OTA 215: Principles of Occupational Therapy in Physical Health - Chapter 4

Pima Medical Institute OTA 215: Principles of Occupational Therapy in Physical Health

Chapter 4: OT Process Evaluation and Intervention in Physical Dysfunction

OT Process Overview

  • Steps in OT Process:

    • Referral/Screening

    • Evaluation

    • Intervention

    • Targeted Outcomes (preferably leading to Discharge)

Fluidity of Evaluation and Intervention

  • Occupational Therapy Practitioners (OTPs) must engage in critical thinking regarding:

    • Client’s needs

    • Demands of the tasks required by the client

  • Collaboration:

    • Occupational Therapists (OTs) and Occupational Therapy Assistants (OTAs) frequently work together as client needs evolve.

    • Importance of updating the Plan of Care (POC) according to changing client needs.

Roles in Occupational Therapy

  • Role of OT:

    • Responsible for overall treatment planning and medical oversight.

  • Role of OTA:

    • Executes the treatment plan developed by the OT.

    • Must demonstrate service competency as per state regulations.

Evaluation Procedures

  1. Screening/Initial Interview:

    • Includes occupational profile and analysis of occupational performance.

  2. Identifying a Frame of Reference (FOR):

    • Understanding for what the evaluation is being conducted and determining appropriate evaluation procedure.

  3. Comprehensive Evaluation:

    • Involves conducting structured interviews, administering tests/tasks, observing the client, and gathering necessary data for planning treatment.

Types of Tests Used

  • Standardized Tests:

    • Follow strict protocols or set administration procedures.

  • Nonstandardized Tests:

    • More subjective with often no specific instructions for item administration, scoring criteria, or interpretation of results.

  • Purpose of Tests:

    • Essential for forming a holistic picture of the patient.

Data Analysis

  • Tasks include:

    • Identifying life roles of the client.

    • Diagnosing role dysfunction.

    • Developing a comprehensive list of problems and assets related to the client's needs.

Treatment Plan Development

  • Involves:

    • Selecting objectives and methods based on assessments of the client’s goals, problems, assets, life roles, needs, values, and context.

Intervention Planning

  • Based on client goals and OT’s analysis of performance deficits:

    • Effective intervention plan should include:

    • Objective and measurable goals with a specific time frame.

    • OT interventions rooted in theory and supported by current evidence.

    • A clear statement outlining the mechanisms for service delivery (types of intervention services, frequency, and duration of sessions).

    • Refer to Box 4.3 (page 51):

    • Contains questions to consider while selecting treatment methods.

Reevaluation/Revision

  • Collaboration between OT and OTA is crucial for this stage:

    • May need to change treatment approaches if the client does not find the therapeutic program helpful or meaningful.

Discharge Planning

  • Initiation:

    • Begins at the initial evaluation and continues throughout the treatment plan.

  • Team Effort:

    • To assess the need for assistive devices, mobility equipment, and support needs of both caregiver and patient.

  • Conclusion of Treatment:

    • Requires a final reevaluation, with OTAs assisting but OTs responsible for writing the discharge summary based on gathered information.

    • Refer to Figure 4.4 (page 53):

    • Displays an example of a treatment plan for OTAs to assist in developing treatment/intervention plans for clients.

Extended Treatment Plan Guide

  • Details can be found on pages 54-56 regarding the advanced treatment plan guide for OTAs in developing effective intervention strategies.