British Journal of Occupational Therapy

The term ‘occupation’ is both ambiguous and encompassing. This term was adopted by the founders of the profession as a means of incorporating a variety of perspectives on the profession. Interrelating concepts deriving from pragmatism and the mental hygiene movement offer a rationale for understanding occupation. Terms used to describe occupation are egocentricity (mind/body elements), exocentricity (time/space elements) and consensuality (social elements). The integration of these aspects in occupation offers an explanation for the holism advanced by the profession at its outset and today.

This article discusses a social cognitive theory called action identification which suggests that the manner in which an action is identified can facilitate behavioural change. Although an action can be identified in many ways, this psychology theory delineates that actions that specify how the action is done are considered a low level identity while actions that signify why the action is performed are at a high level of identity. The level of identification taken by an individual reflects a trade-off between concerns for a comprehensive understanding of the action and how to maintain effective action. Individuals can move between these levels and, in doing so, can change the way in which they view themselves and their world. After a description of the theory and the presentation of two examples of research that document the utility of the theory, application to occupational therapy is suggested. Specifically, action identification theory may explain how the doing in therapy benefits patients more than only verbalisation.

Work may be defined in a number of ways and cover a variety of activities. As well as paid work, it can cover such activities as hobbies, housework, voluntary work and do-it-yourself. It is an important factor in promoting mental health. Meaningful work may actually reduce a client's psychiatric symptoms. A work rehabilitation programme needs to cater not only for those able to progress to open employment but also for those needing supported or sheltered employment. Consequently, the programme should Include a thorough work skills assessment, work adjustment and work skills training, sheltered employment and transitional/supported employment leading, finally, for those who are able, to open employment.

Anger management is a treatment that is of topical interest, particularly to those occupational therapists working with individuals who display problematic anger and aggression. A reliable measure on which to base treatment is essential. This article advocates the use of the Novaco Anger Scale as such a measure, and demonstrates how it can contribute to the planning and provision of a custom-built treatment intervention based on the Novaco anger control procedure.

A new assessment of hand function, the O'Neill Hand Function Assessment, has recently been developed on an Irish adult population. The assessment is based on a commonly used grip classification of the hand and it also contains a non-prehensive section. There are eight tasks In the final version of the assessment. The instructions allow for a description of both the manner of performance (criterion-referenced section) and the speed of performance (norm-referenced section) of the tasks in the assessment.

Reliability studies have been performed on the tasks in the assessment, with high inter-rater reliability (0.96–0.99) and moderate test re-test reliability (0.54–0.79). There is also a description of the validity of the assessment and the total score in the assessment appears to correlate highly with the Nine Hole Peg Test (0.98). The normative data for the speed section are based on 140 non-disabled adults. The assessment has also been applied to 38 orthopaedic and rheumatology patients. The O'Neill Hand Function Assessment appears to fulfil the basic criteria for a standardised assessment.