The thesis sought to investigate the purpose, nature and efficacy of occupational therapy in health service settings. It was based upon the premise that what occupational therapists do in practice is little understood and poorly researched. Therefore, as well as determining the nature of activity, this research also aimed to understand how the activity of occupational therapists might be influenced. The investigation focused upon the work of occupational therapists with older people
with mental health problems, an area of high volume and demand.
Through an examination of the literature on professionalism in health and social care and that concerned with older people with mental health problems, a model of occupational therapy was proposed, underpinned by the research hypothesis. The subsequent research design consisted of
four empirical studies; each testing different aspects of the model of occupational therapy activity. As well as measuring the clinical activity of occupational therapists, views of that activity were obtained from the occupational therapists themselves, service users, and representatives from other disciplines also working with older people with mental health problems.
The results of each study were analysed separately in the first instance. The totality of results were then employed to address the overall research aims, and to draw conclusions about the validity of the model of occupational therapy activity. This demanded further analysis of the findings using a critical theory approach to professional behaviour. In light of this, a revised model of occupational
therapy activity is presented.
This research enabled the activity of occupational therapists to be fully described for the first time,
highlighting both positive aspects and shortfalls. It is has provided evidence of how professionalism in health is driving the activity of occupational therapists. The final chapter presents recommendations for development of a better foundation for occupational therapy activity
