Occupational Therapy Theories

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45 terms · Practice Frame- Work OT 203-1 -Historical Impact on Theory Organization of Knowledge: Paradigm to Frame of Reference

Occupational Therapy's Domain

Supporting health and participation in life through engagement in occupation.

Domains

These are the areas of life an OT can offer assistance with. 6. AACCPP
Areas of Occupation
Client Factors
Performance Skills
Performance Patterns
Context and Environment
Activity Demands

Areas of occupation

ADLs
IADLs
Rest and sleep
Education
Work
Play
Leisure
Social Participation

Client factors

Values, beliefs, and spirituality
Body Functions
Body Structures

Performance skills

Sensory Perceptual Skills
Motor and Praxis Skills
Emotional Regulation Skills
Cognitive Skills
Communication and Social Skills

Performance patterns

Habits
Routines
Roles
Rituals

Context and Environments

Cultural
Personal
Physical
Social
Temporal
Virtual

Activity Demands

Objects used and their properties
Space Demands
Social Demands
Sequencing and timing
Required Actions
Required Body Structures

Outcomes

Occupational performance
Adaptation
Health and wellness
Participation
Prevention
Self Advocacy
Role Competence
Quality of life
Occupational justice

Types of Interventions

Therapeutic use of self
Therapeutic activities
Consultation
Education
Advocacy

1786

Philippe Pinel worked with the mentally ill in Paris

1798

Dr. B. Rush used 'work activity' in Philadelphia

1800's

Samuel Tukes proposed humane/moral treatment for the mentally ill in York, England in response to 'inhumane' treatment of the 'insane

Mary Reilly Quote

"Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health."

1892 Adolph Meyer proposed

'rhythms' of rest - play - work, and return to humanism
Highlighted the difference between opportunity and prescription

1905 Susan Tracy -

known as the 1st OT - instituted a training course and in 1910 published her text Study in Invalid Occupation

1920's

Humanism - 1920's Meyer
Habit Training and Reconstruction

Mechanistic viewpoints

1940's and 1950's with inclusion of activity analysis and rehab models of practice

1917

National Society for the Promotion of OT

1923

Standards for Education in OT

1930's
1940's

Registry established (OTR)
Examination (NBCOT)

1960's
1970's and 80's

COTA's came into being

legislated health care and OT roles

1980's
1990's

birth of occupational science
ADA

2001
2002
2008

2001 WHO revises International Classification of Function
2002 AOTA Publishes the 1st edition of the Occupational Therapy Practice Framework: Domain and Process
2008 2nd edition of the OT Frameworks

Process

The way a practitioner sets up there practice to provide best services.
Evaluation
Intervention
Outcome

Theory

Theory helps to describe, explain and predict behavior and/or relationships between concepts and events
A theory can be classified as a: paradigm, model or frame of reference

Paradigm

'describes a philosophical viewpoint,' is a shared vision and a 'force for unity;' provides a professional identity.
Mosey (OT) proposed that the paradigm contains: philosophy, values, ethical code (ethics), theoretical base, legitimate tools and domain of concern.
The paradigm for OT reflects systems theory which proposes that 'a system is an entity that maintains its existence and functions as a whole through interaction of its parts.'

a paradigm describes a philosophical viewpoint, is a shared vision and force for unity, and provides a professional identity.
According to Mosey - a paradigm contains:\
Philosophy
Values
Ethical code
Theoretical base
Legitimate tools
Domain of concern

Model

attempts to explain the relationship of occupation, person and environment, organizes and categorizes ideas and approaches to thinking about complex problems.
Models do not focus on any specific disability, age group or practice area

Frame of Reference

is a theory of compatible concepts that guides a plan of action for assessment and intervention within a specific OT domain - these usually do focus on specific disabilities, or ages or practice areas.
F'sOR contain: (1) narrowed theoretical base (2) function-dysfunction continua (3) guidelines for evaluation and intervention and (4) research substantiation

emergent properties

Systems function as a whole, so they have properties above and beyond the properties of the parts that comprise them. These are known as emergent properties - they emerge from the system when it is working; they are often unpredictable and are not found in individual parts of the system but in the interaction of those parts.

Legitimate Tools

OT's tools are:
nonhuman environment,
conscious use of self,
teaching-learning process,
purposeful activities,
activity groups
and activity analysis and synthesis.

Purposeful activity

Involves interaction with environment.
matches clients goal
mastery

Conscious use of self

Characteristics:
(1) planned interaction
(2) manipulative
(3) heighented sensitivity of how 'i' impact others
(4) use both verbal and non-verbal communication

Anticipated outcomes:
(1) . relieve fear and/ or anxiety
2. provide reassurance
3. obtain or provide necessary info
4. give advise
5. assist the individual in gaining more appreciation, expression and/or functional use of latent inner resources

Activity groups

"provide a laboratory for living: a microcosm of life, learning and work."
Difference between verbal and activity groups, activity groups: (1) : 1. centrality of activity. 2. immediacy of events, 3. circumscribed focus

Functional group (purposeful action promotes adaptation through engagement in occupation) means:
1. maximum involvment through group centerned action.
2. maximum sence of individual and group ID
3. a flow experiance ( so involved that you loose track of time)
4. spontaneous involvment of members
5. member support and feedback

Activity groups provide:
(1) structure
2. opportunity to express ideas and feelings
3. use of the non human environment
4. method of concretizing behavior ( say exactly what the problem is)
5. tangible means of measuring progress

Cohesiveness
Interpersonal learning
Instillation of hope

Metaphysics

- nature of man: mind body relationship, hierarchy vs heterarchy. Monism vs dualism

Epistemology

= questions of truth: how do we know things to be true? Must we experience something to beilve its true?

Axiology

= study of values 1. aesthetics, what is beautiful and desiarble. 2. ethics - code of conduct

Ethics

Ethics = study of that which is moral, good, or of value in life and actions (Mosey)

The primary goal of ethics is to develop a good character as such ethics is to develop....

Ethics help us to harmonize our interests and roles and avoid abuses of power.

KOHLBERG'S SIX STAGES

Level 1. Preconventional Morality
Stage 1. Obedience and Punishment Orientation.
Stage 2. Individualism and Exchange.
Level II. Conventional Morality
Stage 3. Good Interpersonal Relationships.
Stage 4. Maintaining the Social Order.
Level III. Postconventional Morality
Stage 5. Social Contract and Individual Rights.
Stage 6: Universal Principles.

Gilligan/In a Different Voice - relationships and caring - gender

Individual survival
Self sacrificial caring for others
Morality of non-violence; caring as a universal obligation

Virtues of health care professionals due to 'unique societal role':

Benevolence
Competence
Objectivity
Caring
Compassion

Principles used in clinical ethics:

Autonomy -
Beneficence -
Nonmaleficence -
Fidelity -
Justice -
Veracity -
Paternalism/parentalism -

Core Values and Attitudes of OT

Core Values and Attitudes of OT
Altruism -
Equality -
Freedom -
Justice -
Dignity -
Truth -
Prudence

Ethical dilemmas

occur when we face a situation in which the right or correct action is not clear - this may mean there is more than 1 right action.

Ethical conflicts

occur when our values clash with others causing us to feel uneasy, upset and/or perplexed.

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