I agree Ron and I agree. That is why, I believe that as OTs we look and go
beyond the realms of physical dysfn., that's why I say we take the holistic
view. My only point is that we do look at the 'mechanistic' issue, too, and
often the underlying pathology creates the other issues such as the
associated mental/ emotional, resulting environmental barriers, etc., which
would have otherwise been an non-issue. Sometimes, taking care of those
'mechanistic' issues helps to eliminate or mitigate the rest, and sometimes
they don't. My thoughts are when PTs use the powers of their practice acts,
take care of those physical issues, use 'seemingly' OT approaches, they too
address occupational issues as much as us......I do not agree, what I feel
some OTs are confusing with, that OT does not include or should not include
addressing the physical issues.

My own thoughts are that most OTs  I have come across, do practice OT with
all the tools available to them- true occupations, activities, exercises,
PAMs, splints, AEs, etc. etc.. I have met very-very few OTs that are not
addressing the occupational needs (barring the quality of how a few document
such issues). To me, occupational performance sprites from activity
analysis, physical functioning being a part of it- usually the most visible
and objective part. Since, in the world arena, OTs are mainly involved in
the medical model/ with physical dysfunction issues, OTs should be in tune
to be a holistic practitioner in this arena versus taking a reductionistic
approach. I do not see the reason why a OT should wait for the UE strength/
ROM to be increased by a PT before beginning dressing training or, why have
two disciplines working together in order to achieve the same 'occupational'
outcomes for OTs, and 'physical functioning' outcome for PT- the ability to
physically dress.The difference again is in semantics, theorized approach
and, underlying principle.  I believe with no other complicating factors
viz. mental issues, emotional issues, etc., PTs and OTs are equally
qualified to address this issue, and both disciplines are not needed
simultaneously.

To me the issue is not that OTs are trying to be PTs,  but that we do not
understand the power in the word 'occupation' that entails everything a
person should or wishes to do per societal or developmentally accepted
norms.

I believe OTs should not be further confused in the futile issue of what
modalities is whose, rather understand the underlying occupational needs
that need to taken care of by taking care of the pathology (impairment) if
it can be corrected, disability if that can be changed with 'different'
ability, and the accomodations required for the handicap.....

Ron, it seems you and I agree for the most part. My major contention is that
physical functioning is a very true and major part of occupational
functioning and, sometimes in cases of  physical dysfunctions with no other
overtly mental/ emotional/ social dysfunction, may even become inseperable.
In such cases too, while OTs are addressing the physical functioning issues
directly, they are certainly addressing the occupational  goals of their
clients (or should be), helping them to 'occupy' their lives in meaningful
activities in a pain free, effective, time-sensitive, aesthetic-deligent
world.

Sorry, just couldn't keep it short.
Joe


----- Original Message -----
From: "Ron Carson" <[EMAIL PROTECTED]>
To: "Joe Wells" <[EMAIL PROTECTED]>
Sent: Sunday, August 31, 2003 2:20 AM
Subject: Re[6]: [OTlist] PT does it all!!


> Hey Joe:
>
> For brevity, I've snipped your message.
>
> The  below  paragraph is sort of a mechanistic approach to therapy. This
> type  of  approach  assumes that by fixing the person's "broken" pieces,
> the  whole  person  will  be restored. For example, if someone loses the
> ability  to drive secondary to decreased balance, a mechanistic approach
> assumes  that  by  resorting  their balance, their ability to drive will
> also  be  restored. While for some cases, this approach may be true, for
> others it is just as likely to be false.
>
> Driving,  like  ALL  occupations,  is a complex phenomenon that includes
> physical,   social,   emotional,   environmental   and  mental  factors.
> Successful  engagement  in occupation is not dependent on any one factor
> but  on  the  culmination of ALL the factors. A therapist that assumes a
> mechanistic  approach  may focus on only the most apparent factors, such
> as  physical  impairment,  and  thus  may  miss  other  factors that are
> preventing successful engagement in occupation.
>
> It  is important to assess occupational dysfunction and then to directly
> document  the  dysfunction.  If  occupation  is  made the goal, then the
> therapist  is  much more likely to see the whole picture of occupational
> performance rather than seeing only the pieces that make up occupation.
>
> Ron
>
>
> =============================================
>
> On 8/30/2003,[EMAIL PROTECTED] wrote:
>
>
> JW> Obviously,  you realize on further interrogation one may ask- what's
> JW> the  end  result  (goal) for increased tolerance, increased balance,
> JW> decreased  pain,  decreased  stiffness-  all  would lead to the same
> JW> goal-  increased  occupational  independence, whether or not that is
> JW> addressed directly on paper.
>
>
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