Hello Jody: Please don't assume that I am passing 'judgement' about yours or any other therapist's practice patterns. What I desire to discuss practice patterns in general. And more importantly, whether specific practice pattern are as closely aligned as they should be with what AOTA says is the preferred patterns of the profession.
I have absolutely (and I mean zero) concerns with OT's who treat at the impairment level. Heck, I treat at the impairment level which is often where the greatest gains in occupation can be resolved. However, I do not advocate impairment based treatment unless remediation of an impairment will improve occupation. Likewise, I am not an advocate for adapting unless adapting is the best possible way to empower clients' occupational performance. One of the most common misconceptions about my practice beliefs is that I don't value hands-on treatments including NDT, modalities, etc. I firmly believe that these treatments have a great role in our practice domain but only as we can ensure that using them will improve occupational functioning. Treating an impairment because it MAY improve functioning is what PT does and it's what they've always done. They may not have always articulated it this way but they certainly didn't improve someone's ROM because ROM was good thing. They improved it to improve function. Of course, function is not the same thing as occupation. So while PT may do things to improve function, only OT does things to improve occupation - which is function (+). For me, the bottom line is this. Individual OT's will always have some degree of individuality, but as a profession, our professional organization and it's practitioners should be in better alignment. The degree that the two diverge, the greater the degree of confusion. It makes no sense to tell students that OT is not about upper extremity PT, then to provide orthopedics courses which focus ONLY on the upper extremity. And then to have studnets go to clinical sites where upper injuries are sent to OT and lower injuries are sent to PT. Students must be very confused, I know that I am! Ron ====================================================== On 10/9/2002, [EMAIL PROTECTED] said: Sac> In a message dated 10/07/2002 8:15:53 PM Central Daylight Time, Sac> [EMAIL PROTECTED] writes: >> It's not perfect but it's the only thing that I know to do. No matter >> Sac> I really feel that Ron is taking a narrow view of OT ( I know, I know, he Sac> thinks mine is narrow) He seems to be such an idealogue, with no room for Sac> compromise. One of my teachers was Gary Kielhofner - a big proponent of " we Sac> are not upper extremity PTs" but I don't remember him preaching limiting OT Sac> practice to referrals generated BECAUSE OF Occupational Deficits, and then Sac> only when the patient is ready to work on that Occupation. What about the Sac> therapeutic use of self? I have had many patients like this hypothetical Sac> oner who doesn't want to do self care, but often when they see that it might Sac> be possible, they are more willing to speak the words - yes, I want to dress Sac> by myself. And what about the side of OT that says that engaging in Sac> occupation is healing - Mary reilly's , " Man through the use of his hands Sac> can influence the state of his own health." The pioneer OTs used real Sac> serious crafts - yes even basketweaving - engaging in the craft was and is Sac> healing - but the OT pioneers' patients didn't have an occupational deficit Sac> in basket making, they had some type of psych diagnosis or some debilitating Sac> condition like TB. So I know Ron doesn't think I am a real OT, but I am out Sac> there doing it, I am not just an upper extremity PT, and I choose home health Sac> as my practice setting because people at home really need to do their own Sac> ADLs and care about recovering the ability to do them and the environment is Sac> more conducive and inducive to recovering ADL independence than a nursing Sac> home. He can call ADLs the A word but they are primary occupations to may Sac> people who come to me as home health referrals. And I even claim one more Sac> ADL - carrying things. People who get around with assistive devices have Sac> special challenges in carrying things, and carrying things causes many falls Sac> in those who use ADs for getting around. And yes I am client centered too - Sac> I don't force ADLs down their throats, I ask my home health clients, "What do Sac> you want to do that you can't do now?" And then I use every means to get Sac> there - not just one. If the patient's goal is making cornbread ( and we use Sac> heavy cast iron skillets here in Mississippi ) I approach the goal in at Sac> least 4 ways: improving motor skills, adapting the task, adapting the Sac> environment, and practicing the task. I think if we just adapted the task Sac> that would be a narrow view of OT. I know I am just ranting on and on here Sac> and I do realize that I am not an academic and will never be half the Sac> theorist Ron is or Gary Kielhofner is, I am just kind of an intuitive Sac> technician, but I know I am in the trenches providing a needed service, which Sac> Ron thinks is not OT-- Jody *********��*********** 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] *********��***********
