I am finding it increasingly frustrating to read answers before the questions. Therefore my answer to Danielle is below.
----Original Message----- From: [email protected] [mailto:[email protected]] On Behalf Of Danielle C. Sent: April 1, 2009 2:30 PM To: [email protected] Subject: [OTlist] What the heck is wrong with our profession? Hello all, I am a graduate student finishing my last year to become an OTR. I feel my experience as a learner has largely included a focus on occupation based and client centered practice. Myself and other classmates do have some trouble coming up with goals and relevant treatment strategies though. I think these areas are difficult for students because they require clinical knowledge and expertise that come from actual experience with clinical practice. This is where I agree with the previous post that states that there is a grand disconnect between school/ theory and practice. As students we are armed with our OTPF and we can choose an effective treatment strategy that is within our domain and is focussed on occupation. But when it comes to specifics of making a treatment plan with goals we dont have anything to draw on because we don't have the experience. This is where I think mentorship is so important as well. Does anyone have any suggestions for how to find more case specific examples for treatments for example energy conservation for an individual with myesthenia gravis ? I know occupational therapists are independent learners but it helps to have concrete examples when you are relying so much on book knowledge and paper patients. So many times we can research a treatment method or a clinical condition and find articles or fact sheets that state for example; occupational therapists can work with ... condition in the area of self care or with energy conservation strategies but there is no specific example of what is being done. Not that I am looking to be given answers too easily but it would help to see what an occupational therapist would specifically do in a given situation. Danielle I am very interested in your response to this. How could I have been more helpful? Self care or energy conservation in order to do what? This is where guided interview skills are important. The COPM is a very effective one with built in subjective data collection to give us some outcome measures (also subjective). I tend to equate subjective and client-centred. Energy conservation is important for anyone with myasthenia gravis but what is most important to this individual with myasthenia gravis to be able to do. This is why I find the COPM questions so valuable. What do you need to be able to do? What do you want to be able to do? What does some one else need or want you to be able to do? I tend to structure a COPM interview with a typical day format starting with bed mobility. This comes as a surprise for many people who wouldnt have thought to express the struggle to get to the edge of the bed as a solvable problem. Even if they have no problem they can imagine that someone else might. If we pay attention to the first glitch of the morning it can develop an awareness that we will listen and help them to self organise their own information into occupational goals. So as we go through the day and ask what happens at each stage - Is this the way you have always done it etc? plus the questions above they wind up with a list of major and minor difficulties that are barriers to occupation. These are ranked and voila - some goals to work on if you are lucky. We focus our intervention skills related to myasthenia gravis on the occupations (Ron would say only one) that have the most meaning and value for the client. For example - independence in self care may not be the most appropriate goal, beloved though it is by generations of OTs, if assistance is available and it uses energy better spent maintaining relationships. As experienced therapists we are much better able to mentor if the questions posed to us are about individuals rather than diagnoses. This is much more difficult when there are moderate to severs cognitive deficits. Blessings, Joan 403 652 7928 -- No virus found in this outgoing message. Checked by AVG - www.avg.com Version: 8.0.238 / Virus Database: 270.11.35/2034 - Release Date: 04/01/09 06:06:00 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
