Ron, ?I never did apologize. Just stated a fact that I was not criticizing you for your treatment plan.
It is my summation that you write about the "Philosophy of OT".? I do not think that if you take two seasoned OTs found in the same setting with a strong dedication to their clients and put them in two groups a) Working towards occupation and b)Working on occupation, that you would find much difference in their treatment plans, quite possibly their treatment interventions, and the natural activity progression that occurs in providing skilled occupational therapy.? The true difference comes from their treatment philosophy and the wording that they may use to describe their work.? To me personally this difference in philosophy and wording is irrelevent in the "real world".? But I do see the value of this philosophy when teaching students and therapists who are stuck in a rut pushing cones and peg boards off as therapy. It is also my opinion that it is easy to switch to your line of thinking by just changing a few words in the goal.? Instead of writing "Increase ROM to so much in order to comb hair" I could simply write "Patient will comb her hair with no assistance".? Instead of writing "increase standing balance by so many minutes in order to toilet" one can write "Patient will complete his toileting with min assist.? I think the treatment plan and interventions would be the same depending on the skill level of the therapist and the motivation of the patient. -----Original Message----- From: Ron Carson <[email protected]> To: [email protected] <[email protected]> Sent: Mon, 9 Feb 2009 9:59 pm Subject: Re: [OTlist] From Standing to Toilet Transfers Hey Chris, no need to apologize, even if you are being critical. I like to believe that these on-line discussion hone my actual practice patterns!! Now, on with the discussion... ################################################################## Working ON occupation ~vs~ Working TOWARDS occupation: What's the difference? ################################################################## When working ON occupation, I maintain that occupation-based practice is a straight line from goal to intervention. Along that line, there may be any number of specific intervention, but the line is never broken between treatment and goal. Thus, when I'm working on standing balance for a patient that can't stand at the toilet, I'm working on the line between occupation and treatment. Working TOWARDS occupation is not so direct an approach. Working towards something is "vague" and nondescript. It's the notion that "if I improve standing balance" the patient will be better able to stand at the toilet. This approach is NOT unique to OT and is used by most therapy-type professions. When working TOWARDS occupation, occupation is not necessarily the goal. This is evident when a goal is written like: "Patient will increase right elbow range of motion to 120 active flexion to allow for brushing of hair". GREAT discussion!! Thanks, Ron -- Ron Carson MHS, OT www.OTnow.com ----- Original Message ----- From: [email protected] <[email protected]> Sent: Sunday, February 08, 2009 To: [email protected] <[email protected]> Subj: [OTlist] From Standing to Toilet Transfers cac> You may say that you are working on occupation from the beginning cac> of the session to the end, but it sure sounds to me that you are?at cac> times?working towards an occupation, especially in the beginning of cac> the treatment process.? You state that at several times you worked cac> on sit to stands, standing, and ambulating with the patient.? In my cac> book those are foundati onal skills of an occupation.that got the cac> patient to the point in which they could actually practice their cac> goal of getting on and off the commode to toilet.? Without these cac> core foundational skills of an occupation?the client would not have cac> made it off the bed or out of the chair and would be laying on the cac> floor with a dirty pair of slacks.? I am by no means criticizing cac> your treatment plan, because I would have done the same thing. cac> Archive? cac> www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
