Occupation by design: dimensions, therapeutic power, and creative process.

Two forces are converging, creating conditions both challenging and potentially fruitful for occupational therapy. The profession's knowledge base describing occupation is growing exponentially. At the same time, functional outcomes of intervention are being increasingly valued within the health care environment. Other professions imitate and claim our areas of expertise in the most flattering and dangerous ways. To benefit from the convergence of these forces, occupational therapy must expeditiously translate understanding of occupation into powerful occupation-based practice. Three bridges must be built: a generative discourse, demonstration sites, and effective education. The occupational design approach offers important conceptual tools with which to rapidly build these bridges to powerful practice. Described here are subjective and contextual dimensions of occupational experience, elements of the occupational design process, and how these factors produce therapeutic power through the appeal, intactness, and accuracy of interventions.