Transformative learning involves the questioning of worldviews and underpins shifts in values and identity that are integral to critical occupational therapy practices. Cognitive theories of transformative learning name, but do not address, the experiential dimensions of transformation. The aim of this article is to conceptualize transformative learning from the perspective of narrative phenomenology in occupational therapy. An argument is presented that draws on research in occupational therapy professional reasoning and that makes visible the dimensions of transformation that are inherently experiential and meaning oriented. Three key concepts for a transformative pedagogy are defined and illustrated: scenes, emplotment, and embodied metaphors. The article concludes with the types of learning objectives for which this approach is suited and the pedagogical values that underpin these teaching practices. This article adds to the domain of health care education by defining and illustrating experiential and meaning-based practices as signature pedagogies for transformative learning.

Metaphors are powerful devices for eliciting images of practice. Exploring the metaphors of occupational therapy students provides educators with insight into students’ prior knowledge and the constraints their ideas may present in practice. Metaphorical images of helping held by newly enrolled and Level II fieldwork students were examined. Responses to a structured, open-format questionnaire revealed that the two groups were in agreement about conceptualizations of helping. The findings suggest two overarching themes: (1) the importance of client-centered practice and (2) the inevitability of client autonomy and responsibility. These results imply that educators must prepare students to face the realities of practice: working with unmotivated clients and engaging them in meaningful occupations. Thus, a continued emphasis on client-centered practice and the requisite listening skills for a therapeutic alliance are needed. Research should build on the insufficient knowledge of what happens to identity development in the transition from curricula to practice.

Our daily round of occupations occurs within time and space. Our understanding of occupation has traditionally viewed time and space as part of the external environment. Patterns of the “when?” and “where?” of occupations can be described. But relating time and space to the internal experience of occupation reflects more of the meaning to individuals and more complex patterns arise. Like the varied bits of glass in the object case of an art kaleidoscope, the multiple elements of occupation interact. Reflected in mirrors of our choice, we find always-changing, complex patterns of daily occupation. The elements of occupation most important for maintaining or regaining health and the mirrors and lens through which we view occupation historically have formed shifting patterns in occupational therapy, patterns of how we view ourselves, our practice, and those to whom we provide our services. We must combine the science and the art of occupational therapy as the metaphor of the kaleidoscope combines both, producing awe and wonder at the result.

As the demographics of the United States continue to change and we become a more pluralistic society, the increased diversity of the occupational therapy workforce and our consumers calls for an examination of the profession’s stance on multiculturalism and diversity. Using the metaphor of dance, this article identifies the dance partners as the organization’s leaders and its members. A historical review of the profession from the 1940s to the present traces the partners’ steps to determine which led the dance of diversity during the profession’s development. In this review, I discovered that the period when the profession most effectively and productively explored issues of diversity was during the early- to mid-1990s—a time when the organization and its members worked in harmony. At that time, occupational therapy’s dance with diversity flowed with rhythm and synchronicity.

The term confluent education describes a flowing together of the affective and cognitive elements of learning. Confluent education accords high value to affect because of its core principle that the realization of human potential includes attention to the affective elements of human nature. This article reviews the literature on confluent education, extends a previous introduction of the topic, and proposes an integration of affect into all realms of occupational therapy practice. The visual metaphors, philosophical principles, and practical strategies developed in the literature on confluent education are useful when applied to the functions of occupational therapy practitioners engaged in direct care, education, or research. Because the contexts within which occupational therapy practice occurs today often challenge its affective elements, the author proposes confluence as a timely approach. To advance into the future with the affective strength that has characterized occupational therapy since its inception is a matter of reclaiming the profession’s heart.

Objectives. This article describes the relationship of mothers’ orchestration of daily occupations, the specialized maternal work of parenting a child with a disability, and the mother’s subjective well-being. Method. Mothers’ daily occupations and subjective well-being were studied using multiple in-depth interviews, participant observation of a day’s round of occupations, and scales of well-being. Data were treated to a recursive analysis, which included theoretical notes generated during transcriptions that identified important themes and additional points of inquiry, line-by-line coding of transcripts, and theoretical sorting of codes and regrouping, recoding. To account for patterns in the data, a relational analysis was conducted that included the generation of metaphors. Results. Emergent findings of this analysis identified the mothers’ guiding occupational motif and eight processes of orchestration in their daily routines. The occupational motif, the embrace of paradox, directed the mother’s orchestration of daily occupations. The orchestration processes included planning, organizing, balancing, anticipating, interpreting, forecasting, perspective shifting, and meaning making. Examples illustrate the maternally driven and child-sensitive nature of these processes. Conclusion. In their daily rounds, the mothers studied were attentive to the manner and method with which they interacted with their children to produce child-contingent occupations commensurate with their values of being a good mother. Using these orchestration processes, mothers made sense of their past, designed their present, and planned for their future within their daily occupational rounds for themselves and family members.

This article employs a metaphor of weaving in order to analyze, both historically and critically, the art and science of occupational therapy. To spark reflection about where occupational therapy has been, is now, and would like to progress as the new century approaches, the article is thematically organized around the profession’s two most fundamental convictions. These convictions are termed the warp and weft of occupational therapy. The warp of occupational therapy is defined as our philosophical belief that engagement in occupation can favorably influence health. The weft of occupational therapy is defined as our humanistic value of respect for the person. Occupational therapy is, in turn, regarded as a powerful tapestry of human potential that unfolds when this belief and value are therapeutically applied. By analyzing selective clinical, educational, and research initiatives throughout this century, the article is dedicated to the continued adherence to, and development of, occupational therapy’s core principles.

Objectives. A phenomenological study was conducted to gain understanding of the nature of the lived experience of doing occupational therapy. Method. One hundred and forty-eight occupational therapists nationwide were asked to describe especially satisfying and dissatisfying experiences of practice. The resulting narrative data were analyzed with dimensional analysis techniques. Results. With the metaphor of therapy as story, three overarching dimensions of practice were derived from the narrative data: Change, Community, and Craft. The dimension of Change is strongly related to the ending or outcome of the story, Community encompasses the harmony or disharmony of the interrelationships in the shared story, and Craft includes both the skills of therapy and the broader core experience of doing therapy. Conclusion. These findings are complementary to the three-track mind discussed in the clinical reasoning study and contribute further to our understanding of the experience of doing occupational therapy.