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Jennifer Creek

The Empire strikes back: Learning from practice on the margins

Updated: Oct 19


The Empire strikes back: Learning from practice on the margins - Dr Jennifer Creek (The Occupational Therapy Hub)

This paper is a keynote address delivered at the RCOT annual conference in 2017


Occupational therapy emerged from social movements that were flourishing in the UK and the US towards the end of the 19th and beginning of the 20th centuries, including: women’s suffrage, socialism and the settlement movement. From the beginning, occupational therapy was essentially a women’s profession, dedicated to helping people experiencing marginalisation and deprivation.

In this paper, I discuss the terminology of the margins and the key features of marginal spaces and places that are of interest to occupational therapists. I write about the British Empire, which, at the time occupational therapy was founded, extended around the globe; showing how a colonial worldview influenced the new profession. Great Britain was the centre of the Empire and the colonies were the margins. I explore the two-way traffic of ideas and practices between centre and margins, applying this to both the British Empire and the occupational therapy profession. Occupational therapy, which began on the social margins in Britain and America, became integrated into the mainstream during the 20th century, losing some of its pioneering spirit in the process. I argue that we have much to learn from occupational therapy theory and practice on the margins, where creativity and innovation are thriving. I conclude that mainstream occupational therapy services can be improved by the adoption of ideas, skills and practices from the margins.


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