Institutional ethnography: A method for showing how the context shapes practice

The article illustrates the sociological theory and method of institutional ethnography by describing a study of occupational therapy's mental health practice. Over almost 6 months, the author collected data through observation, interviews, and review of documents. Data describe the practice of occupational therapy in seven adult mental health day programs with at least one site in each of the four provinces of Atlantic Canada. The question asked was, What are the possibilities and constraints for occupational therapists to enable the empowerment of adults who attend mental health day programs? Although developed as a feminist methodology for displaying the social organization of patriarchy, institutional ethnography is used in this study to show how the organizational context invisibly shapes occupational therapy practice. Through this method, occupational therapy ideas about occupation can be seen to be organizationally subordinated. Occupational therapists' work in enabling empowerment through occupations such as "chores" is relegated to the background to make practice fit prevailing medical and psychologic ideas about health.