26:T4e6,

Background. Community mental health care has shifted focus from resettlement to empowerment, reflecting a wider agenda for social inclusion. Purpose. This study evaluated mental health day services from the perspectives of thirty-nine clients. Method. Data analysis of the four focus groups explored the implications for occupational therapy. The data collected were subjected to constant comparative analysis and theoretical sampling. Results. Participants described how mental health day services structured their day and enabled access to support networks. However, many perceived aspects of the services as fostering their dependence and threatening sessions they valued. This dependency led to them feeling alienated and wishing to seek greater influence over decisions about their current and future life. The concept of occupational alienation was used to further interpret their situation. Practice Implications. Occupational therapy could overcome occupational alienation experienced by mental health day service clients, through the development of services within and beyond day services which promote a sense of belonging and offers meaningful occupation.

27:T4f7,

Background. What we do has always played a leading part in social conversations about who we are. In part, these social questions are about occupational identity. Purpose and method. Occupational identity is an emerging concept in the occupational therapy literature. In this paper, the concept of occupational identity is examined through the observations of a former research participant in a previous study on the meaning of gardens and gardening in daily life, and the recent work of researchers in occupational therapy and occupational science. Results. Three themes are examined in these reflections. They are occupation and continuity of occupational identity, the contributions of productivity, leisure and self-care to occupational identity and, the public and private aspects of occupational identity. Practice Implications. Exploration with a client about what occupations are most meaningful in her or his life may be a means to understanding the person's construction of an occupational identity. Understanding the nature of the client's occupational identity may be a necessary beginning to developing a collaborative approach to what is needed in occupational therapy intervention.

28:T552,

Background. According to the existential philosophers, meaning, purpose and choice are necessary for quality of life. Qualitative researchers exploring the perspectives of people who have experienced health crises have also identified the need for meaning, purpose and choice following life disruptions. Although espousing the importance of meaning in occupation, occupational therapy theory has been primarily preoccupied with purposeful occupations and thus appears inadequate to address issues of meaning within people's lives. Purpose. This paper proposes that the fundamental orientation of occupational therapy should be the contributions that occupation makes to meaning in people's lives, furthering the suggestion that occupation might be viewed as comprising dimensions of meaning: doing, being, belonging and becoming. Drawing upon perspectives and research from philosophers, social scientists and occupational therapists, this paper will argue for a renewed understanding of occupation in terms of dimensions of meaning rather than as divisible activities of self-care, productivity and leisure. Practice implications. Focusing on meaningful, rather than purposeful occupations more closely aligns the profession with its espoused aspiration to enable the enhancement of quality of life.

29:T4e6,

Background. Orthotic intervention (splinting) may have become an end unto itself in the minds of therapists and clients rather than the means to