Background and Purpose.Despite the potential in occupational therapy models, there has been little investigation of the ways social class may affect occupations or occupational therapy. This paper explores the occupational impacts of poverty.Methods.Essays by 17 occupational therapy students, who identify as lower class, were coded and analyzed inductively.Results.Class-based shame and stigma led to attempts to “pass” as middle class-an occupation consuming time and energy. Exclusion from middle-class leisure occupations left students with gaps in their adult knowledge. Family was a site of both shame and safety, as well as pressure to succeed. Educational occupations embody marginalization.Practice Implications.Class is not only about money, but also having the right norms, values, and experiences to fit easily in middle-class society. Educational and health care institutions epitomize middle-class assumptions. The experiences of these students may help therapists to examine where they unwittingly enact middle-class norms in practice.
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