ABC Therapeutics Occupational Therapy Weblog

Subtitled: What a Facebook meme gets wrong about Mary Reilly - and why it matters. I was scrolling through Facebook when I came across a meme described as “in conversation with an ancestor.” It placed Mary Reilly’s famous occupational therapy hypothesis beside a contemporary reformulation by Frank Kronenberg.  I am re-posting the meme here for purposes of commentary and professional criticism. Source: Frank Kronenberg, posted to social media July 21, 2026 At first glance, it looked like a respectful update - perhaps an effort to carry a foundational idea forward into a more socially conscious age. But the longer I looked at it, the more concerned I became. This was not just a modernization of Reilly’s language. It was a replacement of her premise. Reilly wrote: “Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.” The generic use of “man” is dated, and at first I thought that might be the subject of the meme. S...

Subtitled: Pornography, professional scope, and the missing clinical threshold. Last month I wrote about an article examining drag as an occupation . My objection was not that drag could not be studied as an occupation. Occupational science can study almost anything people do, including activities that are unfamiliar, controversial, highly personal, culturally specific, or socially contested. That descriptive work can help us understand meaning, identity, habits, routines, context, and participation. That is not occupational therapy, per se, but it might sometimes be additive. The additional leap into occupational therapy practice remains my persistent concern. Once an occupation has been described, authors sometimes attach a few sentences explaining its supposed clinical relevance. The occupational therapist is then asked to acknowledge it, assess it, support it, or incorporate it into practice, even when no particular patient population, health condition, intervention, competency, or...

  Apparently, the definition of critical is critical. A recent mixed-methods study in the Australian Occupational Therapy Journal examines how occupational therapy educators across different countries think about and define critical thinking. The authors found something I have long suspected and have previously documented: occupational therapy educators do not all mean the same thing when they use the term 'critical.' Some define critical thinking in concrete, clinical, pragmatic terms: reasoning, evidence appraisal, decision-making, and reflective practice. Others define it in broader sociopolitical terms: questioning knowledge production, identifying oppressive structures, pursuing social transformation, and taking “critical action.” There is a wide chasm between these definitions. It matters because “critical thinking” is not a minor curricular phrase. The term 'critical' appears everywhere in higher education, accreditation language, learning outcomes, rubrics,...

Thirteen years ago, on the Fourth of July, I wrote about autonomy. At the time, I was trying to understand what I believed was a subtle but important shift occurring within occupational therapy. I argued that our profession was moving away from one of its deepest philosophical commitments: respect for the autonomy and agency of individual human beings. Looking back, I think I was observing a real phenomenon. But I don't think I had yet identified the central issue. Over the past decade I have come to believe that the debate was less about public health or occupational science than I originally thought. Those are manifestations of something deeper. Today I am framing the question differently and in a more fundamental way: Who, exactly, is the recipient of occupational therapy? For most of our history, the answer was obvious. It was the human being sitting in front of us. Everything else flowed from that simple proposition. Perhaps that is why this question seems appropriate for Inde...