I see the horse is not dead yet!!!!
This age old debate revolves around the top down approach and the
bottom up approach to treatment, or the occupation as a means or an
end. We as OTs in physical disabilities can choose either to treat
occupational dysfunction in two ways a) Use occupations as the
treatment modality to combat the issue of occupational dysfunction
either through restoration or compensation or b) Treat the underlying
impairment. In my opinion it simply depends on what is causing the
occupational dysfunction. If an occupational takes an interest in hand
therapy and they decide to specialize in this area (PTs can do this
too) then I would say that the occupational therapist is doing hand
therapy. I would not state that they are doing physical therapy
because this is a gray area. Perhaps a physical therapist takes an
interest in visual perceptual training ( my PT friend did) because of
their strong background in neurorehabilitation. When they utilize this
training during treatment sessions to facilitate better outcomes with
gait and balance, would they state that they are doing occupational
therapy? What if a PT takes a liking to driving evals and training
(IADL),. Would they call it occupational therapy or drivers training?
What Ron is simply trying to do is change the paradigm of occupatonal
therapy and simply rewrite the textbooks we once read in school, by
erasing the biomechanical model. I applaud him to a certain extent,
but at times I an confused by his reasoning.
Hand Therapy does not necessarily mean a cone or peg pusher therapist.
A Hand therapist does not necessarily give the pubilic a certain image
of what OT is , but it is the misguided therapist that provides OT
without meaning in order complete enough time to reach a certain RUG
level or complete the "Three hour rule". I do not think it is Ron's
intent to upset all of the OTs who practice hand therapy, but to guide
phys dys OTs to provide meaning during their therapy sessions in order
to clean up the public perception of what we do.
Chris Nahrwold MS, OTR..
-----Original Message-----
From: Ron Carson <rdcar...@otnow.com>
To: Kristin <OTlist@OTnow.com>
Sent: Fri, 12 Jun 2009 10:04 pm
Subject: Re: [OTlist] Dental Hygienst Knows About OT...
Kristin, I don't really know where to start, so let me just jump in.
In my opinion, the BIGGEST problem facing OT is that we do not do what
we say we do. Comparing AOTA's rhetoric and practice patterns of adult
phys dys OT's does not paint a congruent picture. On paper, the OT
profession is all about occupation. In practice, adult phys dys is all
about UE rehab. For me, this inconsistency is killing our profession!
I'm going to disagree with some of what you've written:
1) A broken finger may or may not cause occupational deficits. And even
if it does, these deficits may not require the skill of an OT.
2) I don't care if the hygienist had a good or bad experience. I do
care
if the experience revolved around occupation.
3) Occupation should NOT be things talked about during rote therapy.
Occupation should be the FOCUS and outcome of treatment.
4) The profession needs therapists who are experts in occupation. Leave
the UE specialization to PT.
Disclaimer:
My comments are not directed towards YOU. They are just
general comments about how I feel towards OT.
Everyone is welcome to join this conversation. Only through
honest and logical dialogue will we better understand and
appreciate everyone's viewpoints.
Thanks,
Ron
~~~
Ron Carson MHS, OT
www.OTnow.com
----- Original Message -----
From: Kristin <kay42...@yahoo.com>
Sent: Thursday, June 11, 2009
To: otlist@otnow.com <otlist@otnow.com>
Subj: [OTlist] Dental Hygienst Knows About OT...
K> I guess I dont understand why it's such a horrible thing for OT's to
K> be knowledgeable and profiecient in treating UE ailments. I agree
K> that shouldn't be the only area for the profession to focus on, but
K> having a broken finger causes dysfunctional occupational performance!
K> At least the dental hygenist had a good experience with OT as opposed
K> to the 'cone therapists'. I would be interested to hear if the
K> therapist discussed what the patient could do at home to reduce pain
K> and improve function. The things we should be talking about when
K> performing more rote therapy techniques.
K> I think the profession needs OT's who are UE specialists! We don't
K> want to loose that specialty area!
K> Kristin
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