Positioning Occupational Therapy in Trauma Care: A Systems-Theoretical Proposal.

This article positions occupational therapy as a reflexive system within trauma care. Drawing from a systems-theoretical perspective, we contrast trauma-focused and non-trauma-focused models—which rely on codings such as integrated/nonintegrated and regulated/dysregulated—with occupational therapy’s guiding distinction of participation/non-participation. We show that therapeutic relevance emerges through meaningful engagement—not predefined interventions. Occupational therapy thus enables trauma care without prescribing change, processing, or resolution. By suspending transformation as a prerequisite for trauma care, occupational therapy offers a structurally open and reflexive response to trauma. The article develops this position theoretically and illustrates its implications through case examples.