Occupational upheaval during resettlement and migration: findings of global ethnography with refugees with disabilities.

There is an emerging interest in issues of occupational justice and occupational deprivation within contemporary occupational therapy practice and theory. To inform this emerging agenda, research with populations at risk of occupational injustice is crucial. This study used a global ethnography framework to explore disabled refugees' access to occupational participation in the context of the U.S. refugee resettlement program. Narrative data from eight Cambodian and seven Somali refugees were combined with documentary analysis and information obtained from service providers. Data were analyzed using grounded theory techniques. Findings revealed a strong policy emphasis on employment and self-sufficiency within the U.S. refugee resettlement program. Consequently, resettlement service providers focused on the dichotomous options of work or welfare, overlooking the broader occupational needs of disabled refugees. Lacking supportive services for developing vocational skills or exploring occupational alternatives, the refugees struggled to find occupational avenues that would earn them social validity and integration into American society, leading to feelings of isolation and inadequacy. Research and practice initiatives with this population need to consider the role of institutional factors in shaping their occupational participation and evolving occupational needs.