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| Theory that provides explanation on how things interact |
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-Interacts with other systems or the outside environment
-Flexible boundaries
-Is intrinsically part of its environment
--E.g. living being, industrial organization |
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-Has relatively little interaction with other systems or the outside environment.
-Rigid and impenetrable boundaries
-Is independent from its environment
--E.g. watch, thermostat |
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1. Nagi disability model
2. Maslow's hierarchy of needs |
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| Examples of Hierarchy (2) |
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| a system of organization replete with overlap, multiplicity, mixed ascendancy, and/or divergent-but-coexistent patterns of relation; state wherein any pair of items is likely to be related in two or more differing ways. |
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| The ICF is an example of what.. |
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| associated with logical thinking |
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| ROM, thinking "inside the box", and math are examples of... |
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associated with disorganized, tangential
-causes critical thinking |
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| thinking "outside of the box", rehab process, activities of intervention, not chaos are examples of... |
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| “subjective state of consciousness in which one becomes totally immersed in the occupation or task at hand and from which satisfaction and well being derives”. |
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Match between one’s skill and the challenge of the activity
Clear short-term goals
One needs to feel one has control
Activity must provide immediate feedback |
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| Anxiety, boredom, or apathy |
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is used to understand the condition that is affecting an individual and to decide on interventions that are in the client’s best interest.
• What is the nature of the illness or developmental problem?
• What are common impairments from this?
• What are the typical contextual factors?
• What theories and research are available for me? |
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Investigative reasoning and analysis of cause or nature of conditions requiring OT intervention
• What are the occ perform problems now or in the future?
• What are the factors that contribute to this problem?
• How are these problems manifested? (skills, habits, routines, occ roles) |
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Reasoning in which therapist considers and uses intervention routines for identified conditions.
• What evaluation and intervention protocols are applicable?
• How are clients usually handled in this setting? |
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Understanding the meaning that a disease, illness, or disability has to an individual is a task that goes beyond the scientific understanding of disease processes and organ systems.
• What is this person’s life story?
• What is the nature of this person as an occupational being?
• How has the health condition affected the person’s life story?
• What activities are most important to this person?
• What activities are most meaningful to this person and useful for meeting therapy goals? |
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considered from two perspectives: the practice context and the personal context.
• Who referred this person and why?
• Who is paying for services and what rules exist?
• What are the expectations of my workplace?
• How much time do I have to see this person?
• What space and equip are available?
• What are my competencies? |
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Asks: What should be done?
• Are the benefits of therapy worth the cost?
• Are the risks of therapy worth the benefits?
• How should I prioritize my caseload?
• What are the limits of how I change my documentation to maximize payment?
• What do I do when there is conflict with team members re patient treatment? |
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Therapy is a communicative process. Must gain the trust of their clients and of people who are important in the clients’ world.
• How can I best relate to this person?
• How can I put this person at ease?
• What is the best way for me to encourage this person?
• What nonverbal strategies should I use in this situation?
• Where should I place myself relative to this person to be close but not ‘invade’?
• What cultural factors do I need to consider as I engage with this person? |
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A blending of all sorts of reasoning for the purposes of flexibility
• Where is this person going?
• How will the various therapy options play out?
• Given the possible future trajectories what is the best action I can take now? |
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| affects EVERYTHING you will do with your client; including experiences, interventions, plans, reflections on our own practice |
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| Launching of this model was the profession's first attempt to promote a holistic perspective for treatment in OT. |
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1. Immediate Contexts
2.Proximal Scale Contexts
3. Community Scale Contexts
4. Societal Scale Contexts |
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| include client and his immediate surroundings such as, work area, home environments, and caregiver-client relationships. Best accomplished by observing specific task performance within the client's natural environment. |
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| includes Frequently encountered behavior settings, such as home, office, classroom, and clinic. The client interacts within the systems of work settings, educational systems, family systems, and health care systems. |
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| include geographic neighborhoods and communities known to client. clients encounter transportation systems, local social, and political systems, religious group systems, and economic systems such as banking and marketing. |
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| include public policies, widely held beliefs and attitudes, and major social institutions. |
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1. Physical Contexts
2. Social Contexts
3. Cultural Contexts
4. Spiritual Contexts
5. Personal Contexts
6. Temporal Contexts
7. Virtual Contexts |
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| Seven Contexts of OT Practice |
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Defined in practice framework as "nonhuman aspects of contexts, including accessibility to and performance within environments having natural terrain, plants, animals, buildings, furniture, objects, tools, or devices"
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| defined in framework as "the availability and expectations of significant individuals, such as spouse, friends, and caregivers. It also includes larger social groups that are influential in establishing norms, role expectations, and social routines." |
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| defined by Wells and Black (2000) as "sum total way of living, including values, beliefs, standards, linguistic expression, patterns of thinking, behavioral norms, and styles of communication that influence behaviors of a group of people and are transmitted from generation to generation" |
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| defined in framework as "fundamental orientation of a person's life; that which inspires and motivates that individual" |
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| Framework defines as "features of the individual that are not a part of a health condition or health status" |
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| Framework defines as "location of occupational performance in time, such as stages of life, time of day or year, and duration" |
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| defined in framework as "environment in which communication occurs by means of airwaves or computers and absence of physical contact" |
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1. Use of space
2. Orientation in space
3. Emotional affiliations with place
4. Vicarious participation in spatially/temporally displaced environments |
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| Dimensions of being in place |
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-Immediate physical activity
-- Ex. range of motion and functional capability related movement in the proximal environment
-Everyday activity
--Ex. routine and often repeated daily trips
-Occasional trips
--Ex. Vacation and long distance trips (usually over-night) |
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-Personal schema
--Ex. A physiologically based axial,
--Maintains balance distinguishes right to left, front to back, up to down
-Specific schemata
--Cognitive linear maps of regularly traveled pathways
-General schema
--An implicit cognitive map of the world as known |
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| Emotional affiliations with place |
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-Personal
--Emotions evoked by personal experiences within particular locations
-Shared
--Mutually developed emotions for place through shared environment and experience of the environment |
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| Vicarious participation in spatially/temporally displaced environments |
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-Reflective
--involvement in places of one's past (either the current environment as it was in the past or previously experienced places located elsewhere)
-Projective
--Vicarious projection into contemporary places that are geographically separated from the individual's current location |
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| Phenomenological perspective |
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| Understanding each person from the perspective of an experienced context (the life world within which he/she defines the self, conducts daily activities, and receives OT intervention) |
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| provides the mechanism for social interaction, and societal development and growth, forming the foundation stone of community, local and national identity,...to the extent of national government or to achieve international goals |
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| exist ing, living, nature and essence. Also described it as the “contemplation and enjoyment of the inner life” |
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| becoming I; becoming competent; and becoming a social being. |
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| Three aspects of becoming: |
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| holds the notions of potential and growth, of transformation and self-actualisation |
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1. A whole that functions as a whole by virtue of the interaction of its parts
2. An entity that is greater than the sum of its parts because it consists of parts, the way the parts act together, and the qualities that emerge from these relationships
3. Anything physical, biological, psychological, sociological, or symbolic
4. An entity that can be static, mechanical, mechanically self regulating, or organismically interactive with the environment
5. An entity with a hierarchy to organize its complexity |
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| 5 things that define a system |
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| the dynamic systems and motions of non-linear systems. |
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1900-1940:
1st Paradigm: Occupation |
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| Community bases, holistic, arts and crafts |
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| 1950’s CRISIS (shift to medical model) |
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| Shift the the medical model, where do OT's fit? |
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1950s-1970s
Mechanistic Paradigm |
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| 2nd paradigm- OATF established, deinstitutionalization |
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| afraid of losing OT, getting lost in other professions, became too fragmented in our own profession |
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1980’s to current
New Paradigm (Really our old paradigm) |
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| 3rd paradigm, technology boom, emphasis on evidence to support practice, MOHO |
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| Distinct Value in history |
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| Articulating value of OT across society and professions |
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Triple Aim of Healthcare (2007)
(OT's value is framed in these) |
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1. Increase quality of care
2. increase efficiency
3. decrease cost |
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| use of occupations as a means of intervention |
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| "to improve health and quality of life through facilitating, participation, and engagement in occupations, the meaningful, necessary and familiar activities of everyday life. OT is client-centered, achieves positive outcomes, and is cost-effective." |
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