Participatory photography as socially transformative occupational practice: Insights from a realist review

Introduction: In the fields of occupational therapy and occupational science there have been calls for practises that focus on social transformation (Farias and Laliberte Rudman, 2019). However, there is a limited evidence base to support understanding of how change comes about through using occupation-based initiatives (Frank, 2022). Participatory photography is a well-documented intervention utilising the occupational form of photography with the intention of bringing about social change, as such it makes an appropriate case study for developing understanding of socially transformative work. Method: to understand how occupationally based interventions might support change process, a realist review of participatory photography was undertaken. Realist review is a method of evidence synthesis that supports theory development based on empirical evidence (Pawson, 2006) and is novel in occupational science. Database searches included Medline, SocINDEX, art full text, PsychINFO, CINAHL, PubMed including 61 documents in the review. Findings: The final programme theory was made-up of 40 explanatory context, mechanism and outcome configurations. Including the importance of skilful facilitation that built trust and supported groups, activating psychological safety, meaning people felt safe to express themselves. However, participatory photography carried risks for participants, and these limited the transformative potential of projects. Implications for OS: This realist review provides a set of evidence-based recommendations that can be adopted by practitioners when using occupation-based interventions for social change. Practitioners who adopt the recommendations will be able to create greater impact and mitigate risks that are inherent in socially transformative work.