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'''Occupational therapy''' (OT) is skilled treatment that helps individuals achieve independence in all facets of their lives. OT gives people the "skills for the job of living" necessary for independent and satisfying lives. Services typically include:
 
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'''Occupational Therapy''', often abbreviated as '''"OT"''', incorporates meaningful and purposeful [[occupation]] to enable people with limitations or impairments to participate in everyday life. [[Occupational therapists]] work with individuals, families, groups and populations to facilitate health and well-being through engagement or re-engagement in occupation. Occupational therapists are becoming increasingly involved in addressing the impact of social and environmental factors that contribute to exclusion and [[occupational deprivation]].<ref name="Townsend"/><ref>Occupational Deprivation: Global Challenge in the New Millennium, Whiteford (2000), British Journal of Occupational Therapy Volume 63, Number 5, pp. 200-204(5)
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</ref>
   
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The [http://www.wfot.org World Federation of Occupational Therapists]defines occupational therapy as a profession concerned with promoting health and well-being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by enabling people to do things that will enhance their ability to participate or by modifying the environment, or the activity to better support participation.<ref>http://www.wfot.org/information.asp</ref>
* Customized treatment programs to improve one's ability to perform daily activities
 
* Comprehensive home and job site evaluations with adaptation recommendations
 
* Performance skills assessments and treatment
 
* Adaptive equipment recommendations and usage training
 
* Guidance to family members and caregivers
 
   
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Another way of thinking about the ideas contained in these definitions could be: occupational therapy is about understanding the importance of an activity to an individual, being able to analyze the physical, mental and social components of the activity and then adapting the activity, the environment and/or the person to enable them to resume the activity. In other words, occupational therapists would ask, "Why does this person have difficulties managing his or her daily activities (or occupations), and what can we adapt to make it possible for him or her to manage better and how will this then impact his or her health and well-being?”
Information from the American Occupational Therapy Association, Inc. 5/05
 
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Occupational therapy gives people the "skills for the job of living" necessary for "living life to its fullest."<ref>AOTA http://www.aota.org</ref>
   
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The College of Occupational Therapists (2004) describes OT as follows: Occupational Therapy enables people to achieve health, well-being and life satisfaction through participation in occupation.
== Occupational therapy practitioners ==
 
Occupational therapy practitioners are skilled professionals whose education includes the study of human growth and development with specific emphasis on the physical, affective, cognitive and environmental components of illness and injury.
 
   
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Occupational Therapy draws from the field of [[occupational science]] to provide an evidence base to practice and develop academic and practice links to other related disciplines such as social science and anthropology, and also utilises a range of generic models to guide the practice of OT.
Most registered [[occupational therapist]]s (OTR) practicing in the field today possess a Bachelor of Science degree in occupational therapy. However, in recent years, the entire profession has advanced its educational standards to post-professional levels. By 2007, all OTRs will enter the field with a Masters (M.S.) or Doctoral degree (OTD or Ph.D.). A certified occupational therapy assistant (COTA) generally earns an associate degree.
 
   
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== Occupation, occupational form and occupational performance ==
Practitioners must complete supervised clinical internships in a variety of health care settings, and pass a national examination (NBCOT or National Board for Certification in Occupational Therapy). Most U.S. states also regulate occupational therapy practice (OTs must possess a license within their state).
 
   
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'''Occupation'''
==Philosophy of occupational therapy==
 
Occupational therapists focus on making independence a reality. While complete independence may not occur depending on the extent of the disability, occupational therapists will work with the patient or client to come up with strategies, techniques, or adaptations so that they can be as independent as possible. Occupational therapists use occupations to enable this. In the context of occupational therapy, occupation refers to meaningful activity.
 
* Engagement in occupation is of value because it provides opportunities for individuals to influence their well being by gaining fulfillment in living.
 
* Through the experience of occupation (or doing), the individual is able to achieve mastery and competence by learning skills and strategies necessary for coping with problems and adapting to limitations.
 
* As competence is gained and autonomy can be expressed, independence is achieved.
 
* Autonomy implies choice and control over environmental circumstances, thus opportunities for exerting self-determination should be reflected in intervention strategies.
 
* Choice and control extend to decisions about intervention, thus identifying occupational therapy as a collaborative process between the therapist and recipient of care. In this collaboration, the patient's values are respected.
 
* Because of its focus on life performance, it is neither somatic, nor psychological, but concerned with the unity of body and mind in doing. (Baum & Christiansen,(p. 36, 1997))
 
   
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Occupation is the dynamic relationship between the occupational form and occupational performance.<ref>Nelson, D., L. (1988)Occupation: Form and Performance. American Journal of Occupational Therapy. 42 (10) pp, 633-641</ref><ref>Nelson, D., L. (1996) Therapeutic Occupation: A Definition. American Journal of Occupational Therapy. 50 (10), pp. 775-782</ref>
== Benefits of occupational therapy ==
 
A wide variety of people may benefit from occupational therapy, these may include people with:
 
*work-related injuries including lower back problems or repetitive strain injuries
 
*physical, cognitive or psychological limitations following a stroke, [[brain injury]] or heart attack
 
*[[arthritis]], [[multiple sclerosis]], or other serious chronic conditions
 
*birth injuries, learning difficulties, or [[developmental disabilities]]
 
*mental health difficulties [[Alzheimer's]], [[schizophrenia]], and [[Post-traumatic stress disorder|post-traumatic stress]]
 
*substance abuse problems or eating disorders
 
*obsessive compulsions, or diagnosed obsessive compulsive disorder (OCD)
 
*burns, spinal cord injuries, or [[amputation]]s
 
*fractures or other injuries from falls, sports injuries, or accidents
 
*visual, perceptual or cognitive impairements
 
*developmental disabilities such as [[autism]] or [[cerebral palsy]]
 
*domestic abuse issues
 
   
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Many people see the term occupation as a job one does. However, the meaning of occupation is seen in a much wider context by an Occupational Therapist. A human being can be engaged in a wide range of occupations: leisure, self-care or educational activities are just a few examples of occupation.<ref>Richards, S. (2003) Occupational Therapy: Comment. The Independent</ref>
== Areas of occupational therapy ==
 
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Occupational therapists work in a vast array of settings, these include:
 
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'''Occupational Form'''
=== Physical ===
 
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*[[Orthopedics]] (fractures/falls clinics)
 
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Wu and Lin (1999) stated that the occupational form was the “...objective pre-existing structure or environmental context that elicits or guides subsequent human performance”. The occupational form consists of objective features. These may include materials, human context and socio-cultural dimensions.<ref>Wu, C and Lin, K. (1999) Defining Occupation: A Comparative Analysis. Journal of Occupational Science. 6 (1), pp. 5-12</ref>
*[[Pediatrics]]
 
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*Elderly rehabilitation
 
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== Occupational therapy process ==
*[[Emergency department|Accident and emergency department]] (or emergency room)
 
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*Hand therapy
 
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An [[Occupational Therapist]] works systematically through a sequence of actions known as the occupational therapy process. There are several versions of this process as described by numerous writers. Creek (2003)<ref>Creek 2003 Occupational Therapy Defined as a Complex Intervention, London COT</ref> has sought to provide a comprehensive version based on extensive research. This version has 11 stages, which for the experienced therapist may not be linear in nature. The stages are:
*Cardiac rehabilitation
 
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*Burns
 
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* Referral
*Road traffic accidents
 
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* Information gathering
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* Initial assessment
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* Needs identification/problem formation
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* Goal setting
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* Action planning
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* Action
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* Ongoing assessment and revision of action
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* Outcome and outcome measurement
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* End of intervention or discharge
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* Review
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== Areas of practice in occupational therapy ==
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There are many areas of practice in occupational therapy which have often been divided into Physical Health and Mental Health. The division is not so clear as occupational therapists consider the physical, mental and social well-being of all clients in every setting. These divisions occur when the setting is defined by the population it serves for example acute physical or mental health settings (e.g.: hospitals), sub-acute settings (e.g.: aged care facilities), outpatient clinics and community settings.
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=== Physical health ===
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* [[Pediatrics - Schools, Community, inpatient hospital based childrens OT]]
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* Acute care hospitals
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* Inpatient [[rehabilitation]] (e.g., Spinal Cord Injuries)
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* [[Rehabilitation]] centres (e.g., TBI, Stroke (CVA), Spinal Cord Injuries, Head Injuries)
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* Skilled nursing facilities
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* Home Health
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* Outpatient clinics (e.g., Hand Therapy, [[orthopaedics]])
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* Specialist assessment centres (e.g., Electronic [[assistive technology]], Posture and Mobility services)
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* Hospices
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=== Mental health ===
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* Mental health inpatient units
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**Adolescent, adult and older people's acute mental health wards
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**Adult and older people's rehabilitation wards
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**Prisons/secure units ([[Forensic psychiatry]])
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**Psychiatric intensive care unit
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**Specialist units for Eating Disorders, Learning disabilities
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* Community based mental health teams
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**Child and adolescent mental health teams
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**Adult and older people's community mental health teams
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**Rehabilitation and recovery and Assertive Outreach community teams
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**Primary care services in GP practices
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**Home treatment teams
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**Early Intervention for Psychosis services
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**Specialist learning disability, eating disorder community services
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**Day services
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**Vocational Services
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Vocational Rehabilitation
   
 
=== Community ===
 
=== Community ===
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Community based practice involves working with people in their own environment rather than in a hospital setting. It can also involve working with atypical populations such as the homeless or at-risk populations.
*Intermediate care
 
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Examples of community-based practice settings:
*Day centres
 
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* Health promotion and lifestyle change
*Schools
 
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* Intermediate care services
*Child development centres
 
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* Day centres
*People's own homes, carrying out therapy and providing equipment and adaptations
 
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* Schools
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* Child development centres
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* People's own homes, carrying out therapy and providing equipment and adaptations
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* Workplaces
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* Homeless Shelters
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* Educational Settings
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* [[Refugee]] Camps<ref name="Occupation">Occupation for Occupational Therapists, Matthew Molineux, Blackwell Publishing, 2004</ref>
   
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== Occupational therapy approaches ==
=== Neurology ===
 
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Services typically include:
*[[Stroke rehabilitation]]
 
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* Teaching new ways of approaching tasks<ref name="The Independent">The Independent Thursday 26th June 2003 Comment</ref>
*Traumatic brain injuries
 
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* How to break down activities into achievable components eg sequencing a complex task like cooking a complex meal<ref name="The Independent"/>
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* Comprehensive home and job site evaluations with adaptation recommendations.
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* Performance skills assessments and treatment.
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* Adaptive equipment recommendations and usage training.
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* Environmental adaptation including provision of equipment or designing adaptations to remove obstacles or make them manageable<ref name="The Independent"/>
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* Guidance to family members and caregivers.<ref name="AOTA">American Occupational Therapy Association, Inc. (2005).</ref>
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The use of creative media as therapeutic activity
   
=== Mental Health ===
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=== Activity analysis ===
*[[CAMHS|Child and adolescent mental health services]] (CAMHS)
 
*[[Forensic psychiatry]]
 
*Prisons/sections
 
*Mental health clinics
 
*Psychiatric rehabilitation programs
 
   
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Activity analysis has been defined as a process of dissecting an activity into its component parts and task sequence in order to identify its inherent properties and the skills required for its performance, thus allowing the therapist to evaluate its therapeutic potential<ref>Creek 2003 Occupational Therapy defined as a complex intervention. London. COT</ref>
== Occupational therapy case studies ==
 
Every day, children and adults have or develop health conditions that significantly affect their ability to manage their daily lives. With the help of occupational therapy, many of these individuals can achieve or regain a higher level of independence. When skill and strength cannot be developed or improved, occupational therapy offers creative solutions and alternatives for carrying out daily activities.
 
   
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=== Therapeutic activity ===
The following examples illustrate occupational therapy and how individuals might benefit from treatment.
 
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Occupational therapists use therapeutic activity or therapeutic occupation to improve an individual's occupational performance and increase function in [[activities of daily living]] (ADLs) and [[self care skills]].
   
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A core and unique feature of occupational therapy practice is the use of occupation as a therapeutic medium<ref>Golledge, J. (1998) Distinguishing between Occupation, Purposeful Activity and Activity, Part 2: Why is the Distinction Important? British Journal of Occupational Therapy, 61(4), pp.157-160.</ref>. An occupational therapy core skill as defined by The College of Occupational Therapists (COT) is the use of activity as a therapeutic tool<ref>COT (2006) COT/BAOT Briefings: Definitions and Core Skills for Occupational Therapists. London: College of Occupational Therapists.</ref>.
=== Alzheimer's disease ===
 
Art Anderson's family was not surprised when the doctor confirmed that his growing memory problems were caused by Alzheimer's disease. The primary concern was the effect that Art's care was having on his wife, who was dealing with health problems of her own. They found help in a day care program for people with Alzheimer's disease. Here Art enjoys social interactions, meals, and leisure activities designed for people with his condition. Art's wife Martha attends weekly group meetings led by an occupational therapist. Martha learns to help her husband to participate as much as possible in the family's routine and how to manage the many tasks that make up her "job of living."
 
   
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Occupational therapists have utilized activities, such as crafts, since the profession was founded<ref>Griffiths, S. and Corr, S. (2007) The Use of Creative Activities with People with Mental Health Problems: a Survey of Occupational Therapists. British Journal of Occupational Therapy, 70(3), pp.107-114.</ref>. The arts and crafts movement in the very early 20th century had ascertained that goal directed activity had a curative effect on the social problems inherent in the newly industrialized societies. The founders of the occupational therapy profession extended this thinking to the treatment of individuals' with mental health problems and as a consequence between 1920 and 1940 much of occupational therapy practice concentrated around the use of crafts as purposeful activities<ref>Taylor, E. and Manguno, J. (1990) Use of Treatment Activities in Occupational Therapy. American Journal of Occupational Therapy, 45(4), pp.317-322.</ref>. The emergence of occupational therapy in physical medicine began during World War II and craft activities were utilised to rehabilitate injured soldiers<ref>Turner, A., Foster, M. and Johnson, S.E. (1997) Occupational Therapy and Physical Dysfunction: Principles, Skills and Practice. Edinburgh: Churchill Livingstone.</ref>. This method of practice was later termed by Mosey<ref>Mosey, A.C. (1985) Psychosocial Components of Occupational Therapy. New York: Raven Press.</ref> as activity synthesis.
Additional occupational therapy services that may be indicated for Alzheimer's Disease patients include an assessment of the home environment. This results in detailed modifications to improve safety, item locations and labeling to enhance Art's independence, and suggestions to make Martha's increasing caregiving tasks more manageable. Occupational therapy adaptations promote efficient completion of Art and Martha's "activities of daily living" and predict and prepare for the patient's functional decline.
 
   
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Activity synthesis or occupational synthesis is the core of occupational therapy practice; occupational therapists, in collaboration with clients, design occupational forms to produce a therapeutic occupation or activity, that is meaningful and purposeful to the client<ref>Nelson, D. (1996) Therapeutic Occupation: A Definition. American Journal of Occupational Therapy, 50(10), pp.775-782.</ref>. The therapeutic activity or occupation may be used to assess the client’s occupational needs or to achieve a therapeutic goal. The component parts of an activity or occupation are matched with the required occupational performance outcomes. For example, the muscle movements elicited by pottery may address fine motor and gross motor skills to improve shoulder flexion and extension, range of movement and elbow extension and flexion.<ref>Tubbs, C. and Drake, M. (2007) Crafts and Creative Media in Therapy. 3rd ed. Thorofare: Slack Incorporated.</ref>.
=== Bipolar disorder ===
 
Robby is a 43 year old male with [[Bipolar disorder]]. Due to his alternating episodes of [[mania]] and [[clinical depression|depression]], Robby is challenged [[cognition|cognitively]]. He has difficulty doing anything that requires more than 3 steps and often forgets the order of the steps. He avoids social interaction, preferring to keep to himself. With Robby's occupational therapist, he began attending a social skills group twice a week. Additionally, the occupational therapist made a laundry checklist outlining the steps for doing laundry individually and put labels on all the buttons and dials of his washing machine. Doing the same, repetitive activities with Robby will help him develop a routine, allowing him to gain independent living skills.
 
   
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Other therapeutic activities or occupations may include cookery activities, such as making a smoothie or a healthy soup. The components of this activity such as planning and following a recipe may address cognitive components of occupational performance such as problem solving, sequencing and learning. Health may be promoted through this occupation, enabling clients to consider healthy eating issues<ref>COT (2008) Health promotion in occupational therapy. London: College of Occupational Therapists.</ref>.
=== Gunshot wound ===
 
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Occupational therapists may further use therapeutic activities or occupations to assess occupational performance. For example, an occupational therapist may ask a client to make a cup of tea or prepare a simple meal to assess performance in activities of daily living (ADLs). An occupational therapist may use a board or card game to assess cognitive components of occupational performance. This application of therapeutic activity/occupation involves use of the core skills of the occupational therapist, chiefly assessment and problem solving<ref>Creek, J. (2003) Occupational therapy defined as a complex intervention. London: College of Occupational Therapists.</ref>.
Jack was going into a convenience store one night when he encountered an armed robber attempting to get away. In the ensuing altercation, Jack was shot in the arm. As a result of the shooting, Jack had multiple surgeries, but still did not have full use of his arm due to his [[Wrist drop|radial nerve palsy]]. Jack's occupational therapist constructed a splint that would allow Jack to have more control over his arm. Additionally, Jack's arm would now be stabilized and be positioned in a more correct posture.
 
   
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== Theoretical Frameworks ==
=== Stroke ===
 
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Occupational Therapists use a number of theoretical frameworks to frame their practice. Note that terminology has differed between scholars. Theoretical bases for framing a human and their occupation being include the following:
Helen Richards is a publishing executive, respected for her business skills and admired for her perfect grooming. Three months ago Helen had a stroke. During her recovery she had to relearn many things, but her first goal was to face the world with her hair and make up in place. Helen's occupational therapist was empathetic and empowering. Together they found the right combination of tools and techniques so that Helen could handle her personal grooming. They also worked on the other tasks she would need to manage her home and return to work. From make-up to management, occupational therapy helped Helen recover the skills she needed.
 
   
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=== Frames of Reference/Generic models ===
=== Developmental problems ===
 
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Frames of reference or generic models are the overarching title given to a collation of compatible knowledge, research and theories that form conceptual practice<ref>Foster, M. (2002) "Theoretical Frameworks", In: Occupational Therapy and Physical Dysfunction, Eds. Turner, Foster & Johnson.</ref>. More generally they can be defined as "those aspects which influence our perceptions, decisions and practice"<ref>Rogers JC (1983), Eleanor Clarke Slagle Lecture. Clinical Reasoning; the ethics, science and art. American Journal of Occupational Therapy, 37(9):601-616</ref>.
Tommy weighed just three pounds at birth. Doctors warned his parents to be on the lookout for problems that might affect his development. In the hospital nursery, an occupational therapist helped ensure that Tommy was taking in enough nourishment. As a toddler, Tommy attended a Head Start program where [[occupational therapist]]s and occupational therapy assistants provided activities to aid his physical and mental development. For youngsters like Tommy, the "job of living" requires basic skills such as eating, playing, and interacting successfully with family members and friends.
 
   
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Frames of reference have generally been a precursor to the design of theoretical models of practice. As such, through the development of such models, different terminology exists to define different frames of reference. Some broad terms as defined by Foster<ref name="Foster">Foster, M. (2002), Theoretical Frameworks, in Occupational Therapy and Physical Dysfunction. Churchill Livingstone</ref> include: Developmental, Biomechanical, Learning and Compensatory.
==See also ==
 
*[[Recreation therapy]]
 
*[[Diversional therapy]]
 
   
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=== Approaches/Intervention models ===
== References ==
 
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These are the methods of carrying out the Frames of Reference. Again, terminology differs depending on your viewpoint and literature base. Using the above author (<ref name="Foster"/>), approaches can include the Adaptive (based on the compensatory Frame of Reference),
Baum C., & Christiansen, C., (1997), The occupational therapy context: Philosophy - Principles - Practice. In C. Christiansen & C. Baum (Eds.), ''Occupational Therapy: Enabling Function and Well Being''. p. 36. Thorofare, NJ: SLACK
 
   
== External links ==
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=== Models ===
   
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=== Theories ===
===Occupational therapy associations===
 
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== Evolution of the philosophy of occupational therapy ==
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The [[philosophy]] of occupational therapy has evolved over the history of the profession. The philosophy articulated by the founders that have owed much to the ideals of [[romanticism]]<ref name="Hocking">Hocking, C (2004). Making a difference: The romance of occupational therapy. South African Journal of Occupational Therapy, 34(2), 3-5.</ref> , [[pragmatism]]<ref name="Breines">Breines, E (1990). Genesis of occupation: A philosophical model for therapy and theory. Australian Occupational Therapy Journal, 37(1), 45-49.</ref> and [[humanism]] which are collectively considered the fundamental ideologies of the past century<ref name="McColl"> McColl, M A, Law, M., Stewart D., Doubt, L., Pollack, N and Krupa, T (2003). Theoretical basis of occupational therapy (2nd Ed). New Jersey, SLACK Incorporated. </ref><ref name="Chapparo"> Chapparo, C. and Ranka. J. (2000). Clinical reasoning in occupational therapy in Higgs J and Jones M (2000) Clinical reasoning in the health professions. 2nd ed. Oxford, Butterworth Heinemann Ltd. </ref><ref name ="Yerxa"> Yerxa, E J (1983). Audacious values: the energy source for occupational therapy practice in G. Kielhofner (1983) Health though occupation: Theory and practice in occupational therapy. Philadelphia, FA Davis. </ref>.
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William Rush Dunton, the creator of the National Society for the Promotion of Occupational Therapy, now the American Occupational Therapy Association, sought to promote the ideas that occupation is a basic human need, and that occupation was therapeutic. From his statements, came some of the basic assumptions of occupational therapy, which include:
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* Occupation has an effect on health and well-being.
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* Occupation creates structure and organizes time.
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* Occupation brings meaning to life, culturally and personally.
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* Occupations are individual. People value different occupations<ref name="Townsend">Townsend, Elizabeth A. and Helene J Polatajko. (2007). Enabling Occupation II: Advancing an Occupational Therapy Vision for Health, Well-Being & Justice Through Occupation. Ottawa: CAOT Publications ACE.</ref>.
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These have been elaborated over time to form the values which underpin the Codes of Ethics issued by each national association. However, the relevance of occupation to health and well-being remains the central theme. Influenced by criticism from medicine and the multitude of physical disabilities resulting from [[World War II]] , occupational therapy adopted a more [[reductionistic]] philosophy for a time. While this approach lead to developments in technical knowledge about occupational performance, clinicians became increasingly disillusioned and re-considered these beliefs<ref name="Turner"> Turner, A. (2002). History and Philosophy of Occupational Therapy in Turner, A., Foster, M. and Johnson, S. (eds) Occupational Therapy and Physical Dysfunction, Principles, Skills and Practice. 5th Edition. Edinburgh, Churchill Livingstone, 3-24..</ref><ref name="Punwar"> Punwar, A.J. (1994). Philosophy of Occupational Therapy in Occupational Therapy, Principles and practice. 2nd Ed. Williams and Wilkins, Baltimore, 7-20.</ref>. As a result, client centeredness and occupation are re-emerging as dominant themes in the profession, perhaps indicating growing maturity and self confidence<ref name="Douglas"> Douglas, F M (2004). Occupational still matters: A tribute to a pioneer. British Journal of Occupational Therapy, 67(6), 239. </ref><ref name="Whiteford"> Whiteford, G. and Fossey, E. (2002). Occupation: The essential nexus between philosophy, theory and practice. Australian Occupational Therapy Journal, 49(1), 1-2.
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</ref><ref name="Polatajko"> Polatajko, H (2001). The evolution of our occupational perspective: The journey from diversion through therapeutic use to enablement. Canadian Journal of Occupational Therapy, 68(4), 203-207.
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</ref>. Over the past century, the underlying philosophy of occupational therapy has evolved from being a diversion from illness, to treatment, to enablement through meaningful occupation<ref name="Townsend"/>. This became evident through the development and widespread adoption of the [http://en.wikipedia.org/wiki/Canadian_model_of_occupational_performance Canadian Model of Occupational Performance].
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The two most commonly mentioned values are that occupation is essential for health and the concept of [[holism]]. However, there have been some dissenting voices. Mocellin in particular advocated abandoning the notion of health through occupation as obsolete in the modern world and questioned the appropriateness of advocating holism when practice rarely supports it<ref name="Mocellin1"> Mocellin, G. (1988). A perspective on the principles and practice of occupational therapy. Generally they need to eat loads of bananas and chocolate. British Journal of Occupational Therapy, 51(1), 4-7. </ref><ref name="Mocellin2"> Mocellin, G. (1995). Occupational therapy: A critical overview, Part 1. British Journal of Occupational Therapy, 58(12), 502-506. </ref><ref name="Mocellin3"> Mocellin, G. (1996). Occupational therapy: A critical overview, Part 2. British Journal of Occupational Therapy, 59(1), 11-16. </ref>. The values formulated by the American Association of Occupational Therapists have also been critiqued as being therapist centred and not reflecting the modern reality of multicultural practice<ref name="Kielhofner"> Kielhofner, G. (1997). Conceptual Foundations of Occupational Therapy. 2nd Ed. Philadelphia, F.A.Davis. </ref><ref name="Hocking/Whiteford"> Hocking, C and Whiteford, G (1995). Multiculturalism in occupational therapy: A time for reflection on core values. Australian Occupational Therapy Journal, 42(4), 172-175. </ref>.
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Central to the philosophy of occupational therapy is the concept of occupational performance. In considering occupational performance the therapist must consider the many factors which comprise overall performance. This concept is made more tangible using models such as the person-environment-occupation model proposed by Law et al. (1996)<ref>The Person-Environment-Occupation Model, Law et al (1996), Canadian Journal of Occupational Therapy, vol 63 n1 p9-23 Apr 1996</ref>. This approach highlights the importance of satisfactions in one's occupations, broadening the aim of occupational therapy beyond the mere completion of tasks to the holistic achievement of personal wellbeing.
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In recent times occupational therapists have challenged themselves to think more broadly about the potential scope of the profession, and expanded it to include working with groups experiencing [[occupational deprivation]] which stems from sources other than disability<ref>Occupational Therapy without borders:learning from the spirit of survivors, Kronenburg et al, Churchill Livingstone 2004</ref>. Examples of new and emerging practice areas would include therapists working with [[refugee]]s<ref name="Occupation"/>, and with people experiencing [[homelessness]]<ref>The Process and Outcomes of a Multimethod needs assessment at a homeless shelter, Finlayson et et al (2002), American Journal of Occupational Therapy</ref>
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==Challenges for Occupational Therapy==
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A key challenge for occupational therapy is to develop and maintain a definition of it's nature and scope. Cara and MacRae (2002) <ref>Psychosocial Occupational Therapy, Cara and MacRae (2002), Thompson Delmar</ref> assert that whilst this presets a challenge, it also results in a unique flexibility which allows the discipline to move with the flow of social, cultural and environmental change. This difficulty in definition may be a cause of chronic strain for practitioners <ref>Occupational Therapy in Community Mental Health Teams: a Continuing Dilemma? Role Theory offers an Explanation, Hughes (2001), British Journal of Occupational Therapy, Volume 64, Number 1,pp. 34-40(7)</ref> and may also contribute to a lack of role definition and subsequent blurring <ref>Role overlap between occupational therapy and physiotherapy during in-patient stroke rehabilitation: an exploratory study, Booth and Hewison (2002) Journal of Interprofessional Care</ref>.
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Recent literature has also called for Occupational Therapy to address the political nature of who we are and what we do (Kronenberg and Pollard 2005).
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== The World Federation of Occupational Therapists ==
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The[http://www.wfot.org World Federation of Occupational Therapists] (WFOT) is the key international representative for Occupational Therapists and Occupational Therapy around the world and the official international organisation for the promotion of Occupational Therapy. Founded in 1952, WFOT currently has 66 member associations. Click on the link below to WFOT member nations to find specific information about each country’s history, occupational therapy education system, registration requirements and relevant organizations.
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==Occupational Therapy Associations==
 
* [http://www.wfot.org World Federation of Occupational Therapists]
 
* [http://www.wfot.org World Federation of Occupational Therapists]
* [http://www.aota.org The American Occupational Therapy Association, Inc.]
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* [http://www.aota.org The American Occupational Therapy Association]
* [http://www.ausot.com.au/ Australian Association of Occupational Therapists]
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* [http://www.ausot.com.au Australian Association of Occupational Therapists]
* [http://www.ergotherapie.at/ Austrian Occupational Therapy Association]
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* [http://www.cot.co.uk British Association/College of Occupational Therapists]
* [http://www.botabd.netfirms.com/ Bangladesh Occupational Therapy Association]
 
* [http://www.cot.co.uk/ British Association/College of Occupational Therapists]
 
 
* [http://www.caot.ca Canadian Association of Occupational Therapists]
 
* [http://www.caot.ca Canadian Association of Occupational Therapists]
* [http://www.isot.org.il/ Israeli Society of Occupational Therapy]
 
* [http://www.aito.it/ Italian Association of Occupational Therapists]
 
* [http://www.aito.it/ Korean Association of Occupational Therapists]
 
* [http://www.geocities.com/otuganda/ Uganda Association of Occupational Therapists]
 
* [http://www.nzaot.com New Zealand Association of Occupational Therapists]
 
   
===Occupational therapy associations by US state===
+
== Occupational Therapy Education ==
  +
* [http://www.enothe.hva.nl The European Network of Occupational Therapy in Higher Education]
{{col-begin|width=35em}}
 
  +
{{col-3}}
 
  +
== Licensing and Registration requirements ==
* [http://www.alota.org Alabama]
 
  +
* [http://www.rehablicense.com/professional.php?profID=6 Occupational Therapy License Information]
* [http://www.akota.org Alaska]
 
* [http://www.ability.org.uk/ergo.html Arizona]
+
* [http://www.hpc-uk.org/ Health Professions Council, UK]
  +
* [http://kidshealth.org/parent/system/ill/occupational_therapy.html  Kids Health for Parents - Occupational Therapy Association]
* [http://www.arota.org Arkansas]
 
  +
* [http://www.bls.gov/oco/ocos078.htm  US Department of Labor - Occupational Outlook Handbook - 2008, 2009 edition]
* [http://www.otaconline.org California]
 
  +
* [http://www.goarmy.com/amedd/m_spec/jobs.jsp?job=65A&iom=C499-ITBP-MCMS-040108-NA-8021-AOC65A US Army Medical Specialist Corps, Occupational Therapist (65A) ]
* [http://www.otacco.org Colorado]
 
  +
* [http://www.connota.org Connecticut]
 
  +
==Se also==
* [http://www.dotaonline.org Delaware]
 
  +
*[[Physical therapy]]
* [http://www.flota.org Florida]
 
  +
* [http://www.gaota.com Georgia]
 
  +
==References==
* [http://www.otah-hawaii.com Hawaii]
 
  +
{{reflist|2}}
* [http://www.id-ota.com Idaho]
 
  +
*Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Occupational Therapists, on the Internet at http://www.bls.gov/oco/ocos078.htm (visited July 11, 2008).
* [http://www.ilota.org Illinois]
 
* [http://www.inota.com Indiana]
 
* [http://www.iowaot.org Iowa]
 
* [http://www.kansasot.org Kansas]
 
* [http://www.kotaweb.org Kentucky]
 
{{col-3}}
 
* [http://www.lota.org Louisiana]
 
* [http://www.meota.org Maine]
 
* [http://www.mdota.org Maryland]
 
* [http://www.maot.org Massachusetts]
 
* [http://www.mi-ota.com Michigan]
 
* [http://www.functionfirst.org Minnesota]
 
* [http://www.angelfire.com/ms/msota Mississippi]
 
* [http://www.motamo.net Missouri]
 
* [http://www.mtota.org Montana]
 
* [http://www.notaonline.org Nebraska]
 
* [http://www.nvota.org Nevada]
 
* [http://www.nhoccupationaltherapy.com New Hampshire]
 
* [http://www.njota.org New Jersey]
 
* [http://www.nmota.org New Mexico]
 
* [http://www.nysota.org New York]
 
* [http://www.ncota.org North Carolina]
 
* [http://www.ndota.com North Dakota]
 
{{col-3}}
 
* [http://www.oota.org Ohio]
 
* [http://www.okota.org Oklohoma]
 
* [http://www.otao.com Oregon]
 
* [http://www.pota.org Pennsylvania]
 
* [http://www.riota.org Rhode Island]
 
* [http://www.scotassociation.org South Carolina]
 
* [http://www.iw.net/~sdota South Dakota]
 
* [http://www.tnota.org Tennessee]
 
* [http://www.tota.org Texas]
 
* [http://www.uotaonline.org Utah]
 
* [http://www.vtot.org Vermont]
 
* [http://www.vaota.org Virginia]
 
* [http://www.wota.org Washington]
 
* [http://www.wvota.org West Virginia]
 
* [http://www.wota.net Wisconsin]
 
* [http://www.wyota.org Wyoming]
 
{{col-end}}
 
   
  +
#Baum C., & Christiansen, C., (1997), The occupational therapy context: Philosophy - Principles - Practice. In C. Christiansen & C. Baum (Eds.), ''Occupational Therapy: Enabling Function and Well Being''. p. 36. Thorofare, NJ: SLACK
===Occupational therapy links===
 
  +
#Bing, R.K. (1981) Occupational therapy revisited: A paraphrastic journey. American Journal of Occupational Therapy, 35(8):499-518.
* [http://www.ot4function.com Occupational Therapy for Function - Treatment Plan for Adult Physical Disabilities]
 
  +
#Low, J. (1992). The reconstruction aides. American Journal of Occupational Therapy. Jan;46(1):38-43,
* [http://www.inpractice.org inPractice.org - Online tools for managing practice placement]
 
  +
#Meyer, A. (1922). The philosophy of occupation therapy. Archives of Occupational Therapy, 1, 1-10.
  +
Buchanan, M. (1941). "letter " Journal of Occupational Therapy 3(2): 12.
  +
  +
Hobcroft, N. (1949). "Life in the Occupational Therapy Department at Porirua." New Zealand Occupational therapy Newsletter Number Two. (May).
  +
  +
New Zealand Occupational Therapy Registration Board (1950). "Minutes of the New Zealand Occupational Therapy Registration Board." 20th June.
  +
  +
New Zealand Occupational Therapy Registration Board (1970b 17th July). "Minutes of the New Zealand Occupational Therapy Registration Board."
  +
  +
New Zealand Registered Occupational Therapists Association (1949). "AGM Minutes."
  +
  +
NZJOT (1996). New Zealand Journal of Occupational Therapy 47(1): 19.
  +
  +
NZNJ (1940). "Editorial " New Zealand Nursing Journal 33(11): 346.
  +
  +
Packer, T., & Stickney, Jan (1991). "Advanced Diploma in Occupational Therapy: A comparison of therapists before and after." Journal of New Zealand Association of Occupational Therapists Inc. 42(1): 3-7.
  +
  +
Skilton, H. (1981). Work for your life - the story of the beginning and early years of occupational therapy in New Zealand. Hamilton, Hudlo Printers.
  +
  +
Wilson, L. H. (2004). Role differentiation in a professionalising occupation: the case of occupational therapy, New Zealand Department of Management Dunedin University of Otago PhD.
   
  +
----
=== Occupational therapy blogs ===
 
   
  +
{{Allied health professions}}
*[http://www.therapytimes.com/blog Occupational Therapists' blogs on Therapy Times] - Occupational Therapists' blogs on Therapy Times
 
*[http://www.housingot.co.uk/page9.htm The Occupational Therapy Blog] - British
 
*[http://metaot.com/blog Meta OT] - British
 
*[http://abctherapeutics.blogspot.com/ ABC Therapeutics Occupational Therapy Weblog] - US
 
*[http://www.podcasternews.com/details.php?P=10 Mental Health Missives] podcast, US
 
   
  +
[[Category:Occupational therapy]]
=== Universities offering OT programs ===
 
*[http://www.aic.edu/pages/370.html American International College]
 
*[http://www.bu.edu/sargent/programs/graduate.html#occupational_therapy Boston University]
 
*[http://www.columbiaot.org/ Columbia University]
 
*[http://www.healthsciences.duq.edu/ot/ Duquesne University]
 
*[http://www.cpnahs.howard.edu/AHS/Ot/Introduction.htm Howard University]
 
*[http://www.musc.edu/chp/ot/ Medical University of South Carolina]
 
*[http://almond.admin.nene.ac.uk:7777/portal/page?_pageid=113,1969698&_dad=portal&_schema=PORTAL Northampton University UK]
 
*[http://www2.sjsu.edu/ot/ San Jose State University]
 
*[http://www.spalding.edu/frame.asp?pg=db2.asp?id=415 Spalding University]
 
*[http://www.downstate.edu/chrp/ot SUNY Downstate Medical Center]
 
*[http://www.jefferson.edu/jchp/ot/index.cfm Thomas Jefferson University]
 
*[http://www.tu.edu/departments.php?id=69 Touro University Nevada]
 
*[http://wwwnew.towson.edu/ot/ Towson University]
 
*[http://www.ot.ualberta.ca University of Alberta]
 
*[http://www.rehab.ubc.ca University of British Columbia]
 
*[http://www.uca.edu/divisions/academic/chas/ot.html University of Central Arkansas]
 
*[http://www.shrs.pitt.edu/ot/index.html University of Pittsburgh]
 
*[http://www.usc.edu/schools/ihp/ot// University of Southern California]
 
*[http://www.une.edu/chp/ot/ University of New England]
 
*[http://hsc.uwe.ac.uk/hsc/index.asp?pageid=516 University of the West of England, UK]
 
*[http://www.usip.edu/ot/index.shtml University of the Sciences in Philadelphia]
 
*[http://www.washington.edu/ University of Washington]
 
*[http://ot.wustl.edu/ Washington University in St. Louis]
 
*[http://www.otagopolytechnic.ac.nz Otago Polytechnic, Dunedin, New Zealand]
 
 
[[Category:Special education|O]]
 
[[Category:Special education|O]]
  +
[[Category:Rehabilitation medicine]]
 
[[Category:Therapy]]
 
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Latest revision as of 18:43, 26 August 2009

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Occupational Therapy, often abbreviated as "OT", incorporates meaningful and purposeful occupation to enable people with limitations or impairments to participate in everyday life. Occupational therapists work with individuals, families, groups and populations to facilitate health and well-being through engagement or re-engagement in occupation. Occupational therapists are becoming increasingly involved in addressing the impact of social and environmental factors that contribute to exclusion and occupational deprivation.[1][2]

The World Federation of Occupational Therapistsdefines occupational therapy as a profession concerned with promoting health and well-being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by enabling people to do things that will enhance their ability to participate or by modifying the environment, or the activity to better support participation.[3]

Another way of thinking about the ideas contained in these definitions could be: occupational therapy is about understanding the importance of an activity to an individual, being able to analyze the physical, mental and social components of the activity and then adapting the activity, the environment and/or the person to enable them to resume the activity. In other words, occupational therapists would ask, "Why does this person have difficulties managing his or her daily activities (or occupations), and what can we adapt to make it possible for him or her to manage better and how will this then impact his or her health and well-being?”

Occupational therapy gives people the "skills for the job of living" necessary for "living life to its fullest."[4]

The College of Occupational Therapists (2004) describes OT as follows: Occupational Therapy enables people to achieve health, well-being and life satisfaction through participation in occupation.

Occupational Therapy draws from the field of occupational science to provide an evidence base to practice and develop academic and practice links to other related disciplines such as social science and anthropology, and also utilises a range of generic models to guide the practice of OT.

Occupation, occupational form and occupational performance

Occupation

Occupation is the dynamic relationship between the occupational form and occupational performance.[5][6]

Many people see the term occupation as a job one does. However, the meaning of occupation is seen in a much wider context by an Occupational Therapist. A human being can be engaged in a wide range of occupations: leisure, self-care or educational activities are just a few examples of occupation.[7]

Occupational Form

Wu and Lin (1999) stated that the occupational form was the “...objective pre-existing structure or environmental context that elicits or guides subsequent human performance”. The occupational form consists of objective features. These may include materials, human context and socio-cultural dimensions.[8]

Occupational therapy process

An Occupational Therapist works systematically through a sequence of actions known as the occupational therapy process. There are several versions of this process as described by numerous writers. Creek (2003)[9] has sought to provide a comprehensive version based on extensive research. This version has 11 stages, which for the experienced therapist may not be linear in nature. The stages are:

  • Referral
  • Information gathering
  • Initial assessment
  • Needs identification/problem formation
  • Goal setting
  • Action planning
  • Action
  • Ongoing assessment and revision of action
  • Outcome and outcome measurement
  • End of intervention or discharge
  • Review

Areas of practice in occupational therapy

There are many areas of practice in occupational therapy which have often been divided into Physical Health and Mental Health. The division is not so clear as occupational therapists consider the physical, mental and social well-being of all clients in every setting. These divisions occur when the setting is defined by the population it serves for example acute physical or mental health settings (e.g.: hospitals), sub-acute settings (e.g.: aged care facilities), outpatient clinics and community settings.

Physical health

  • Pediatrics - Schools, Community, inpatient hospital based childrens OT
  • Acute care hospitals
  • Inpatient rehabilitation (e.g., Spinal Cord Injuries)
  • Rehabilitation centres (e.g., TBI, Stroke (CVA), Spinal Cord Injuries, Head Injuries)
  • Skilled nursing facilities
  • Home Health
  • Outpatient clinics (e.g., Hand Therapy, orthopaedics)
  • Specialist assessment centres (e.g., Electronic assistive technology, Posture and Mobility services)
  • Hospices

Mental health

  • Mental health inpatient units
    • Adolescent, adult and older people's acute mental health wards
    • Adult and older people's rehabilitation wards
    • Prisons/secure units (Forensic psychiatry)
    • Psychiatric intensive care unit
    • Specialist units for Eating Disorders, Learning disabilities
  • Community based mental health teams
    • Child and adolescent mental health teams
    • Adult and older people's community mental health teams
    • Rehabilitation and recovery and Assertive Outreach community teams
    • Primary care services in GP practices
    • Home treatment teams
    • Early Intervention for Psychosis services
    • Specialist learning disability, eating disorder community services
    • Day services
    • Vocational Services

Vocational Rehabilitation

Community

Community based practice involves working with people in their own environment rather than in a hospital setting. It can also involve working with atypical populations such as the homeless or at-risk populations. Examples of community-based practice settings:

  • Health promotion and lifestyle change
  • Intermediate care services
  • Day centres
  • Schools
  • Child development centres
  • People's own homes, carrying out therapy and providing equipment and adaptations
  • Workplaces
  • Homeless Shelters
  • Educational Settings
  • Refugee Camps[10]

Occupational therapy approaches

Services typically include:

  • Teaching new ways of approaching tasks[11]
  • How to break down activities into achievable components eg sequencing a complex task like cooking a complex meal[11]
  • Comprehensive home and job site evaluations with adaptation recommendations.
  • Performance skills assessments and treatment.
  • Adaptive equipment recommendations and usage training.
  • Environmental adaptation including provision of equipment or designing adaptations to remove obstacles or make them manageable[11]
  • Guidance to family members and caregivers.[12]

The use of creative media as therapeutic activity

Activity analysis

Activity analysis has been defined as a process of dissecting an activity into its component parts and task sequence in order to identify its inherent properties and the skills required for its performance, thus allowing the therapist to evaluate its therapeutic potential[13]

Therapeutic activity

Occupational therapists use therapeutic activity or therapeutic occupation to improve an individual's occupational performance and increase function in activities of daily living (ADLs) and self care skills.

A core and unique feature of occupational therapy practice is the use of occupation as a therapeutic medium[14]. An occupational therapy core skill as defined by The College of Occupational Therapists (COT) is the use of activity as a therapeutic tool[15].

Occupational therapists have utilized activities, such as crafts, since the profession was founded[16]. The arts and crafts movement in the very early 20th century had ascertained that goal directed activity had a curative effect on the social problems inherent in the newly industrialized societies. The founders of the occupational therapy profession extended this thinking to the treatment of individuals' with mental health problems and as a consequence between 1920 and 1940 much of occupational therapy practice concentrated around the use of crafts as purposeful activities[17]. The emergence of occupational therapy in physical medicine began during World War II and craft activities were utilised to rehabilitate injured soldiers[18]. This method of practice was later termed by Mosey[19] as activity synthesis.

Activity synthesis or occupational synthesis is the core of occupational therapy practice; occupational therapists, in collaboration with clients, design occupational forms to produce a therapeutic occupation or activity, that is meaningful and purposeful to the client[20]. The therapeutic activity or occupation may be used to assess the client’s occupational needs or to achieve a therapeutic goal. The component parts of an activity or occupation are matched with the required occupational performance outcomes. For example, the muscle movements elicited by pottery may address fine motor and gross motor skills to improve shoulder flexion and extension, range of movement and elbow extension and flexion.[21].

Other therapeutic activities or occupations may include cookery activities, such as making a smoothie or a healthy soup. The components of this activity such as planning and following a recipe may address cognitive components of occupational performance such as problem solving, sequencing and learning. Health may be promoted through this occupation, enabling clients to consider healthy eating issues[22]. Occupational therapists may further use therapeutic activities or occupations to assess occupational performance. For example, an occupational therapist may ask a client to make a cup of tea or prepare a simple meal to assess performance in activities of daily living (ADLs). An occupational therapist may use a board or card game to assess cognitive components of occupational performance. This application of therapeutic activity/occupation involves use of the core skills of the occupational therapist, chiefly assessment and problem solving[23].

Theoretical Frameworks

Occupational Therapists use a number of theoretical frameworks to frame their practice. Note that terminology has differed between scholars. Theoretical bases for framing a human and their occupation being include the following:

Frames of Reference/Generic models

Frames of reference or generic models are the overarching title given to a collation of compatible knowledge, research and theories that form conceptual practice[24]. More generally they can be defined as "those aspects which influence our perceptions, decisions and practice"[25].

Frames of reference have generally been a precursor to the design of theoretical models of practice. As such, through the development of such models, different terminology exists to define different frames of reference. Some broad terms as defined by Foster[26] include: Developmental, Biomechanical, Learning and Compensatory.

Approaches/Intervention models

These are the methods of carrying out the Frames of Reference. Again, terminology differs depending on your viewpoint and literature base. Using the above author ([26]), approaches can include the Adaptive (based on the compensatory Frame of Reference),

Models

Theories

Evolution of the philosophy of occupational therapy

The philosophy of occupational therapy has evolved over the history of the profession. The philosophy articulated by the founders that have owed much to the ideals of romanticism[27] , pragmatism[28] and humanism which are collectively considered the fundamental ideologies of the past century[29][30][31].

William Rush Dunton, the creator of the National Society for the Promotion of Occupational Therapy, now the American Occupational Therapy Association, sought to promote the ideas that occupation is a basic human need, and that occupation was therapeutic. From his statements, came some of the basic assumptions of occupational therapy, which include:

  • Occupation has an effect on health and well-being.
  • Occupation creates structure and organizes time.
  • Occupation brings meaning to life, culturally and personally.
  • Occupations are individual. People value different occupations[1].

These have been elaborated over time to form the values which underpin the Codes of Ethics issued by each national association. However, the relevance of occupation to health and well-being remains the central theme. Influenced by criticism from medicine and the multitude of physical disabilities resulting from World War II , occupational therapy adopted a more reductionistic philosophy for a time. While this approach lead to developments in technical knowledge about occupational performance, clinicians became increasingly disillusioned and re-considered these beliefs[32][33]. As a result, client centeredness and occupation are re-emerging as dominant themes in the profession, perhaps indicating growing maturity and self confidence[34][35][36]. Over the past century, the underlying philosophy of occupational therapy has evolved from being a diversion from illness, to treatment, to enablement through meaningful occupation[1]. This became evident through the development and widespread adoption of the Canadian Model of Occupational Performance.

The two most commonly mentioned values are that occupation is essential for health and the concept of holism. However, there have been some dissenting voices. Mocellin in particular advocated abandoning the notion of health through occupation as obsolete in the modern world and questioned the appropriateness of advocating holism when practice rarely supports it[37][38][39]. The values formulated by the American Association of Occupational Therapists have also been critiqued as being therapist centred and not reflecting the modern reality of multicultural practice[40][41].

Central to the philosophy of occupational therapy is the concept of occupational performance. In considering occupational performance the therapist must consider the many factors which comprise overall performance. This concept is made more tangible using models such as the person-environment-occupation model proposed by Law et al. (1996)[42]. This approach highlights the importance of satisfactions in one's occupations, broadening the aim of occupational therapy beyond the mere completion of tasks to the holistic achievement of personal wellbeing.

In recent times occupational therapists have challenged themselves to think more broadly about the potential scope of the profession, and expanded it to include working with groups experiencing occupational deprivation which stems from sources other than disability[43]. Examples of new and emerging practice areas would include therapists working with refugees[10], and with people experiencing homelessness[44]

Challenges for Occupational Therapy

A key challenge for occupational therapy is to develop and maintain a definition of it's nature and scope. Cara and MacRae (2002) [45] assert that whilst this presets a challenge, it also results in a unique flexibility which allows the discipline to move with the flow of social, cultural and environmental change. This difficulty in definition may be a cause of chronic strain for practitioners [46] and may also contribute to a lack of role definition and subsequent blurring [47].

Recent literature has also called for Occupational Therapy to address the political nature of who we are and what we do (Kronenberg and Pollard 2005).

The World Federation of Occupational Therapists

TheWorld Federation of Occupational Therapists (WFOT) is the key international representative for Occupational Therapists and Occupational Therapy around the world and the official international organisation for the promotion of Occupational Therapy. Founded in 1952, WFOT currently has 66 member associations. Click on the link below to WFOT member nations to find specific information about each country’s history, occupational therapy education system, registration requirements and relevant organizations.

Occupational Therapy Associations

Occupational Therapy Education

Licensing and Registration requirements

Se also

References

  1. 1.0 1.1 1.2 Townsend, Elizabeth A. and Helene J Polatajko. (2007). Enabling Occupation II: Advancing an Occupational Therapy Vision for Health, Well-Being & Justice Through Occupation. Ottawa: CAOT Publications ACE.
  2. Occupational Deprivation: Global Challenge in the New Millennium, Whiteford (2000), British Journal of Occupational Therapy Volume 63, Number 5, pp. 200-204(5)
  3. http://www.wfot.org/information.asp
  4. AOTA http://www.aota.org
  5. Nelson, D., L. (1988)Occupation: Form and Performance. American Journal of Occupational Therapy. 42 (10) pp, 633-641
  6. Nelson, D., L. (1996) Therapeutic Occupation: A Definition. American Journal of Occupational Therapy. 50 (10), pp. 775-782
  7. Richards, S. (2003) Occupational Therapy: Comment. The Independent
  8. Wu, C and Lin, K. (1999) Defining Occupation: A Comparative Analysis. Journal of Occupational Science. 6 (1), pp. 5-12
  9. Creek 2003 Occupational Therapy Defined as a Complex Intervention, London COT
  10. 10.0 10.1 Occupation for Occupational Therapists, Matthew Molineux, Blackwell Publishing, 2004
  11. 11.0 11.1 11.2 The Independent Thursday 26th June 2003 Comment
  12. American Occupational Therapy Association, Inc. (2005).
  13. Creek 2003 Occupational Therapy defined as a complex intervention. London. COT
  14. Golledge, J. (1998) Distinguishing between Occupation, Purposeful Activity and Activity, Part 2: Why is the Distinction Important? British Journal of Occupational Therapy, 61(4), pp.157-160.
  15. COT (2006) COT/BAOT Briefings: Definitions and Core Skills for Occupational Therapists. London: College of Occupational Therapists.
  16. Griffiths, S. and Corr, S. (2007) The Use of Creative Activities with People with Mental Health Problems: a Survey of Occupational Therapists. British Journal of Occupational Therapy, 70(3), pp.107-114.
  17. Taylor, E. and Manguno, J. (1990) Use of Treatment Activities in Occupational Therapy. American Journal of Occupational Therapy, 45(4), pp.317-322.
  18. Turner, A., Foster, M. and Johnson, S.E. (1997) Occupational Therapy and Physical Dysfunction: Principles, Skills and Practice. Edinburgh: Churchill Livingstone.
  19. Mosey, A.C. (1985) Psychosocial Components of Occupational Therapy. New York: Raven Press.
  20. Nelson, D. (1996) Therapeutic Occupation: A Definition. American Journal of Occupational Therapy, 50(10), pp.775-782.
  21. Tubbs, C. and Drake, M. (2007) Crafts and Creative Media in Therapy. 3rd ed. Thorofare: Slack Incorporated.
  22. COT (2008) Health promotion in occupational therapy. London: College of Occupational Therapists.
  23. Creek, J. (2003) Occupational therapy defined as a complex intervention. London: College of Occupational Therapists.
  24. Foster, M. (2002) "Theoretical Frameworks", In: Occupational Therapy and Physical Dysfunction, Eds. Turner, Foster & Johnson.
  25. Rogers JC (1983), Eleanor Clarke Slagle Lecture. Clinical Reasoning; the ethics, science and art. American Journal of Occupational Therapy, 37(9):601-616
  26. 26.0 26.1 Foster, M. (2002), Theoretical Frameworks, in Occupational Therapy and Physical Dysfunction. Churchill Livingstone
  27. Hocking, C (2004). Making a difference: The romance of occupational therapy. South African Journal of Occupational Therapy, 34(2), 3-5.
  28. Breines, E (1990). Genesis of occupation: A philosophical model for therapy and theory. Australian Occupational Therapy Journal, 37(1), 45-49.
  29. McColl, M A, Law, M., Stewart D., Doubt, L., Pollack, N and Krupa, T (2003). Theoretical basis of occupational therapy (2nd Ed). New Jersey, SLACK Incorporated.
  30. Chapparo, C. and Ranka. J. (2000). Clinical reasoning in occupational therapy in Higgs J and Jones M (2000) Clinical reasoning in the health professions. 2nd ed. Oxford, Butterworth Heinemann Ltd.
  31. Yerxa, E J (1983). Audacious values: the energy source for occupational therapy practice in G. Kielhofner (1983) Health though occupation: Theory and practice in occupational therapy. Philadelphia, FA Davis.
  32. Turner, A. (2002). History and Philosophy of Occupational Therapy in Turner, A., Foster, M. and Johnson, S. (eds) Occupational Therapy and Physical Dysfunction, Principles, Skills and Practice. 5th Edition. Edinburgh, Churchill Livingstone, 3-24..
  33. Punwar, A.J. (1994). Philosophy of Occupational Therapy in Occupational Therapy, Principles and practice. 2nd Ed. Williams and Wilkins, Baltimore, 7-20.
  34. Douglas, F M (2004). Occupational still matters: A tribute to a pioneer. British Journal of Occupational Therapy, 67(6), 239.
  35. Whiteford, G. and Fossey, E. (2002). Occupation: The essential nexus between philosophy, theory and practice. Australian Occupational Therapy Journal, 49(1), 1-2.
  36. Polatajko, H (2001). The evolution of our occupational perspective: The journey from diversion through therapeutic use to enablement. Canadian Journal of Occupational Therapy, 68(4), 203-207.
  37. Mocellin, G. (1988). A perspective on the principles and practice of occupational therapy. Generally they need to eat loads of bananas and chocolate. British Journal of Occupational Therapy, 51(1), 4-7.
  38. Mocellin, G. (1995). Occupational therapy: A critical overview, Part 1. British Journal of Occupational Therapy, 58(12), 502-506.
  39. Mocellin, G. (1996). Occupational therapy: A critical overview, Part 2. British Journal of Occupational Therapy, 59(1), 11-16.
  40. Kielhofner, G. (1997). Conceptual Foundations of Occupational Therapy. 2nd Ed. Philadelphia, F.A.Davis.
  41. Hocking, C and Whiteford, G (1995). Multiculturalism in occupational therapy: A time for reflection on core values. Australian Occupational Therapy Journal, 42(4), 172-175.
  42. The Person-Environment-Occupation Model, Law et al (1996), Canadian Journal of Occupational Therapy, vol 63 n1 p9-23 Apr 1996
  43. Occupational Therapy without borders:learning from the spirit of survivors, Kronenburg et al, Churchill Livingstone 2004
  44. The Process and Outcomes of a Multimethod needs assessment at a homeless shelter, Finlayson et et al (2002), American Journal of Occupational Therapy
  45. Psychosocial Occupational Therapy, Cara and MacRae (2002), Thompson Delmar
  46. Occupational Therapy in Community Mental Health Teams: a Continuing Dilemma? Role Theory offers an Explanation, Hughes (2001), British Journal of Occupational Therapy, Volume 64, Number 1,pp. 34-40(7)
  47. Role overlap between occupational therapy and physiotherapy during in-patient stroke rehabilitation: an exploratory study, Booth and Hewison (2002) Journal of Interprofessional Care
  • Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2008-09 Edition, Occupational Therapists, on the Internet at http://www.bls.gov/oco/ocos078.htm (visited July 11, 2008).
  1. Baum C., & Christiansen, C., (1997), The occupational therapy context: Philosophy - Principles - Practice. In C. Christiansen & C. Baum (Eds.), Occupational Therapy: Enabling Function and Well Being. p. 36. Thorofare, NJ: SLACK
  2. Bing, R.K. (1981) Occupational therapy revisited: A paraphrastic journey. American Journal of Occupational Therapy, 35(8):499-518.
  3. Low, J. (1992). The reconstruction aides. American Journal of Occupational Therapy. Jan;46(1):38-43,
  4. Meyer, A. (1922). The philosophy of occupation therapy. Archives of Occupational Therapy, 1, 1-10.

Buchanan, M. (1941). "letter " Journal of Occupational Therapy 3(2): 12.

Hobcroft, N. (1949). "Life in the Occupational Therapy Department at Porirua." New Zealand Occupational therapy Newsletter Number Two. (May).

New Zealand Occupational Therapy Registration Board (1950). "Minutes of the New Zealand Occupational Therapy Registration Board." 20th June.

New Zealand Occupational Therapy Registration Board (1970b 17th July). "Minutes of the New Zealand Occupational Therapy Registration Board."

New Zealand Registered Occupational Therapists Association (1949). "AGM Minutes."

NZJOT (1996). New Zealand Journal of Occupational Therapy 47(1): 19.

NZNJ (1940). "Editorial " New Zealand Nursing Journal 33(11): 346.

Packer, T., & Stickney, Jan (1991). "Advanced Diploma in Occupational Therapy: A comparison of therapists before and after." Journal of New Zealand Association of Occupational Therapists Inc. 42(1): 3-7.

Skilton, H. (1981). Work for your life - the story of the beginning and early years of occupational therapy in New Zealand. Hamilton, Hudlo Printers.

Wilson, L. H. (2004). Role differentiation in a professionalising occupation: the case of occupational therapy, New Zealand Department of Management Dunedin University of Otago PhD.


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