves) and remaining reflexive throughout (Finlay, 2021).
The researcher then sought to preserve the communication of the students’ voices in order to maintain the ‘spirit’ initially captured in the interviews (Carless, 2010, p. 53). Performative methodologies are recommended as a way of communicating research findings and as a method of creating experience as well as blurring the self-other divide (Carless, 2010). This is therefore a form of social constructivism whereby experiences grow and evolve from experiences as they are communicated and experienced, allowing deeper resonance through engaged interaction between the voices of the participants and the reader. An aim was to understand and illuminate student experience to a greater depth and with greater resonance with the reader (Carless & Douglas, 2010).
Therefore, themes were then organised and developed into acts and scenes of a play, drawing upon methods of performance narrative (maintaining stories) and performance ethnography (theatre) (Denzin, 2003; Carless, 2010; Carless & Douglas, 2010; Douglas & Carless, 2013). The researcher read books such as Alan Bennett’s Talking Heads and Shakespeare’s The Taming of the Shrew for guidance on how to write a play. Self-selected pseudonyms were used to protect anonymity of participants. Reflexivity took place throughout the research in the form of reflexive diaries (Finlay, 2006; Darawsheh, 2014) and I poetry (Gilligan et al., 2003). This was done with critical self-awareness relating to being a parent of a dyslexic child. The researcher was neither emic or etic and used the diaries and I poetry as a way of regulating emotions and maintaining self-awareness whilst considering the perspectives brought to the research through their own position as a white, middle aged, working, British woman.
Findings
Readers are requested to imagine a performance whereby a light is shone on the participants, who are sitting in a row upon a stage. Act 1 Scene 1 “it would say if it wasn’t” relates to experiences of diagnosis. Scene 2 “I think you’ve got a problem” addresses the problematising of dyslexia and the impact on identity. A narrator guides the reader through the Act and Scenes. Readers are requested to consider the impact of the experiences on occupational potential as they read.
Act 1, Congruent and Incongruent Environments, Occupational Potential and Possible Selves
Scene 1. “It would say if it wasn’t!”
Characters in order of appearance, Narrator, Abigail, Angela (researcher), Penny and Paula.
Narrator
Welcome to Act 1 Scene 1, entitled, “It would say if it wasn’t”. Inevitably the experience of diagnosis was prominent in the storied accounts of the participants. Abigail, Penny and Paula are going to tell us their stories about their experiences of diagnosis.
Abigail
Mum kept saying, “She’s struggling with her spelling”. Mum knew, she always knew, and they just said, “Oh we’ll see how she goes, she’s fine” and then when I was in year 8 or 9 the school agreed to assess me and …. So, this teacher, that I didn’t know that well, sat me in a store cupboard which had like loads of files everywhere and did a spelling test with me and told me I had a specific learning disability and that was it. That was the end of it. No paying for a proper assessment, no feedback, … no form. That was it. No anything, we didn’t get anything.
Narrator
Specific learning disability is a term which often arises. I wonder if it is a suitable term and am curious about why it is used instead of dyslexia. Abigail was at high school, about to do her GCSEs (final high-school examinations) when she was placed in a store cupboard for some kind of assessment. A curious approach. Let’s hear more from her.
Abigail
I was in year 8 or 9, coming up to GCSEs and that was enough for the school to give me extra allowance in my exams. … extra 25%. This non-standardised assessment that was done by one of the teachers like it was so,… haphazard (laughs). I would have been 13 and I’m 27 now. So that was when the school sort of, yes, kind of acknowledged something but it was very much shady. So, it was still so covered up and nothing really addressed.
Narrator
It felt shady, covered up, non-standardised, haphazard?
Angela
Did your mum talk to them at all?
Abigail
Mum took it as like, “Ok, that’s that”. They wouldn’t do anything else. That was for them, their level of assessment.
Angela
Did anyone say well that means dyslexia?
Abigail
We were just left with that; Mum still knew, and I think at this point I was presuming, and it got to the point where I was coming home from school and napping. Like I would sleep, I’d come straight home and sleep. I was exhausted every day. I’m a good sleeper anyway but I’d sleep all night as well and Mum was just, she could just see I was so tired from high school, just exhausted every day, straight home and straight asleep.
As I was growing up, …my sisters, one was beauty, one was brains, and I was brawn. I think secretly I thought, “well I’m kind of pretty and I know I’m intelligent and I know I know my stuff” but because I see things differently people don't think I’m clever and when I got this diagnosed (at A level college), it was like, “Oh, that’s why!”
Narrator
Abigail was labelled the brawn in the family. It seems that it was when she moved to 6th form college and finally received a diagnosis properly things began to make more sense. Let’s hear from Penny, who was diagnosed dyslexic and dyspraxic during her postgraduate studies as a mature student.
Penny
First of all, I thought, “I’m sure it will come back that I am” and when it came back that it was a specific learning disability I was really upset. I was crying at home, and Veronica was saying “It’s not that bad” and …It was that word, disability. We looked up dyspraxia and she was going, “Yep, that’s you, that’s you, that’s you”. I’m not so upset now. I’m ok about it. I just thought, it’s the word disability, it makes you feel vulnerable. It just, I felt a little bit sort of, gosh, that there was something wrong with you. It’s just not a nice word, is it? Especially on this course. You see people with illnesses, you know, physical disabilities and you see how capable they are and just, and so any difference in a person doesn’t have to be, you know, a huge problem. People live with all sorts of conditions and have very fulfilling lives.
Paula
When I went to see the psychologist, he said, “Oh yeah, it’s as you suspected, you have got some mild deficiencies”. I think he said “In certain areas” blah de blah. So, he didn't use the word dyslexia either. So, when I got the report and it said mild specific learning disability or whatever, I was like quite upset because that sounded loads more stigma. We are talking about stigma at the moment (at university) and that felt worse than someone saying mild dyslexia. I was a bit like, “Oh, I don't want that!” (Laughs) I want it to be dyslexia because that, I can tell people. I know people don’t understand it all but if you tell someone I’ve got mild dyslexia they're like, “Ok, I kind of know what that means” but otherwise they are like, “What?” Oh, I didn't really know. I’ve got problems with my visual processing, what’s that? I don't even know myself what that is (laughs), you know.
So yeah, I was a bit gutted when I read that and then when I asked and went to that interview with, meeting the disability lady yesterday and I asked her and she didn't seem to know why I was asking that and she said, “Oh, well it would say if it wasn't” and I'm like, “Well surely it would say if it was!” So, she had a look at it... It was like she didn't really know either to be honest which is just a bit weird cos I was like, “Am I just asking a stupid question here?” But she didn't know either. It didn't make much sense.
Narrator
So, the term specific learning disability doesn’t seem to make much sense to Abigail, Penny and Paula. It seems clarification was difficult to obtain. How confusing for them. Let’s hear from Jo and Anne in Scene 2.
Scene 2 “I think you’ve got a problem”
Jo
I was like, “I'm not dyslexic, no way” cos I had friends who were dyslexic, I thought, “Well, I'm not like them” but then I was a bit like, by then I was at the end of my tether. I was having to work so hard…. So, I was like, “Well at the end of the day if he thinks there’s something in it, I should maybe go check it out”. So yeah. I went for screening, and they weren't sure; and then I was like, “Well, now I just need to know”. So, I went and got the test done and it turned out I was. … I think then it took me an awfully long time even through this course to kind of accept and integrate that diagnosis into who I am and how that works for me - because I think, … …it always feels like cheating.
Angela
What, to have the diagnosis?
Jo
Yeah, to have the diagnosis, and to use it… ’Cos like I say, the dyslexic friends I know are dyslexic in a different way from me, they particularly struggle with writing. Theirs is much more noticeable - more obvious and more profound. … I was like, when it was people who weren't badly dyslexic, I’d be like, “I don't really get why they got a computer!” Do you know what I mean? - I was kind of aware of my own prejudice for want of a better word against those who weren't super dyslexic. But then I got extra time in my final exams and everything.
As I've been able to recognise more of the features of dyslexia within myself, I have felt more comfortable about the diagnosis. But it is, I've had to push myself really far to know what they are, almost it’s like I couldn't accept it without proof that I recognised. Like, everyone else around me was like, “Well that’s fine, there’s no problem with this” and I was like, “Yeah, well that’s what you think...!” (Laughs) And then to see it for myself it’s like, “Oh yeah, actually, there is something I'm doing different here”. … To be fair, as well, in my undergrad, … before I’d got the diagnosis, I had completely written myself off as far as doing any further study. Just not gonna do it, I'm just not that person… “I'm just not an academic person, so why continue to do things that are a real struggle, when you're good at other stuff?” Then I got the diagnosis, and I was like, “Oh, well ok, so maybe that’s not true and I could do more stuff”.
Narrator
As Jo reflects on the process of coming to terms with her dyslexia diagnosis and what this means to her identity, she highlights how this influenced her life decisions. I find it interesting and worrying that she had written herself off as far as further academic study. How many undiagnosed people do this?
Jo’s story resonates with aspects of Anne’s account. Let’s hear from Anne who also experienced diagnosis during her undergraduate degree.
Anne
He says, “I need to speak to you. I think you’ve got a problem”.
Angela
So, right, so this is the tutor who picked up that you might be dyslexic?
Anne
This is the chap who picked up that I might be dyslexic. But at the end he has written, “You must improve your English if you expect to get a job” and that’s it. He was really eccentric, and it was like (sharp intake of breath) “I’ve come to uni and he’s saying I won’t get a job. Something’s not right!”
Narrator
As she speaks Anne shows an assignment from her degree with annotations from her tutor.
Angela
So, this was the first indication you’d ever had? You got through ‘A’ levels and GCSEs and did alright in these?
Anne
Yeah
Angela
So, was that quite a shock to you?
Anne
Well yes it was, … he was like, “Your English, it’s not up to standard. How did you get through?” I was like, “Well” I said, “Is it just because I’ve lived at home all my life?” I said, “do you think it’s because … I just I’m (county)? It’s just the way I speak?” He was like, “No, no, no, there’s a difference. People on the course are from all different areas. They don’t write like they speak”. So, from that I was, “Ohhh!” And he said, “Go and speak to the dyslexic people and see if you are” and from that I went and got the test and … yeah, they said I was really.
Narrator
Act 1 ends here. I have found this act fascinating, particularly to hear about the process of diagnosis and individual thoughts about the terms used and impact on possibilities. Dyslexia diagnosis came as a surprise to both Jo and Anne who were both on undergraduate degrees when tutors noticed some discrepancies and prompted them to be assessed. I find it interesting that the discourse surrounding this is quite negative from their tutors, something is not right, being the main message to both and resulting in concerns about their futures.
Discussion
This research met the objective of exploring the temporal narrative experiences of post graduate dyslexic healthcare students. Act 1 ‘Congruent and Incongruent Environments, Occupational Potential and Possible Selves’ communicates the complexities of the environmental impact within education and suggests challenges to perceptions of possibilities and potentiality. This research shows the realisation of occupational potential is inextricably linked to the synergy of personal, socio-cultural, historical, and political and economic factors (Wicks, 2001).
As shown here in the participants' narratives, diagnosis using either term, dyslexia or specific learning disability does not automatically correlate or result in a dyslexia friendly environment or easy diagnostic acceptance. Furthermore, the implications on each participant show the complexities involved in occupational potential as confidence in occupations such as study skills were undermined. Paula, Penny and Jo were diagnosed as adults and found the term specific learning disability confusing and upsetting, particularly as they were not told of its meaning. The term lacks salience to them as far as their sociological, cultural and historical contexts (Markus & Nurius, 1986) which is in contrast to the term dyslexia. Importantly, once diagnosis was clear it was not seen as a barrier to future possible selves or occupational potential. On the contrary it worked as an acknowledgement of their way of learning and provided an explanation for their self-concepts, enabling them to recruit agency as they made decisions based upon their own understandings. Some participants had predicted the outcome of their assessment and had salient possible selves as dyslexic which was neither desired nor feared.
Acceptance and successful adaptation to a concept such as a diagnosis is more effective if the person is able to imagine a life which holds meaning, purpose and competence (Morley et al., 2005; Battistutta et al., 2018). However, this depends on how salient a possible self is, and the narratives show some of the complexities surrounding this. The surprise and confusion caused by the word or label disability may have resonated with feared possible selves by furnishing criteria against which the participants were evaluating themselves (Markus & Nurius, 1986). Feared selves are avoided when possible and strategies are actively put in place to avoid them (as shown by Jo when she decided she was not academic). Research shows the feelings associated with feared possible selves act to countervail desired possible selves and actions are put into place to actively avoid their occurrence (Markus & Ruvolo, 1989; Oyserman, 2008; Frazier et al., 2021). The diagnosis of specific learning disability comes as a surprise and presents the participants with a view of their possible selves they had not previously held salient. Discrepancies between who they perceived themselves to be and being informed of different, unconsidered possibilities led to the experience of “dysphoria and dejection”, also identified by Carver et al. (1999, p. 876) and more latterly by Battistutta et al. (2018).
Internal previously unacknowledged prejudices are challenged when a group identity ascribed to others becomes salient to the self and a process of acknowledging the similarities supports the transitional process of adjustment. Jo acknowledged this with an admission of prejudice against people receiving additional support such as technology when symptoms did not present as severely dyslexic. In these narratives the ‘othering’ of ‘disability’ and ‘dyslexia’ groups as different rather than similar to the norm is relevant, resonating with Zárate & Garza (2002) and Collinson (2022). This was challenged when membership of the group altered and became salient as each participant knew how to adapt to their dyslexic selves and enact agency towards occupational participation and potential.
Even without the ambiguity around the use of the term dyslexia Jo and Anne struggled with the implications of an altered identity as dyslexic. This transactional process took place for both of them without preconceived ideas of a possible self as dyslexic (Manzi et al., 2010; Brunswick & Bargary, 2022). For them, the term was not salient with their self-concepts and contradicted how they perceived themselves and both acknowledged they had adapted occupational participation, accordingly, employing agency to facilitate reaching occupational potential. This reaching of occupational potential through occupational participation succeeded in then leading to desired possible selves. These two participants sought validation to confirm their identities as dyslexic while simultaneously developing their possible selves as future healthcare professionals (Turner & Knight, 2015).
An assessment should result in fair access to support (Dyslexia-SpLD-Trust, 2009; British Dyslexia Association, 2014) and help people at all ages to reach their potential in study skills and possible selves. Diagnosis during adulthood led to a distinct turning point in Jo’s narrative where she propelled herself in a new direction as a result. New possible selves which are more personally controlled and less socially constrained, became viable (Markus & Nurius, 1986) to her. As a result of diagnosis Jo begins to alter her aspirations and view her future desirable successful academic possible selves as attainable. For Jo there was not an easy process of acceptance as she found it challenging to accept a change to her personal and social identities. In contrast, Anne faced two challenges to her working self-concept on diagnosis. Firstly, being dyslexic and the implications this had for her and secondly the supposition of her tutor that she may not get a job, challenging her future possible self as someone who is vocationally employed.
Within the two scenes discussed here the participants’ narratives were analysed via the lenses of possible selves and occupational potential which were situated alongside each other. The narratives show that past experiences combine with society’s attitudes and prejudices to influence their self-perceptions and what may be possible for their present and future. For participants, self-doubts were apparent, and confidence was vulnerable, although new opportunities and occupational participation allowed new perceptions of possible selves and self-concepts to evolve. How occupational potential is met through occupational participation and unmet is shown to be influenced by the social surroundings as well as the age at which experiences are processed and considered.
The fact that the participants practiced their sense of strength is apparent in their recruitment of agency to effect change and maintain their possible selves and potentiality. A sense of hope and excitement for the future is perpetuated by perceptions of themselves within the elaborate roles which they enact through occupational participation. Within this is an elaborate perception of possible selves, informing agency and meaning for occupations, which in turn allows the development of competence and fuels potentiality. Remembering that people have the potential and power to act as well as the potential and power not to act is essential here (Asaba & Wicks, 2010).
These participants overcame hardships to reach their desired possible selves, often struggling with the multiple demands of academic courses and tolerating occupational imbalance (Durocher et al., 2014) to become who they aimed to be. There are examples within the narratives of overcoming hardship and indeed using it as a countervailing influence. The oppressive and/or augmentative environments suppressing and/or facilitating occupational participation, allowed (or hindered) progress and development of occupational identities and occupational potential in order to reach desirable possible selves. Figure 1, Model of Occupational Potential and Possible Selves demonstrates this showing how maintaining a focus on possible selves provides motivation for engagement and participation in occupations and use of agency by suffusing occupations with additional meaning and purpose. Central to this whole process is agency which may fluctuate but is needed from the beginning of the journey through to the end where desirable possible selves are reached, and perceptions of new ones begin to evolve.
On identifying the interconnectedness and interdependence of occupational potential and possible selves (one may never reach a possible self if occupational potential is not reached through occupational participation) the researcher began creating diagrams of the concepts, with the person and agency alongside each other, engaging in occupation, developing occupational identity within augmentative or obstructive environments (often school was obstructive, and home/parents were augmentative), influencing identity and progression towards desired possible selves. This process of merging and synthesising the concepts pictorially facilitated further distillation of the findings, analysis and discussion through a process described by Walker & Avant, (2011) as concept derivation. This was also an easier way to describe the concepts within the original thesis (Murphy, 2017).
This process which acknowledged the interconnected nature of occupational participation, occupational potential and identity in order to reach possible selves, led to the construction of the Model of Occupational Potential and Possible Selves. As the issues of potentiality and possibility through occupational participation are missing from existing occupational therapy models it is beneficial to occupational therapy and education to consider how these research findings may benefit future practice.
This model highlights the issue of reaching potential through occupational participation and use of agency in order to become who we have the potential to be encourages abductive top-down reasoning to explore what might be possible in the future, which barriers may be obstructive and what could enable reaching the desired outcomes of a future possible self through occupational participation. It is a model which facilitates a goal and occupation orientated approach whereby actions, occupations, or what we do, explicitly influence who we wish to be in the future. Future selves can facilitate transitions, be transformative and guide the occupational therapy and educational process. The model situates the temporality of occupational participation with future potentiality so that what is done now through occupational participation is saliently positioned as influencing the future self.
The Model of Occupational Potential and Possible Selves is a distinct model in its own right which builds upon earlier occupational therapy models. This model adds potentiality through occupation and possible selves (Markus & Nurius, 1986) as an additional but distinct entity showing the association between occupational participation, our identities and our destinations (Nurra & Oyserman, 2018). This Model can guide occupational therapists and educators to explore the interaction between the person, their environment, their occupational participation, and engagement with valued, important, meaningful and purposeful occupations. It is through this interaction we, as occupational beings, develop occupational identity and reach occupational potential in order to become the selves we have the potential to be. In addition, the concept may be used creatively within a timeline of past, present and future to allow the elaboration of perceptions of desirable possible selves and the actions required to enable them to come into fruition as suggested in the work of Fernan (2021) who asserts possible selves could be instrumental as an intervention.
Ascertaining and supporting the development and elucidation of perceptions of possible selves which are desirable and acknowledging feared possible selves is a method of establishing which occupations may be meaningful and purposeful as well as which may be best avoided (Nurra & Oyserman, 2018; Oyserman & Dawson, 2021). This enhances goal orientated occupational engagement and participation, shown in Oyserman & Dawson’s (2021) research to enhance motivation. There is a symbiotic and cyclical relationship between possible selves, occupational potential and participation whereby the more purposeful participation in occupations, the more likely the desired possible self is to become elaborated and come into fruition. Similarly, meaning and purpose ascertained from desired possible selves infuses occupations with additional meaning and purpose, supporting the development of occupational identities and reaching occupational potential.
Drawing from the work of Oyserman (2008), Oyserman et al. (2004, 2006, 2007, 2011, 2015, 2017, 2018) and Oyserman and Dawson (2021) who identified that the path and context are as important as the destination, occupational therapists are in the ideal position of establishing what the path may entail in order to support clients and indeed students to reach the goal and aimed for possible self. This model has the potential to guide professional reasoning, enhancing the process of goal setting and ensuring occupational therapy focuses on potentiality and challenging occupational possibilities in order to focus on how life could be in the future.
Importantly, the model also acknowledges which actions should be implemented in the present and which valued, meaningful and purposeful occupations will be vital in realising potential. The hoped-for possible self which requires acknowledgement of the necessary actions and a plan to challenge barriers realistically can be discussion points in the collaborative client centred goal setting process to ensure and enhance possibilities.
Using the interrelationship of occupations and possible selves as a guide, a formulation may be co-constructed to guide intervention. Discussion of how to combat occupational injustices such as occupational imbalance, occupational alienation, occupational marginalisation and occupational deprivation (Durocher et al., 2014) including the importance of maintaining health and wellbeing through balanced occupations is an inherent part of this model which can be used with marginalised groups as well as addressing diversity issues within the profession.
Limitations
This research has limitations. The research did not include public involvement, which would have benefitted the quality of design, findings and dissemination. Member checking did not take place, although participants were offered transcripts for this purpose. This research is qualitative with a big Q (Braun & Clarke, 2022; Finlay, 2021) in that it does not align with the positivist or even post positivist, objective, realist/essentialist epistemological stance, therefore could be criticised for lack of generalisability or scientific rigour. However, it is instead ‘artfully interpretive’ (Finlay, 2021, p. 104) and aims more for transferability, typical of qualitative research. Furthermore, the research explored the lived experiences of 9 dyslexic post graduate healthcare students and this paper reports on five participants, which may be perceived to be a small number. This is due to the limitations of space in this paper which aimed to present the Model of Occupational Potential and Possible Selves. However, the full thesis can be accessed online. The study lacked diversity as all participants were white and experienced their educational journeys within the British context, albeit in different cities and towns. They all attended the same university for their post graduate healthcare courses and were all in the age range of 21-35 years old, thereby excluding (unintentionally) older and younger representation. Future research should consider representation of diverse and intersectional populations and public involvement in design and dissemination. Furthermore, future research can focus on the usefulness and implementation of the Model of Occupational Potential and Possible Selves in occupational therapy and education.
Conclusion
The Model of Occupational Potential and Possible Selves is introduced here, and it is hoped that readers can identify some usefulness to the profession of occupational therapy as well as its use in education in which the barriers and facilitators of occupational potential can be identified in order to support students and occupational therapy clients to reach their potential through occupation.
This article has discussed the importance of congruent and incongruent possible selves showing how environmental factors can facilitate and impede perceptions of self and the future from the viewpoint of dyslexic healthcare students. There are possibilities that incongruent environments can be detrimental to any child and adult and the impact of the augmentative and diminutive environments should never be underestimated. The research shows how identities and possibilities are shaped and challenged by educational experiences in dyslexic children and adults. This research adds to the conceptual knowledge for occupational therapy and education and is the first to identify the significance of these two concepts working together. It is essential that our profession expands, and empirical research continues to develop concepts that can be applied and considered for contemporary occupational therapy. The transitionary and ecological nature of occupational potential and possible selves are considered here together, each informing the other to provide complimentary concepts which have interdependency as well as augmentative tendencies and opportunities. This research led to the introduction of The Model of Occupational Potential and Possible Selves, a model which demonstrates the relationship of agency, occupational identity, occupational potential and possible selves, showing how occupational participation and engagement can be infused with greater meaning when salient possible selves are perceived.
-
Data Availability
The data that support the findings of this study are available from the corresponding author, upon reasonable request.
-
How to cite:
Murphy, A. (2025). A narrative inquiry of dyslexic post graduate healthcare students: presentation of the model of occupational potential and possible selves. Cadernos Brasileiros de Terapia Ocupacional, 33(spe1), e3954. https://doi.org/10.1590/2526-8910.ctoAO405039542
References
-
Asaba, E., & Wicks, A. (2010). Occupational terminology: occupational potential. Journal of Occupational Science, 17(2), 120-124. http://doi.org/10.1080/14427591.2010.9686683
» http://doi.org/10.1080/14427591.2010.9686683 - Asaba, M. E. K. (2005). I’m not much different: occupation, identity, and spinal cord injury in America Los Angeles: University of Southern California.
-
Battistutta, L., Commissaire, E., & Steffgen, G. (2018). Impact of the time of diagnosis on the perceived competence of adolescents with dyslexia. Learning Disability Quarterly, 41(3), 170-178. http://doi.org/10.1177/0731948718762124
» http://doi.org/10.1177/0731948718762124 -
Braun, V., & Clarke, V. (2022). Thematic analysis: a practical guide London: Sage Publications. http://doi.org/10.1007/978-3-319-69909-7_3470-2
» http://doi.org/10.1007/978-3-319-69909-7_3470-2 -
British Dyslexia Association – BDA. Department for Education. (2014). SEND code of practice. Retrieved in 2024, September 25, from https://www.bdadyslexia.org.uk/advice/children/my-childs-education/send-code-of-practice
» https://www.bdadyslexia.org.uk/advice/children/my-childs-education/send-code-of-practice -
Brunswick, N., & Bargary, S. (2022). Self-concept, creativity and developmental dyslexia in university students: effects of age of assessment. Dyslexia, 28(3), 293-308. PMid:35818173. http://doi.org/10.1002/dys.1722
» http://doi.org/10.1002/dys.1722 -
Carless, D. (2010). Who the hell was that? Stories, bodies and actions in the world. Qualitative Research in Psychology, 7(4), 332-334. http://doi.org/10.1080/14780880902951435
» http://doi.org/10.1080/14780880902951435 -
Carless, D., & Douglas, K. (2010). Performance ethnography as an approach to health‐related education. Educational Action Research, 18(3), 373-388. http://doi.org/10.1080/09650792.2010.500085
» http://doi.org/10.1080/09650792.2010.500085 -
Carver, C. S., Lawrence, J. W., & Scheier, M. F. (1999). Self-discrepancies and affect: incorporating the role of feared selves. Personality and Social Psychology Bulletin, 25(7), 783-792. http://doi.org/10.1177/0146167299025007002
» http://doi.org/10.1177/0146167299025007002 - Clandinin, J., & Connelly, M. (2000). Narrative inquiry: experience and story in qualitative research San Francisco: Jossey-Bass.
-
Collinson, C. (2022). Dyslexia and othering: an anti-definitional approach to Lexism. British Journal of Special Education, 49(1), 24-40. http://doi.org/10.1111/1467-8578.12397
» http://doi.org/10.1111/1467-8578.12397 -
Cross, S., & Markus, H. (1991). Possible selves across the life span. Human Development, 34(4), 230-255. http://doi.org/10.1159/000277058
» http://doi.org/10.1159/000277058 -
Darawsheh, W. (2014). Reflexivity in research: promoting rigour, reliability and validity in qualitative research. International Journal of Therapy and Rehabilitation, 21(12), 560-568. http://doi.org/10.12968/ijtr.2014.21.12.560
» http://doi.org/10.12968/ijtr.2014.21.12.560 -
Denzin, N. (2003). Performance ethnography: critical pedagogy and the politics of culture. London: Sage Publications. http://doi.org/10.4135/9781412985390
» http://doi.org/10.4135/9781412985390 -
Douglas, K., & Carless, D. (2013). An invitation to performative research. Methodological Innovations Online, 8(1), 53-64. http://doi.org/10.4256/mio.2013.0004
» http://doi.org/10.4256/mio.2013.0004 -
Durocher, E., Gibson, B., & Rappolt, S. (2014). Occupational justice: a conceptual review. Journal of Occupational Science, 21(4), 418-430. http://doi.org/10.1080/14427591.2013.775692
» http://doi.org/10.1080/14427591.2013.775692 -
Dyslexia-SpLD-Trust. Department of Children Schools and Families. (2009). Identifying and teaching children and young people with dyslexia and literacy difficulties: an independent report from sir Jim Rose to the Secretary of State for Children, Schools and Families. Retrieved in 2024, September 25, from https://www.thedyslexia-spldtrust.org.uk/media/downloads/inline/the-rose-report.1294933674.pdf
» https://www.thedyslexia-spldtrust.org.uk/media/downloads/inline/the-rose-report.1294933674.pdf - Fernan, T. (2021). Imagining ‘possible selves’ as an intervention strategy for incarcerated youth. Acta Criminologica: Southern African Journal of Criminology & Victimology, 34(1), 48-69.
-
Finlay, L. (2006). ‘Rigour’, ‘ethical integrity’ or ‘artistry’? Reflexivity reviewing criteria for evaluating qualitative research. British Journal of Occupational Therapy, 69(7), 319-326. http://doi.org/10.1177/030802260606900704
» http://doi.org/10.1177/030802260606900704 - Finlay, L. (2021). Thematic analysis: the ‘good’, the ‘bad’ and the ‘ugly’. European Journal Qualitative Research in Psychotherapy, 11, 103-116.
-
Frazier, L. D., Schwartz, B. L., & Metcalfe, J. (2021). The MAPS model of self-regulation: integrating metacognition, agency, and possible selves. Metacognition and Learning, 16(2), 297-318. PMid:33424511. http://doi.org/10.1007/s11409-020-09255-3
» http://doi.org/10.1007/s11409-020-09255-3 -
Gilligan, C., Spencer, R., Weinberg, M., Bertsch, T., & Camic, P. (2003). On the listening guide: a voice-centered relational method. In J. Rhodes & L. Yardley (Eds.), Qualitative research in psychology: expanding perspectives in methodology and design. Washington: American Psychological Association. http://doi.org/10.1037/10595-009
» http://doi.org/10.1037/10595-009 -
Levitt, H. M., Motulsky, S., Wertz, F., Morrow, S., & Ponterotto, J. (2017). Recommendations for designing and reviewing qualitative research in psychology: promoting methodological integrity. Qualitative Psychology, 4(1), 2-22. http://doi.org/10.1037/qup0000082
» http://doi.org/10.1037/qup0000082 -
Lindsay, S., Chan, E., Cancelliere, S., & Mistry, M. (2018). Exploring how volunteer work shapes occupational potential among youths with and without disabilities: a qualitative comparison. Journal of Occupational Science, 25(3), 322-336. http://doi.org/10.1080/14427591.2018.1490339
» http://doi.org/10.1080/14427591.2018.1490339 -
MacDonald, S. (2012). Biographical pathways into criminality: understanding the relationship between dyslexia and educational disengagement. Disability & Society, 27(3), 427-440. http://doi.org/10.1080/09687599.2012.654992
» http://doi.org/10.1080/09687599.2012.654992 -
Manzi, C., Vignoles, V. L., & Regalia, C. (2010). Accommodating a new identity: possible selves, identity change and well-being across two life-transitions. European Journal of Social Psychology, 40(6), 970-984. http://doi.org/10.1002/ejsp.669
» http://doi.org/10.1002/ejsp.669 -
Markus, H., & Nurius, P. (1986). Possible selves. The American Psychologist, 41(9), 954-969. http://doi.org/10.1037/0003-066X.41.9.954
» http://doi.org/10.1037/0003-066X.41.9.954 - Markus, H., & Ruvolo, A. (1989). Possible selves: personalized representations of goals. In L. A. Pervin (Ed.), Goal concepts in personality and social psychology (pp. 211–241). New Jersey: Lawrence Erlbaum Associates.
-
Morley, S., Davies, C., & Barton, S. (2005). Possible selves in chronic pain: self-pain enmeshment, adjustment and acceptance. Pain, 115(1-2), 84-94. PMid:15836972. http://doi.org/10.1016/j.pain.2005.02.021
» http://doi.org/10.1016/j.pain.2005.02.021 - Murphy, A. (2017). Possible selves and occupational potential of students with dyslexia: a narrative inquiry (Doctoral thesis). Leeds Beckett University, Leeds.
-
Murphy, A., & Stevenson, J. (2019). Occupational potential and possible selves of master’s level healthcare students with dyslexia: a narrative inquiry. Journal of Occupational Science, 26(1), 18-28. http://doi.org/10.1080/14427591.2018.1517387
» http://doi.org/10.1080/14427591.2018.1517387 -
Nurra, C., & Oyserman, D. (2018). From future self to current action: an identity-based motivation perspective. Self and Identity, 17(3), 343-364. http://doi.org/10.1080/15298868.2017.1375003
» http://doi.org/10.1080/15298868.2017.1375003 - Oyserman, D. (2008). Possible selves: Identity-based motivation and school success. In H. Marsh, R. Craven & D. McInerney (Eds.), Self-processes, learning and enabling human potential dynamic new approaches (Vol. 3, pp. 269-288). Charlotte: Information Age Press.
-
Oyserman, D., & Dawson, A. (2021). Successful learning environments support and harness students’ identity-based motivation: a primer. Journal of Experimental Education, 89(3), 508-522. http://doi.org/10.1080/00220973.2021.1873091
» http://doi.org/10.1080/00220973.2021.1873091 -
Oyserman, D., Bybee, D., Terry, K., & Hart-Johnson, T. (2004). Possible selves as roadmaps. Journal of Research in Personality, 38(2), 130-149. http://doi.org/10.1016/S0092-6566(03)00057-6
» http://doi.org/10.1016/S0092-6566(03)00057-6 -
Oyserman, D., Bybee, D., & Terry, K. (2006). Possible selves and academic outcomes: how and when possible selves impel action. Journal of Personality and Social Psychology, 91(1), 188-204. PMid:16834488. http://doi.org/10.1037/0022-3514.91.1.188
» http://doi.org/10.1037/0022-3514.91.1.188 -
Oyserman, D., Brickman, D., & Rhodes, M. (2007). School success, possible selves, and parent school involvement. Family Relations, 56(5), 479-489. http://doi.org/10.1111/j.1741-3729.2007.00475.x
» http://doi.org/10.1111/j.1741-3729.2007.00475.x -
Oyserman, D., Johnson, E., & James, L. (2011). Seeing the destination but not the path: effects of socioeconomic disadvantage on school-focused possible self content and linked behavioral strategies. Self and Identity, 10(4), 474-492. PMid:22053148. http://doi.org/10.1080/15298868.2010.487651
» http://doi.org/10.1080/15298868.2010.487651 -
Oyserman, D., Destin, M., & Novin, S. (2015). The context-sensitive future self: possible selves motivate in context, not otherwise. Self and Identity, 14(2), 173-188. http://doi.org/10.1080/15298868.2014.965733
» http://doi.org/10.1080/15298868.2014.965733 -
Oyserman, D., Lewis Junior, N. A., Yan, V. X., Fisher, O., O’Donnell, S. C., & Horowitz, E. (2017). An identity-based motivation framework for self-regulation. Psychological Inquiry, 28(2-3), 139-147. http://doi.org/10.1080/1047840X.2017.1337406
» http://doi.org/10.1080/1047840X.2017.1337406 -
Oyserman, D., Elmore, K., Novin, S., Fisher, O., & Smith, G. C. (2018). Guiding people to interpret their experienced difficulty as importance highlights their academic possibilities and improves their academic performance. Frontiers in Psychology, 9, 781. http://doi.org/10.3389/fpsyg.2018.00781
» http://doi.org/10.3389/fpsyg.2018.00781 -
Taff, S. D., Clifton, M., Smith, C. R., Lipsey, K., & Hoyt, C. R. (2024). Exploring professional theories, models, and frameworks for justice-oriented constructs: a scoping review. Cadernos Brasileiros de Terapia Ocupacional, 32, e3638. http://doi.org/10.1590/2526-8910.ctoar27953638
» http://doi.org/10.1590/2526-8910.ctoar27953638 -
Turner, A., & Knight, J. (2015). A debate on the professional identity of occupational therapists. British Journal of Occupational Therapy, 78(11), 664-673. http://doi.org/10.1177/0308022615601439
» http://doi.org/10.1177/0308022615601439 - Turpin, M., & Iwama, M. K. (2011). Using occupational therapy models in practice: a field guide Edinburgh: Churchill Livingstone.
- Walker, O., & Avant, C. (2011). Strategies for theory construction in nursing Boston: Pearson Education Inc.
-
Wicks, A. (2001). Occupational potential: a topic worthy of exploration. Journal of Occupational Science, 8(3), 32-35. http://doi.org/10.1080/14427591.2001.10597273
» http://doi.org/10.1080/14427591.2001.10597273 -
Wicks, A. (2005). Understanding occupational potential. Journal of Occupational Science, 12(3), 130-139. http://doi.org/10.1080/14427591.2005.9686556
» http://doi.org/10.1080/14427591.2005.9686556 - Wilcock, A. (1998). An occupational perspective of health New Jersey: Slack.
-
Yerxa, E. J. (1998). Health and the human spirit for occupation. The American Journal of Occupational Therapy, 52(6), 412-418. PMid:9612490. http://doi.org/10.5014/ajot.52.6.412
» http://doi.org/10.5014/ajot.52.6.412 -
Zárate, M. A., & Garza, A. A. (2002). In-group distinctiveness and self-affirmation as dual components of prejudice reduction. Self and Identity, 1(3), 235-249. http://doi.org/10.1080/152988602760124865
» http://doi.org/10.1080/152988602760124865
Edited by
-
Section editor
Prof. Dr. Daniel Cezar da Cruz
The data that support the findings of this study are available from the corresponding author, upon reasonable request.
