Occupational Therapy Fundamentals: OTPF, Goals, and Core Concepts

Purpose of the OTPF

- Provides the central concepts that ground occupational therapy practice to guide OT practice

- Tool that allows for language to be standardized among the profession, students, communication with the public, policymakers, etc

- Highlights the core belief in the positive relationship between occupation and health and the view of people as occupational beings

Important Definitions: occupational therapy

the therapeutic use of everyday life occupations with persons, groups, or populations for the purpose of enhancing or enabling participation

Important Definitions: occupational therapy practitioners

occupational therapists and occupational therapy assistants

Important Definitions: occupational therapy clients

- persons

`ex: middle school student with diabetes interested in developing self management skills to test blood sugar levels

- groups

`ex: group of students with diabetes interested in problem solving the school setting's support for management of their condition

- populations

`ex: all students in the school provided with access to food choices to meet varying dietary needs and desires

Defining the goal(s): health

- a state of complete physical, mental, and social well being

- not merely their absence of disease or infirmity

Defining the goal(s): well being

- general term encompassing the total universe of human life domains:

`physical

`mental

`social aspects

that make up what can be called a 'good life

Defining the goal(s): participation

involvement in a life situation

Defining the goal(s): engagement in occupations

performance of occupations as the result of choice, motivation, and meaning within a supportive context (including environmental and personal factor)

Aspects of the OT Domain

- occupations

- contexts

- performance patterns

- performance skills

- client factors

occupations

- Central to a client's health, identity, and sense of competence

- Meaningful and valued everyday activities

Contexts

Environmental and personal factors

Performance Patterns

Habits, routines, roles, and rituals

Performance skills

Observable, goal-directed actions

Client factors

- The specific capacities, characteristics, or beliefs that influence performance in occupations

- Affected by the absence or presence of illness, disease, deprivation, and disability

- Also takes into consideration life stages and experiences

OT process

- evaluation

- intervention

- outcomes

The 9 types of occupations

1. ADLs

2. IADLs

3. Health management

4. Rest and sleep

5. Education

6. Work

7. Play

8. Leisure

9. Social participation

ADLs vs IADLs

- ADLs: activities oriented toward taking care of one's own body and completed on a routine basis

`bathing/showering

`eating/chewing

`sexual activity

- IADLs: activities to support daily life within the home and community

`care for others

`meal prep/cleanup

Health management

- activities related to developing, managing, and maintaining health/wellness routines, the goal is improving or maintaining health to support participation in other occupations

`physical activity

`social and emotional health promotion and maintenance

`symptom and condition management

Rest and sleep

- activities related to obtaining restorative rest and sleep to support engagement in other occupations

`rest

`sleep preparation

`sleep participation

Education

- activities needed for learning and participating in the educational environment

`formal education participation

`informal personal education needs or interest exploration

work

- labor or exertion related to the development, production, delivery or management of objects or services; benefits may be financial or nonfinancial

`Employment interests and pursuits

`Employment seeking and acquisition

`Job performance and maintenance

`Retirement preparation and adjustment

`Volunteer exploration

`volunteer participation

play

- activities that are intrinsically motivated, internally controlled, and freely chosen and that may include suspension of reality exploration, humor, risk taking, contests, and celebrations

`play exploration

`play participation

leisure

- nonobligatory activity that is intrinsically motivated and engaged in during discretionary time, that is, not committed to obligatory occupations such as work, self-care, sleep

`leisure exploration

`leisure participation

variations of occupations: co occupations

- typically involve more than 1 person

- steps and actions taken by the client rely on others participations

variations of occupations: parallel co occupations

- occupations that occur within the vicinity of another person, groups, or people

- doesn't happen with anyone else

variations of occupations: shared occupations

- 2 or more people are engaged in the same occupation

- different activities within that occupation

variations of occupations: nested occupations

several occupations are conducted at the same time and co occur

social participation

- activities that involve social interaction with others, including family, friends, peers, and community members, that support social interdependence

`community participation

`Family participation

`friendships

`Intimate partner relationships

`Peer group participation

contexts

- environmental factors

- personal factors

environmental factors

- Natural and human made changes to the environment

- Products and technology

- Support and relationships

- Attitudes

- Services, systems, and policies

personal factors

- age

- sexual orientation

- gender identity

- race/ethnicity

- Cultural identification and cultural attitudes

- Social background, social status, and socioeconomic status

- Upbringing and life experiences

- Habits and past and current behavioral patterns

- Individual psychological assets

- education

- Profession and professional identity

- lifestyle

- Profession and professional identity

performance patterns

- habits

- routines

- roles

- rituals

habits

- specific, automatic behaviors performed repeatedly, relatively automatically, and with little variation

`can be healthy or unhealthy

`can be efficient or inefficient

`can be supportive or harmful

routines

- patterns of behavior that are observable, regular, and repetitive and that provide structure for daily life

`Can be satisfying, promoting, or damaging

`Require a time commitment and are embedded within cultural and ecological contexts

roles

aspects of identity shaped by culture and context that may be further conceptualized and defined by the client and the activities and occupations one engages in

rituals

- symbolic actions with spiritual, cultural, or social meaning contributing to the client's identity and reinforcing values and beliefs

`Strong affective component and consists of a collection of events

performance skills

- motor skills

- process skills

- social interaction skills

motor skills

- group of performance skills that represent small, observable actions related to moving oneself or moving and interacting with objects in the context of performing a personally and ecologically relevant daily life task

`Positioning of the body

`Obtaining and holding objects

`Moving self and objects

`Sustaining performance

process skills

- group of performance skills that represent small, observable actions related to selecting, interacting with, and using tangible task objects

- carrying out individual actions and steps

- preventing problems of occupational performance from occurring or reoccurring in the context of performing a personally and ecologically relevant daily life task

`Sustaining performance

`Applying knowledge

`Organizing timing

`Organizing space and objects

`Adapting performance

social interaction skills

- group of performance skills that represent small, observable actions related to communicating and interacting with others in the context of engaging in a personally and ecologically relevant daily life task performance that involves social interactions with others

`Initiating and terminating social interaction

`Producing social interaction

`Physically supporting social interaction

`Shaping content of social interaction

`Maintaining flow of social interaction

`Verbally supporting social interaction

`Adapting social interaction

client factors

- Values, beliefs, and spirituality

- Body Functions

- Body Structures

Values

acquired beliefs and commitments, derived from culture, about what is good, right, and important todo

beliefs

something that is accepted, considered to be true, or held as an opinion

spirituality

deep experience of meaning brought about by engaging in occupations that involve the enacting of personal values and beliefs, reflection, and intention within a supportive contextual environment

body functions

- physiological functions of body systems (including psychological)

`mental functions

`sensory functions

`Neuro musculoskeletal and movement related functions

`Cardiovascular, hematological, immune, and respiratory system functions

`Voice and speech functions; digestive, metabolic, and endocrine system functions; genitourinary and reproductive functions

`skin and related structures

body structures

anatomical parts of the body such as organs, limbs, and their components

occupation

- personal and meaningful engagement, personalized

- occur over time

- observable

- occur in context and environment

- combination of client factors, performance skills, and patterns

`ex: father making a pb&j for a child at home

activity

- task itself, regardless of the meaning behind it

- objective

`ex: making pb&j

steps to activity analysis

1. what is being analyzed

`ex: making PB&J

2. what is the relevance and importance

`ex: we're hungry and PB&J are classic quick fix

3. what are the space, object, and social requirements

4. what are the sequencing and timing demands

`each step should include: action verb, how the action takes place, objects used or interacted with, time elements (IA), amounts used (IA)

5. what are the required body functions

6. what are the required body structures

7.what are the required performance skills

`supported by body function and structures

clinical and professional reasoning

• Identify multiple demands,
  required skills, and potential
  meanings of activities and
  occupations

• Gain a deeper understanding of
  the interrelationships among
  aspects of the domain that affect
  performance and that support
  client-centered interventions and
  outcomes
  • Theoretical principles and models
  • Knowledge about the effects of
  conditions on participation
  • Evidence based practice to support
  interventions
  • Supports client-centered approach
  • Evaluation, interventions, outcome
  measures
  • To enhance clients’ participation in
  occupations

evaluation

• occupational profile

`includes information about client’s needs, problems, and concerns about performance in occupations

• analysis of occupational performance: collects and interpret information to identify supports and barriers related to occupational performance and establish targeted outcomes

intervention 

• promotes health, well-being, and participation 

• intervention process

  ` intervention plan

  ` intervention implementation 

  ` intervention review 

outcomes

• directly related to the interventions provided and to the targeted occupations, performance patterns, performance skills, client factors, and contexts

• outcomes are measured

• summarized as

` occupational performance

` prevention

` health and wellness

` quality of life

` participation

` role competence

` well-being

` occupational justice