Ron, As someone with as unique an experience as yours or more so. 30 yrs OT, clinical practice in multiple areas, academia, researcher and back in the clinic full time, in a few different countries I want to add a couple of interesting thoughts.
1. We know that people do not generalize new information well until they have experienced putting it in practice in a variety of situations. Hence if we really work on functionally, occupationally based OT we need to address learning in a variety of real life settings. The same applies to therapists and how they learn. I think we rely on this experience being provided in the clinical affiliations but frequently the focus is on the basic survival skills. 2. Often those teaching students are unable to integrate the practices themselves or are not able to place them in real life clinical situations. On going continuing education needs to include providing those opportunities for our clinical educators as well. Educators and theorists need to be able to model and provide clear application examples that are relevant to today's clinical situations. We need to break down the learning for therapists. Believe me I think therapists are "hungry" to learn where they can follow the steps. OK just a couple of early morning thoughts. Need to get back to the research before heading off to the clinic Sue D > Date: Tue, 17 Feb 2009 06:11:00 -0800 > From: [email protected] > To: [email protected] > Subject: Re: [OTlist] Philosophy ~vs~ treatment in the "real world"? > > I believe that taking time to listen to our patient/clients is what enables > us to employ the soft theories. I find that I feel that I've usually served > my patient/client well when I listen to them and develop the plan of care > based upon what he or she is telling me is important to him or her. Think > about the "thank you" notes we receive: the greatest compliment is when I > read that I really listened to my patient; I "took the time" that was needed, > etc. > > I think that when someone says, "he or she is a really good therapist," that > therapist has probably consistently applied both hard and soft theory in > their practice. > > Different treatment settings will either allow or preclude this from > occurring and that is why I enjoy home health. The treatment session pace is > a little slower, the treatment is one-on-one. I know when I am feeling > frustrated in my work, it is often due to being overwhelmed with too many > visits scheduled in a day and I am rushed. I may start to feel an imbalance > in my employment of hard and soft theory. > > I find home health to be one of the optimal venues for OT and wish other > treatment settings afforded the same opportunity. > > Susan > > --- On Mon, 2/16/09, Ron Carson <[email protected]> wrote: > > From: Ron Carson <[email protected]> > Subject: [OTlist] Philosophy ~vs~ treatment in the "real world"? > To: [email protected] > Date: Monday, February 16, 2009, 9:09 PM > > I fancy myself as being in a rather unique position to address this > question. In the twelve years since graduating from OT school, I've gone > from full-time clinician, to full-time academician back to full-time > clinician. > > The "real" world of OT is generally considered to be the clinic. In > this > setting, theory and philosophy often take a back seat to rigors and > demands of for-profit health care. Theory is not totally void in > practice, but it certainly is not part of everyday discussion and in my > experience it often does not drive practice. While there are many > possible explanation for this, I offer only one. > > A theory is not a part of practice because it is not seen as having > DIRECT application. These types of theory are abstract and difficult to > 'pin down' in the real world. Clinician's minds are overwhelmed > with > practical clinical decisions and taking time to access abstract thought > is not part of the time sensitive equation of daily treatment. Thus, > well thought out theories are often left in the classroom or in > clinician's notebooks. > > In my experience, clinician's cling to theories such as NDT, Bobath, > constraint-induced treatment, etc. These "hard" theories all have > an > application and hands-on component lacking in "soft" theories such > as > Enabling Occupation, therapeutic relationship, Practice Framework, etc. > But, I believe these soft theories are equally important and perhaps > even more important to our profession. > > As clinician's we *MUST* integrate "soft" theory into our > daily > practice. We *MUST* develop a sense of who we are as both as a > profession and individuals and this comes from "soft" theory. While > are > most easily grasped, developed and recognized, they tend to not define > who and what we are. > > Obviously, I offer no solutions to the age-old debate of theory ~vs~ > practice but I felt compelled to write something!! > > Ron > > -- > Ron Carson MHS, OT > www.OTnow.com > > > > -- > 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] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
