Re: why is no one writing?

[Incandescent]

Hi Donna: By way of introduction I am an OT in Canada and work in Forensic Psychiatry with a focus on rehabilitating Mentally Disordered Offenders in the community.  I have been a member of this listserv since it first appeared on the internet, at least that is what I believe. You have raised some interesting concerns and issues.  I would like to address your most pressing concern around Frames of Reference.  However, before I give you information on resources which will give you some idea about Frames of Reference, I would like address a few points you have made in your post. The first point is that you have said that maybe people aren't writing because the topics tend to be very deep, and may not be a reflection of what practitioners want to discuss.  I have two perspectives on your comment.  The first perspective relates to the listserv itself and to revisit the moderators role in it in the recent past.  The second perspective relates to specifically to being "very deep" and reflective. It is possible that there might be other OTs who share your perception Donna.  Personally,  I don't share this perspective, and I certainly can't claim that even my perspective is either shared by others or that it is valid.  I think there are two reasons for members not posting like they used to.  Part of it is simply the fact that it is summer, and many of us would prefer being outdoors rather than looking at a computer screen.  Secondly, I recall some months ago when this listserv used to "rock" with so many posts that we couldn't keep up with them.  There have been many issues which have led to heated discussions in the past, and hopefully this will happen again.  In my opinion the last time that this listserv quite literally rocked (you can take my use of that expression any way you like :-)) was when the discussion focused on whether PTs should be allowed on it or not.  This question was raised by the moderator, and subsequently the moderator initiated a vote on the issue, and then the moderator decided against majority opinion to ask the PT to leave the listserv, and proceed also to start another listserv on which the moderator said all rehab professionals could join.  Subsequently, the tone of the debate became somewhat personal.  And a listserv member in a reactionary tone told the moderator that he could go home with his proverbial bat :-))  Of course the moderator told this member to unsubscribe due to the personal tone of his posts, which were largely directed at the moderator himself.  However, my *impression* is that asking the PT to unsubscribe, in the face of majority support to be inclusive might in part have led people not to participate or unsubscribe.  It is not for me to comment on what the moderator's role should be, other than the fact that it needs to be moderate and democratic. Now for the second perspective Donna, this relates more directly to your post.  Based on the concern raised by you that you need to inform your fieldwork student's school as to what "frames of reference" you use - in this context I think that any OT would need to reflect on their practice to make this determination.  In my opinion if you expect the listserv to make for "an exchange of treatment ideas for a variety of disabilities/conditions our patients have..." then it would help you to be a little reflectful of how you would integrate those ideas into OT theoretical knowledge as well as your past professional experience.  In my opinion your present dilemma of not knowing what frames of reference you utilize in your practice may well be because you have so far focused on the technicalities of your work.  And while there is absolutely nothing wrong in your doing so (in fact in your case it might even make you more result oriented).  However, in my opinion one does need to be reflectful in order to get a big picture idea of one's practice, rather than simply have the technical skills of one's own practice area.  At the same time I don't want to come off sounding superior to you by any means.  In fact I am almost certain that I can probably learn a lot more from you than you  can from me. And being reflective does not necessarily mean getting philosophical.  It means gaining an appreciation of the larger ideas underlying our profession.  Otherwise it is like "cram for the exam", we can't just talk the talk, we need to walk it as well, at least this is my opinion.  In your post you have touched upon a major practice model in OT, MOHO, but there are certainly others as well.  However, one would be ill advised to superficially slap on these ideas to one's practice simply to be "with it", because these models of practice and other frames of reference undergird our ability to practice as OTs.  We are NOT simply technicians, though there is a lot of technical expertise we require while working at the performance component level. Also please note that there is a distinction between models of practice, and frames of reference.  MOHO is an example of the former. Now for the resources on frames of reference, I would recommend you look at the following resources (in order of relevance based on the population you work with): 1.  Occupational Therapy: Practice Skills for Physical Dysfunction, 4th Edition. (Edited) by Lorraine Williams Pedretti.  Published by Mosby, St. Louis. (1996). (I know a more recent edition of the Pedretti text has been published either in 2000 or 2001.  I have the fourth edition (1996), in that I would look at Part III of the text in particular.) 2.  Psychosocial Occupational Therapy: Frames of Reference for Intervention by Mary Ann Bruce and Barbara Borg (2nd Edition), Published by SLACK Inc. (1993).  This text provides an excellent overview of NINE frames of reference.  And even though its focus is psychosocial, it will provide you with an excellent snapshot of frames of reference. 3.  Occupational Therapy: Enabling Function and Well Being Edited by Charles Christiansen and Carolyn Baum.  Published by SLACK Inc. (1997).  See particularly Chapter 4: Theoretical Contexts for the Practice of OT; and Chapter 21: Meeting the Challenges of Disability: Models for Enabling Function and Well Being. 4.  Willard & Spackman's Occupational Therapy (9th Edition) Edited by Maureen E. Neistadt & Elizabeth Blesedell Crepeau.  Published by Lippincott-Raven Publishers (1998).  See chapter 23 in particular. 5.  Enabling Occupation: An Occupational Therapy Perspective.  Published by the Canadian Association of Occupational Therapists (1997).  It elaborates on the Canadian Model of Occupational Performance.  See Chapter 3 in particular. I hope one of these resources will help you in replying to the school.  Good luck. Biraj P.S.:  What is SOB an abbreviation of, not what it typically stands for I am sure :-)) mr silva wrote: I wonder if maybe people aren't writing because the topics tend to be very deep, and may not be a reflection of what practitioners want to discuss.  For example, when I joined, what I hoped I would find, and what I unfortunately haven't found, is an exchange of treatment ideas for a variety of disabilities/conditions our patients have, and ways to improve our technical skills.  As I'm saying this, however, I do have to ask the group a "deeper" question.  So, I'd like to start dialogues in 2 different directions.  The first is something I really need, asap, as I've got a student coming soon and a form to fill out.  The second dialogue, however, is of far more interest to me.  Here goes: 1.  I've got a Level 1 student coming sooooon, and the school wants to know what Frames of Reference I am using.  Now, I really hesitate to ask this question of you all, as I really, really do no want to get into philosophical discussions.  I'm leaving these issues to the theorists.  I presume Ron is rolling is eyes right now - I'm really not picking on you Ron - but I don't want to get into a discussion about this - I just need some fast, quick help.  I work in home health with a variety of paitents with a variety of conditions.  Can anyone tell me what Frames of Reference they use in this type of setting? 2.  How about we talk about an area that is one of my favorite directions for OT to go into - pulmonary rehab.  For the longest time, I really didn't have a good handle on how to treat these patients, beyond energy conservation.  But a couple of years ago, I found this fabulous website (see attachment above) and which has specific treatment ideas for various conditions - one of the best OT websites around, I believe.  I used this site as a springboard for doing further reading and research into this condition, and it has totally changed the way I work with patients, and has really made me a much more effective practitioner.  Now, whenever I work with a patient with a pulmonary (and often cardiac) diagnosis, I give them an information packet, rich with information, and especially teach them to really listen to what their bodies are telling them (by way of symptoms) and to act accordingly.  For example, if they are cognitively intact, we discuss SOB - what makes them SOB, what makes it worse, better, etc, so they can really start thinking about it.  Very often, they have been SOB for so long, they don't think about it, and only notice it when it is really bad.  However, they can make real changes in their lives if they recognize the early stages of SOB, and learn to "nip it in the bud" right away before it gets worse, by performing proper breathing techniques.  We then discuss the Levels of SOB (I've whittled the levels down to 3 is it is much more user friendly for the elderly) and teach how to apply them.  We actually practice many different ADLs and leisure activities, teaching the patient self-monitoring skills, until they can control their breathing, without my intervening.  I can't tell you what a powerful difference this has made in patients lives, and it was all through this website, jumpstarting ideas and getting me excited about possibilities. This is what I hope this forum will produce - a real dialogue ideas.  What do you all think?  In exchange for sharing this wonderful website with you, please, please, please, help me with #1 - Frames of Reference - please, please, please!!!Donna