Urie Bronfenbrenner

And that really came from the way I'd like to see the research go next.

You know, actually, how do we, you know, support and embrace and acknowledge that Bronfenbrenner's ecological system? How do we bring the home into the setting? And that's all settings.

You know, we're talking here about like, you know, this was an earlier setting in a primary school.

But for me, actually, this goes beyond this.

And this slide also shows different levels.

It's, uh, the Bronfenbrenner's, um, ecological model, and you can see the orange is the individual le- level, and not only, you know, there's a systems approach here.

So individual, family, community, environment, and society, all these levels and, you know, where there's a barrier, um, that a youth can meet when trying to obtain this care.

Reardon and colleagues illustrate the range of individual and systemic-level barriers in mental health care that were reported across multiple qualitative and quantitative studies.

So they wanted to get a clearer picture of what those influences actually are.

And they used an ecological systems lens drawing on Bronfenbrenner's ecological systems theory and the person-environment-occupation model to explore the factors at different levels that affect practice.

They combined this with the participant-focused knowledge translation framework, which looks at how therapists blend evidence, professional reasoning, and the demands of their context into everyday decisions.

The research question guiding the study was, what factors influence the scope of occupational therapy practice in school-based settings? Rather than just look at what individuals do, the researchers also wanted to capture how practice is shaped by policy, school culture, and clinical reasoning.

The researchers ran six focus groups with occupational therapists who'd already taken part in an earlier nationwide survey and agreed to be contacted again.

Findings were then organized using the knowledge translation model and across Bronfenbrenner's three levels, macro, meso, and micro.

21 school-based occupational therapists across the United States took part.

All were women and most were experienced with over 60% having 10 or more years experience in practice.

They exist as multiple systems.

You know, Bronfenbrenner's work is fantastic in that kind of area around thinking about all the sort of circles around the child.

all the different environments that they're in.

Yeah, and that's why it can be quite cool.

It's based on how kids and families grow in the context of their environment.

It's based on like Bronfenbrenner's ecological model.

Oh,

right.

Yes.

I also have, like, fallen in love with Bronfenbrenner's, [laughs] um, ecological systems model.

What is this? Say it again.

Bronfenbrenner's ecological-

Oh, don't think I can spell.

That's hysterical.

Yes

...

Right.

We have to start with Bronfenbrenner's ecological systems theory.

Oh, I always think of this like those, um, those Russian nesting dolls.

Yes.

The kid on the table

... exactly, the individual child on the exam table, you are missing the vast majority of the clinical picture.

So Bronfenbrenner forces us to look outward in these concentric circles.

First is the microsystem.