Career Transitions: Transforming Turbulent Turning Points ... · PDF fileand...

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L.E.G.A.C.Y.™ Appreciative Life Review:An Emerging Model to Support Occupation-Based Practice in Mental Health

Nicole O. Hansen, MS, MOT, OTR/L, CHWC, GCDF

University of Minnesota Program in Occupational Therapy

[email protected]

Copyright © 2017 Nicole O. Hansen. All Rights Reserved.

Minnesota Occupational Therapy Association Conference November 11, 2017

Introduction


L.E.G.A.C.Y.™ Appreciative Life Review (Onori Hansen, 2016)

Workshop Objectives


▪ Identify and explain the theoretical foundations of

L.E.G.A.C.Y.™: The Occupational Narrative Model.

▪ Describe and discuss the role, benefits, and application

of L.E.G.A.C.Y.™: The Occupational Narrative Model in

contemporary occupational therapy practice.

▪ Demonstrate how the L.E.G.A.C.Y.™: The Occupational

Narrative Model facilitates the creation of meaningful

occupational narratives to support occupational

engagement, performance, and satisfaction with a case

study of a client in midlife transition.

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L.E.G.A.C.Y.™: The Occupational Narrative Model

“Man’s main task in life is to give birth to himself, to become what he potentially is.”

~Erich Fromm


“Being – Doing – Becoming – Belonging”

(Onori Hansen, 2017)


The Occupational Narrative Model (Onori Hansen, 2017)

occupational narrative defined


Individual and collective stories of being, doing, becoming, and belonging (Onori Hansen, 2017).

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“Being”


Existence or living

Presence

Essence and distinctive nature of an individual

Stillness (antithesis of action/doing)

Mindfulness and contemplation

“Doing”


Purposeful action

Non-purposeful action

Active /Passive

Expression of our beingor “core essence”

Mechanism for personal growth self-fulfillment social interaction generativity contributions/legacy societal development

“Becoming”


Adds concept of future to being and doing

Process of Becoming

Human Growth & Development

Transformation

Self-Actualization

Striving to give birth to oneself

Flow - peak or optimal experiences in which time disappears and hopes are fulfilled

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“Belonging”


“Belonging is the innate human desire to be part of something larger than us.”

primal yearning

try to acquire it by fitting in and by seeking approval (barrier and hollow substitute)

“True belonging only happens when we present our authentic, imperfect selves to the world,

our sense of belonging can never be greater than our level of self-acceptance.”

Brene Brown, The Gifts of Imperfection (2010)

True Belonging


“True Belonging is

the spiritual practice of believing in and belonging to yourself so deeply that you can share your most authentic self with the world and

find sacredness in both being a part of something and standing alone

in the wilderness

True belonging

doesn ’t require you to change who you are;

it requires you to be who you are.”

Brene Brown, Braving The Wilderness: The Quest for True Belonging and the Courage to Stand Alone (2017)

The Occupational Narrative

andL.E.G.A.C.Y.™ Appreciative

Life Review in OT

Meaningful occupational narratives facilitate being, doing,

becoming and belonging

Occupational Narrative supports:

“Participation naturally occurs when clients are actively involved

in carrying out occupations or daily life activities that they find

purposeful and meaningful” (OTPFW, 2014).

Patterns of Living - habits, routines, roles, and rituals can be a

support or barrier to participation (occupational performance)

Satisfaction – individuals experience well-being and quality of life

when they participate in occupations that are personally

meaningful


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TheOccupational Narrative

Approach

“Narratives influence and are influenced by the person-environment-occupation-performance” (Hinojosa, Kramer, Royeen, 2017, p. 169).

Occupational narratives are our past, present, and future stories of participation, patterns of living, and the meaning we assign to them.

▪ Contemplative

▪ Reflective

▪ Meditative or

▪ Action-based (Wilcock & Townsend, 2014)

▪ Occupational Narratives are individually and collectively constructed & reconstructed

▪ Occupational Narratives support health, well-being and participation by providing a framework to encourage occupational patterns that are meaningful and purposeful while making sense of challenges and setbacks (Onori Hansen, 2017).



Theoretical Foundations

Lifespan Development


Psychosocial Development

(Erik & Joan Erikson, 1950, 1982, 1997; Jeffrey Jensen Arnett, 2004)

Adult Lifecyle Model of Human Development

(Frederic Hudson, 2001)

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Emerging AdulthoodAges 18 – 25

Jeffrey Jensen Arnett (2004)

Post-Modern Developmental Stage

Transition from Adolescence to Adulthood

▪ Identity Exploration (relationships and work)

▪ Instability (navigating choices)

▪ Self-Focused (personal growth)

▪ Feeling In-Between (not quite an adult)

▪ Age of Possibilities (optimistic and high expectations


Young AdulthoodAges 25 - 40

IntimacyAbility to develops intimate ▪

relationships

Friends, family, spouse, ▪

significant others

Isolation

▪ Inability to form meaningful relationships

▪ Fear of commitment


Middle Adulthood “Midlife”Ages 40- 65

Generativity

▪ Creation of a lasting legacy through family, work achievements, or other contributions

▪ Desire to contribute to younger generations, community & society

▪ Satisfaction with occupational &family roles

Stagnation

A belief and feeling that life ▪

is meaningless

Extreme self▪ -absorption


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Late Adulthood “Elderhood”Ages 65 +

Ego Integrity

A belief & feeling that ▪ life was worth living ▪ minimal regrets▪ lasting contributions were

made▪ motivation to continue

seeking life fulfillment and satisfaction

Despair

regrets for what one has done ▪

or not done

fears about death▪

Pondering the meaning and ▪

significance of one’s life


Adult Life Cycle Model of Human Development (Hudson, 2001)

8 Main Life Chapters

Twentysomethings to

Ninetysomethings

Relatively Stable

Constructive Period

Predictable yet Challenging

Traditional Milestones

6 Core Human Values

Identity

Achievement

Intimacy

Play and Creativity

Search for Meaning

Contribution

CyclicalValues-Based

Transition-FocusedDecades Orientation

Focal Points


Traditional Life Reviewand

Reminiscence


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life review defined


“A naturally occurring universal process,

characterized by the progressive return to

consciousness of past experiences and unresolved

conflicts which are surveyed and reintegrated”

(Butler as cited in Haight and Haight, 2007).

origin of the life review


Introduced concept of universal life review in seminal ▪

article, The Life Review: An Interpretation of

Reminiscence in the Aged (Robert Butler, 1963).

Created paradigm shift by challenging stereotype of ▪

old age as state of physical & mental decline.

Reframed reminiscence and life review as normal ▪

process with potential for positive outcomes

“time of harvest” & celebration

facilitate adaptive responses

acceptance that one ’s life was well-lived & meaningful

(ego integrity)

reminiscence defined


“…the recall of memories. This is usually characterized

as simple daydreaming, storytelling, or nostalgia by

oneself or with others.” (Haber, 2006)

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qualities of reminiscence

non-evaluative

spontaneous or volitional

selective or unselective

purposeful or non-purposeful

alone or shared

fun & enjoyable

personal & engaged (self-focused)

disengaged & impersonal (event-focused)


qualities of life review

normal & universal

volitional & purposeful

evaluative & meaning-focused

individual process with therapeutic listener

includes unresolved conflicts & difficult memories

structured with lifespan approach

therapeutic or generative

reframing & reintegration

coming to terms (acceptance)


“Life review is also more

likely than reminiscence to

be an evaluative process, in

that participants examine

how their memories

contribute to the meaning

of their life, and they may

work at coming to terms

with more difficult

memories” (Haber, 2006).


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final thoughts on life review

▪ Erikson’s 8th stage, Ego Integrity versus Despair, traditionally sets the contextual and temporal stage for the life review

▪ Impetus for life review

life crisis

transition

regrets (actions or omissions)

pondering the significance of one’s life

thoughts or fears about death as one nears the end of life

▪ Life review may facilitate maladaptive responses


Appreciative Inquiry


appreciative inquiry defined


▪ “a collaborative and highly participative,

system-wide approach to seeking, identifying,

and enhancing the ‘life-giving forces’ that are

present when a system is performing optimally

in human, economic, and organizational terms”

(Watkins & Mohr, 2001).

▪ life-giving forces = strengths and assets

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origins of appreciative inquiry


David Cooperrider & Colleagues (1980s)

▪ Case Western Reserve University▪ Weatherhead School of Business▪ Department of Organizational Behavior

Philosophy & approach in organizational development

Developed as transformational change process

Copyright © 2017 Nicole O. Hansen. All Rights Reserved. Copyright © 2017 Nicole O. Hansen. All Rights Reserved.

appreciative inquiry assumptions

In every society, organization or group, something works.

What we focus on becomes our reality.

The act of asking questions of an organization or group influences the group in some way.

It is important to value differences.

The language we use creates our reality.


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traditional paradigm

▪ problem-solving approach

▪ identify, define & fix problems, deficits, weaknesses

▪ underlying premise: do less of what is not working well

“Deficit Thinking”


appreciative inquiry paradigm

▪ identify & amplify strengths “the best of what is” or what is working well

▪ imagining possibilities to facilitate change & generativity “the best of what could be”

▪ underlying premise: do more of what is working well create bridge between “the best of what is” with vision of “what might be”

“Possibility Thinking”


the appreciative inquiry 5-D cycle

(Moore & Tschannen-Moran, 2010)


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Social Constructivism &Narrative Therapy

Social Constructivism

▪ Contextual influences shape perceptions (social, cultural, linguistic)

• influence interpretation and construction of reality

• multiple versions of reality (truth is relative to individual’s context)

▪ Focuses on creation of meaning

Narrative Therapy

▪ “Re-stories” or “Reframes” life narratives

▪ Create alternative narratives

Explores contexts

New perspectives & meanings

Change directions

Author new chapters


Person-Environment-Occupation-Performance (PEOP)

Key Characteristics of PEOP

Client-Centered

Person-Environment-Occupation is Central

Ecological Model Influences

Biological, Psychological, and Social Interactions

Person-Environment Fit


Principles of PEOP

Views Occupation from a Developmental Perspective

Drive for occupational engagement or participation▪

Multi▪ -dimensional and complex nature of occupation

Importance of the environment context▪

Temporal influences ▪

Inherent nature of occupations▪

Influence on health and well▪ -being

(Hinojosa, Kramer, & Royeen 2017)


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The Role of Narrative in PEOP

▪ “Narratives influence and are influenced by the

person-environment-occupation-performance”

(Hinojosa, Kramer, Royeen, 2017, p. 169)

▪ Narrative is starting point in PEOP Process

▪ Client’s Perspective

Person-Environment-Occupation-Performance Factors

Past, Present, and Future

Perceptions and Meanings

Attitudes and motivations

Identifying needs and goals

▪ Narrative influences OT assessment and evaluation


L.E.G.A.C.Y.™ Appreciative Life Review


appreciative life review defined


“an intentional process that facilitates remembering

positive and negative experiences, in context, to

create appreciative and meaning-focused narratives

which facilitate well-being and adaptive responses”

(Onori Hansen, 2017).

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Premise of Appreciative Life Review

“…people of all ages review their past at various times; they look back to

comprehend the forces and experiences that have shaped their lives”

(Butler, 1963).

unresolved developmental milestones are not considered permanent and may

be revisited for successful reconciliation. (Sigelman & Rider, 2015)


Premise of Appreciative Life Review

Motivations for Life Review by Young and Midlife Adults

▪ recent problem or crisis

▪ therapeutic/cathartic after traumatic or significant life experience

▪ evaluate the present (rather than reconcile & reframe the past)

▪ life transitions and significant decisions

Shifting the Contextual and Temporal Stage of Life Review

▪ Facilitates ongoing “life course corrections”

▪ Encourages “appreciative mindset” and positive reframing

▪ Increases sense of autonomy (being author of new life chapters)

▪ Encourages relational reconciliation and resolution of unfinished business

▪ Facilitates adaptive responses and normal developmental milestones

▪ Facilitates positive life transitions and decision-making



Life Purpose

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purpose defined

one’s “…compelling reason for being alive” (Hudson & McLean, 2006).

“that deepest dimension within us – our central core or essence –

where we have a profound sense of who we are, where we came from, and where we’re going.”

Leider (1997)


qualities of purpose

woven into a person’s identity and is central to personality

a central and self-organizing life aim

organizes & stimulates goals and influences behaviors

provides a sense of meaning

offers direction yet following that direction is optional

does not require achievement of a designated outcome (e.g. goal)


McKnight & Kashdan (2009)

final thoughts about purpose

“Meaning does not always drive purpose…

meaning probably drives the development of purpose.

Once a purpose becomes developed,

purpose drives meaning”

(McKnight & Kashdan, 2009).

▪ Purpose & meaning have a temporal, bidirectional relationship

▪ A person may have a single purpose or multiple purposes

▪ Exists on 3-dimensional continuum (“Scope – Strength – Awareness”)


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Meaning


meaning defined“…the sense made of, and significance felt regarding,

the nature of one’s being and existence.”

(Steger et al., 2006)


qualities of meaning

Meaning is an individual rather than universal construct (Frankl, ▪ 1959/2006)

• “the transitoriness of our existence in no way makes it meaningless”

present realities and past are preserved from transitioriness (narrative •

and legacy)

“…▪ good deeds are never wasted and not forgotten. What cannot be

achieved in one lifetime will happen when one lifetime is joined to another”

(Kushner, 1986).

Narrative and lasting legacy▪


(Frankl, 1959/2006)

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creating meaning

“Activity and occupational demands are

the specific features of an activity and

occupation that influence its meaning

for the client and the type and amount

of effort required to engage in it”

(OTPFW, 2014).

▪ Symbolic

▪ Metaphorical

▪ Unconscious


ascribing meaning

Values: “principles, standards, or qualities considered worthwhile by the client who holds them” (OTPFW, 2014)

Beliefs: “cognitive content held as true” (Moyers & Dale, 2007 as cited in OTPFW, 2014)

Spirituality: “…the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred” (Puchalaski et al., 2009 as cited in OTPFW, 2014)



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Generativity“Shifting the Context”


generativity defined

“The desire and commitment to

care for younger generations, the community, and/or

society

by creating and sharing a legacy

that is personally meaningful and significant”

(Nicole Onori Hansen, 2016).


origins of generativity

Plato’s Symposium (Wakefield, 1998) ▪ Love is the antecedent to generativity.

▪ “In Plato’s view, all people are pregnant with physical or

mental generative products, awaiting the inspiration for

their birthings that can only come through a loving

relationship with another person” (McAdams, 2001).

“To be generative is to give birth to a beautiful product…” (McAdams, 2001).

Ultimate expression of generativity considered the birth of a child.

Appeases the human yearning for immortality.


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qualities of generativity

Paradoxical in Nature

▪ Agentic element - create a legacy that will outlive the self

▪ Communal element - expresses care & concern for future generations

▪ “…curious blend of narcissism and altruism” (McAdams, 2001)

Composite or integration of self-actualization & altruism

▪ Concurrent fulfillment of one’s purpose & altruism

▪ Transcendent actualization (Maslow, 1970)


final thoughts on generativity

Generativity arises from inner needs & external forces such as cultural or societal expectations (Erikson in McAdams, 2001).

Generative concerns & behaviors increase from young to middle-adulthood but relationship between generativity & age is not clear (McAdams, 2001).

Generativity is not about immortality as much as caring or the next generation with ordinary acts of kindness (Erikson in McAdams, 2001).


L.E.G.A.C.Y.™ Appreciative Life

Review: A Tool to Create

Occupational Narratives


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Role of Occupational Narrative

andL.E.G.A.C.Y.™

Appreciative Life Review in Contemporary

OT Practice


Meaningful occupational narratives facilitate being, doing,

becoming and belonging

Occupational Narrative supports:

“Participation naturally occurs when clients are actively involved

in carrying out occupations or daily life activities that they find

purposeful and meaningful” (OTPFW, 2014).

Patterns of Living - habits, routines, roles, and rituals can be a

support or barrier to participation (occupational performance)

Satisfaction - individuals experience well-being and quality of life

when they participate in occupations that are personally

meaningful


andL.E.G.A.C.Y.™


OT Practice

Create Meaningful Occupational Narratives to Facilitate, Enable and Support:

participation and occupational engagement

healthy patterns of living

health, well-being, and satisfaction (quality of life)

adaptive responses (e.g. reconciliation & acceptance)

developmental and psychosocial milestones

development of purpose and meaning

acquisition and preservation of occupational identity

life transitions



andL.E.G.A.C.Y.™


OT Practice

Create Meaningful Occupational Narratives to Facilitate, Enable and Support:

identification of regrets, grief, and unfinished business

relational reconciliation and reconnection

resolution of unfinished business

remembrance of positive life stories and experiences

construction of generative life narratives & redemption stories

cultivation of positive and appreciative mindset

amplification of strengths, values & best experiences

creation of a personally meaningful vision with plan & goals

a purposeful, values-centered, strengths-based & meaning-focused life


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TheOT Practice Framework,Occupational Narrative

andL.E.G.A.C.Y.™

Appreciative Life Review

▪Overarching Statement: “Achieving health, well-being, and participation in life through engagement in occupation…”

▪ “OT services are provided for… promotion of health and wellness for clients with disability and non-disability related needs including acquisition & preservation of occupational identity”

▪Occupational identity is important for healthful, productive & satisfying life.

Occupational Therapy Practice Framework (AOTA, 2014)

▪ “Narratives influence and are influenced by the person-environment-occupation-performance” (Hinojosa, Kramer, Royeen, 2017).

▪Narrative is starting point in PEOP Process

Person-Environment-Occupation-Performance Model (Christiansen, Baum & Bass, 2015)

Occupational narratives are our past, present, and future stories of participation, ▪

patterns of living and the meaning we assign to them.

Occupational Narratives ▪ support health, well-being, and participation by facilitating the development of occupational identity and patterns of living that are meaningful and purposeful.

Occupational Narrative Model & L.E.G.A.C.Y.™ Appreciative Life Review (Onori Hansen, 2016 & 2017)


TheOT Practice Framework,Occupational Narrative

andL.E.G.A.C.Y.™

Appreciative Life Review

“Using a client-centered approach, the practitioner gathers information to

understand

▪ what is currently important and meaningful to the client …

▪ and to identify past experiences and interests that may assist in

the understanding of current issues and problems.

▪ …the client, with the assistance of the occupational therapy

practitioner, identifies priorities and desired targeted outcomes

▪ that will lead to the client’s engagement in occupations that

support participation in life.

▪ Only clients can identify the occupations that give meaning to

their lives and select the goals and priorities that are important

to them (OTPFW, 2014).”


Benefits of Occupational Narrative

andL.E.G.A.C.Y.™


OT Practice

Aligns with OT Practice Framework

Easily integrated with occupation-based theories & practice

Supports current paradigm shift in OT

Client-centered (with developmental emphasis)

Multi-dimensional approach

Person Environment and Context

Occupation

Performance

Appropriate for all practice settings including community & well populations

Evaluation & Treatment


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Benefits of Occupational Narrative

andL.E.G.A.C.Y.™


OT Practice

▪ Practical framework & process focused on non-physical client factorsthat impact:

• participation

• patterns of living

• satisfaction

▪ Supports occupational profile

occupational history

roles, routines, habits, rituals

environment/context

occupational participation (supports and barriers)

▪ Identifies client needs, wants, priorities & goals with focus on purpose and meaning

▪ Individual narratives (past, present, future)


Application of Occupational Narrative

andL.E.G.A.C.Y.™


OT Practice

Case StudyMary

▪ 38 years old, single, librarian▪ midlife transition

▪ seeking career change

▪ social anxiety & depression

Session 1▪ Intake Interview to gather client’s occupational narrative

▪ Use appreciative, strengths-based questions in L.E.G.A.C.Y.™ Core areas

▪ What is the most significant relationship in your life?

▪ Tell me about a time in your life when you had a peak experience or were at yourvery best and felt most happy or fulfilled.

▪ Tell me about a time in your life when you had a setback or turning point. What did you learn about yourself? What was the silver lining?

▪ What were you doing the last time you lost track of time?

▪ What would make your life matter?

▪ What would be the best outcome of OT for you?

▪ Evaluate and determine next steps in assessment and intervention

▪ Collaborate with client to develop preliminary plan and goals



andL.E.G.A.C.Y.™

Appreciative Life Review in

Contemporary OT Practice

The L.E.G.A.C.Y.™ Lifeline Collage

▪ “Being and Outsider” (Childhood)

▪ “Finding My Place, Finding My People” (Adolescence)

▪ “Positive Setbacks” (Young Adulthood)

▪ “New Beginnings” (Midlife)

Life Chapters of Mary’s Occupational Narrative

Your friends are your family.▪

You have a strong desire to be connected to nature and the earth.▪

You are open to experiencing new and different things. You are curious and like to learn. ▪

You crave social interaction on your own terms with a focus on neighborhood ▪ & community.

You are ready to find a community to that is ▪ “home” and establish a network of connections.

▪ You are ready to seek therapy to overcome social anxiety/depression and develop an intimate

relationship.

Patterns of Living, Occupations, Participation and Contexts in Mary’s Narrative


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andL.E.G.A.C.Y.™

Appreciative Life Review in

Contemporary OT Practice

Mary’s Life Vision

My vision is to share my life with a significant other, friends, and the community by using my time and talents and

establishing a home in a quiet, tree-lined, multi-generational neighborhood.

3 Month Goals

▪ Move to a home that is closer to work and in a quieter neighborhood.

▪ Explore the education and certification requirements of my top career choices (Adult Basic and Secondary

Education, Training & Development, and organizing) through web research, volunteering, and local university resources.

▪ Begin clarinet lessons to prepare for joining an amateur music group and meeting new friends.

▪ Attend the gym 4 times per week to establish a cardiovascular and strength training routine and meet new friends.

▪ Begin attending therapy on a regular basis for personal growth and to overcome anxiety and depression issues.

Weekly Goals

Explore the Association for Talent Development website on Tuesday or Thursday night for ▪ 1 hour to learn more about career opportunities and certifications and in the field.

Go to the gym in North Mankato on Wednesday after work to gather information about classes and do ▪ 30 minutes of cardiovascular exercise.

Call or email the therapy office during my lunch hour on Wednesday or Thursday to get information about fees and ▪

payments.



References

Arnett, J. J. (2004). Adolescence and Emerging Adulthood 2nd ed. New Jersey: Pearson.

Brown, B. (2017). Braving the wilderness: the quest for true belonging and the courage to stand alone . New York:

Random House.

Brown, B. (2014). The gifts of imperfection: let go of who you think you're supposed to be and embrace who you are.

Charleston, SC: Instaread Summaries.

Butler, R. N. (1963). The life review: An interpretation of reminiscence in the aged. Psychiatry, 26(1), 65-76.

Christiansen, C. H., Baum, C. M., & Bass, J. D. (2015). Occupational therapy performance, participation, and well-being. Thorofare, NJ: SLACK Inc.

Erikson, E. H. (1950). Childhood and society. N.Y.: W.W. Norton & Company.

Erikson, E. H. (1982). The life cycle completed: A review. New York: W. W. Norton & Company.

Erikson, E. H., & Erikson, J. M. (1997). The life cycle completed. New York: W.W. Norton. (Original work published in 1982)

Frankl, V. E. (2006). Man's search for meaning. Boston: Beacon Press. (Original work published in 1959)

Haber, D. (2006). Life Review: Implementation, Theory, Research, And Therapy. The International Journal of Aging and Human Development, 63(2), 153-171.

Haight, B. K., & Haight, B. S. (2007). The handbook of structured life review. Baltimore: Health Professions Press.

Hansen, N. O. (2016). L.E.G.A.C.Y.™: An Appreciative Life Review Model (Unpublished master’s capstone paper). Winona State University.

Hinojosa, J., Kramer, P., & Royeen, C. B. (2017). Perspectives on Human Occupation: theories underlying practice. Philadelphia: F.A. Davis Company.

Hudson, F. M. (2001). Mastering the art of self-renewal: Adulthood as continual revitalization. New York: MJF Books.

Hudson, F. M., & McLean, P. D. (2006). Life launch: A passionate guide to the rest of your life. Santa Barbara, CA: Hudson Institute Press.


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References

Kottler, J. A. (2004). Introduction to therapeutic counseling: voices from the field. Australia: Thomson-Brooks/Cole.

Leider, R. (2004). The power of purpose: Creating meaning in your life and work. San Francisco: Berrett-Koehler. (Original work published in 1997)

Maslow, A. H. (1970). Motivation and personality. New York: Harper & Row.

McAdams, D.P. (2001). Generativity in midlife. In M.E. Lachman (Ed.), Handbook of midlife development (pp. 395-443).

New York: John Wiley & Sons, Inc.

McKnight, P. E., & Kashdan, T. B. (2009). Purpose in life as a system that creates and sustains health and well-being:

An integrative, testable theory. Review of General Psychology, 13(3), 242-251.

Moore, M., & Tschannen-Moran, B. (2010). Coaching psychology manual. Philadelphia: Wolters Kluwer Health/Lippincott,

Williams & Wilkins.

Moyers, P., & Dale, L. M. (2007). The guide to occupational therapy practice. Bethesda, MD: AOTA Press.

Occupational therapy practice framework: domain & process. (2014). Bethesda, MD: AOTA Press/American Occupational Therapy Association.

Puchalski, C., Ferrell, B., Virani, R., Otis-Green, S., Baird, P., Bull, J., . . . Sulmasy, D. (2009). Improving the Quality of Spiritual Care as a Dimension of Palliative Care: The Report of the Consensus Conference. Journal of Palliative Medicine, 12(10), 885-904

Sigelman, C. K., Rider, E. A., & George-Walker, L. D. (2015). Life span human development. South Melbourne, Vic.:

Cengage Learning.

Steger, M. F., Frazier, P., Oishi, S., & Kaler, M. (2006). The meaning in life questionnaire: Assessing the presence of and search for meaning in life. Journal of Counseling Psychology, 53(1), 80-93.

Wakefield, J.C. (1998). Immortality and the externalization of the self: Plato’s unrecognized theory of generativity.

In D.P. McAdams & E. de St. Aubin (Eds.), Generativity and adult development (pp. 133-174). Washington, DC: American Psychological Association.


References

Watkins, J. M., & Mohr, B. J. (2001). Appreciative inquiry: Change at the speed of imagination. San Francisco, CA:

Jossey-Bass/Pfeiffer.

Wilcock, A. A. (2002). Reflections on doing, being and becoming*. Australian Occupational Therapy Journal, 46(1), 1-11.

Wilcock, A.A., & Townsend, E.A. (2014). Occupational justice. In B.A. Boyt Schell, G. Gillen, & M. Scaffa (Eds.), Willard and Spackman’s occupational therapy (12th ed., pp. 541-552). Philadelphia: Lippincott Williams & Wilkins.


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