Occupation-Based Practice

Defined by the UNH the Department of Occupational Therapy Department
Approved March 2011

Occupations are activities one engages in during daily life - what people spend their time and energy doing. Occupations reflect and support one’s interests and skills, and they help us as humans meet our individual needs and desires.  Occupational pursuits develop roles and routines within a cultural context that give a person a sense of identity and life meaning. Participation in occupations is central to a person’s health, sense of well-being and life satisfaction.   

Occupation-based practice (OBP) reflects the foundational values of the occupational therapy profession and the academic discipline of occupational science, and is congruent with AOTA’s Occupational Therapy Practice Framework (AOTA, 2008).  It is true occupational therapy practice.  The goal of OBP is to improve the satisfaction and capacity of individuals, groups, and society, for engaging in desired occupations where and when they naturally occur.  Such engagement enhances valued roles, positively influences overall health and quality of life, and assists in developing and reaffirming the identity of individuals or groups. Occupational engagement may be supported or hindered by a person’s motivation and body functions, performance skills and patterns, demands of the occupation, and physical, social, cultural, and economic environments. Occupation-based practice addresses any of these factors, acknowledging that optimal performance, satisfaction and meaning occurs within a natural context. OBP is inherently client-centered and collaborative throughout the evaluation and intervention process.  Whether the “client” refers to an individual or group, when practice is occupation-based, occupational therapists begin by gathering information about the client’s occupations, seeking to understand the nature and value of participation in the natural context.  Barriers and supports for occupational engagement are uncovered, and client needs, goals, and priorities are identified so that interventions can be tailored to enhance participation and satisfaction in the performance of desired occupations.  

During occupation-based evaluation, occupational therapists begin with an overt focus on understanding the client’s most relevant occupations and how satisfied the client is with how they are performed.  Occupational therapists observe occupational performance ideally in the natural context, or as closely simulated to where, when and how the occupation typically occurs. Standardized and non-standardized evaluation methods are used to gather information about facilitators and barriers of occupational performance, including client motivation and body functions, performance skills and patterns, demands of the occupation and environmental and contextual factors. 

During occupation-based intervention, occupational therapy practitioners use relevant occupations as their primary means to achieve goals related to performance.  This may include using occupations to establish or remediate client skills and body functions, promote health, or prevent dysfunction. While participating in meaningful occupations, specific tasks might be modified to better match the person’s abilities, or aspects of the environment might be adapted for improved occupational performance and participation.  While occupational therapy practitioners’ intervention is occupation-based, there may be times when purposeful activity and preparatory methods are necessary to promote performance.  When these methods are applied, occupational engagement remains the goal of occupational therapy.  It is the therapist’s responsibility to make the relation between methods and occupational performance explicit during the intervention.  Occupation-based practice clearly remains focused on supporting the client’s active and meaningful participation in daily life.  It enhances the social and community participation of people in their chosen occupations within real life contexts, thereby positively influence health, a sense of well-being, one’s self-identity, and quality of life.