" How do you feel about the Practice Framework; seems the Domain enables and empowers us to work towards occupation-based treatment through the use of other type of activity until the client is able to participate in true occupation. Curious about thoughts on that."
Alice Krauss Alice ,Ron, Charles and others: I did read the Practice Framework sometime back and agree with Alice's observation. I e-mailed the following suggestions to my RA. Please bear with me, it is a rather long post. Also, I felt Deborah Amini's article on "Occupational Deprivation" in the Advance for OTs (March 22, 2004) was very well written and does contribute to this discussion on the "Scope of OT" and our quest to define our practice. My post to my RA: I have showed my changes/ suggestions in red while quoting the actual draft in blue. "The practice of occupational therapy means the identification/ classification (diagnosis) of occupational dysfunction, therapeutic use of goal oriented tasks/ activities (occupations) and interventions that utilize tools that enhance a performance component and/or facilitate an intended function (such as application of orthoses, supportive/ assitive devices, exercises, PAMs, etc.) with individuals or groups for the purpose of participation in roles and situations in home, school, workplace, community, and other settings." My suggestions stems from my belief that "occupations" include all tasks/ activities that an individual performs to "occupy" self -physically, mentally/ emotionally, socially in a constructive, age/ sex/ socio-culturally appropriate (accepted/expected) manner. The common man, physicians or other referral sources, may perceive "...everyday life activities" (as used synonymous for "occupations" in the draft) as use of actual tasks alone such as dressing, bathing, toileting (basic self-care) as the only interventional tool to be used by OTs and discredit the true range of services performed by OTs. I feel " goal oriented tasks/ activities " (yes, the same old phrase) will include all such physical and mental occupations required for functional outcomes such as use of goal-oriented exercises on Mr. X. (though not necessarily an everyday activity for a rather pre-morbidly sedentary Mr. X. ) for strengthening/ arthrometric restoration post CVA to facilitate independence in dressing self or work as a factory supervisor. Or, the intervention to retrain or facilitate adaptations for a certain Mr. Y., who wants to be able to leisurely golf (again not a 'everyday' task in the commonly perceived sense of the word). I believe my suggestions also helps us define the OT practice reflective of our work across a wide range of settings such as wellness, pediatrics, post TBI, hand and low-vision therapy as well. I also, strongly believe we must also keep in mind the movement for gaining direct access by us and other related professions (we are already a direct- access profession in most parts of the world and 30-odd states in the US). We must position ourselves as competent 'first contact/ primary care' clinicians that can identify/ classify occupational dysfunctions (the ICF system truly helps our purpose). Rehab diagnoses are certainly what we are used to doing and with some training, I believe OTs can grasp this concept. If we cannot identify the problems independently , how can we be the first contact? And then, who should be the ones identifying occupational dysfunctions? In my opinion, if the definition could incorporate a similar language as I have suggested, it will give us the latitude that we seek in our scope to address all conditions/ ages and use all tools available to us. I also believe to be perceived as equals in the rehab/ health arena and by the public to our kins PTs, audiologists, etc. our academic preparation must be equal as well. I strongly urge every OT to read the APTA Scope of PT practice to compare our professional practices as well. Occupation= Any purposeful, goal oriented behavior, task, activity/ function that is age/ sex/ socio-culturally appropriate (per accepted/ expected 'norms'), this also accounts for performance aspects such as speed/ finesse required to function. Occupational dysfunction= Any disruption or deprivation that causes the inability to physically, mentally/ emotionally, socially function per accepted/ expected norms. Occupational disruption= Temporary break in "occupational" functioning per accepted/ expected norms. Example: A professional singer unable to perform publically due to a sore throat. Occupational deprivation= The inability to (occupationally) function, maladaptations in functioning in a rather permanent way or over an extended period. Example: A stroke patient unable to take care of himself, or, an alcoholic that lost his job due to his drinking habits. Thank you for the opportunity to share my thoughts. Joe _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ==============================================
