Reinforcing occupational performance, engagement, and participation as the core concepts of occupational therapy

Background. The core concepts of occupational performance, occupational engagement, and occupational participation are unique to the occupational therapy profession. However, their definitions and applications are inconsistently presented across conceptual models of practice and have been challenged within the occupational therapy and occupational science literature. Objective. This study aimed to describe the discursive controversies presented within the occupational therapy literature for the inclusion or exclusion of the three core concepts within occupational therapy. Methods. A conceptual review of the literature was undertaken to uncover applications and controversies of the three core occupational concepts. Each concept was analysed based on its features, attributes, and characteristics (Podsakoff, 2016) through an anti-oppressive lens. An anti-oppressive lens within occupational therapy focuses on minimizing discourses and practices that exclude or limit certain social groups from achieving occupational equity and rights through autonomous informed decision making about their occupational lives. Results. The applications of the three core concepts appeared to be distinct, yet, related, and covered the breadth of occupational outcomes desired across social groups. Removing core concepts would lead to occupational inequities. Conclusions. The inclusion of all three concepts as core outcomes of occupation-centred practice ensures the professions focus on occupational equity across diverse social groups.