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Barbara E. Milliken, Ed.D., OTR/L, CVW


Background: While occupational therapy (OT) identifies itself as a holistic profession, there is little guidance in the literature and in academia to assist practitioners in addressing spirituality. An assignment was developed to provide a platform for occupational therapy assistant students to explicitly screen for clients’ perspectives of spiritual occupations. This paper summarizes the client responses to that assignment.

Method: Occupational therapy assistant students in a Midwestern community college conducted a 5-question spirituality screening in the context of their Level I and Level II fieldwork placements. While this exercise began as a student assignment, the value of the client feedback was recognized, themes emerged, and a retrospective content analysis ensued.

Results: Clients overwhelmingly identified as spiritual. Initially their associated spiritual occupations were largely religious-oriented activities. However, when questioned further, responses expanded to include nonreligious occupations that could inform occupation-based therapeutic interventions. Most clients maintained or deepened their spiritual beliefs despite their illness. Lastly, clients identified the practitioner’s therapeutic use of self as spiritually supportive, while others associated spirituality with functional goals.

Conclusion: A single inquiry regarding a client’s spirituality appears insufficient to adequately guide client-centered occupation-based treatment intervention. Clinicians are encouraged to articulate OT’s distinct value related to spirituality to all clients.


The author reports no potential conflicts of interest.