OTH 716: Occupational Therapy Foundations Midterm Review

Occupational Therapy

The therapeutic use of everyday life occupations to enhance or enable participation for persons, groups, or populations.

Health and Well-being

The ultimate aim of OT services is to achieve health, well-being, and participation in life through engagement in occupation.

Ontology

The nature of being, one of the core elements of the philosophy of occupational therapy.

Epistemology

The nature of knowledge, one of the core elements of the philosophy of occupational therapy.

Axiology

The nature of right action, one of the core elements of the philosophy of occupational therapy.

Core Values of Occupational Therapy

The seven core values are Altruism, Equality, Freedom, Justice, Dignity, Truth, and Prudence.

Occupational Therapy Practice Framework (OTPF-4)

A framework that provides a shared language and structure for the practice of occupational therapy.

Domain

Outlines the profession's focus, encompassing Occupations, Contexts, Performance Patterns, Performance Skills, and Client Factors.

Process

Describes how OT services are delivered through a dynamic, client-centered cycle of Evaluation, Intervention, and Targeting of Outcomes.

Activity Analysis

A method for deconstructing tasks to design therapeutic interventions.

Therapeutic Use of Self

The intentional use of the practitioner's personality and skills to build a collaborative relationship.

Shared Decision Making

A central principle that aligns with OT's values by integrating clinical evidence with a client's personal values and preferences.

Ethical and Legal Standards

The profession holds its members to high ethical and legal standards, requiring specific education, certification, and ongoing professional development.

Characteristics of a Profession

A profession is distinguished from a job by foundation, unique approach, specialized training, autonomy and responsibility, code of ethics, intellectual work, and self-regulation.

Foundation of a Profession

Built upon established theories and principles derived from prior and ongoing research.

Unique Approach

Utilizes a unique methodology for solving problems or creating solutions.

Specialized Training

Entry requires extensive, intensive, and competency-based learning experiences, leading to initial and ongoing certification or licensure.

Autonomy and Responsibility

Possesses a dual relationship of professional autonomy and responsibility to clients and society.

Code of Ethics

A formal code of ethics with established sanctions regulates the relationship between colleagues and clients.

Intellectual Work

The work performed is intellectual, creative, and original, requiring the consistent exercise of discretion and judgment.

Self-Regulation

Regulated by a formal professional association (such as the American Occupational Therapy Association - AOTA) and societal laws.

Core Beliefs of OT

The OT profession codified its core beliefs and ideals in 1995 to guide the actions and attitudes of its members.

Altruism

Unselfish concern for the welfare of others.

Equality

Perceiving all individuals as having the same fundamental human rights and opportunities.

Freedom

Allowing the individual to exercise choice and demonstrate independence, initiative, and self-direction.

Justice

Upholding moral and legal principles such as fairness, equity, truthfulness, and objectivity.

Dignity

Valuing the inherent worth and uniqueness of each person.

Truth

Being faithful to facts and reality.

Prudence

The ability to govern and discipline oneself through the use of reason.

5 Standards of Practice for Occupational Therapy

1. Professional Standing and Responsibility

2. Service Delivery

3. Screening Evaluation and Reevaluation

4. Intervention Process

5. Outcomes, Transition, and Discontinuation

Professional Standing and Responsibility

This standard requires that OT practitioners deliver services consistent with the philosophical foundation of occupational therapy

3. Key responsibilities include:

• Delivering services that reflect OT's core values, expertise in the therapeutic use of occupation, professional behaviors, and therapeutic use of self.

• Practicing in accordance with AOTA standards, as well as federal, state, and payer requirements.

• Maintaining current licensure, certification, or registration

Service Delivery

This standard outlines how OT practitioners provide skilled services and ensure client safety

Key responsibilities include:

• Providing skilled services through direct contact with clients (in-person, telehealth) or indirect approaches like consultation and advocacy.

• Ensuring client safety throughout the entire occupational therapy process.

• Continuously evaluating the effectiveness of the services provided within their practice setting

Screening, Evaluation, and Reevaluation

This standard details the process of gathering and interpreting data to understand the client's needs

Key responsibilities include:

• The OT is responsible for all aspects of the screening, evaluation, and reevaluation process, including accepting referrals, collaborating with the client to create an occupational profile, analyzing performance, and interpreting data....

• The OTA contributes to this process by administering delegated assessments and reporting the results to the OT.

• Using evidence-based and standardized assessment tools.

• Completing and documenting evaluation results according to established time frames and standards.

• Communicating results while respecting client confidentiality and referring clients to other professionals when needed.

• Educating referral sources about the scope of OT services

Intervention Process

This standard covers the development and implementation of the intervention plan based on the evaluation.

Key responsibilities include:

• The OT holds overall responsibility for developing, documenting, and implementing the intervention plan, including providing appropriate supervision to the OTA.

• Collaborating with the client to develop a plan that reflects their needs, priorities, and safety

• Using professional reasoning and evidence to select and implement appropriate interventions, such as occupations, activities, and advocacy.

• The OTA collaborates with the OT to select, implement, and modify interventions consistent with their competency level and client goals.

• The OT modifies the plan as needed, while the OTA contributes by providing information on the client's responses to intervention.

• Documenting all services provided according to established standards.

Outcomes, Transition, and Discontinuation

This standard focuses on measuring the results of therapy and managing the conclusion of services

Key responsibilities include:

• The OT is responsible for selecting, implementing, and interpreting outcome measures to document progress and determine when to transition or discontinue services.

• The OTA contributes by implementing delegated outcome measures and reporting results to the OT.

• The OT prepares a safe and effective transition or discontinuation plan based on client goals and outcomes.

• The OTA provides information and documentation to assist in developing this plan

• Both practitioners collaborate with the client, family, and other professionals during the transition or discontinuation process

• Ethically reporting outcomes to payers and relevant entities

Evidence-Informed Practice

Services must be consistent with best practice approaches, and practitioners must apply evidence ethically and appropriately.

Client-Centered Care

Services must be client-centered, demonstrating cultural humility, recognizing bias, and obtaining client consent throughout the process.

Stakeholders in Occupational Therapy

Defined as anyone involved in or affected by a course of action.

Key Stakeholders

Clients and families, the public and community, employers, legislators and lobbyists, regulatory boards and accreditors, insurance companies, Medicare, and Medicaid, healthcare organizations, other service providers, and the OT profession itself.

Philosophy of Occupational Therapy

Provides the foundational beliefs and values that sustain the profession's identity, guide its practice, and distinguish it from other disciplines.

Right Action

Right action is client-centered, collaborative, and relationship-driven; contextually aware, recognizing the interplay between the person and their environment; and guided by principles of dignity, empathy, and a belief in every person's potential.

Adolf Meyer

Emphasized the importance of balance in the rhythms of work, play, rest, and sleep for health, stating that humans must adapt to life's changes through doing.

"performance is its own judge and regulator"

adolf meyer

"Occupation is as necessary to life as food and drink"

William Rush Dunton

"Man, through the use of his hands as they are energized by mind and will, can influence the state of his own health."

Mary Reilly

William Rush Dunton

Declared that occupation is a fundamental human need with curative powers for the mind, body, and soul.

Mary Reilly

Reframed the profession's foundation, proposing that purposeful activity could influence one's health by integrating mind, body, and will.

Elizabeth Yerxa

Argued for an 'authentic' OT focused on the client's self-actualization, choice, and realization of meaning through occupation.

Suzanne Peloquin

Highlighted the centrality of empathy as essential for a therapeutic relationship that changes both client and therapist.

Domain of Occupational Therapy

The domain outlines the areas of human experience in which OT practitioners have established knowledge and expertise.

Occupations

Occupations are the everyday, personalized activities that people do to occupy their time and bring meaning and purpose to life.

Activities of Daily Living (ADLs)

Activities oriented toward taking care of one's own body; fundamental for survival.

Instrumental ADLs (IADLs)

More complex activities supporting daily life within the home and community.

Health Management

Activities to develop, manage, and maintain health and wellness routines.

Rest and Sleep

Activities related to obtaining restorative rest and sleep.

Education

Activities needed for learning and participating in an educational environment.

Work

Activities for engaging in employment or volunteer work.

Play

Intrinsically motivated activities providing enjoyment, entertainment, or diversion.

Leisure

Nonobligatory, intrinsically motivated activities engaged in during discretionary time.

Social Participation

Activities involving interaction with others that support engagement in desired social roles.

Contexts

The broad construct that shapes how individuals engage in occupations.

Environmental Factors

The physical, social, and attitudinal surroundings, including the natural and built environment, technology, support systems, and policies that enable or restrict participation.

Personal Factors

The specific background features of an individual's life and identity that are not part of a health condition, such as age, gender identity, race, culture, socioeconomic status, and life experiences.

Performance Patterns

The acquired habits, routines, roles, and rituals that structure daily life and can support or hinder occupational performance.

categories of performance patterns

habits, roles, routines, rituals

Habits

Specific, automatic behaviors.

Routines

Established sequences of occupations or activities that provide structure for daily life.

Rituals

Symbolic actions with spiritual, cultural, or social meaning.

Roles

Sets of behaviors expected by society and shaped by culture and context.

Performance Skills

Goal-directed, observable actions used to perform a desired occupation.

categories of performance skills

motor skills, process skills, social interaction skills

Motor Skills

Actions related to moving oneself or objects (e.g., stabilizing, reaching, lifting).

Process Skills

Actions used to manage and modify tasks (e.g., choosing tools, sequencing steps, adapting).

Social Interaction Skills

Actions used to communicate and interact with others (e.g., taking turns, expressing emotions).

Client Factors

Specific capacities, characteristics, or beliefs that reside within the individual and influence performance in occupations.

Categories of Client Factors

values, beliefs, spirituality, body functions, body structures

Values, Beliefs, and Spirituality

Principles, standards, or qualities considered worthwhile; cognitive content held as true; and a person's search for meaning and purpose.

Body Functions

The physiological functions of body systems (e.g., mental, sensory, musculoskeletal functions).

Body Structures

The anatomical parts of the body that support body functions (e.g., nervous system, cardiovascular system).

Evaluation

The foundation for intervention by gathering and interpreting data to understand the client's needs and goals.

Occupational Profile

A summary of the client's occupational history, experiences, patterns of daily living, interests, values, and needs.

Analysis of Occupational Performance

The step in which the client's performance is observed and analyzed to identify supports and barriers.

Synthesis

The therapist pulls all data together to develop hypotheses about strengths and deficits, create client-centered goals, and select outcome measures.

Intervention

The process consists of skilled actions taken by OT practitioners to facilitate engagement in occupation.

Intervention Plan

A collaborative plan that guides actions, based on theories, evidence, and the client's goals.

Intervention Implementation

The process of putting the plan into action.

Intervention Review

A continuous process of re-evaluating and reviewing the plan and progress toward outcomes.

Types of interventions as outlined in the OTPF-4

Occupations and Activities, Interventions to Support Occupations, Education and Training, Advocacy, Group Interventions, and Virtual Interventions

Occupations and Activities

Using client-directed daily life activities and their components to meet therapeutic goals.

Interventions to Support Occupations

Methods that prepare the client for occupational performance (e.g., splinting, assistive technology, environmental modification).

Education and Training

Sharing knowledge (education) and facilitating the acquisition of concrete skills (training).

Advocacy

Promoting occupational justice by empowering clients (self-advocacy) or acting on their behalf.

Group Interventions

Use of distinct knowledge of the dynamics of group and social interaction and leadership techniques to facilitate learning and skill acquisition across the lifespan.

Virtual Interventions

Use of simulated, real-time, and near-time technologies for service delivery absent of physical contact, such as telehealth or mHealth.

List the different approaches to interventions

create/promote, establish/restore, maintain, modify, prevent,

Create/Promote

Enhances performance for all people, without assuming a disability is present.

Establish/Restore

Teaches new skills or restores abilities that have been impaired.

Maintain

Preserves abilities and prevents deterioration.

Modify

Adapts the task or environment to allow participation.

Prevent

Reduces the risk of occupational performance problems before they occur.