“Participation Matters” is the theme for Occupational Therapy in 2026.
As an Occupational Therapist and stroke survivor, it really resonates with me, but it also makes me think about what we actually mean when we say someone is participating.
Because participation is often judged purely by what we can see like going to work or attending appointments. But physically showing up is only part of the story. For me, to participate optimally, I have to think about all the challenges I might encounter along the way. Invisible things like fatigue, pain, resilience and communication.
I have to plan accordingly. That might mean using my walking frame, having a support worker, using a voice amplifier, planning rest breaks, changing the environment, adapting how I approach an activity, or simply doing something differently from how I did it before my stroke. From the outside, some of these things might look like limitations. For me, they are often what make participation possible in the first place.
I write in my book:
“There you go, Em, have a good day,” the waiter at the café near my workplace would say, positioning my take-away coffee cup with a straw into my frame’s cup holder. After a few months of adapting to my new work routine, I was finally able to enjoy my morning coffee at my desk again. As a coffee drinker now unable to carry a cup, this clever addition to my frame was amazing.
Reinventing Emma, page 210
And this is where I think Occupational Therapy has such an important role to play. OTs don’t simply ask whether you can do a task; we look at the whole picture encompassing the person, the occupation, the environment, and the physical, cognitive, emotional, and social factors that can create barriers or enable participation. We find ways to adapt the task, the environment, or the approach so that someone can participate in what actually matters to them.
Because adapting something doesn’t make the participation less meaningful. In many cases, it makes it more meaningful and far more sustainable. I can fully participate in many of the things that matter to me because I’ve worked out what I need to make them possible, and there’s something incredibly empowering about that. It’s not about pretending the challenges aren’t there, nor is it about pushing through at all costs. It’s about understanding the challenges, finding solutions, and creating a way forward.
Every task I do and every occupation I engage in might look different from how it did before my stroke. But that doesn’t make it less valuable. If anything, the adaptations allow me to engage in those occupations more fully, with greater meaning and in a way that I can sustain over time.
And perhaps that’s something we don’t talk about enough when we discuss participation. It doesn’t have to look a particular way. It doesn’t have to mean doing something entirely independently or doing things the way everyone else does them. Sometimes, participation looks like a completely different way of doing something. And those adaptations are often what allow someone to be fully present, connected, and engaged.
That, to me, is the power of Occupational Therapy. OTs facilitate participation by helping people identify what matters, understand what gets in the way, and find ways to make meaningful occupations possible. Because participation isn’t simply about being there; it’s about being able to be part of the things that give your life meaning.
That’s why Participation Matters.