Monday, April 4, 2011

OT A to Z: C is for Context

The letter "C" seemed to offer many opportunities to explore, such as the array of topics suggested by @clissa89: cognition, creativity, client-centered, children, culture, and context! Whereas other professions also address many of these areas, I think context is something uniquely considered by OTs. So, today, C is for Context!!

The concepts for environment and context are often considered together and these terms may even be used interchangeably. Context is defined in the Occupational Therapy Practice Framework (AOTA, 2008) as interrelated conditions that surround the client and are within the client. These include cultural, temporal, personal, and virtual. Context is distinguished from environment in that environment refers to the external situations that surround the client to include the physical and social environments. In general, OTs emphasize occupational performance at the intersection of the client, the context and environment, and the activity.

The cultural context is includes the customs, beliefs, activity patterns, and behavioral expectations accepted by the society of which the person is a member. The temporal context is the experience of time as shaped by occupational participation and includes aspects such as time of day, duration of activity, rhythm, tempo, and stage of life. The personal context considers aspects of the individual that are not part of the health condition and includes things such as age, gender, as well as socioeconomic and educational status. Finally, the virtual context is when communication occurs in the absence of physical contact and may be real-time or asynchronous.

The aspect of context that I have spent the most time thinking about recently is that of cultural context. I am fortunate to co-teach a service learning course in Belize for OT students and we spend a lot of time considering the cultural context of the adult and pediatric clients we serve while we there. Immersion in another culture is such a profound way to experience cultural aspects of occupational performance - everything from the value of various occupations to the manner of engaging in occupations. It is a powerful learning experience as we strive to better understand the cultural context and, perhaps most importantly, not relay on or emphasize aspects of our cultural context.

In thinking about context, do you
  • tend to specifically address aspects of context in your assessment and intervention, or are they aspects you consider as part for of the whole picture when working with your clients and families?
  • emphasize one of the aspects of context more frequently that others?
For you personally, what aspect of your contexts either support or hinder your occupational performance?

American Occupational Therapy Association. (2008).Occupational therapy framework: Domain and process(2nd ed.). American Journal of Occupational Therapy, 62,625–683.


  1. I have had Doris Pierce's (2003) wheel drummed into me and consequently consider people in terms of spatial, temporal and sociocultural contexts. Really like the inclusion of 'virtual' context though!

    Temporal context has the biggest influence on my occupational performance. I value punctuality highly, live by my diary and watch and can't function without the 'correct' amount of sleep. My most commonly used phrase at the minute is "I don't have the time" or "I could have spent that time better if...".


  2. I value punctuality but am notoriously unpunctual, I'm rubbish at negotiating time, always trying to fill every second of it with too much. I'm hoping that gradually I'm readjusting this to create the just right challenge for my students in terms of how much I expect us to complete in a session.
    I still manage to be at least 5 minutes late everywhere (sorry everyone) even if I think I've left on time.
    I think we tend to underestimate cultural aspects and forget that there are so many sub cultures that each have their own rules. I think asking clients about what they believe or what is important should form part of our assessments. It's also why I would be an advocate of taking that little bit of extra time to chat and get to know the client as a person too (despite the pressure of stats and seeing so many clients a day - quality not quantity, indeed I think that some of the negative reviews people have given OT is where we haven't done that, listened and heard!)

  3. Hi Bridgett I am currently a student obtaining my masters in occupational therapy. I have been to Belize for medical volunteer work and am curious about the work you do there. I enjoyed my experience there greatly and would love if you could expand more on the program you work with there?