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Occupational Therapy Theory & Practice

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Mel Chapman

on 7 May 2014

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Transcript of Occupational Therapy Theory & Practice

Occupational Therapy Theory & Practice
Melissa Chapman
CMOP-E
Occupation is “the bridge that connects person and environment” (Polatajko et al., 2007, p.23).
MOHO
Performance
Dynamic interaction between person, environment and occupation
Environment
Physical & Social
Personal causation
Values
Interests
Roles & habits
Objective &
subjective
Performance
Skill
Participation
Occupational identity
Occupational competence
Spirituality
Affective
Cognitive
Physical
Productivity
Self-care
Leisure
Physical
Institutional
Social
Cultural
Introduction
Practice models explain how theoretical ideas can be implemented into a plan of action to provide service to clients (Reed & Sanderson, 1999) .
CMOP-E
MOHO
Canadian Model of Occupational Performance and Engagement
Model of Human Occupation
Judy: 63 year old women
"It's a housing commission special needs unit... it's got rails, it's got everything you know".
"All my friends are down in Miami you know, and I'm sort of stuck up here...no car or anything"
"I have home help come in for an hour to do the floors and that...if i want them to...they can do more"
"My main problem of corse is my mobility and the deformity on my feet...i can't even walk on carpet without anything on my feet...but they've been stabilised by orthotics and specially made surgical shoes."
"(Doctor's)They said my nerve response times weren't as good as they could be, so to consider not driving...so I've handed my licence in and sold my car "
Person
Occupation
Environment
Subjective experience of performance.
Townsend, E. &Polatajko, H. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, and justice through occupation. Ottawa, ON: CAOT Publications ACE.
Kielhofner, G. (2007). Model of human occupation: Theory and application (4 ed.). Baltimore, MD: Lippincott Williams & Wilkins.
Compare models
CMOP-E
Clinical Reasoning & Intervention
Clinical reasoning & Intervention
Enablement skills:
Scientific and diagnostic reasoning:
Use the information from the diagnosis to understand and predict Judy's condition and progression

Narrative reasoning:
Understand Judy's interests and values from her story.

Pragmatic reasoning:
What services are available, what is their cost
Sensory motor function
Diagnosis:
CMT
Polio
Physical:
Interventions guided by the Canadian Model of Client-centred Enablement.
(Stadnyk, Phillips, Sapeta, MacAulay, Champion, Tam & Craik, 2009).
Adaptations to the environment, advocacy for Judy’s need for appropriate transportation, collaboration with Judy and local services, coordination of information, and education to promote Judy’s performance of occupations
References
Polatajko, H. J., Davis, J., Strewart, D., Cantin, N., Amoroso, B., Purdie, L., & Zimmermann, D. (2007). Specifying the domain of concern: Occupation as core. In E. A. Townsend & H. J. Polatajko (Eds.), Enabling occupation II: Advancing an occupational therapy vision for health, well-being, and justice through occupation. (pp. 13-36). Ottawa, ON: CAOT Publications ACE.
Kielhofner, G. (2007). The basic concepts of human occupation. In G. Kielhofner (Ed.), Model of human occupation: Theory and application (4 ed., pp. 11-23). Baltimore, MD: Lippincott Williams & Wilkins.
Ikiugu, M. N. (2007). Psychosocial conceptual practice models in occupational therapy. St Louis, MO: Mosby Elsevier.
Law, M., Polatajko, H., Baptiste, S., Townsend, E. (2002). Core concepts of occupational therapy. In E. Townsend (Ed.), Enabling occupation: An occupational therapy perspective, revised edition. (pp. 29-56). Ottawa, ON: CAOT Publications ACE.
“it (not being able to walk on carpet) really affects me…and it gets very frustrating”
“I’ve got to be honest with you, motivation is a big thing…because exercises tire me out and I’ve got things to do around the house here…if I’m exercising in the morning it takes me twice as long to do what’s got to be done.”
“I go to solace since I’ve lost my husband, I run my support group (for CMT), and I occasionally do a little bit of charity work for the kidney foundation”.
“I’m a reader, my thing is to do what I have to do in the morning, like housework …usual a late lunch… then I like to sit down or sometimes sit out in the sun there and just read the paper and have my little nana nap”
“I’m very restricted mobility wise and strength wise… because of the way I am it takes me longer (to do things)”.

“Gold Coast volunteer transport occasionally have like little bus trips...they’ve got the mini bus and I find it a bit hard to get up there”
Narrative and interactive reasoning:
Understand Judy's interests and motivation for doing what she does. Gathering an understanding about Judy's values and subjective views.

Pragmatic reasoning:
What are Judy's perceived skills, how can theses be utilised or enhanced so Judy can do what she wants to do.
Interventions
Can be directed towards alteration of any of the four principle constructs, which ultimately leads to reorganisation of the whole system (Kielhofner, 2007).

This approach unites mind and body to understand how the body is mindful and the mind embodied (Ikiugu, 2007).
-Visual representation
-Performance capacities
-OT domain
-Person centered practice
-What motivates a person to do things
-Assessment tools to guide assessment and interventions
-Vocabulary

CMOP-E
Occupation is “the bridge that connects person and environment” (Polatajko et al., 2007, p.23).
Performance
Dynamic interaction between person, environment and occupation
Spirituality
Affective
Cognitive
Physical
Productivity
Self-care
Leisure
Physical
Institutional
Social
Cultural
"It's a housing commission special needs unit... it's got rails, it's got everything you know".
"All my friends are down in Miami you know, and I'm sort of stuck up here...no car or anything"
"I have home help come in for an hour to do the floors and that...if i want them to...they can do more"
"My main problem of cause is my mobility and the deformity on my feet...i can't even walk on carpet without anything on my feet...but they've been stabilised by orthotics and specially made surgical shoes."
"(Doctor's)They said my nerve response times weren't as good as they could be, so to consider not driving...so I've handed my licence in and sold my car "
Person
Occupation
Environment
Townsend, E. &Polatajko, H. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, and justice through occupation. Ottawa, ON: CAOT Publications ACE.
Clinical reasoning & Intervention
Enablement skills:
Scientific and diagnostic reasoning:
Use the information from the diagnosis to understand and predict Judy's condition and progression

Narrative reasoning:
Understand Judy's interests and values from her story.

Pragmatic reasoning:
What services are available, what is their cost
Sensory motor function
Diagnosis:
CMT
Polio
Physical:
Interventions guided by the Canadian Model of Client-centred Enablement.
(Stadnyk, Phillips, Sapeta, MacAulay, Champion, Tam & Craik, 2009).
Adaptations to the environment, advocacy for Judy’s need for appropriate transportation, collaboration with Judy and local services, coordination of information, and education to promote Judy’s performance of occupations
Environment
Physical & Social
Personal causation
Values
Interests
Roles & habits
Objective &
subjective
Performance
Skill
Participation
Occupational identity
Occupational competence
Subjective experience of performance.
Kielhofner, G. (2007). Model of human occupation: Theory and application (4 ed.). Baltimore, MD: Lippincott Williams & Wilkins.
Clinical Reasoning & Intervention
“it (not being able to walk on carpet) really affects me…and it gets very frustrating”
“I’ve got to be honest with you, motivation is a big thing…because exercises tire me out and I’ve got things to do around the house here…if I’m exercising in the morning it takes me twice as long to do what’s got to be done.”
“I go to solace since I’ve lost my husband, I run my support group (for CMT), I occasionally do a little bit of charity work for the kidney foundation”.
“I’m a reader, my thing is to do what I have to do in the morning, like housework …usual a late lunch… then I like to sit down or sometimes sit out in the sun there and just read the paper and have my little nana nap”
“I’m very restricted mobility wise and strength wise… because of the way I am it takes me longer (to do things)”.

“Gold Coast volunteer transport occasionally have like little bus trips...they’ve got the mini bus and I find it a bit hard to get up there”
Narrative and interactive reasoning:
Understand Judy's interests and motivation for doing what she does. Gathering an understanind about Judy's values and subjective views.

Pragmatic reasoning:
What are Judy's perceived skills, how can theses be utilised or enhance so Judy can do what she wants to do.
Interventions
Can be directed towards alteration of any of the four principle constructs, which ultimately leads to reorganisation of the whole system (Kielhofner, 2007).

This approach unites mind and body to understand how the body is mindful and the mind embodied (Ikiugu, 2007).
Identified to best suited Judy- best explanatory power
MOHO
Scientific and diagnostic reasoning- Predict limits to performance and likely impact on occupation.

Narrative and interactive reasoning- Build rapport with Judy, encourage collaboration and understanding of Judy's interesets and values based on her story.

Ethical reasoning- Are interventions right for Judy, are they enabling her equitable engagement in meaningful occupations.

MOHO
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