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Occupational Therapy International, 7(2), 8798, 2000 Whurr Publishers Ltd

Occupational science:
A renaissance of service to
humankind through knowledge

ELIZABETH J. YERXA University of Southern California, Los Angeles, CA,

USA
ABSTRACT: The context for the development of occupational science, the study
of the human as an occupational being, included the worldwide increase in the population of people with chronic impairments, decreased resources for people with
handicaps, growth in the complexity of daily life and the global maturation of the
profession of occupational therapy. Occupational science promises that occupational therapists will define the knowledge base of the profession and its appropriate
scope of practice through scholarly work. Occupational scientists need to develop a
fresh synthesis of ideas from those scholarly disciplines that view the human as a
complex being who interacts with the environment by using occupation over the
three time spans of evolution, human development and learning; occupation as
agency; and viewing the person served as Homo occupacio, a dynamic, open
human system. The occupational human engages in daily life through development
of a repertoire of skills which adheres to the rules of culture. Such study will need to
include the contexts in which people carry out their rounds of occupation. The
detective work of occupational scientists, contributing to but not bound by the
immediate demands of occupational therapy practice, will be guided by the values
and traditions of the field to ensure its relevance and ethical foundation. The most
important tool of the world community of occupational therapists will be the mind
of the occupational therapist, who, through knowledge of occupation, will foster
human capability and influence health.
Key words: occupational science, occupation, agency, health, doctoral study.
Introduction
One of the most exciting pathways of my lifelong professional journey is the
road to the development of occupational science (Yerxa et al., 1989; Yerxa,
1993). I welcome the opportunity to explore this terrain with my esteemed

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colleagues from all over the planet who have joined in our adventure. We
search for new ideas which can contribute to a renaissance of service to
humankind by an occupational therapy profession which defines itself through
knowledge while being true to its values and traditions.
The journey begins with the context of the birth of occupational science.
What local and global conditions fostered the search for such a powerful set of
ideas? Then, how did our version of occupational science develop at the University of Southern California? What are some of the important ideas which
seem fruitful for investigation by occupational scientists in the year 2000?
And finally, what implications might occupational science hold for our profession as we enter a new millennium?
The context
Occupational science, the study of the human as an occupational being,
turned out to be a set of ideas whose time had come. On a global level it was
stimulated by such trends as: (1) the increasing population of people with
chronic impairments which impeded their participation in the daily life of
their culture (Guerrero et al., 1999); (2) public policy debates about both the
needs and rights of such people, including their desire for equality of capability
(Bickenbach, 1993); (3) the decreasing role of governments in providing
material resources for people with handicaps, with cost-curtailing attempts to
circumscribe the practice of all health professions; (4) cutting-edge new
approaches for the study of acting human beings in real-life contexts
(Csikszentmihalyi and Larson, 1984; Lincoln and Guba, 1985); (5) the mindboggling growth in the complexity of daily life with resultant problems in
organizing and using ones time, orchestrating ones activities, balancing roles
and achieving competence and satisfaction through occupation (Hochschild,
1997); and (6) a readiness for occupational therapists to leap into the
unknown waters of concepts and ideas because of the worldwide maturation of
our profession. This latter growth was inspired by the twin forces of the global
move of occupational therapy education away from technical schools into
universities, with increasing emphasis on ideas and postgraduate study, and
growing excitement and pride about occupational therapy practice and its
potential to serve humankind (Mounter and Ilott, 1997). For example, our
profession could advocate a new idea of health that would not exclude people
with chronic impairments (Pfeiffer, 1999). This contribution would require
that occupational therapy define its own knowledge base and from that create
its own definition and scope of practice.
People with disabling conditions are often categorized as sick by traditional
definitions of health even though they participate in the daily routines of their
culture. They are not ill but simply have impairments as most humans do at

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some time in their lives. The traditional definition of health as absence of

pathology leaves a large segment of this population in exile. Through knowledge
occupational therapists could promote an alternative definition of health that
includes people with impairments in the mainstream of society (Prn, 1993).
History of the University of Southern California (USC)
In the early 1980s, our faculty, postgraduate students and key clinicians
formed a community of scholars to develop and test ideas. We were eager to
further the intellectual traditions of former faculty members Mary Reilly and
A. Jean Ayres, both of whom epitomized creative scholarship and commitment to postgraduate education as essential to nurturing practice.
Our community, through a great deal of study, dialogue and critical thinking, saw the need for a scholarly doctoral programme focused on occupation.
Such a curriculum, based on our vision of relevant knowledge, would support
education and research at a high level of sophistication, contribute to further
innovation in occupational therapy practice and fulfil our responsibility to the
university by generating new knowledge.
In carrying out our mission we developed an essential resource called the
Center for the Study of Occupation. It served as the repository for our
research and teaching materials, which were made available to the entire
community to foster our scholarship.
We decided that the new doctoral programme should fit the criteria for a
Doctor of Philosophy degree that is, that it be a scholarly and not an applied
course of study. This decision underlined our view of occupation as a rich,
universal concept worthy of serious study, requiring unconstrained exploration
for its understanding. We wanted to generate not a model of practice, but the
basic knowledge necessary and sufficient for practice (Reilly, 1969).
In developing the PhD curriculum we first considered the uniqueness of
occupational therapy practice, identifying relevant sources of knowledge
needed to support it. Simultaneously we articulated our philosophy, especially
our view of the person. This would assure that our science would be congruent
with the history and traditions of the field.
Significant to the success of our efforts was reaching out to other academic
disciplines. We presented our ideas to them, sought opportunities to do collaborative research, connected with their theories and concepts, and urged
our students to enrol in their courses. We were gratified by seeing growing
enthusiasm for occupational science among leaders from other academic units
and witnessing their Aha! reactions as they gained new understanding of the
ideas supporting occupational therapy.
The Doctor of Philosophy degree in occupational science was approved by
the graduate school in 1989. Subsequently, 20 individuals have obtained PhD

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degrees in the programme. I am no longer the chair of the department but am

deeply impressed by the work continuing at USC. As we had hoped, occupational science is having a positive impact on occupational therapy education,
practice and research, while blossoming into a bona fide academic field of
study.
The programme at USC represented our own vision of occupation. As is
often the case with new emerging paradigms, other academics from occupational therapy schools around the world were simultaneously developing their
perspectives on occupational science. For example, I had contact with those
in Australia, Canada, Sweden, England, Finland, Japan, Taiwan, Ireland,
Scotland and Wales. I was gratified to meet Ann Wilcock in Australia and
continue to cheer her vision in launching the Journal of Occupational Science:
Australia. Dr Wilcock, other academics and I soon discovered that we were
exploring similar terrain and using congruent words to describe it. We could
converse in the language of occupation in spite of differences in culture and
environments. It was a global idea whose time had come.
Significant concepts for scholarly investigation
I continue to study occupation as an independent scholar because, now that I
have retired, I am no longer working with a community. Therefore, the
remainder of this paper will consist of one persons perspective my own on
the future of occupational science.
I assume the following: (1) that occupational science has such a rich
potential and so many facets that it will need to be developed by an array of
scholars from occupational therapy academic programmes worldwide (no
single person or school owns it); (2) our profession needs new knowledge to
enable it to fulfil its covenant with society by improving and legitimizing our
practice; (3) a true profession develops its own configuration of knowledge
grounded in its own traditions and values. It is not defined by other disciplines.
Science
Because occupational science is an emerging discipline its realization will
require the creative work of discovering and synthesizing ideas from other relevant fields of study into a fresh configuration. Reilly called this process doing
our detective work. Such sleuthing will create a new pair of glasses through
which we may view the human as an occupational being. These lenses will
enable us to see the people we serve with new clarity, enabling us to do a better job.
For occupational science, research goes beyond the traditional hypothesis
testing, independent and dependent variables and statistical analysis by
emphasizing scholarly investigation which searches out new ideas and puts

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them together in revolutionary new ways according to the rules of scholarship

(Yerxa, 1994). This synthesis will address questions of the greatest importance
not only to occupational therapists but to global society as a whole. Such
queries begin with courageously studying the interactive complexity of both
the human and occupation. For example, how did the human evolve as an
occupational being, using skill in order to adapt to changing environmental
challenges over aeons of time? How does a single human develop into an occupational being throughout the span of one life in order to become competent
in the occupations expected of his or her culture? And, finally, how does each
human learn the skills required to pursue our interests, achieve our goals, survive, contribute and find our own unique place within our culture? As
Montgomery (1984) suggested, our science needs to address the three time
spans of evolution, development and learning. Occupational science needs to
be basic enough to explore freely but grounded enough to contribute to the
development of our profession.
Occupation
Notice that occupation is what humans do when they act as agents of their
own intentions in order to achieve a goodness of fit with their environments.
Occupation is therefore self-initiated, self-organized activity which is goaldirected (even if the goal is to have fun) and contextualized in a specific environment over a span of time. It is energized by unique interests and expressed
as skill, which enables people to be competent, participating, productive
members of their culture; in place by virtue of their capabilities, finding symbolic meaning through agency.
Each culture classifies its relevant occupations conceptually for example,
as play, work, leisure, sleep and rest. These categories answer the question,
what are you doing? and to some extent, why? A persons experience of the
day-to-day quality of life seems to be constituted of engagement in such occupations organized into a repertoire.
View of the person
A person may be viewed from different perspectives according to emphasis;
for example, Homo sapiens (wise), Homo symbolicus (symbolic) (Deacon,
1997), Homo faber (tool maker) (Arendt, 1959), Homo ludens (player) and so
on. The Latin root, occupacio, means to seize or take possession. I take this to
mean that Homo occupacio, the occupational human, is seized by his or her
occupations and in so doing takes possession of his or her world. How might
Homo occupacio be described and understood?
First, such a person might be seen as engaging in occupation as a multilevel, dynamic, open human system who interacts with the environment
through the use of hands, mind and will (Reilly, 1962). Thus to understand

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such engagement we need to ascertain how the biological, psychological, cultural and symbolic-spiritual levels of people contribute to and are affected by
their occupations. For example, play is an occupation requiring a biological
unfolding for its spontaneity, which contributes to significant learning
through exploration, develops a sense of agency, creates the ability to assume
appropriate social roles (Vygotsky, 1978) and offers exposure to the rituals of
ones culture, with rules and symbolic meanings. Play also takes place in an
environment that affords both challenges and opportunities. To understand
Homo occupacio requires addressing all of these levels in interaction with the
qualities of the environment.
In my next life I should like to focus on the study of play because it represents such a rich prototype of occupation, involving all levels of the human
system in interaction with the environment. Play makes an essential contribution to human development and learning (Reilly, 1974) but its significance is
largely unappreciated both by scientists and ordinary people.
In a stimulating work, Lakoff and Johnson (1999) showed that most
abstract concepts used in everyday communication as well as in science and
philosophy are metaphorical, and thus metaphors constitute a primary tool of
thought and language. What is the source of such a pervasive way of thinking?
Through providing overwhelming evidence, these authors showed that
metaphor is embodied. It is grounded in common human body experiences
such as encounters with objects, space, time and movement (Lakoff and Johnson, 1999). For example, human purposes metaphorically are translated into
desired objects, as in I saw an opportunity for success and grabbed it (1999:
53). This metaphor is based on grasping a coveted object (correlating satisfaction with holding a desired physical object).
I see that this work, connecting newly emerging, interdisciplinary cognitive science to everyday experience, underlines the importance of the childs
intense involvement in play and exploratory learning for the development of
thinking and communication skills, although the authors did not discuss such
an implication. It seems to substantiate the significance of the embodied
experience of play and its outcome of learning the rules of objects, people and
motion (Reilly, 1974).
It is stimulating to learn that other metaphors used to describe achieving a
purpose are also derived from occupations. For example, achieving a purpose is
getting something to eat (shes hungry for success), hunting (Im shooting for a promotion), fishing (its time to fish or cut bait) and farming (these are the fruits of
his labour). Thus, embodied experiences of occupation in play and in the real
world influence how human systems learn to think and communicate about
all significant components of life. Lakoff and Johnsons work (1999) showed
the importance of this embodied learning to being able to participate in society, thus supporting the use of play and other occupations as therapy.
Our science needs to address how people set goals, make conscious
choices, define themselves and become responsible for themselves through

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engagement in occupation. How do they become effective managers of their

own environments by orchestrating their occupations in daily life? How do
they use their time to achieve a healthful balance of occupations while fulfilling social expectations?
The occupational human has unique interests providing the motivational
energy to engage in occupation and withstand the frustration accompanying
learning new skills. We need to study the development of interests, exploration, curiosity, the search for novelty and active seeking of challenge. These
are often subsumed under the rubric intrinsic motivation (Csikszentmihalyi,
1975; Burke, 1977; Kohn, 1993).
Homo occupacio is a self-organizing system who responds to specific environmental challenges with occupation creating an adaptive response. This successful self-organization leads to skill being available in the face of new, unknown
challenges. Thus, by engagement in occupation, the individual modifies and
develops a unique nervous system (Edelman, 1989; Donald, 1991; Deacon,
1997). My play and work literally help to construct who I am. Occupation and
the brain seem to develop cooperatively in a co-evolutionary process.
New knowledge from the interdisciplinary study of evolution of the nervous system provides better understanding of the individuality, flexibility and
plasticity of the evolving, developing mind. It seems that the brain develops
new connections and capacities through use, including occupation. It is so
flexible in its structuring that the individual develops many redundant neurological capabilities. These result in the person acquiring multiple ways of
achieving the same function (for example, throwing a ball) (Deacon, 1997).
New understanding of how the self-organizing brain develops might apply to
sequencing occupational therapy for people with impairments, suggesting new
ways to pose environmental challenges to achieve capability.
The occupational human is one who has skills and resources as products of
evolution, development and learning. Thus, occupational scientists emphasize
what people can or might be able to do rather than deficits and pathologies.
We view Homo occupacio in an optimistic light, as Meyer and Vygotsky did.
We ask, what can this individual do that he or she believes is worth doing
(Vash, 1981)?
The occupational human engages in daily life through development of a
repertoire of skills which adheres to the rules of culture and uses habits to
conserve energy. These repertoires enable people to manage their own environments. Therefore, occupational scientists need to learn much more about
the daily routines that enable people to do what they need and want to
accomplish to find their place in the culture (Beisser, 1989). Our concept of
the activities of daily living needs to be broadened beyond self-care to include
the entire repertoire of daily routines. We need to become ardent students of
all of lifes daily activities.
As occupational beings, humans may learn to regulate their emotions by
engaging in occupation (Donaldson, 1992). We need to know much more

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about the relationship between engagement and occupation and attainment

of emotional balance, life satisfaction and happiness. For example, Frankl
(1984) posited that happiness results from what one does rather than from
pursuing it as a goal in itself. Some current explanations of the effects of
engagement in occupation on emotional state (Csikszentmihalyi, 1975) are
enticing but need augmentation beyond the psychological level. Although
occupational therapists often seek to ameliorate emotional problems through
the therapeutic interpersonal relationship, occupational scientists might better study the effects of engagement in the occupation itself as restorative of
emotional balance.
Health
Occupational scientists might validate a different view of health in contrast to
the traditional one of freedom from impairment or pathology. For example,
Prn (1993), an existential philosopher, proposed that health was achieved
when a persons repertoire of skills enabled him or her to achieve vital goals in
a specific environment. This view excites me as an occupational scientist
because it opens the door to health and social participation for the many of
the worlds people who have impairments. This new view of health encourages our scholars to understand how enabling people with impairments to
develop a repertoire of skills destigmatizes them and enables them to be, and
to be perceived as, healthy, functioning participants in society.
Environment
Occupational scientists will need to study the contexts or environments in
which people carry out their rounds of occupation. The environment may also
be examined from multiple levels according to its demands and resources. For
example, to adapt or achieve a goodness of fit, a person needs to respond to
physical, psychological, social, cultural and symbolic-spiritual challenges in
his or her surroundings by using occupation. A central issue for occupational
scientists is finding just the right level of environmental challenge. This is the
appropriate demand as ascertained by the individuals ability to respond successfully and develop skill. By understanding how to pose this degree of challenge we not only enable people to learn competence, increasing their
confidence in capability, but tap into their evolutionary strengths and
resources (Diamond, 1997).
Occupational scientists perceive environments as embedding challenges,
difficulties and demands but also as providing affordances (Gibson, 1988) or,
as Meyer (1922, 1977) said, opportunities. This knowledge provides new
insight into the essence of occupational therapy: the ability to establish a
challenge that does not overwhelm or underwhelm but that fosters an adaptive response for a specific person at a given point in time in the real world.

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Creating such a challenge in the context of unique personal and environmental differences is the keystone of the knowledge applied in occupational therapy practice.
Concern with how to create an appropriate environmental challenge fostering capability requires that occupational scientists learn much more about
how to structure environments which are user-friendly for all people, including those with impairments. Members of the Independent Living Movement
have urged public policy makers to view disability not as residing in people,
but as a primary deficit in the environment which impairs their capability.
Our study of the environment could support such a perception, fuelling advocacy efforts to create more user-friendly environments around the world.
Values
As an occupational science detective, I need to develop a conceptual map
that will guide my scholarship, leading me to treasures which can contribute
to but not be bound by the immediate demands of practice. How might I seek
such knowledge to strengthen our profession and those it might serve? Here I
look to the traditions and values of occupational therapy to guide my investigation. (This is a good argument for assuring that occupational therapists and
scientists are well socialized into the history of our profession, worldwide.)
Such values as holism, optimism about potential, viewing people with
impairments as part of the mainstream, discovering and enhancing the
healthy aspects of people, understanding the subjective, encouraging selfdirectedness and choice and viewing occupation as being as essential to life as
food and water are a few examples.
Occupational therapists who value holism often practise in a medically
oriented environment that separates the mind from the body, speaking of
physical disability or mental health. This separation often limits the way occupation may be used as therapy and may result in a failure to meet important
human needs (Burnett and Yerxa, 1980). Yet, new knowledge from interdisciplinary cognitive science supports holism (Damasio, 1994; Lakoff and Johnson, 1999). Emotions make an essential contribution to practical reasoning as
it is used in the everyday world of work, play and relationships. Damasio
(1994) proposes that the brain and the rest of the body are an indissociable
organism integrated by interactive biochemical and neural regulatory circuits,
that the human organism interacts with the environment as an ensemble (not
as brain alone nor body alone) and that mental phenomena can be understood only in the context of an organism interacting in an environment that
is partially a product of the organisms activity itself.
Disciplines offering relevant knowledge which seem to share some of these
values and therefore fit with our epistemology include evolutionary biology,
anthropology, developmental and social psychology, interdisciplinary cognitive science, management theory, social geography, sociology and philosophy.

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Because the interaction of Homo occupacio and the environment is so complex, it is difficult to omit any scholarly resource. However, I have found the
most gold in those disciplines which fit occupation without inconsistencies
in world view or clashes in values. Although occupational therapists need to
understand pathology as a source of challenge, I do not expect to find fruitful
ideas in disciplines which focus on the pathological or reduce people to physical, deterministic entities such as genes (Dawkins, 1989; Lewontin, 1993).
Cultures
A great opportunity awaits us in developing occupational science on a global
scale. We need to understand how differences and similarities in culture affect
the occupational human and vice versa. At the highest levels, occupation is a
universal phenomenon, but at a cultural level, it may be expressed in unique
ways. For example, if play behaviour is the developmental antecedent of work
behaviour, as Reilly (1969) posited, how does this continuum vary from culture to culture and among subcultures? As a global community of scholars, we
have the opportunity to study commonalities and differences worldwide, freeing ourselves from the danger of viewing occupation too narrowly, through the
distorting lenses of our own culture.
Implications
What are some potential benefits to the occupational therapy profession and
those we serve as a result of the further development of occupational science?
First, this knowledge will enable us to achieve the essence of true professionalism self-definition of our own realm of practice. I believe that such
knowledge will enable occupational therapy practice to achieve its worldwide
potential to contribute to human healthfulness and to do so as an open professional system, adapting to future changing environmental conditions with
new, effective models of practice.
This knowledge, fostering a practice that enables capability and adaptive
skill, will contribute to the life opportunities for people both with and without
impairments. Thus, the creators of public policy and the public at large will
begin to see that impairments need not be equated with incapacity, tragedy or
a life deemed not worth living. Societies that have exterminated people with
impairments have always used that argument (Proctor, 1988). Occupational
science, by contributing new understanding of adaptive skill and how to
develop it, will counter these voices of pessimism with an ethical stance: how
can this life be transmuted into one worth living through occupation which
finds a way to elicit capability?
The promise of occupational science is rich indeed. The gold we discover
through our own scholarly work has the potential to transform not only those
we serve and the environments in which they carry out their daily lives, but

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we ourselves, the world community of occupational therapists. For our most

important tool is not a technical aid such as a hand splint or an ADL checklist. Rather, it is the mind of the occupational therapist who, through knowledge of occupation, learns how to foster human capability and influence
health. It is not the truth that makes you free. It is your possession of the
power to discover the truth (Lewontin, 1997: 32).
Acknowledgment
This paper is based, in part, on a presentation made at the 12th International
Congress of the World Federation of Occupational Therapists in Montreal,
Canada, on 3 June 1998.
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Address correspondence to Elizabeth J. Yerxa, EdD, LHD (Hon) ScD (Hon) OTR, FAOTA,
Route 1, 196 Columbine, Bishop, CA 93514, USA.