An Occupational Adaptation explanation for response to COVID-19

By Cynthia Evetts
Director of the TWU School of Occupational Therapy

A pandemic has taken over planet earth. We are challenged to adapt to a myriad of demands in how we approach daily occupations because of a potentially deadly contagion. Occupational Adaptation theory can offer an explanation for our actions and reactions to the current situation.

We all have desires for mastery in our daily lives. The environment presents constant demands, and when these match our personal desires, we are presented with an occupational challenge and a resulting press for mastery. Our adaptive responses lead to the relative mastery we seek. Let’s use students of occupational therapy to illustrate the adaptation process in a COVID-19 world.

Students desire mastery of the occupational therapy domain and process so they can be successful students now and occupational therapists in the future. The academic role expectations are to enroll in school, go to class, learn from instructors and practice with peers, participate in community and clinic to gain experience and build confidence, graduate, pass the certification exam and become a licensed occupational therapist with a rewarding career. At the same time, students are occupational beings with multiple and varied roles—each with its own set of expectations and demands; employee, parent, citizen and friend, for example. The press comes from all of these roles and the student’s ability to orchestrate a satisfying, occupationally balanced lifestyle.

But all environmental demands and related occupational challenges changed drastically when COVID-19 hit. Campuses shut down and all course work went online while students were left with the same desires and press for mastery. All the adaptive strategies that had been previously established to meet the demands of being an occupational therapy student needed to be re-examined for efficiency, effectiveness and satisfaction to self and others.

Our homes, once used for meeting needs for self-care and family, now serve also as our place of work, education, socialization and leisure. How we use our time, our space, our internet bandwidth and our electronic devices has all changed. Adaptation becomes necessary to modify the environment, renegotiate space, set boundaries for self and others and complete a host of once familiar occupations that must now be accomplished in new or different ways.

When everything around us is in a state of flux, it is natural to revert to well established habits and routines. But when our normal patterns of behavior are no longer effective, dysfunction can ensue. If we are so stressed or distracted that we cannot complete everyday tasks, or if we encounter what seem to be unreasonable or insurmountable barriers—we may feel stuck, desperately trying to repeat what has worked in the past. In our attempts to break out of these ineffective patterns, we may appear frenetic or disorganized until we are able to blend behaviors from our existing repertoire with newly discovered ways of achieving relative mastery.

When students feel stuck, instructors can help by providing feedback, pointing to possibilities for adaptation and restructuring the environmental demands and expectations. This is what we, as occupational therapists, would do for our clients—and it is what we all can do for ourselves and for one another. As we ease into new routines and form new habits, online learning and communication may not seem so bad. Even though we miss the physical aspects of social contact, we understand how to respond to the changing demands of the environment, we have gained new adaptive skills to use now and in the future, and we now know that we can adapt until things change again. Because they will. They always do. The good news is that we are infinitely capable of adaptation.