Participation and mental health: an example of theory development in occupational therapy

Background: The International Classification of Functioning, Disability and Health defined components of health and health related states. There are four components, including participation, which is defined as ‘a person’s involvement in a life situation’. However, activities and participation are linked so a lack of conceptual clarity exists (Khetani & Coster, 2007). Aim: To critically explore methods of theory construction in order to develop a conceptual framework of participation of people experiencing mental health needs. Method: A critical literature review was undertaken to identify relevant methods of theory construction. Findings: Thirteen methods of concept analysis were identified, many of which were derived from a framework developed by Wilson in 1963 (Beckwith et al 2008). Key elements of concept analysis were identified. Walker and Avant’s (2011) method of theory development is widely used in nursing (e.g. Manais 2010) and is developing credence in occupational therapy (e.g. Wagman et al 2011). Walker & Avant’s (2011) approach to theory construction is applicable to occupational therapy because it enables the development of theory that is not only defensible but congruent with practice. This approach was adopted to develop the concept of participation in mental health. Implications: With conceptual clarity, a common language for describing health and health-related states emerges. It also enables tools to be developed to measure participation in clinical practice and research studies. The Research Centre for Occupation & Mental Health (RCOMH) will use the theory of participation in mental health to design robust research studies about the effectiveness of occupational therapy in mental health