Hello Biraj:
Thanks for your comments.
I have a couple comments/questions on your post.
---------- On 2/25/2001, Incandescent Said:
I> In my opinion each OT interprets the idea of "occupation" in their own
I> way, and based on what is meaningful for the client.
When talking about occupation, there is a certain duality which is helpful
to understand. AS I see it, occupation, is both an actual doing and a
theoretical doing.
"Actual occupation" is the 'nuts and bolts' of occupational performance.
Following the Canadian Model of Occupational Performance (CMOP),
occupational performance requires:
1. Person (spiritual, physical, cognitive and affective components),
2. Occupation
3. Environment
By definition, OT's are skilled in facilitating clients to discover and
engage in actual occupation.
"Theoretical occupation" are theories of human development,
self-actualization, psychology, sociology, adaptation, anthropology, etc.
These are theories which educate OT's about occupation's importance to
living, role competence, growth and development, health, quality of life,
etc. Theoretical occupation is the source for occupation-based Frames of
References. Theoretical occupation is what give OT's their uniqueness and
speciality in health care. Theoretical occupation is the foundation of all
that we should be doing in practice, education and research.
I think OT's and clients should freely interpret actual occupation (what
does the client want to do and why) but should ONLY interpret the
theoretical doing after careful scrutiny of the myriad of theories and
concepts relating to human occupation.
If I'm reading your statement correctly, you are suggesting that the actual
doing of occupation is based on clients' and therapists' interpretations of
importance and meaning. Is this correct? If so, I totally agree. But I still
come back to the argument that therapists understanding of theoretical
occupation should be rooted in existing theory and remain relatively
unchanged.
I> In fact the idea of occupation is virtually transparent in actual
I> practice. And generally one cannot categorically distinguish any OTs
I> practice as being occupation-based or otherwise, without either talking
I> to the OT and understanding her/his reasoning, or without knowing the
I> client clinically.
While I certainly agree that it may be impossible to understand a
practitioners theoretical base by simple treatment observation, what may be
most important is does the practitioner know their theoretical base
I> Personally, I don't see anything wrong if an OT practice focuses on Upper
I> Extremity dysfunction. In fact I don't even think that it is in any way
I> contradictory to "occupation-based" practice of OT. Occupation-based
I> practice is largely a matter of how the OT views client's goals, and the
I> intervention/treatment approach the OT may adopt.
This definition doesn't rhyme with anything I have read about
occupation-based practice.
I> I don't recall *ever* seeing any evidence in the literature which either
I> considers U/E focus in OT as compromising the role of OT, or undermining
I> the OT profession as a whole.
You raise a good point. (Maybe someone on the list can provide references to
such articles) And I agree, but there are several articles about OT
reinventing itself in the coming years. Most recently:
OT Practice, 5(1):12-5, 2000 Jan 3. "Occupation-based practice: reinventing
ourselves for the new millennium"
Few, if any of these articles about reinvention indicate that UE focus or
component focus is our future "bread and butter".
I> And I cannot imagine where the idea or concept of "UE PT" may have
I> originated from. To even suggest that UE (or for that matter any
I> performance component) is exclusively linked to any particular profession
I> other than OT (in this case PT), actually diminishes the OT role.
Biraj, I agree but I also believe that a profession MUST have an expertise.
That is one of the hallmarks of a profession - it does something better than
any other profession. So, in your opinion, what is OT's expertise?
I> And I realize that by saying this I might be turning this discussion over
I> on its head. However, I think all OTs need to practice their profession
I> based on their own understanding of what OT means to them. Just as the OT
I> profession is not prescriptive with its clients, we cannot be
I> prescriptive with any particular definition of OT where our own fellow
I> OTs are concerned.
While respecting your opinion I am not sure I can agree. Within all
professions, their is an ever-changing but none the less stated, domain of
concern. Often, professional domain of concern is spelled out in State
practice acts but they are also delineated with the profession's Practice
guidelines. Behavior or treatment falling outside the profession's domain is
at best considered unethical and at worse illegal. [This is why I previously
indicated that an OT stating that what they are doing may be seen as PT is
opening themselves up to litigation.]
As members of a professional organization we are free to interpret practice
only as how the profession is defined by credentialling agencies (NBCOT,
AOTA, State practice acts, etc). We are not free (legally anyway) to
practice 'as how we see fit). There must be obvious limitations to what OT
can and can not do. Within this obviously broad range, we do have room to
interpret what is and what isn't OT. Once again, go outside the end-points
of the professional continuum and one is not practicing OT.
Ron
I> Regards,
I> Biraj
I> Ron Carson wrote:
>> Hello Donna:
>>
>> I am sorry but I have difficulty understanding how
>> "[taking] on roles similar to what some refer to as UE PT" is good for our
>> profession. While it may be good for the pocketbooks of those OT practicing
>> like PT's, I don't understand how it's good for the profession. To
>> me, OT's practicing like UE PT's are hindering the profession, not expanding
>> it.
>>
>> Ron
>>
>> ----------
>> On 2/24/2001, [EMAIL PROTECTED] Said:
>> Mac> Evan, I must agree with your point of view on this matter......when I
>> Mac> graduated in '99 as a COTA, there were very few jobs available. Our
>> Mac> professors told us it was our responsibility to "be creative" in finding some
>> Mac> kind of niche in order to get into the profession. Many of my fellow
>> Mac> graduates have had to take on roles similar to what some refer to as UE PTs,
>> Mac> home health care, therapeutic rec, and various other off-sets of OT. As long
>> Mac> as we keep in mind our philosophy in treating the whole person, and
>> Mac> maintaining/improving function, I believe we are expanding the perspective of
>> Mac> what OT is and how valuable it is in all settings. Every one of us has to be
>> Mac> an advocate for OT every chance we get..........Donna
>>
>> ---------
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