Ch. 14 Models of Practice and Frames of Reference

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Frame of Reference

Using a model of practice and a ________________ to guide one's practice is essential to evidence-based practice.

Theory

__________ allows the occupational therapy practitioner to structure and organized his or her intervention and is used to develop hypothesis for intervention.

Models of Practice

Occupational therapy ___________________ help practitioner organize their thinking around the philosophical based of the profession, which is occupation.

Model of Human Occupation (MOHO)

The ________________________ views occupation in terms of volition, habituation, performance, and environment.

Client-centered approach

___________________refers to understanding the client's desires and wishes for intervention and outcome.

Plasticity

Refers to the phenomenon that the brain is capable of change and through activity one may get improve neurological synapses is called brain _________________.

Frame of Reference

A ________________ provides practitioners with specifics on how to treat specific clients.

Principles

_____________ explain between the relationships of two or more concepts. For instance, once the concept of color is learned, such as blue and yellow, a child learns the principle that mixing these two colors produces green.

Biomechanical frame of reference

The ___________________ is derived from theories in kinetics and kinematics (science that study the effects of forces and motion on material bodies).

Dysfunction

_________________ results when the person's ability to process information is restricted in such a way that carrying out routine tasks is impossible.

The model of practice that views occupation in terms of volition, habituation, performance, and environment.

Definition for Model of Human Occupation (MOHO)?

Evidence-based practice

Choosing the intervention techniques based upon the best possible research.

ldeas that explain the relationship between two or more concepts.

Define principles.

Cognitive disability

A frame of reference based on the premise that cognitive disorders in those with mental health disabilities are caused by neurobiological defects or defects related to the biologic functioning of the brain.

A way of organizing that takes philosophical base of the profession and provides terms to describe practice, tools, for evaluation, and a guide for intervention.

Definition for model of practice.

Biomechanical

A frame of reference derived from theories in kinetics and kinematics and used with individuals who have deficits in the peripheral nervous, muscoloskeletal, integumentary (e.g., skin), or cardiopulmonary system.

Performance

The motor, cognitive, and emotional aspects required to act upon the environment.

Volition

A person's motivation, interests, values, and belief in skill.

Occupation

The everyday things people do and in which they find meaning.

A system that applies theory and put principles into practice, providing practitioners with specifics on how to treat specific clients.

What is frame of reference?

Habituation

One's daily patterns of behaviors, one's roles, and one's everyday routine.

Occupational adaptation

A model of practice articulated by Schkade and Schultz, that purposes that OT practitioners examine how they may change the person, environment, or task so the client may engage in occupations.

Concepts

ldeas that represent something in the mind of the individual.

Brain plasticity

The phenomenon that the brain is capable of change and through activity one may get improved neurological synapses, improved dendritic growth, or additional pathways.

A set of ideas which help explain things and how they work.

Define theory?

Environment

The physical, social, and societal surroundings in which the person is involved.

Occupational Therapy Practice Framework (OTPF)

Designed to assist practitioners in defining the process and domains of OT. Defines the process of OT as a dynamic, ongoing process including evaluation, intervention, outcome.

Activity of everyday life, named organized, and given value and meaning by individuals and a culture.

Definition for occupation?

Occupation

_________ is everything people do to occupy themselves, including looking after themselves, enjoying life, and contributing to the social and economic fabric of their communities

An outline of domain of OT and describes evaluation and intervention process involving the use of occupation.

Occupational Therapy Practice Framework provides what?

Model of practice and frame of reference

The contents of the OTPF do not reflect the detailed information needed by practitioiners that is provided by ____________.

Frame of reference

Is a tool to guide one's intervention?

Frame of reference

A system that applies theory and puts principles into practice, providing practitioners with specific clients.

What to do and how to evaluate and intervene with clients.

A frame of reference tells you what?

Have research to support the principles guiding evaluation and interventiion?

Frame of reference has what?

Theory

An explanation of a natural phenomenon that is supported by a large body of scientific evidence obtained from many different investigations and observations

Psychology, medecine, nursing, and social work.

Occupational therapy borrows theories from other disciplines such as?

Analysis

Theory is the ______________ of a set of facts in their relation to one another.

Concepts and principles

There are two major structural components to theory:

Concepts

Words or symbols in language used to represent mental images.

Concepts

A mental grouping of similar objects, events, ideas, or people. (like the concept CHAIR can refer to high chairs, swings, reclining chairs...).

How one represents the relationship between two things. Ex: 'A bird is an animal that has wings and flies.'

Which statement refers to concepts?

A set of interrelated assumptions, concepts, and definitions that presents a systematic view of phenomena by specifying relationships among variables, with the purpose of explaining and predicting the phenomena.

Theory incorporates ideas and is defined as?

Theory

Students frequently resist ________. There is a desire to "get in there and do something" and not to discuss why it is done. One may ask, "Why is important to know about and use _______ in occupational therapy practice?"

Road map

Not applying theory to practice is similar to taking a trip without a __________. The trip will be disorganized and lack structure.

Appreciation

It is necessary to develop an ___________ for theory, because only when an individual knows the reason something is done can he or she do it well; only when a person knows the theory on which various practices and techniques are based will he or she be innovative and employ good clinical reasoning.

Theory is a key element in problem setting and in problem solving. It is the tool that enables the practitioner to 'name it and frame it.'

Parham states the importance of theory:

1.)To validate and guide practice, 2.) to justify reimbursement, 3.) to clarify specialization issues, 4.) to enhance the growth of the profession and the professionalism of its members, 5.) and to educate competent practitioners.

Additional reasons for using theory include?

To validate and guide practice.

First reason for using theory include?

To justify reimbursement.

Second reason for using theory include?

To clarify specialization issues.

Third reason for using theory include?

To enhance the growth of the profession and the professionalism of its members.

Fourth reason for using theory include?

To educate competent practitioners.

Fifth reason for using theory include?

Science-based disciplines such as biology, chemistry, physics, psychology, and occupational science.

Theories specific to occupational therapy practice originated in?

Mosey, Kielhofner, Ayres, Reilly, Llorens, and Fidler

Theories used in occupational therapy include those developed by?

Theory is linked to clinical practice through models of practice and frame of reference, the means by which theory relates to intervention.

How does the practitioner apply theory to practice?

Model of practice, conceptual model, practice model, and frame of reference

Which terms have been used interchangeably in texts?

Evidence-based practice

Using a model of practice ensures a systematic examination of the client and is an important step in providing _____________.

Model of Human Occupation (MOHO)

Is perhaps the best-researched model of practice in occupational therapy. Model of practice that views occupation in terms of volition, habituation, performance, and environment.

Canadian Model of Occupational Therapy (CMOP)

Has also generated a wealth of research to support its design. The core of this model is spirituality, which is defined broadly as anything that motivates or inspires a person.The person, environment (which includes institutions), and occupations are the other parts of the model.

Canadian Occupational Performance Measure

Is a semistructured interview based on this model and provides practitioners with the tool to organize their thoughts.

Canadian Occupational Performance Measure

This interview tool helps identify the family's priorities for their child with special needs and assists in developing therapy goals with the child's primary caregivers. Distributed by the AOTA.

Person-Environment-Occupation-Performance (PEOP)

A model of practice developed by Christiansen and Baum provides definitions and describes the interactive nature of human beings. This model provides generic, broad terms for each area (e.g., person, environment, occupation, performance).

Person-Environment-Occupation-Performance (PEOP)

Person includes the physical, psychological aspects of the individual. Environment includes the physical and social supports, and those things that interfere with the individual's performance. Occupation refers to the everyday things people do and in which they find meaning. Peformance refers to the actions of occupations.

Person

Includes the physical, psychological aspects of the individual in the Person-Environment-Occupation-Performance (PEOP) model of practice.

Environment

Includes the physical and social supports, and those things that interfere with the individual's performance in the Person-Environment-Occupation-Performance (PEOP) model of practice.

Occupation

Refers to the everyday things people do and in which they find meaning performance in the Person-Environment-Occupation-Performance (PEOP) model of practice.

Peformance

Refers to the actions of occupations in the Person-Environment-Occupation-Performance (PEOP) model of practice.

Occupational adaptation

In this model, occupation is viewed as the primary means for the individual to achieve adaptation. Individual adaptation is seen as both a state of being and a rocess that can be examined at a given time, over a specified time period, or over a lifetime.

Occupational adaptation

This model focuses on the person, the occupational environment, and the interaction. It supports compensatory techniques if necessary.

Knowledge

Williamson states that "Frames of reference are produced from the body of ___________ of the profession and address a spedific aspect of the profession's domain of concern."

Intervention

Depending on the focus of ____________, the practitioner may use several frames of reference at one time or use them sequentially over time.

Which apply theory and put principles into practice.

One of the most efficient and practical ways to conduct evidence-based practice is to examine frames of reference, __________________.

Population, theory regarding change, function and dysfunction, principles of intervention, role of the practitioner, and evaluation information.

A frame of reference includes a description of the?

Population, continuum of function and dysfunction, theory regarding change, principles, role of the practitioner, assessment instruments.

Necessary parts of a frame of reference?

Population

The frame of reference identifies the types of diagnoses that would benefit from the intervention. For example, clients who experience decreased strength and endurance are typically treated using the biomechanical FOR.

Continuum of function and dysfunction

The FOR defines behaviors that are characteristics of function and dysfunction according to the principles. The therapist evaluates these behaviors, which vary according to the FOR, during the assessment process.

Theory regarding change

The FOR will describe the theory and hypotheses regarding change. For example, many of the neurological FOR (e.g., neurodevelopmental theory [NDY], sensory integration [SI], motor control) are based upon of brain plasticity, which refers to phenomenon that the brain is capable of change and through activity one may get improved neurological synapses, improved dendritic growth, or additional pathways. Therefore intervention is aimed at improving neuronal firing and generating improved activity through repetition.

Principles

The FOR defines the underlying principles behind the evaluatiion and intervention.These statements, which relate back to the theoritical base, describe how an individual is aided to make changes and progress from a state of dysfunction and function.

The principles of the FOR allows practitioners to use clinical reasoning to determine whether the FOR may benenfit their client (although it may not be originally intended for that population). For example, the principle of strengthening is that by repetitive muscle contractions, more fibers are recruited and the muscle is able to lift more. Practitioners benefit from knowing the principle behind strengthening is the recruitment of more muscle fiber.

Why is important to understand principles?

Role of the practitioner

The _____________ is based upon the principles and theory of the FOR. These statements provide a guide as to how the practitioner will interact with the client and the environment. This is based upon research evidence that supports the expectation that if an OT employs a certain technique the client's function will improve. Subsequently, OT practitioners can be assured when using a FOR that it worked for someone else.

Behavioral frame of reference

To reward positive behaviors and ignore negative ones.

Neurodevelopment frame of reference

Requires that the practitioner touch the client throughout the movement and facilitate a normal movement pattern.

Assessment instruments

The FOR also provides the OT practitioner with a variety of instruments to operationalize the principles. For example, Allen's Cognitve Levels was designed to identify the level of cognitive functioning for clients and to be used with the cognitive disability frame of reference.

Cognitive disability frame of reference

Proposed by Claudia Allen this frame of reference Is based on the premise that cognitive disorders in those with mental health disabilities are caused by neurobiologic defects or deficits related to the biologic functioning of the brain. derived from research in neuroscience, cognitive psychology, information processing, and biologic psychiatry.

The Sensory Integration and Praxis Tests, Miller Assessment for Preschoolers, Adult Sensory Profile, and clinical observations.

Are based upon SI principles and designed to assist the therapist in determining hoe the client would benefit from the FOR

Sensory Integration and Praxis Tests

SIPT administered by OTR- measures sensory integration process that affects learning and behavior in kids 4-9. looks at visual perception, praxis, vestibular skills

Miller Assessment for Preschoolers

School readiness assessment for 2-5 y.o. children- looks at language, cognitive, sensory/motor, complex tasks- are kid ready for school?

Biomechanical frame of reference

A frame of reference derived from theories in kinetics and kinematics; used with individuals who have deficitis in the peripheral nervous, musculoskeletal, integumentary, or cardiopulmonary system

Developmental frame of reference

Identifies the highest level motor, social, cognitive skills in which a client can engage, and facilitate improvements in function from the staring point. Grade activities so that the client cane achieve them, but is slightly challenged. Help "close the gap" in the areas in which the client is unable to perform.

Motor control frame of reference

Work with the client impaired motor skills through activities in the natural environment. Allow the client to make mistakes and learn from them. This FOR suggests that the practitioner provide verbal and physical cues as necessary. Practice should take place in short sessions with frequent breaks.

Perceptual motor training FOR

Work with the client on improving his memory, cognitive skills, safety awareness, and visual perception through a variety of table top activities. May include many computer-type games and strategies.

Sensorimotor frame of reference

Work on improving the client motor skills through practice of occupations. The OT practitioner sets up activities in which the client practices his coordination.

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