PROCESS

occupational therapy process

the client- centered delivery of occupational therapy services.

evaluation, intervention, outcomes

The three-part process includes

direct services, indirect services

service delivery approaches

organizations serve as a mechanism, organizations supports OTs as stakeholders in carrying out the mission of the organization, organizations employ OTs in roles in which they use their knowledge of OT indirectly

practice with organizations and systems

performed with an understanding of the specific situation of the client and the specific occupations the client wants or needs to do

occupational and activity analysis

Evaluation

focused on finding out what the client wants and needs to do; determining what the client can do and has done; and identifying supports and barriers to health, well-being, and participation.

consultation, occupational profile, analysis of occupational performance, synthesis of evaluation process

The evaluation consists of

Intervention

consists of services provided by occupational therapy practitioners in collaboration with clients to facilitate engagement in occupation related to health, well-being, and achievement of established goals consistent with the various service delivery models.

Health promotion

is “the process of enabling people to increase control over, and to improve, their health”

intervention plan, intervention implementation, intervention review

The intervention process is divided into three components:

patient-reported outcomes

PRO

transition, discontinuation

outcomes

activity demands

is typically required to carry out the activity regardless of client and context.

occupation demands

what is required by the specific client (person, group, or population) to carry out an occupation.

Relevance and importance, Objects used and their properties, Space demands, Social demands, Sequencing and timing demands, Required actions and performance skills, Required body functions, Required body structures

types of demand (8)

Occupations and Activities

Types of Occupational Therapy Interventions

Occupations and Activities

selected as interventions for specific clients are designed to meet therapeutic goals and address the underlying needs of the client’s mind, body, and spirit.

Interventions to Support Occupations

Methods and tasks that prepare the client for occupational performance are used as part of a treatment session in preparation for or concurrently with occupations and activities or provided to a client as a home-based engagement to support daily occupational performance.

Training

Facilitation of the acquisition of concrete skills for meeting specific goals in a real- life, applied situation. In this case, skills refers to measurable components of function that enable mastery. Training is differentiated from education by its goal of enhanced performance as opposed to enhanced understanding, although these goals often go hand in hand

Self-regulation

Actions the client performs to target specific client factors or performance skills. Intervention approaches may address sensory processing to promote emotional stability in preparation for social participation or work or leisure activities or executive functioning to support engagement in occupation and meaningful activities.

Advocacy

Efforts directed toward promoting occupational justice and empowering clients to seek and obtain resources to support health, well-being, and occupational participation.

Self-advocacy

Advocacy efforts undertaken by the client with support by the practitioner

Virtual Intervention

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

Create, promote (health promotion)

An intervention approach that does not assume a disability is present or that any aspect would interfere with performance. This approach is designed to provide enriched contextual and activity experi- ences that will enhance performance for all people in the natural contexts of life

Establish, restore (remediation, restoration)

Approach designed to change client variables to establish a skill or ability that has not yet developed or to restore a skill or ability that has been impaired

Maintain

Approach designed to provide supports that will allow clients to preserve the performance capabilities that they have regained and that continue to meet their occupational needs. The assumption is that without continued maintenance in- tervention, performance would decrease and occupational needs would not be met, thereby affecting health, well-being, and quality of life.

Modify

Approach directed at “finding ways to revise the current context or activity demands to support performance in the natural setting, \[including\] compensatory techniques . . . \[such as\] enhancing some features to provide cues or reducing other features to reduce distractibility”

Prevent

Approach designed to address the needs of clients with or without a disability who are at risk for occupational performance problems. This approach is designed to prevent the occurrence or evolution of barriers to performance in context. Inter- ventions may be directed at client, context, or activity variables

Occupational performance

Act of doing and accomplishing a selected action (performance skill), activity, or occupation

Improvement

Increased occupational performance through adaptation when a performance limitation is present

Enhancement

Development of performance skills and performance patterns that augment existing performance of life occupations when a performance limitation is not present

Prevention

Education or health promotion efforts designed to identify, reduce, or stop the onset and reduce the incidence of un- healthy conditions, risk factors, diseases, or injuries. Occupational therapy promotes a healthy lifestyle at the individual, group, population (societal), and government or policy level

Wellness

“Active process through which individuals \[or groups or populations\] become aware of and make choices toward a more successful existence”

Quality of life

Dynamic appraisal of the client’s life sat- isfaction (perceptions of progress toward goals), hope (real or perceived belief that one can move toward a goal through se- lected pathways), self-concept (composite of beliefs and feelings about oneself), health and functioning (e.g., health status, self-care capabilities), and socioeconomic factors (e.g., vocation, education, income;

Participation

Engagement in desired occupations in ways that are personally satisfying and congruent with expectations within the culture

Role competence

Ability to effectively meet the demands of the roles in which one engages

Well-being

Contentment with one’s health, self-es- teem, sense of belonging, security, and opportunities for self-determination, meaning, roles, and helping others

Occupational justice

Access to and participation in the full range of meaningful and enriching occupations afforded to others, including opportunities for social inclusion and resources to par- ticipate in occupations to satisfy personal, health, and societal needs

Approaches to intervention

specific strategies selected to direct the evaluation and intervention processes on the basis of the client’s desired outcomes, evaluation data, and research evidence. Approaches inform the selection of practice models, frames of references, and treatment theories.