Intro to OT_3rd Exam Evolve Questions

What is a code of ethics

provides direction to members of a profession for mandatory behavior and protects the rights of clients, subjects, their significant others, and the public. It establishes standards for professional conduct and decision-making.

How does critical race theory explain the connection between systems and occupation?

This means that structures can marginalize people with disabilities, communities of color, and those who are oppressed. OT practitioners value occupational justice and inclusion for all. They must consider all factors interfering with people’s ability to engage safely and meaningfully in society.

What is ethical distress vs ethical dilemma vs locus of authority

Ethical distress: feelings that something is amiss and often signifies the need to work through the ethical decision-making process

Ethical dilemma: two courses of actions that the OTP must decide which to take

Locus of Authority: requires a decision about who should be the primary decision-maker. OTPs must consider who is responsible for making the decision

What are the six principles in the Occupational Therapy Code of Ethics?

1. Beneficence: OTP contributes to good health and welfare of client

2. Nonmaleficence: OTP shall do no harm

3. Autonomy: Self-determination and the OTP respecting client’s desires.

4. Justice: OTP provides fair and equitable services to all clients.

5. Veracity: OTP tells the truth and represents their qualification, education and competence accurately.

6. Fidelity: OTP must treat clients, colleagues and other professionals with respect, fairness, and integrity. As well as maintaining confidentiality.

What are the six steps to ethical decision-making?

1. Gather relevant facts

2. Identify the ethical problem

3. Clarify professional duties in this situation as outlined by AOTA

4. Explore alternatives and desired outcomes as well as consequences

5. Decide and complete the action

6. Evaluate the process and the outcome

Which term refers to the judgement of one’s behaviors that is right and wrong?

Morals

What is the difference between morals, values and principles?

Morals: character and behavior from the point of view of right and wrong

Values: the core ideals and priorities that both individuals and the profession hold dear

Principles: The fundamental guidelines and rules

Which principle states that the practitioner should “do no harm”?

Nonmaleficence

What principle is violated when an OT practitioner fails to maintain current state licensure to practice?

Justice; refers to the obligation to comply with the laws and regulations

What is the last step in ethical decision-making?

Evaluating the process

What are the Eight Dimensions of Wellness according to SAMHSA?

1. Emotional: Listen to feelings and express feelings to trusted people, staying positive

2. Intellectual: expand knowledge and stimulate curiosity

3. Spiritual: connection to self, others, and identify values and peace in life

4. Physical: be active, get rest, reduce stress and increase energy

5. Environmental: safe space that support mental and physical health

6. Social: sense of belonging and create a healthy support system and friendships

7. Occupational: find satisfaction through work, school or volunteering

8. Financial: understanding finances and having food money habits and planning

Explain what digital wellness is and how it affects mental health?

Digital wellness is a way of life in which technology is integrated into daily life to promote optimal health and well-being. For overall wellness, take breaks from screens, set times to social media and turn off unnecessary notifications

Why can community care be regarded as a step beyond self-care?

Self-care is positioned as taking time to do things that help an individual, community care means taking time to ensure those liberties for all fellow people

It is people committed to leveraging their privilege to be there for one another in various ways

Who introduced the impact of mental health on function in Mental Health First Aid?

MHFA demonstrates how OT’s roots in mental health can be widely applied to health, safety, and community well-being. Dr. Margaret (Peggy) Swarbrick,contributed frameworks, models, and research of MHFA.

She created the strengths based Eight Dimensions of Wellness model

Why is it important for clients and healthcare professionals to engage in self-care?

It lowers your risk of illness

What are some of the negative effects of social media on self-care and mental health?

It interferes with rest and relaxation

People feel bad as they compare themselves

It can cause people additional stress

Which of the following dimensions is NOT part of the Eight Dimensions of Wellness Model?

Techonolgy

What is the intent of community care mindset?

Supporting everyone physically and mentally

What are the steps to setting boundaries?

1. Define the desired boundary

2. Communicate what you need

3. Stay Simple: Don’t over explain

4. Set Consequences: Say what is important and why

What is the role of the OT fieldwork supervisor?

Educate students on OT practices

Embrace all types of learning

Support them in client intervention

Role model inclusive behaviors

How do OT practitioners demonstrate the art of therapy?

Designing intervention specific to client’s goals, personality and interests

How do OT practitioners best embody inclusion among colleagues who have disabilities?

Speak up and support them

Describe the occupational therapist and OTAs relationship?

To collaborate to provide quality services to clients, while supporting each other

Which term is used to define the belief that all people are entitled to access those things they want to do.

Occupational Justice

Which mode from the Intentional Relationship Model is depicted as the OT practitioner develops goals and strategies with the client?

Collaborating-developing goes and strategies with the client

Which term describes the aspect of self that others see without the benefit of knowing a person’s intentions, motivations, and limitations?

Perceived Self

What are some techinques for OTPs to develop trust?

Be Direct with decisions

Remember to put the client first

Be honest with clients

Use clear language that the client understands

What technique summarizes the client’s thoughts and feelings?

Clarification

What element of reasoning considers the diagnosis, strengths, and weaknesses of the client?

Scientific

At what step in the thought process of therapeutic reasoning do practitioners observe clients and conduct standardized evaluations?

Gather data

What type of therapeutic reasoning strategy focuses on the disease or disability and determines what will be the most appropriate modalities to use to improve functional performance?

Scientific- examines the client’s medical conditions cause, symptoms, progression, prognosis and management as it effects the occupational performance

What stage describes the practitioner who feels most comfortable performing and refining the techniques and procedures learned in school?

Novice

What are some recommended techniques to advance one’s therapeutic reasoning skills?

Explore the literature

Reflect on performance

Seek feedback from others

Engage in continuing education

The __________________________ is unique because it is designed to benefit the one being served.

therapeutic relationship

Elisabeth Kübler-Ross defined the universal states of loss as ________, ___________, ____________, ___________, and ____________.

Elisabeth Kübler-Ross defined the universal states of loss as ________, ___________, ____________, ___________, and ____________.

Denial

Anger

Bargaining

Depression

Acceptance

The _____________________________________ developed by Taylor, consists of ________ therapeutic modes.

Intentional Relationship Model

six

OT practitioners must possess a level of __________ so they can mindfully examine their role in the intervention process.

Self-awareness

The ________ is what an individual would like to be if free of the demands of mundane reality.

Ideal self

The ____________ is the aspect of self that others see without the benefit of knowing the person’s intentions, motivations, and limitations.

perceived self

In general, developing and sustaining therapeutic relationships involves the ability to develop ___________, demonstrate ____________, understand _____________ and _________, and use active listening.

trust

empathy

verbal

nonverbal communication

What are the characteristics of a therapeutic relationship?

Therapeutic relationships differ from friendships and is mostly one sided

The goal is for one person (the client) to benefit. Although the practitioner often receives a “reward,” in the form of helping another person, it is not the intention or design of the interaction.

OT practitioner is aware of the client’s needs and uses technical and interaction skills to select responses or courses of action that benefit the client. This process of using one’s interactions for the benefit of another is referred to as the “art of relating” and termed the therapeutic use of self.

What is the therapeutic use of self?

Involves awareness of oneself, including such things as how one communicates, presents oneself, responds during interactions, and relates to others.  

The OTP continually assesses their interaction skills and makes judgments about how to use the skills to help the client

What is meant by the ideal self, the perceived self, and the real self?

Ideal Self-what an individual would like to be if free of the demands of mundane reality. The “perfect self,” with only desirable qualities

Perceived Self-what others see without the benefit of knowing a person’s intentions, motivations, and limitations (i.e., as defined only by outward behavior)

Real Self- a blending of the internal and external worlds involving intention and action, plus environmental awareness.

What are the six modes of interacting according to Taylor’s Intentional Relationship Model?

• Advocating

• Collaborating

• Empathizing

• Encouraging

• Instructing

• Problem-solving

How can an OT practitioner develop trust with a client?

• Follow through with plans.

• Be on time to appointments with clients.

• Be honest with clients.

• Do not overpromise things you cannot deliver.

• Be cautious when disclosing personal information.

• Discuss clients’ progress and intervention plans in private.

• Always involve the client in decisions.

• Be direct with decisions.

• Use clear language so the client understands.

• Address any concerns that develop in the therapeutic relationship.

• Remember to put the client first.

• Respect the client by being prepared for the session.

What is empathy, and how can it be developed?

The ability to place oneself in another person’s position and understand the other’s experience

Techniques to Develop Empathy

• Read stories about others who have undergone significant life events.

• Participate in activities of other cultures.

• Interview others to understand their life views.

• Watch movies depicting stories of people who may have experienced trauma, disease, disability, or health conditions, and discuss the characters’ stories.

• Reflect on the stories of clients and peers.

• Reflect in writing how you felt after viewing a movie or reading a story about a person with a disability, trauma, or condition.

• Experience a condition by spending a day in a wheelchair, not using your hand for your morning routine, wearing glasses that make it difficult to see, and so forth. Discuss how the experiences made you feel and what you learned.

• Spend time socially with a person who has a disability to understand their life view.

• Attend a support group meeting to better understand the issues clients face.

• Talk with clients in a waiting room (be sure to get permission first).

• Try to imagine conditions, disability, or trauma from the family and client’s point of view.

What are some verbal and nonverbal communication strategies used in therapeutic relationships?

Verbal-speaking confidently and clearly help clients trust them in an appropriate speed and tone

Nonverbal-facial expressions, eye contact, tone of voice, touch, and body language. Practitioners are aware of their own nonverbal communication expression.

OTP should also be sensitive to and watchful for nonverbal forms of communication from clients as well. The nature of the client’s disability may make it difficult for them to verbally communicate or understand verbal communication

How can practitioners actively listen to clients?

Techniques to Improve Active Listening

• Practice using restatement, reflection, and clarification.

• Role-play a variety of interviews.

• Interview others and ask for feedback. Try to summarize what they told you.

• Receive feedback from peers.

• Record (or videotape) conversations to review how you listened.

• Identify strengths and weaknesses.

• Develop techniques to improve listening skills by setting goals.

• Observe others and identify active listening techniques they used.

The ______________ element of therapeutic reasoning addresses the question “What are the possible things that can be done for this client?”

Scientific

The ____________ element of therapeutic reasoning addresses questions such as “What is the right and fair path to take?”

Ethical

The ____________ element of therapeutic reasoning is evident in the skill used by the OT practitioner to guide the treatment process and select the “right action.”

Artistic

In the first step of the therapeutic reasoning process, the OT practitioner _________________.

uses theory to generate questions

The practitioner generates a ______________ using the cues regarding the client’s needs.

hypothesis

____________ reasoning is a strategy used by the OT practitioner to understand the client as a person. It involves face-to-face interactions.

Interactive

___________ reasoning considers the client’s condition, as a whole, including the disease or disability and what it means to the person, the physical context, and the social context.

Conditional

Generally, authors describe five different stages of career development: ____________, ______________, ______________, _______________, and _________________.

novice

advanced beginner

competent

proficient

expert

What is therapeutic reasoning?

A cognitive thought process in which information from many sources are gathered and synthesized to form the evaluations, implement plan, and assess outcome.  This process is dynamic and nonlinear.  

The OT practitioner must actively think about and process information from multiple sources.

What is the therapeutic reasoning thought process?

It can be described in 6 steps:

1) use theory to generate questions

2) gather data

3) identify occupational challenges

4) create an intervention plan

5) implement the intervention plan

6) assess outcomes.

These steps are presented linearly, but in reality OT practitioners revisit steps throughout the process.

Provide an example of scientific, ethical, and artistic elements of therapeutic reasoning.

Scientific: The OT practitioner looks up the diagnosis and standard medical treatment for a particular client.

Ethical: The OT practitioner refers the client to another therapist when she realizes the client’s condition is one in which the other therapist specializes.

Artistic: The OT practitioner is stern with a client who needs firm direction and later that week discloses that she has an uncle who has a similar diagnosis. Knowing when to be firm and when to disclose personal information is considered part of the “art” of therapy.

What are the types of therapeutic reasoning?

Scientific Reasoning-understand the client’s medical condition

Procedural Reasoning-think about the steps to take and guidelines

Narrative Reasoning-understand the client’s story

Ethical Reasoning-think about what should be done

Interactive Reasoning- strategy used when OTP wants to understand the client as a person

Pragmatic Reasoning- Understanding the factors that may influence intervention; such as cost, referral source, client’s commitment, environment

What are the stages of therapeutic reasoning?

novice

advanced beginner

competent

proficient

expert

What is the focus of a novice practitioner?

learning procedural skills (e.g., assessment & treatment planning procedures) necessary to practice

Feels most comfortable performing and refining the techniques and procedures learned in school.

Novice practitioners may not feel as comfortable using interactive reasoning strategies

What is the focus of an advanced beginner?

Recognizes additional cues and begins to view the client as an individual

However, the advanced beginner still may not see the whole picture.

What is the focus of a competent practitioner?

Sees more facts and determines the importance of these facts and observations

At this stage, practitioners have a broader understanding of the client’s problems and are more likely to individualize intervention.

However, they are still developing flexibility and creativity.

What is the focus of the proficient practitioner?

Views whole situations instead of as isolated parts.

Practical experience allows them to develop a direction and vision of where the client should be going.

If the initial plans do not work, the proficient therapist easily modifies plans.

What is the focus of an expert practitioner?

Recognize and understand rules of practice; however, for this group of practitioners, the rules shift to the background .

The expert practitioner often uses intuition to know what to do next

Expert practitioners use procedural, interactive, and conditional skills without difficulty

They draw from past therapeutic situations to process imagined outcomes for the current client

True/False: The elements of science, art and ethics are combined in practice

True

True/False Therapeutic relationships require that OTPs act in the same manner with every client

False

Rhonda has CHF, she wants to remain in her home. She is referred to an OTP who specializes in what type of practice?

Aging in Place

Ben works in a rehab center and is asked to look at a client’s driving. What is the OTPs role in driving?

Evaluate aspects- physical and psychosocial

There are how many Dimensions of Wellness Model?

Eight (8)