I  just  love  this  place. We have such diversity; around the world and
each end of the treatment perspective!

I  think  you  make  excellent points. I hope some students will jump in
here!!!

Thanks,

Ron

--
Ron Carson MHS, OT
www.OTnow.com

----- Original Message -----
From: Sue Doyle <[email protected]>
Sent: Tuesday, February 17, 2009
To:   [email protected] <[email protected]>
Subj: [OTlist] Philosophy ~vs~ treatment in the "real world"?


SD> Ron,
SD> As someone with as unique an experience as yours or more so. 30 yrs
SD> OT, clinical practice in multiple areas, academia, researcher and
SD> back in the clinic full time, in a few different countries I want to
SD> add a couple of interesting thoughts.

SD> 1. We know that people do not generalize new information well until
SD> they have experienced putting it in practice in a variety of
SD> situations. Hence if we really work on functionally, occupationally
SD> based OT we need to address learning in a variety of real life
SD> settings. The same applies to therapists and how they learn. I think
SD> we rely on this experience being provided in the clinical
SD> affiliations but frequently the focus is on the basic survival skills.

SD> 2. Often those teaching students are unable to integrate the
SD> practices themselves or are not able to place them in real life
SD> clinical situations. On going continuing education needs to include
SD> providing those opportunities for our clinical educators as well.
SD> Educators and theorists need to be able to model and provide clear
SD> application examples that are relevant to today's clinical
SD> situations. We need to break down the learning for therapists.
SD> Believe me I think therapists are "hungry" to learn where they can follow 
the steps.

SD> OK just a couple of early morning thoughts. Need to get back to the
SD> research before heading off to the clinic

SD> 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
>> 
>> 
>> 
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>> 
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