Hi Jim: I consider any approach "non-therapeutic" when it does not result in any benefit to the client, and most of the time is administered due to the therapist's laziness/ lack or misplaced understanding of the client's needs/ burn-out or, use of time as "space fillers".
We can argue that placebos too have therapeutic value. However, we also know that placebo- therapy is not reimbursable. Well, we may choose to discuss value placed based on actual evidence that will discard use of placebos. Not ignoring hierarchal evidence, as clinicians we also understand that "therapeutic value" may be realized on an individual client by client basis. Again, notwithstanding modern day reimbursement issues or the evidence-based practice, placebos have a well documented therapeutic value in history. Of course, we cannot and do not practice placebo therapy though :-). However, I do not place all placebos as "non-therapeutic" automatically either. On a similar token, leisure/ recreation has a strong therapeutic value in our profession as long as the therapist (and, ideally the client) understand the intended outcome. Of course, in the medical model, we all know that we can not get paid for gardening, but if we use gardening as the "means" to improve a client's standing balance in order to perform his ADL at the sink level; it is a functional outcome and a reimbursable service. Coming back to what I think is "non-therapeutic", I go back to the meaning of "therapy" = "help". Working on arm strengthening when the MMT reveals a 5/5 grade or ROM when it's within normal limits, is not therapeutic. However, if the goal was not to increase strength/ ROM but to address- activity tolerance, or balance with free/ resisted movements of UE simulating tasks that are routinely and customarily performed by the client, or a graded work-hardening schedule as in the case of an injured worker, or addressing power/ finesse/ control as with UE athletic injuries, etc. (i.e. performance factors that may have been affected) in order to function independently in their required occupational roles while using tasks that may seem like strengthening, is indeed therapeutic. Of course, the client/ guardian needs to then understand the difference, or else the efforts will be washed out and the therapeutic value is not fully realized. In other words, does the therapy "help" the client's condition that needs to be addressed, and does the client/ guardian place a value to it? Therefore, an activity/modality by itself does not render itself occupationally "therapeutic" or "non therapeutic". It is how we choose to use them. Joe -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Jim Arceneaux Sent: Friday, August 17, 2007 6:58 PM To: [email protected] Subject: Re: [OTlist] Why are YOU on this list Hi Joe, Would you elaborate on what you mean by "non-therapeutic approaches." Jim Joe Wells <[EMAIL PROTECTED]> wrote: Arley Johnson stated "....WE are the only profession that knows enough about each area to put it all together in a functional, real world context, identify the limitations and address that area for remediation. All within our practice guidelines!" Arley: I love the way you put it. I agree with you completely. In my opinion, it is this "pan-function", holistic viewpoint that separates us from other professions. It is this understanding that can help us become the "gatekeepers" of rehab services. At the same time, I also believe that while this ('holistic' view) is our common thread, OTs can practice/ specialize in different areas- hand, pediatrics, geriatrics, cardiovascular, lymphedema, pain/ neurological conditions, driver's rehab, low vision, etc. Of course, functioning within the scope of OT. Example: A cardiologist is still a physician. So, if an OT is an UE Therapist, when that is the need for remediation, and incorporates biomechanical approaches to fulfill the occupational needs of the clients- I feel that he/ she is justly performing occupational therapy. However, as in my earlier post, and as faced by Ron's friend, if they just do UE therapy for no "therapeutic" reason, they are not only not performing OT (excuse my two negatives), they are just not doing any kind of therapy. Let's embrace all our specialization and share the common platform of OT. And, let's just discard our "non-therapeutic" approaches. This in turn will bridge the gap between theory and practice. Joe No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.5.476 / Virus Database: 269.11.15/949 - Release Date: 8/12/2007 11:03 AM -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] **************************************************************************** ********** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************** ********** --------------------------------- Looking for a deal? Find great prices on flights and hotels with Yahoo! FareChase. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] **************************************************************************** ********** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************** ********** No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.476 / Virus Database: 269.11.15/949 - Release Date: 8/12/2007 11:03 AM No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.5.476 / Virus Database: 269.11.15/949 - Release Date: 8/12/2007 11:03 AM -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
