Hi all Every time I sit down to reply there is a thoughtful post by someone else. Anne made many of the points I was thinking about. Since I work in the Canadian Model I'm not sure what the Framework steps are. One thing is sure, I very seldom have a client who can articulate either an occupational deficit or goal. I think that is my job based on what they say or do. The COPM questions help if I ask myself, What do they need to do, want to do or are expected to do? I need to elicit from them what 'the problem' is preventing them from doing - what they typically did before the problem. Most of this I'll get from just listening or watching. If the problem is weakness, for instance I'll get them to show me how it affects them. Do you see your clients in their homes? Most people will tell their troubles to an empathetic listener and even if the problem is a 'medical' one the 'troubles' will include the things they are prevented from doing. Most people want to tell their story. I did a long post some time ago (when I broke my shoulder) about how components can become occupations when they become difficult or impossible to perform. I guess I'm saying I need to do OT by the person not by the book but knowing the book helps me organise what I get from the person so I can express it in OT language. Our model says the problems and goals are developed collaboratively and some of my part of the collaboration is the OT language. Another big difference, of course is how we get paid. Some time ago I observed a recreation therapist in a geriatric exercise group. He attached occupation to every move he asked them to make. ' this will make it easier to carry the groceries, to turn your doorknob, to turn the key, to get on the bus, to comb your hair, to stand up from your chair, to bend down to your grandchildren'. Those people really worked for him and they told their stories, too. Joan
> -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf > Of Ron Carson > Sent: Wednesday, April 26, 2006 1:45 PM > To: [EMAIL PROTECTED] > Subject: Re: [OTlist] Occupation > > Hello Ann (and hopefully others): > > It seems like you are in agreement with what I'm trying to say. Now, > here's where it gets sticky, at least for me. > > IF, we are meeting client's where they are (i.e. the medical model) what > are we doing differently that our PT partners? > > How does meeting our clients in the medical model mesh with AOTA's > Conceptual Framework model? > > Thanks, > > Ron > > ----- Original Message ----- > From: [EMAIL PROTECTED] <[EMAIL PROTECTED]> > Sent: Wednesday, April 26, 2006 > To: [email protected] <[email protected]> > Subj: [OTlist] Occupation > > > Dac> If we truly want to be client centered, then I think it is more important to > Dac> meet them where THEY are, rather than expecting them to understand where > we > Dac> are. If we are to work with people who have sustained a medical illness or > Dac> injury, they are dealing with it within the medical model - going to their > Dac> doctor, possibly trying to treat it with medicine or alternative approaches, but > Dac> whatever they are doing, it is within the medical model. To them, the > Dac> impairment IS the problem, not the occupation. We may feel that engaging > in > Dac> occupation will be the most efficient and effective means of giving them back > what > Dac> they can't even articulate that they want, but it is not(in my opinion) > Dac> realistic to expect them to recognize this at the outset. Any education > program > Dac> geared at people who are not currently experiencing a problem is not going > to > Dac> be all that effective, as they won't recognize the need to pay attention to > Dac> something that has no immediate relevance in their life, and once they have > a > Dac> problem, it is the problem that they will be focusing on. Since the problem > Dac> is their focus, we need to be able to articulate to them how we can help > Dac> them with their problem, while we gradually introduce the way in which that > Dac> problem may be impacting their occupation and ways in which we can > alleviate > Dac> that. To continue to garner the referrals, or be recognized as worthy of 3rd > Dac> party reimbursement, we need to be able to articulate this within the medical > Dac> model to the referral sources and payors as well. They are functioning within > Dac> the medical model, and that is where we have to meet them, not try to force > Dac> them to meet us outside of that model. > Dac> Ann > >>> Hello All: > >>> > >>> Simple, our clients are seeking answers to problems. They want > >>> theseproblems fixed. But the problems are not occupation, the > >>> problems are > >>> things like weakness, loss of balance, developmental delay, > >>> depression,etc. Clients see these 'components' as the problem and > >>> this is what they > >>> expect their therapist to address. This is the way the entire > >>> world of > >>> medicine works and for OT to be any different just doesn't work. > >>> > >>> What I think needs to be done is for our patients to recognize > >>> loss of > >>> occupation as the primary problem. Then, they recognize the need > >>> for an > >>> occupational therapist. And as far as I can tell, the ONLY way > >>> that this > >>> is going to happen on a large scale is for AOTA to put > >>> together a > >>> NATIONAL ad campaign directed at educating people about > >>> occupation and > >>> thus occupational therapy. > >>> Ron > > > > > > > > -- > Unsubscribe? > [EMAIL PROTECTED] > > Change options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > Help? > [EMAIL PROTECTED] > > -- > No virus found in this incoming message. > Checked by AVG Free Edition. > Version: 7.1.385 / Virus Database: 268.4.6/324 - Release Date: 4/25/2006 > -- No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.1.385 / Virus Database: 268.4.6/324 - Release Date: 4/25/2006
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