Abstract:

The construct of functional independence in performance areas has become what some might consider the hallmark of occupational therapy practice. This construct, as a predominant goal, or even ideal, of occupational therapy, however, embodies philosophical assumptions that bear scrutiny. For example, do clients and therapists conceive of function in the same way? When we speak of our clients being independent, do we mean they perform without any help, or do we mean they need appropriate help from persons or technology? In this paper I explore the assumptions underlying the construct of functional independence in performance areas. Further, I clarify why helping clients attain wholeness, autonomy, meaning, and purposiveness despite non-function and dependence forms a better principle of occupational therapy.