Chapter 23 Overview of the Occupational Therapy Process

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Chapter 23: Overview of the Occupational Therapy Process and Outcomes Denise Chisholm and Barbara

Chapter 23: Overview of the Occupational Therapy Process and Outcomes Denise Chisholm and Barbara A. Boyt Schell Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Learning Objectives 1. Describe the components of the OT process. 2. Discuss how evidence

Learning Objectives 1. Describe the components of the OT process. 2. Discuss how evidence from research and practice is integrated in the OT process. 3. Explain the professional reasoning typically associated with components of the OT process. 4. Apply the OT process to a client cases. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

OT as a Process • Occupation is the central focus of OT services •

OT as a Process • Occupation is the central focus of OT services • OT services incorporate therapeutic use of occupation to promote client’s engagement and performance of their preferred daily activities • The use of occupation as: – an end goal; and – a means to achieve OT’s unique contribution to health services Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

The OT Process Map Copyright © 2014 Wolters Kluwer Health | Lippincott Williams &

The OT Process Map Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Components of the OT Process • The starting point of the OT process is

Components of the OT Process • The starting point of the OT process is evaluation, followed by intervention and reevaluation • Outcomes are inherent in the process and serve as goals to guide therapy process • Evidence provides background that supports OT process Each component of the process will be described in more detail in subsequent slides Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Evaluation • OT decision: “Who is my client and does my client need OT

Evaluation • OT decision: “Who is my client and does my client need OT services? ” • Evaluation includes: – occupational profile; – analysis of occupational performance; and – targeted outcomes Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Occupational Profile • The occupational profile provides a summary of client’s history, resources, and

Occupational Profile • The occupational profile provides a summary of client’s history, resources, and performance • Focus on understanding and describing client’s occupational performance • The OT collects and organizes data on client’s occupational: – history; – contexts; and – goals Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Analysis of Occupational Performance • The analysis of occupational performance is collection, organization, and

Analysis of Occupational Performance • The analysis of occupational performance is collection, organization, and synthesis of objective data on client’s occupational performance • The OT has client perform selected activities important to their occupations using valid and reliable assessment tools • The ideal performance situation reflects client’s reallife situation Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Targeted Outcomes • After occupational profile and analysis of occupational performance are completed, final

Targeted Outcomes • After occupational profile and analysis of occupational performance are completed, final task of evaluation is to define targeted outcomes – client’s occupational performance problems that OT interventions can appropriately target • The OT and client: – create short-term and longterm goals; and – determine procedures to measure progress toward goals Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Evidence Focus during Evaluation • Considerations include: – theories most relevant for client and

Evidence Focus during Evaluation • Considerations include: – theories most relevant for client and clinical setting; – available research regarding reliability and validity of appropriate assessment tools; and – preferences of client Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Intervention • The primary question or therapy decision OT has to make during intervention

Intervention • The primary question or therapy decision OT has to make during intervention is “What OT interventions can best help my client? ” • Intervention includes: – Intervention plan; and – Intervention implementation Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Intervention Plan • The intervention plan determines selection of specific OT activities to address

Intervention Plan • The intervention plan determines selection of specific OT activities to address client’s targeted outcomes • The intervention plan is developed in collaboration with client • Determine range of interventions appropriate to: – address client’s occupational performance problems; and – select those with potential to improve performance and match client’s occupational profile Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Intervention Implementation • The intervention implementation puts plan into action – carrying out interventions

Intervention Implementation • The intervention implementation puts plan into action – carrying out interventions and monitoring client’s response • The OT: – observes and examines client’s performance while engaging in interventions; and – adjusts as needed to achieve targeted outcomes Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Evidence Focus during Intervention • Considerations include: – the relationship between selected intervention and

Evidence Focus during Intervention • Considerations include: – the relationship between selected intervention and theories relevant for client and clinical setting; – available research about benefits of selected interventions; – experiences of the OT; and – preferences of the client Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Reevaluation • OT decision during reevaluation is “How has OT affected my client’s performance?

Reevaluation • OT decision during reevaluation is “How has OT affected my client’s performance? ” • Reevaluation includes: – Re-analysis of occupational performance; – Review of targeted outcomes; and – Identify action Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Re-analysis of Occupational Performance • The re-analysis of occupational performance includes systematically measuring and

Re-analysis of Occupational Performance • The re-analysis of occupational performance includes systematically measuring and re-collecting of data • Imperative: use same measures during reevaluation as used in evaluation • The OT compares data obtained from original evaluation with reevaluation findings Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Review of Targeted Outcomes • The review of targeted outcomes determines whether OT interventions

Review of Targeted Outcomes • The review of targeted outcomes determines whether OT interventions achieved intended targeted outcomes through goal attainment • The OT determines changes in client’s occupational performance relevant to measurable goals established during evaluation Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Identify Action • Based on re-analysis of occupational performance and review of targeted outcomes

Identify Action • Based on re-analysis of occupational performance and review of targeted outcomes the OT: – determines to continue therapy; – refers client to another service or specialty; or – discontinues services Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Evidence Focus during Reevaluation • Considerations include: – Available research regarding reevaluation for specific

Evidence Focus during Reevaluation • Considerations include: – Available research regarding reevaluation for specific type of client and assessment tools administered at evaluation – Combining evaluation and intervention research Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Applying the OT Process Copyright © 2014 Wolters Kluwer Health | Lippincott Williams &

Applying the OT Process Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Application The OT process is: • A cycle which may repeat; and • Requires

Application The OT process is: • A cycle which may repeat; and • Requires regular attention to both evaluation and intervention Try it out on a case in the text, online, or in your fieldwork! Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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