Cited by 319Occupational Therapy Practice and ResearchEmpathy and Medical EducationMedicine, History, and Philosophy

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The Narrative Nature of Clinical Reasoning

Mattingly, Cheryl·1991·American Journal of Occupational Therapy

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Abstract

Narrative reasoning is a central mode of clinical reasoning in occupational therapy. Therapists reason narratively when they are concerned with disability as an illness experience, that is, with how a physiological condition is affecting a person’s life. In this paper, narrative reasoning is contrasted with propositional reasoning, and two kinds of narrative thinking are examined. The first is the use of narrative as a mode of speech that can be contrasted with biomedical discourse, in which disability is framed as physical pathology. The second involves the creation rather than the telling of stories. Therapists try to “emplot” therapeutic encounters with patients, that is, to help create a therapeutic story that becomes a meaningful short story in the larger life story of the patient.

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Items 201–300 of 316

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Mostert, E., Zacharkiewicz, A., & Fossey, E. M. (1996) · Australian Occupational Therapy Journal · doi:10.1111/j.1440-1630.1996.tb01848.x · Cited by 5
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Battin, G. S., Romsland, G. I., & Christiansen, B. (2021) · Social Science & Medicine · doi:10.1016/j.socscimed.2021.113904 · Cited by 5
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Kolehmainen, N., Francis, J., & McKee, L. (2008) · British Journal of Occupational Therapy · doi:10.1177/030802260807101202 · Cited by 5
“Similarly in occupational therapy, several authors have suggested that clinical expertise is based on experience-based knowledge (Mattingly 1991b, Paterson et al 2006).”
Background
Models of Adaptation—An Adaptation Process After Stroke Analysed from Different Theoretical Perspectives of Adaptation
Forsberg‐Wärleby, G., & Möller, A. R. (1996) · Scandinavian Journal of Occupational Therapy · doi:10.3109/11038129609106694 · Cited by 5
The meaning of psychosocial occupational therapy in a life‐story perspective. a long‐term follow‐up of three cases
Eklund, M., Rottpeter, J., & Vikström, F. (2003) · Occupational Therapy International · doi:10.1002/oti.185 · Cited by 5
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Problem Solving in Occupational Therapy
Robertson, L., & Griffiths, S. L. (2012) · doi:10.1002/9781118702833.ch1 · Cited by 5
The Phenomenology of Early Psychosis Elicited in an Occupational Therapy Expressive Evaluation
Zafran, H., Tallant, B. K., Gélinas, I., et al. (2017) · Occupational Therapy in Mental Health · doi:10.1080/0164212x.2017.1338982 · Cited by 4
“…therapists and addresses the stated gap that “[t]he clinical problems that are systematically most difficult for therapists are those that fall within the phenomenological domain, yet these have been given the least amount of attention in the education of therapists” (Mattingly, 1991, p. 985).”
Background
Vocational rehabilitation for young stroke survivors in Gauteng public healthcare: Occupational therapists’ perceptions1
Dreyer, G., & van Niekerk, M. (2021) · Work · doi:10.3233/wor-213460 · Cited by 4
“Hierarchyintheoccupationaltherapytreatmentpro-cessseemstobelieclinicalreasoning[57,58]and client-centred, [55, 59] evidence-based practice [50].”
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Burke, H. K., Sample, P. L., Bundy, A. C., & Lane, S. J. (2024) · Journal of Occupational Therapy Education · doi:10.26681/jote.2024.080107 · Cited by 9
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Perner, S., & Danielsson, L. (2021) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2021.1986872 · Cited by 4
“The narrative model of CR focuses mainly on understanding the patients’ experiences and subjective expressions of their story (Edwards and Richardson, 2008; Mattingly, 1991; Mattingly and Fleming, 2019).”
Method
Thinking in Stories: Narrative Reasoning of an Occupational Therapist Supporting People with Profound Intellectual Disabilities’ Engagement in Occupation
Haines, D., & Wright, J. (2021) · Occupational Therapy In Health Care · doi:10.1080/07380577.2021.2022260 · Cited by 4
“They pictured future images of who their patients could be thereby creating a ‘prospective treatment story’ (Mattingly, 1991, p. 1001).”
BackgroundInfluential
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Nesbit, K. C., Randall, K., & Hamilton, T. B. (2016) · Internet Journal of Allied Health Sciences and Practice · doi:10.46743/1540-580x/2016.1581 · Cited by 4
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Chouinard, J., Grenier-Mélançon, G., & Mandeville, L. (2012) · Les cahiers internationaux de psychologie sociale · doi:10.3917/cips.093.0135 · Cited by 4
Domain 7
Whiteing, N. L. (2008) · CRC Press eBooks · doi:10.1201/b13538-10 · Cited by 4
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Klerk, D., & Magdalena, S. (2014) · Cited by 4
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Haines, D. (2015) · University of Brighton Repository (University of Brighton) · Cited by 4
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Hansen, B. W., Pedersen, H. A., Berring, L. L., & Josephsson, S. (2024) · Scandinavian Journal of Occupational Therapy · doi:10.1080/11038128.2024.2394212 · Cited by 3
“OTs try to structure therapy in a narrative way, as an unfolding story through ‘emplotment’ of the therapeutic encounters with patients [19].”
Influential
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“On the narrative approach to the self, see Peacock and Holland (1993), the edited work by Skinner, Pach, and Holland (1998), and McAdams (2019); in relation to healing narratives and the self, see the work by Mattingly (1991, 1998), Mattingly and Garro (2001), and Kleinman (1988).”
Method
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Lancaster, S., & Zachry, A. H. (2023) · Journal of Occupational Therapy Education · doi:10.26681/jote.2023.070206 · Cited by 3
“As asserted by Mattingly (1991), "a narrative model of reasoning ... is fundamental to the thinking of [those in training to become] occupational therapists" (p. 998).”
BackgroundInfluential
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Bailey, D. M. (2001) · The Occupational Therapy Journal of Research · doi:10.1177/153944920102100204 · Cited by 3
“Mattingly, 1991, 1998a; Mattingly & Fleming, 1994).”
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Barrett, J. J., Scheerer, C. R., & Estes, J. P. (2005) · Occupational Therapy In Health Care · doi:10.1080/j003v18n04_01 · Cited by 3
“Sound clinical reasoning is essential to occupational therapy (Fleming, 1991a; Fleming, 1991b; Mattingly, 1991a; Mattingly, 1991b; Leicht & Dickerson, 2001).”
Background
Physiotherapists' Perspectives on Professional Practice in Comparison to Occupational Therapists'.
Ogiwara, S. (2003) · Journal of Physical Therapy Science · doi:10.1589/jpts.15.53 · Cited by 3
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Svidén, G., & Hallin, M. (1999) · Scandinavian Journal of Occupational Therapy · doi:10.1080/110381299443753 · Cited by 3
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de Cuiabá, F., de Almeida, F. M., Azevedo, R. C. D. S., et al. (2018) · Geriatrics Gerontology and Aging · doi:10.5327/z2447-211520181800046 · Cited by 3
Honouring the Sacred in Childbirth: a Midwife's Stories of Women's Developing Sense of Self
Lennox, S. (2002) · Open Access Victoria University of Wellington | Te Herenga Waka (Figshare) · doi:10.26686/wgtn.16920586 · Cited by 5
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Medhurst, A., & Ryan, S. (1996) · British Journal of Occupational Therapy · doi:10.1177/030802269605900605 · Cited by 3
“The aspects of narrative that link to emplotment were used by the therapist to help her tell the family's story, and to make possible future stories; however, the description by Mattingly (1994) was difficult to grasp.”
Method
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Lennox, S. (2002) · doi:10.26686/wgtn.16920586.v1 · Cited by 3
““Narratives make sense of reality by linking the outward world of actions and events to the inner world of human intention and motivation” (Mattingly, 1991, p.999).”
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Bieler, P. (2024) · Campus Verlag eBooks · doi:10.12907/978-3-593-45878-6 · Cited by 3
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Fisher, G. S. (1997) · Occupational Therapy In Health Care · doi:10.1080/j003v11n01_02 · Cited by 2
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Feiler, M. (2003) · Springer eBooks · doi:10.1007/978-3-642-55899-3_2 · Cited by 2
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Michallet, B., Falardeau, M.-C., & Chouinard, J. (2017) · Approches inductives Travail intellectuel et construction des connaissances · doi:10.7202/1039515ar · Cited by 2
“…humain ne peut être ignorée dans les soins de santé, particulièrement en réadaptation en déficience physique, car elle est un facteur déterminant dans la façon de réagir de la personne lorsque celle-ci est confrontée à la maladie ou aux pertes de capacités (Howard & Howard, 1997; Mattingly, 1991).”
Narrative Reasoning in Practice
Bishop, E. T. (2019) · Journal of the American Podiatric Medical Association · doi:10.7547/17-099 · Cited by 2
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Zannini, L., & Daniele, K. (2020) · Encyclopaideia · doi:10.6092/issn.1825-8670/11634 · Cited by 2
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Meier, J. (2019) · Cited by 1
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“…beschreiben sie detailliert die vielen Nuancen der ergotherapeutischen Praxis, u. a. ▬ eine Definition des Klinischen ReasoningProzesses (Mattingly 1991b), ▬ eine Sichtweise der Therapeutin als Problemlöserin mit drei unterschiedlichen Denk- oder Schlussfolgerungsstrategien, um…”
Background
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Background
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Mortenson, W. B. (2009) · cIRcle (University of British Columbia) · doi:10.14288/1.0090265
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Cloutier, E. (2016) · uO Research (University of Ottawa)
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“(Monrouxe, Rees, Endacott, & Ternan, 2014), revise perspectives (Mattingly, 1991), and find meaning in both familiar (Jenstad & Donnelly, 2015) and unfamiliar contexts (Ekelman et al.”
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Authors: Mattingly, C.
Affiliations: University of Illinois Chicago (US)
Corresponding author: Mattingly, Cheryl
ORCID: Mattingly, Cheryl
Venue: American Journal of Occupational Therapy
Publisher: SAGE Publications
Published: 1991-11
Volume: 45
Issue: 11
Pages: 998-1005
ISSN: 0272-9490 (ISSN-L)
1943-7676
DOI: 10.5014/ajot.45.11.998
OpenAlex: W2141806496
Cited by: 319
References: 0
Citations by year: 2026: 6 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 4 · 2021: 14 · 2020: 9 · 2019: 12 · 2018: 8 · 2017: 12 · 2016: 10 · 2015: 10 · 2014: 9 · 2013: 8 · 2012: 5
FWCI: 20.09
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: American Journal of Occupational Therapy (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › Occupational Therapy › Occupational Therapy Practice and Research
Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
Keywords: narrative thinking, clinical reasoning, occupational therapy, propositional reasoning, biomedical discourse, emplotment, therapeutic stories, life stories, narrative therapy
MeSH terms: Clinical Competence, Communication, Creativity, Female, Humans, Imagination, Interprofessional Relations, Male, Occupational Therapy, Problem Solving, Professional-Patient Relations, Thinking

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The Narrative Nature of Clinical Reasoning

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