Learning Together: Applying Socio-cultural Activity Theory to Collaborative Consultation in School-Based Occupational Therapy

Abstract

Socio-cultural activity theory (SCAT) was used to examine the nature of collaborative working in a case study of school-based occupational therapy (SBOT) in Ontario. Collaborative consultation has been widely adopted in SBOT practice. However, we know little about the impact of collaboration for students and lack understanding about how the organization of SBOT service contributes to collaborative working among educators and occupational therapists. Grounded in theoretical understanding about the distributed nature of group learning, SCAT was used as a conceptual and analytical tool in this study to describe SBOT collaborative consultation from multiple stakeholder perspectives. The research took place in two phases. Phase One involved case study research to describe SBOT for three students with disabilities from multiple stakeholder perspectives. Data were gathered using a combination of observation, document analysis, and interviews involving participants directly involved in the delivery of SBOT with each focal participant. SCAT provided a framework for describing the nature of joint effort. Dilemmas emerging from incongruence between elements in the activity system were identified and described. Common characteristics in two cases enabled cross-case analysis to also identify features of collaborative working that facilitated educational programming and outcomes for students with developmental disability. In Phase Two, program administrators participated alongside service recipients and service providers in a series of focused discussion workshops to reflect on case study findings and prioritize areas for program improvement. Developmental Work Research (Engeström, 2000) and Appreciative Inquiry (Cooperrider, Whitney, & Stavros, 2003) methods were used within a participatory action research approach to facilitate organizational learning among stakeholders. Engagement of stakeholders supported program administrators in critically examining decision-making for the delivery of SBOT service in the region studied. Combining practice-driven dilemmas with conceptual tools of analysis enabled a multiple-perspective understanding about the social, cultural, and historical work practices that have influenced collaborative interactions in SBOT practice and led to the development of principles for improving how work is shared. Program administrators used their shared understanding to propose a new model for delivering SBOT services.