We hear a lot about determining what occupations are meaningful for our clients, but many times simply identifying the occupation itself is not enough. Instead we need to dig further and determine why the occupation is meaningful so that we can be sure to incorporate it in a meaningful context or suggest appropriate alternative occupations when participation is no longer possible.

Context matters.
It is important to realize that the same occupation can be meaningful in one context, and yet not meaningful in another. If we haven’t identified the heart of what makes the occupation meaningful, we may end up trying to engage clients in something meaningless, all the while thinking it will be meaningful.

For example, I enjoy sewing as an occupation and have for many years. At one point I even thought I’d enjoy sewing as a career, but I did not. The difference in context between sewing for those I loved vs sewing for strangers stripped the occupation of its meaning. In the same way, consider the context in which your clients completed their meaningful occupations and try to maintain the same or similar context with interventions.

Motivation matters.
Have you ever enjoyed a specific occupation until you were required to do it? Perhaps you enjoyed cooking the occasional meal for your family until you went away to college and had to cook every meal. Or perhaps you enjoyed taking long drives in the country for pleasure until you had to make a 45 minute commute to work every day.

If you’ve experienced anything like this before with occupations you love then you’ve witnessed how motivation matters. Keep this in mind if you find yourself setting goals for, instead of with, your clients. It’s possible that simply because you told them they need to do something, it may no longer feel meaningful to them.

Process and procedures matter.
The actual process and procedures used in the performance of the occupation matter, too. A client may tell you they enjoy cooking, but do they cook from scratch or use mixes? If they like woodworking, do they do hand tools or power tools? If they garden, do they grow plants from seed or purchase transplants?

In some cases, simplifying the occupation by grading it down in this way can allow clients to maintain participation, but in other cases it may change the occupation so significantly that it is no longer recognizable (or meaningful) to the client. Keep this in mind as you develop interventions and work towards goals. If a client seems uninterested in something you thought would be meaningful, take a step back and consider the way you’re engaging them in the occupation and how this compares to the way they’ve previously participated.

Performance matters.
The reality is, sometimes clients can no longer perform an occupation at the level they view as satisfactory. For them, continued engagement in that occupation may be a constant personal reminder of what they can no longer do. And that can make participation in the occupation depressing rather than meaningful.

Alternatively, you could introduce a new occupation with similar aspects to the one they previously excelled at, but still different enough that it allows them to view themselves as beginners and to lower their personal expectations of performance. The challenge is finding an occupation that will be meaningful to them, but if you’ve taken the time to explore why prior occupations were meaningful, it can be easier to identify possible alternatives.

Occupations can be meaningful for so many reasons, and those reasons can vary significantly from client to client. By taking the time to identify not only the occupations themselves but also the reasons our clients find those occupations to be meaningful, we can more successfully develop interventions and assist our clients through the occupational therapy process and to a mutually satisfying discharge.