The power of "occupation" is in the " all inclusive" factor of human functioning (life- functions). Viewing "life" as a sum total/ synthesis of physiological/ physical, mental, emotional and social functioning. Where any one aspect or multiples of such functioning components may cause an effect on the others thus, causing an effect on life itself. Where these functional components result in "life's occupation/ functions"- the ability to indulge and perform activities appropriately needed tro live life "wholly".
Where a living being is seen as an 'occupational being' and not just a 'physical being' (but as a physical body that has the ability to act, think, imagine, emote and co-exist with his fellow-beings and his environment, caring for them and himself).................... Where life is living.......and, the total of cease of the physiological/ physical, mental, emotional and social functioning is _______. I think you are misunderstanding my point that I made in my last post. I do not advocate a 'mechanistic' approach by itself, but in order to have a holistic (occupational) approach, you cannot discard any one facet of it- whether it be physical, mental, emotional or social. Hence, the biomechanical aspects of functioning related to physical functioning, is very much an area that the occupational therapist is/ must be cognizant and competent to address as well. As in my earlier post, I stated that this aspect in itself may at times cause occupational independence/ improvement, with no other factors complicating occupational performance. While I hope that "occupation" is our domain, legally we cannot claim it as ours only. With a couple of states yet to regulate OT in the US, anybody can practice it there. While the principle of occupation has certainly be claimed by our profession- and, "occupation" is what we "do-mainly", it is not our domain in the strictest legal sense, since it is practiced overtly or covertly by other professions. (The very topic of our thread). I agree and truly believe that the difference between PT and OT is mainly based upon the underlying principle and focus...we OTs are 'occupational' focused. I have met very very few OTs in my 8 years of practice in the US (across all clinical settings barring acute-pysch.) that, do not go beyond the realms of physical functioning. The "power" of occupation also lies in how we accomodate for handicaps, i.e, going beyond treating impairments/ addressing disabilities. I agree that though Reeves has very limited physical functioning but his life is not and should not be devoid of occupations. Thus, the power of OT goes beyond the chartered waters of physical functioning. However, as this thread was started- heard very few stuff on how OTs benefitted Reeves. We know because we are in the field that he must have received OT. To a lay person it is the doctors, and nurses and then, the PT does it all! Well, his therapists were able to synthesize his though very limited physical functioning to help him with environmental controls- an essential aspect of his ADLs. And, then gaining on his mental/ social functioning, created an adaptive environment as needed to yet have "occupations" that interest him/ are meaningful to him. He was facilitated/ trained/ learned to utilize his physical functions to the best- e.g, puff/ turn head/ blink eyes for environmental controls, improve his sitting balance/ tolerance, ensure intact integumetary status to be able to sit on his wheelchair for extended period of times, etc. Again as "occupation" includes physical functioning, as OTs we do and must know to identify physical issues and address/ utilize it to facilitate appropriate human occupation. Or else, occupation will be addressed elsewhere as well, and the profession will continue to be encroached...... "Physical functioning" is not our centre stage, "life functions" are........ To me life's functions are human occupations! Joe ----- Original Message ----- From: "Ron Carson" <[EMAIL PROTECTED]> To: "Joe Wells" <[EMAIL PROTECTED]> Sent: Saturday, September 06, 2003 5:38 AM Subject: Re[8]: [OTlist] PT does it all!! > Hello Joe: > > Sorry for taking so long to write back! > > I don't feel that a therapist can use both a mechanistic and > occupational (i.e. holistic) approach. The two approaches are at > opposite ends of the spectrum. Neither do I think that a therapist can > selectively or randomly shift back in forth between the two approaches. > I believe that a person must preselect how they view people and > pathology. > > Another difference that I feel is in your statement is your comment that > "PTs ... address occupation issues as much as us." I firmly believe that > occupation is our unique domain. When I say unique, I mean unique. OT's > that are trained in occupation have a tremendous asset to offer their > clients and an asset that no other discipline can even begin to > understand nor practice. > > Also, while I know of several OT's that exclude physical function from > their treatment, I am not such a therapist, nor do I advocate such > exclusion. Physical function is a contributor to successful occupation > just as much as any other entity and if it is limiting occupation, then > it should be addressed. However, I think that physical function is only > ONE of many factors that affect occupation. Unfortunately, I feel that > some OT's are too focused on the physical function at the expense of > occupational function. > > To focus on physical function is PT (hence the name Physical therapy). > To focus on occupational function is OT (hence the name Occupational > therapy). Bear in mind that by definition, occupational function > includes physical function but physical function does not include > occupational function. Also Joe, physical function is not a necessary > element for some types of occupation. > > There are many occupations that involve mental rather than physical > function. If this were not true, then our clients with high-level > quadriplegia would not have any occupations. And I am confident that > Christopher Reeve's life is full of occupation, even though he has > almost no physical function. > > Joe, you make a statement about the power of the occupation. From you > perspective, what is that power? > > Thanks for the dialogue, I truly find it educational and inspiring! > > Ron > > > > > =============================================================== > On 8/31/2003,[EMAIL PROTECTED] wrote: > > JW> I agree Ron and I agree. That is why, I believe that as OTs we look and go > JW> beyond the realms of physical dysfn., that's why I say we take the holistic > JW> view. My only point is that we do look at the 'mechanistic' issue, too, and > JW> often the underlying pathology creates the other issues such as the > JW> associated mental/ emotional, resulting environmental barriers, etc., which > JW> would have otherwise been an non-issue. Sometimes, taking care of those > JW> 'mechanistic' issues helps to eliminate or mitigate the rest, and sometimes > JW> they don't. My thoughts are when PTs use the powers of their practice acts, > JW> take care of those physical issues, use 'seemingly' OT approaches, they too > JW> address occupational issues as much as us......I do not agree, what I feel > JW> some OTs are confusing with, that OT does not include or should not include > JW> addressing the physical issues. > > JW> My own thoughts are that most OTs I have come across, do practice OT with > JW> all the tools available to them- true occupations, activities, exercises, > JW> PAMs, splints, AEs, etc. etc.. I have met very-very few OTs that are not > JW> addressing the occupational needs (barring the quality of how a few document > JW> such issues). To me, occupational performance sprites from activity > JW> analysis, physical functioning being a part of it- usually the most visible > JW> and objective part. Since, in the world arena, OTs are mainly involved in > JW> the medical model/ with physical dysfunction issues, OTs should be in tune > JW> to be a holistic practitioner in this arena versus taking a reductionistic > JW> approach. I do not see the reason why a OT should wait for the UE strength/ > JW> ROM to be increased by a PT before beginning dressing training or, why have > JW> two disciplines working together in order to achieve the same 'occupational' > JW> outcomes for OTs, and 'physical functioning' outcome for PT- the ability to > JW> physically dress.The difference again is in semantics, theorized approach > JW> and, underlying principle. I believe with no other complicating factors > JW> viz. mental issues, emotional issues, etc., PTs and OTs are equally > JW> qualified to address this issue, and both disciplines are not needed > JW> simultaneously. > > JW> To me the issue is not that OTs are trying to be PTs, but that we do not > JW> understand the power in the word 'occupation' that entails everything a > JW> person should or wishes to do per societal or developmentally accepted > JW> norms. > > JW> I believe OTs should not be further confused in the futile issue of what > JW> modalities is whose, rather understand the underlying occupational needs > JW> that need to taken care of by taking care of the pathology (impairment) if > JW> it can be corrected, disability if that can be changed with 'different' > JW> ability, and the accomodations required for the handicap..... > > JW> Ron, it seems you and I agree for the most part. My major contention is that > JW> physical functioning is a very true and major part of occupational > JW> functioning and, sometimes in cases of physical dysfunctions with no other > JW> overtly mental/ emotional/ social dysfunction, may even become inseperable. > JW> In such cases too, while OTs are addressing the physical functioning issues > JW> directly, they are certainly addressing the occupational goals of their > JW> clients (or should be), helping them to 'occupy' their lives in meaningful > JW> activities in a pain free, effective, time-sensitive, aesthetic-deligent > JW> world. > > JW> Sorry, just couldn't keep it short. > JW> Joe > > > JW> ----- Original Message ----- > JW> From: "Ron Carson" <[EMAIL PROTECTED]> > JW> To: "Joe Wells" <[EMAIL PROTECTED]> > JW> Sent: Sunday, August 31, 2003 2:20 AM > JW> 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. > >> > >> > >> *****************************��********************************** > >> > >> To remove yourself from the OTnow mail list, 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] > >> > >> *****************************��*********************************** > >> > > > JW> *****************************��********************************** > > JW> To remove yourself from the OTnow mail list, send a message to: > > JW> [EMAIL PROTECTED] > > JW> In the message's *body*, put the following text: > > JW> unsubscribe OTlist > > JW> - > > JW> List messages are archived at: > > JW> http://www.mail-archive.com/[EMAIL PROTECTED] > > JW> *****************************��*********************************** > > > *****************************��********************************** > > To remove yourself from the OTnow mail list, send a message to: > > [EMAIL PROTECTED] > > In the message's *body*, put the following text: > > Remove {insert the address that you wish removed} from the OTnow list > > - > > List messages are archived at: > > http://www.mail-archive.com/[EMAIL PROTECTED] > > *****************************��*********************************** > *****************************��********************************** To remove yourself from the OTnow mail list, send a message to: [EMAIL PROTECTED] In the message's *body*, put the following text: Remove {insert the address that you wish removed} from the OTnow list - List messages are archived at: http://www.mail-archive.com/[EMAIL PROTECTED] *****************************��***********************************
