Exploring the Role of Participation: Understanding Participation From the ICF Perspective

Dear readers,

I’m Aleyna Kayım, SPOTeurope’s Event Coordinator. Happy OT month to all of us, today I would like to examine with you a “participation” terminology that has been defined many times over the years, which I am very interested in and think fits the philosophy of the month.

Participation, as defined in the International Classification of Functioning, Disability, and Health (ICF), is “involvement in life situations”. This broad perspective extends to our occupations, and roles we inhabit that define and shape our daily activities. Viewing participation through an occupational therapy lens allows us to appreciate its significance in facilitating meaningful engagement, promoting well-being, and fostering independence across various life domains.

The International Classification of Functioning, Disability and Health (ICF)

The International Classification of Functioning, Disability and Health (ICF), developed by the World Health Organization (WHO) in 2001, serves as a comprehensive classification. Primarily serving as a classification tool, it complements the WHO’s International Classification of Diseases (ICD). Additionally, the ICF incorporates a new model of human functioning and disability to elucidate the interplay between health conditions and contextual factors.

Key Factors

The World Health Organization emphasizes the broad implementation of the International Classification of Functioning, Disability, and Health (ICF) as a guiding framework for social policy, research, education, and clinical practice worldwide. By highlighting participation, the ICF offers a universal language and framework for understanding health and related states, facilitating a holistic approach to describing health, functioning, and disability that emphasizes individuals’ engagement within their environments, ultimately promoting inclusive practices globally.

The content and application of the model also underscore that the concept of participation shouldn’t be viewed in isolation from other contexts. Like every context, participation is interlinked with and influences both itself and other factors.

Participation from Occupational Therapy Perspective

Participation in occupation is linked to human development, life satisfaction, and overall health, with meaningful activities. The concept of occupation comprises two primary components in interaction: occupational form and the individual. Occupational form encompasses the nature of the activity and external conditions derived from culture and context, while the individual brings capabilities, purpose, and meaning to the activity. This interaction yields occupational performance, observed as individuals engaging in activities, which fosters self-determination and autonomy through mastering experiences. Occupational performance is a dynamic process influenced by personal motivation, interests, habits, and the broader social, physical, and cultural contexts. In essence, the occupational perspective focuses on the significance of daily activities for health and development, emphasizing the subjective experiences of meaning, autonomy, and self-determination, the complex interrelationships between different types of occupations.

Additionally,the concept of participation permeates theoretical frameworks like role theory, and symbolic interaction theory, as well as application models such as MOHO, CMOP-E, and PEOP, in addition to clinical approaches.

In summary, irrespective of the clinical context and the field of application, the concept of participation deserves heightened significance and should be integrated as a fundamental perspective in intervention approaches, both in assessment and intervention stages.


  1. Hemmingsson, H., & Jonsson, H. (2005). An occupational perspective on the concept of participation in the International Classification of Functioning, Disability and Health—some critical remarks. The American Journal of Occupational Therapy59(5), 569-576.
  2. Maxwell, G. R., Granlund, M., & Augustine, L. (2018, June). Inclusion through participation: understanding participation in the international classification of functioning, disability, and health as a methodological research tool for investigating inclusion. In Frontiers in Education (Vol. 3, p. 41). Frontiers Media SA.
  3. Van de Velde, D., Coussens, M., De Baets, S., Sabbe, L., Vanderstraeten, G., Vlerick, P., … & De Vriendt, P. (2018). Application of participation in clinical practice: key issues. Journal of rehabilitation medicine50(8), 679-695.
  4. Prodinger, B., Darzins, S., Magasi, S., & Baptiste, S. (2015). The International Classification of Functioning, Disability and Health (ICF): Opportunities and challenges to the use of ICF for occupational therapy. World Federation of Occupational Therapists Bulletin71(2), 108-114.
  5. Maritz, R., Baptiste, S., Darzins, S. W., Magasi, S., Weleschuk, C., & Prodinger, B. (2018). Linking occupational therapy models and assessments to the ICF to enable standardized documentation of functioning. Canadian Journal of Occupational Therapy85(4), 330-341
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