Actually, the WHO model, International Classification of Function, has also changed to a more positive schema, focusing on function, rather than dysfunction. See attached for more info. http://www3.who.int/icf/icftemplate.cfm
> ---------- > From: aaron eakman > Reply To: [EMAIL PROTECTED] > Sent: Thursday, June 27, 2002 6:32 PM > To: [EMAIL PROTECTED] > Subject: Re: Framing the Problem > > I left an entry-level graduate program with the notion of addressing: > function - Purpose - MEANING. > > I learned from my clinical affiliations and earlier employment: FUNCTION - > FUNCTION - FUNCTION. > > I believe that functioning impacts purpose and meaning. Enhanced > functioning (whether remediating an impariment or minimizing a disability) > is of great importance. However, I have not often addressed handicap > thoroughly due to the constrictions of my practice setting (e.g. acute > rehabilitation or inpatient medical). It may be that practice arenas > strongly influence the extent to which impairment/diability/handicap are > addressed by the occupational therapist. > > Reimbursement also represents a strong govenor against OT's manimizing > handicaps. OTs have been succesful and have made money within the medical > arena, addressing impairment (e.g. hand therapists). Medicare directs the > practioner to focus treatmen upon function (disability) and areas deemed > "medically necessary". Money is a reality. I believe that should OTs wish > to move to develop their influence upon "handicap", that they learn to > cultivate public opinion that would demand payment for minimizing handicaps. > Or help to develop an interest in the public that would encourage private > payment for services. > > How well are OTs educated about the WHO's delinations of > impairment/disability/handicap? How much of the OT curriculum addresses > handicap, disability and so on? How many working OTs are quite satisfied > with addressing imapairment or disability? (a lot I would venture) What > incentives exist for an OT practioner to expand or emphasize handicap in > their treatment? > > Aaron Eakman > > > ----- Original Message ----- > From: "Ron Carson" <[EMAIL PROTECTED]> > To: <[EMAIL PROTECTED]> > Sent: Thursday, June 27, 2002 3:59 PM > Subject: Framing the Problem > > > > Here's another interesting thought, maybe. > > > > If the symptoms of a person with a stroke are put on a continuum, one > > possible example might be: > > > > > > |- High cholesterol ->Stroke > event ->Impairments ->Disability ->Handicap -| > > > > The above shows that the client had high cholesterol which eventually > > caused a stroke, leaving the patient with impairments, preventing them > > from caring for themselves, being productive or having fun (i.e. a > > disability) and thus keeping them from fulfilling their social roles > > (i.e. handicap). > > > > The above continuum is very vague. You can fill in the categories with > > whatever fits. For example, 'impairments' might include: > > > > -decreased balance > > -decreased range of motion > > -increase pain, etc > > > > Disability might include: > > > > -inability to dress > > -inability to eat > > -inability to bathe, etc > > > > > > Now, here's a question. Based on the above example, what exactly is the > > 'problem' with this hypothetical client? > > > > In reality, most people can tell that there are really many 'problems' > > and issues associated with the client's current condition. > > > > Each profession involved with this client, will see 'problems' from a > > different primary perspective. For example, a dietitian may see the > > primary 'problem' as the clients poor nutritional habits; the surgeon > > will see the arterial plaque buildup as the primary 'problem', the > > primary care physician may see the actual stroke event as the> > > 'problem'. While each profession does not categorically exclude other > > professions' concerns, each profession has a PRIMARY domain of concern. > > Anything outside of this domain may be considered adjunctive or 'nice > > to know' information but is certainly not going to be evaluated, > > treated and considered as part of that profession's outcome. > > > > Where does OT fit on the above continuum? In other words, ow might the > > OT profession define the 'problems' with this client? Is the primary > > 'problem' that the client may not be able to move their hand, arm, > > foot? Or is the primary 'problem' that the client may not be able to > > brush their teeth, drive their car or go to work (or whatever > > disability the client's experiencing)? > > > > It appears to me that as a profession, we articulate that the client's > > disability (i.e. occupational deficits) are the primary 'problems'. > > However, much of what I read and witness indicates that many, many > > practitioners are not practicing within primary domain. Instead, they > > are practicing from an impairment perspective which say's that the loss > > of range of motion, strength, coordination, etc are the primary > > 'problems'. > > > > While some may argue that my stamens are just rhetoric, I believe that > > they may hold some merit in understanding different experiences of > > practitioners, students and educators. For how the 'problem' is defined > > dictates both the nature of treatment and the desired outcome. > > > > So, how SHOULD the profession frame the 'problem' and how ARE > > practitioners actually framing the 'problem'? If the two are different > > is this a problem? What can or should be done about this? Should I get > > a life and quit worry about this? <grin> > > > > Ron > > > > *********��*********** > > > > Unsubscribe? Send a message to [EMAIL PROTECTED] > > > > In the message's *body*, put the following text: unsubscribe OTlist > > > > ** List messages are archived at: > > > > http://www.mail-archive.com/[email protected] > > > > *********��*********** > > > > *********��*********** > > Unsubscribe? Send a message to [EMAIL PROTECTED] > > In the message's *body*, put the following text: unsubscribe OTlist > > ** List messages are archived at: > > http://www.mail-archive.com/[email protected] > > *********��*********** > > > *********��*********** Unsubscribe? 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