Ron,
?I never did apologize. Just stated a fact that I was not criticizing you for
your treatment plan.
It is my summation that you write about the "Philosophy of OT".? I do not think
that if you take two seasoned OTs found in the same setting with a strong
dedication to their clients and put them in two groups a) Working towards
occupation and b)Working on occupation, that you would find much difference in
their treatment plans, quite possibly their treatment interventions, and the
natural activity progression that occurs in providing skilled occupational
therapy.? The true difference comes from their treatment philosophy and the
wording that they may use to describe their work.? To me personally this
difference in philosophy and wording is irrelevent in the "real world".? But I
do see the value of this philosophy when teaching students and therapists who
are stuck in a rut pushing cones and peg boards off as therapy.
It is also my opinion that it is easy to switch to your line of thinking by
just changing a few words in the goal.? Instead of writing "Increase ROM to so
much in order to comb hair" I could simply write "Patient will comb her hair
with no assistance".? Instead of writing "increase standing balance by so many
minutes in order to toilet" one can write "Patient will complete his toileting
with min assist.? I think the treatment plan and interventions would be the
same depending on the skill level of the therapist and the motivation of the
patient.
-Original Message-
From: Ron Carson
To: cmnahrw...@aol.com
Sent: Mon, 9 Feb 2009 9:59 pm
Subject: Re: [OTlist] From Standing to Toilet Transfers
Hey Chris, no need to apologize, even if you are being critical. I like
to believe that these on-line discussion hone my actual practice
patterns!! Now, on with the discussion...
##
Working ON occupation ~vs~ Working TOWARDS occupation: What's the
difference?
##
When working ON occupation, I maintain that occupation-based practice is
a straight line from goal to intervention. Along that line, there may be
any number of specific intervention, but the line is never broken
between treatment and goal. Thus, when I'm working on standing balance
for a patient that can't stand at the toilet, I'm working on the line
between occupation and treatment.
Working TOWARDS occupation is not so direct an approach. Working towards
something is "vague" and nondescript. It's the notion that "if I improve
standing balance" the patient will be better able to stand at the
toilet. This approach is NOT unique to OT and is used by most
therapy-type professions. When working TOWARDS occupation, occupation is
not necessarily the goal. This is evident when a goal is written like:
"Patient will increase right elbow range of motion to 120 active flexion
to allow for brushing of hair".
GREAT discussion!!
Thanks,
Ron
--
Ron Carson MHS, OT
www.OTnow.com
- Original Message -
From: cmnahrw...@aol.com
Sent: Sunday, February 08, 2009
To: OTlist@OTnow.com
Subj: [OTlist] From Standing to Toilet Transfers
cac> You may say that you are working on occupation from the beginning
cac> of the session to the end, but it sure sounds to me that you are?at
cac> times?working towards an occupation, especially in the beginning of
cac> the treatment process.? You state that at several times you worked
cac> on sit to stands, standing, and ambulating with the patient.? In my
cac> book those are foundati
onal skills of an occupation.that got the
cac> patient to the point in which they could actually practice their
cac> goal of getting on and off the commode to toilet.? Without these
cac> core foundational skills of an occupation?the client would not have
cac> made it off the bed or out of the chair and would be laying on the
cac> floor with a dirty pair of slacks.? I am by no means criticizing
cac> your treatment plan, because I would have done the same thing.
cac> Archive?
cac> www.mail-archive.com/otlist@otnow.com
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