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Iðjuþjálfun í ljósi gagnrýnna sjónarhorna. Umfjöllun um verk K. W. Hammell og gildi þeirra fyrir iðjuþjálfun á Íslandi.

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Authors
Snæfríður Þóra Egilson
Guðrún Pálmadóttir
Issue Date
2018

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Snæfríður Þóra Egilson, Guðrún Pálmadóttir. Iðjuþjálfun í ljósi gagnrýnna sjónarhorna. Umfjöllun um verk K. W. Hammell og gildi þeirra fyrir iðjuþjálfun á Íslandi. Iðjuþjálfinn. 2018; 39: 6-13.
Abstract
Iðjuþjálfun á Íslandi byggir á hugmyndum og vinnubrögðum sem hafa orðið til og eru almennt viðtekin í hinum vestræna heimi. Þrátt fyrir ólíkar aðstæður og menningarlegan margbreytileika hafa ýmsir fræðimenn talið eðlilegt að yfirfæra þessi sjónarmið og aðferðir yfir á meginhluta mannkyns. Kanadíska fræði konan Karen Whalley Hammell hefur hvatt til umræðu um fræðilegar undirstöður iðjuþjálfunar og iðjuvísinda. Skrif hennar einkennast af gagnrýnum sjónarhornum þar sem hún rýnir í og dregur í efa margt af því sem iðjuþjálfar hafa hingað til gengið að sem gefnu, sérstaklega áherslu fagsins á sjálfstæði og einstaklingshyggju frekar en gagnkvæmni og félagsleg sjónarhorn. Í þessari grein eru rakin skrif Hammell á árunum 2004-2018 og efni þeirra tengt skrifum annarra fræðimanna um svipað efni eftir því sem við á. Tekin eru fyrir þau málefni sem hún hefur einkum beint sjónum að, það er að segja flokkun og gildi iðju, skjólstæðingsmiðuð nálgun, menning ar leg auðmýkt, rétturinn til iðju og færni nálgunin. Umfjöllunin er tengd við ólíkar að stæður fólks, almenn mannréttindi og félagslega undirokun ákveðinna hópa. Þótt umfjöllun Hammell geti verið ögrandi þá lýsir hún líka trú á iðjuþjálfun sem fagi og þeim ólíku möguleikum sem í því búa. Gagnrýna umræðu má nýta á uppbyggilegan hátt og íslenskir iðjuþjálfar eru hér með hvattir til að beina sjónum sínum í auknum mæli að hinum ólíku aðstæðum og valkostum sem fólk býr við og hvernig þau hafa áhrif á og móta líf þess. Þá er mikilvægt að iðjuþjálfar hasli sér völl á fjölbreyttum starfsvettvangi og taki þátt í stefnumótandi aðgerðum sem stuðla að möguleikum fólks til að eiga hlutdeild í iðju sem gefur lífi þeirra merkingu og stuðlar að auknum lífsgæðum. Ör fjölgun og hækkandi menntunarstig iðjuþjálfa á Íslandi fela í sér tækifæri til aukinnar fjölbreytni í starfi.
Occupational therapy in Iceland is based on theoretical ideas and practices that have been developed and are generally accepted in the Western world. Despite global diversity and different circumstances, some leading scholars have thought it appropriate to present these culturally-specific assumptions and practice procedures as universal and applicable to the whole world. Karen Whalley Hammell, a Canadian scholar, has encouraged the occupational therapy community to commence a critical discussion about the theoretical foundations of occupational therapy and occupational science. Her writings are characterized by such critical perspectives as she questions current occupational therapy ideology and practice, especially the emphasis on independence and individualism rather than interdependence and social perspectives. This article provides an overview of Hammell’s writings during the last fourteen years and, when appropriate, the content draws on writings of other scholars. The focus is on specific issues that Hammell has emphasized, such as occupational classification, client-centred practice, cultural humility, occupational rights, and the capability approach. The discussion is linked to different contexts, human rights, power relations, and social oppression of certain groups. From early on Hammell has argued that many of the profession’s assumptions and claims are culture-specific, reflecting the lives of people who are independent, autonomous and productive at the labour market. This is for example manifested in the traditional classification of occupation by its purpose into self-care, productivity and leisure rather than by the meaning it has to people. Furthermore, through her critical analysis of client-centered practice she has identified several means by which power is held and exercised by the occupational therapy profession and socially and culturally specific ideologies are maintained. During the last ten years Hammell has increasingly turned her focus towards the issue of occupational rights and used the capability approach as a tool to demonstrate the role of occupational therapists in advancing people’s possibilities to engage in meaningful occupations. Even though Hammell’s arguments can be challenging for occupational therapists, she also expresses faith in the occupational therapy profession. We, the authors, encourage Icelandic occupational therapists to use her critical discussion constructively to enable people’s right to engage in meaningful and purposeful occupations through an emphasis on their opportunities to do what they have abilities to do. This includes an in creased emphasis on the way in which different con texts, barriers, and opportunities affect and shape the lives and well-being of people and communities. Increasing number and higher educational level of Icelandic occu pational therapists has the potential of opening up diverse possibilities for practice in a wide range of settings, including health and social policymaking, with the aim of promoting people’s potential for occupational engagement. Then occu pational therapy will become even more important, relevant, and valuable to Icelandic society.
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