RHS 303
TRANSITION OF THEORY AND TREATMENT
Philosophical
Base:
Philosophy
of
occupational
Therapy
represent
the
profession’s view of the nature of existence
and gives meaning to and guides the action of
the profession.
The Philosophical base of Occupational Therapy
(adopted in April 1979)
Man is an active being whose development is
influenced by the use of purposeful activity. Using
their capacity of intrinsic motivation, human being
are able to influence their physical and mental health
and their social and physical environment through
purposeful activity. Human life includes a process of
continuous adaptation. Adaptation is a change in
function that promotes survival and self
actualization.
Biological,
psychological
and
environmental process at any time throughout the
life cycle. Dysfunction may occur when adaptation is
impaired. Purposeful activity facilitates the adaptive
process.
(cont….)
Occupational Therapy is based on the belief
that
purposeful
activity
(occupation),
including its interporsonal and environmental
components, may be used to prevent and
mediate dysfunction, and to elicit maximum
adaptation. Activity as used by occupational
Therapist includes both and intrinsic and a
therapeutic purpose. (resolution 532-79,
1979,p.785)
Theory Base
The body of knowledge in Occupational
Therapy and its theoretical base derived from
several broad scientific areas including
biologic and behavioral sciences, sociology,
anthropology and medicine.
Transition of theory to treatment
The transition from theory to viable treatment
strategies is not direct. An intermediary
mechanism is required.
A diagrammatic presentation:
Theories
(from the scientific bases)
Academic Discipline
(Occupational Sciences)
Occupational Therapy Theory
Philosophical base of the Profession
professional Model
Frame of Reference
MODEL
• A model is defined as a theoretical
simplification of a complex reality and consists
of several explicitly defined concepts.
• In order to improve the theoretical foundation
we need to explain the theoretical concepts
that underpin their practice.
WHY STUDY MODELS ?
1. Models provide a link between theory and practice.
2. Model define and focus the area of interest to OT
practitioners.
3. Models provide a framework for assessment,
intervention & evaluation.
4. Models contribute to a sound philosophical base
for the profession.
5. Model provides a common vocabulary to
communicate ideas.
6. Models facilitate professional unity.
7. In OT practice there are common themes present
throughout all the models. Those areconcern for individual person.
the value of human occupation.
the recognition of each human as a total
entity.
- willingness to share professional
knowledge to improve lives of others.
8. Models should be reviewed regularly.
CAUTIONS
WHILE FOLLOWING MODELS
• Models are not “cookbooks”. They are guide books
used as helpers in organizing the practice of OT but not
in dictating the practice.
• Is not a solution to every problem.
• Sometimes used to form the boundaries of practice.
• Models should be viewed as inclusive not exclusive.
• A single best model does not exist in occupational
therapy.
Types of Models
• Two types of models present in occupational
therapy.
1. Conceptual model
2. Practice model
Two types of models in OT:
• 1. Conceptual Models – explain WHY OT works,
validate value of OT but tend to be generic and do
not address specific areas of practice.
• 2. Practice Models – explain HOW OT works, gives
guidelines for specific types of evaluation and
intervention
Mosey's Model:
“Occupational Therapy Loop”
PHILOSOPHY
ASSUMPTIONS ETHICS ART SCIENCE
MODEL
RESEARCH
FRAMES OF
REFERENCE
PRACTICE
DATA
• Conceptual model:
It explains about the ideas why the
profession works in a particular way.
• Practice model:
It is used to explain how the ideas of
the theoretical model can be
implemented into a plan of actions.
An important aspect of
Conceptual Model –
Frame of Reference
Frame of reference is based in philosophy.
Philosophy is expressed in
- view points
- beliefs
- values & attitudes
Frame of Reference, Defined
“A set of interrelated, internally consistent
concepts, definitions, and postulates that
provide a systematic description of and
prescription for a practitioner's interaction
within a particular aspect of a profession's
domain of concern.“
Mosey
Frame of Reference
• Theoretical base (propositions)
- conceptualization of man’s purpose for interacting with the
environment.
-areas addressed within our domain of concern of target
population.
• Basic Assumptions:
-Concepts, constructs, relationships, principles, postulates
• Function/disability continuums:
- definition of function
-definition of dysfunction
-treatment expectations/outcomes
-evaluation content/treatment focus
(cont….)
• Behavior indicative of function-dysfunction
-behavior to be elicited in evaluation
-representative evaluation method
-behaviors to be changed in treatment
-outcome measures
-guidelines for analysis of evaluative activities
• Postulates regarding change and intervention
-rationale for conceptualizing process of change
-sequencing of treatment strategies
-representative change techniques
-guidelines for activity analysis
-short term and long term treatment goals
OCCUPATIONAL
THERAPY
PROCESS
Occupational Therapy Process
• REFERRAL STAGE
• Receive referral
• Identify pertinent data from referral
• Collect additional data, if needed.
• Summarize the referring data.
CONCEPTUAL MODEL SELECTION STAGE
• Review possible occupational therapy conceptual
models
• Select a tentative theoretical model
-
-
SCREENING EVALUATION STAGE
Select screening instruments consistent with
theoretical model
Interpret data from the instruments
COMPREHENSIVE EVALUATION STAGE
Review list of comprehensive assessment
techniques consistent with the conceptual
model.
Select the assessment techniques based on the
priorities established from the referral and
screening stages
OCCUPATIONAL THERAPY DIAGNOSIS STAGE
-
List all the problems identified
-
Group the problems into categories
suggested by the conceptual model.
• Occupational
therapy
diagnosis
is
described as complete knowledge to
distinguish
occupational
performance
functional
task
levels
role
and
problems
and
that
occupational
therapists by virtue of their education
and experience are able to treat or
manage.
OCCUPATIONAL THERAPY PRACTICE
- MODEL SELECTION STAGE
-
-
-
Review tentatively selected theoretical model
Considering the occupational therapy diagnosis,
select the theoretical model that best address
the diagnosis.
Identify possible occupational therapy practice
models based on the theoretical model.
Select a tentative occupational therapy practice
model
PLANNING STAGE
-
-
Prioritize the list of categories and problems
based on the client (family, referral source) and
therapist discussion.
Develop a list of expected changes.
Determine when these changes should be
expected.
Based on practice model consider possible
intervention strategies.
IMPLEMENTATION STAGE
-
Begin with first goal statement
Continue with goal list.
Planning process involves selection of media
Major media are1. Creative arts
2. Manual skills
3. Educational tasks
4. Daily living task
5. Functional equipment
6. Avocational activities (recreation)
7. Prevocational exploration and training tasks
8. Use of self
9. Exercise
Active participation by individual
REVIEW STAGE
-
Select an assessment methodology that can
detect change in client.
REVISION STAGE
-
-
Revision stage
Determine what barriers occurring
Explore which options are reducing the barriers.
Determine if OT services are required to resolve
the problem
DISCHARGE STAGE
-
Collect data on the progress toward all goal
statements
Document the status on goal statement at
discharge.
Discharge the client.
FOLLOW-UP STAGE
-
Discuss the client the need for follow up
Document arrangements for follow up visit