OCCUPATIONAL THERAPY PRACTICE FOR CHILDREN WITH ADHD IN EAST JERUSALEM: PROFESSIONAL VALUES, INSTITUTIONAL CONSTRAINTS, AND THE POLITICS OF CARE
DOI:
https://doi.org/10.46827/ejphs.v9i2.268Keywords:
occupational therapy, ADHD, East Jerusalem, qualitative research, thematic analysis, professional practice, Palestine, structural barriers, sensory integration, cultural competencyAbstract
This study explores the description of practice by occupational therapists (OTs) in East Jerusalem working with children with attention deficit hyperactivity disorder (ADHD) and how their practice is influenced by professional values, expectations of change and institutional context. The rationale for this study is primarily based on observational evidence and gaps in the empirical literature in the field of occupational therapy for ADHD in politically contested, resource-limited, and culturally specific contexts, such as East Jerusalem, where Palestinian children experience the compounded burden of structural, geographic, and political barriers to care. Methodology: This study was conducted using a qualitative methodology, composed of semi-structured interviews of 29 occupational therapists working in school, clinic and early childhood services in East Jerusalem. Data were analysed using reflexive thematic analysis (Braun & Clarke, 2006). The results yielded six themes: session as negotiated space; aspirations and institutional reality; competing change agendas; professional values as practice driver; East Jerusalem as practice context; and navigating resistance and accommodation. The results disclose that the nature of the practice of OT in East Jerusalem is first and foremost a milieu of chronic under-resourcing, institutional discrepancy, political insecurity, and an almost-conspicuous absence of a collective professional infrastructure, instead of principally formal, theoretical or evidence-based protocols .Therapists routinely drew from sensory regulation (the intervention of choice), improvised given insufficient equipment and space, and balanced clashing mandates from parents, schools, and institutions. Cultural responsiveness, therapeutic relationship and individualization emerged as de facto core values underpinning structural constraint treatment practice. This study is the first empirical insight into occupational therapy in a community with ADHD in East Jerusalem and has important implications for education, service provision and policy change.References
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