Final Flashcards
T/F : The heart of occupational therapy is within the medical model, treating symptoms.
False
Which best describes OTs focus, when determining OT needs?
what is the matter with you?
What matters to you?
let me tell you what matters
No answer text provided.
What matters to you?
Kielhofner describes traditional medical model as:
- Client centered, scientific, realist
- Reductionist, mechanistic and scientific
- No answer text provided.
- Holistic, mechanisitic and realist
Reductionist, mechanistic and scientific
The 6 principles of client centered practice include all of the following except:
-Therapeutic partnership and shared responsibility
-Accessibility and flexibility
-Client autonomy and choice
-systems of orientation
Respect for diversity
-Enablement and empowerment
systems of orientation
Systems theory helps us to understand how things:
- plan
- interact
- organize
- react
interact
The launching of _______ was the professions first attempt to promote holistic perspective for treatment by an OT.
- organism
- reductionist
- holism
- MOHO
MOHO
T/F: A new grad OT can specialize in one area of practice?
False
T/F: Social dynamics in families and communities, and occupational performance within multiple and changing contexts are examples of complex systems
True
T/F: physical, social, cultural contexts should always be considered in OT
True
T/F: Frames of reference are in place to guide our reasoning?
True
Per Mosey, we have three levels of OT theory and they are the following, except:
- Fundamental body of knowledge
- Performance
- Applied body of knowledge
- Practice
Performance
T/F: Community practice aims to restore health and life balance.
True
According to Willcock, which can lead to stress related illness?
- Occupational imbalance, family dynamics, task deprivation
- Occupational imbalance, occupational deprivation, occupational alientation
- Occupational alienation, social justice, performance of tasks
- Boredom, group projects, social participation
Occupational imbalance, occupational deprivation, occupational alientation
Per wilcock, which of the following is not a health promotion model :
-Social justice
-Ecological sustainability
wellness
-Preventative medicine
-wealth
-Community development
wealth
T/F: Toglias approach was originially designed for TBI
True
Toglias approach has a foundation in which of the following?
- neuroscience
- orthopedics
- psychology
- pediatrics
neuroscience
T/F: If my client has a cognitive dysfunction and no self awareness Toglias approach is a great FOR to facilitate improvements in task performance.
False
Allen Cognitive level is used in mental health and which other population?
- dementia
- PD
- pediatrics
- orthopedics
dementia
Folks with normal cognitive abilities sometimes function at lower ACL levels due to which of the following?
- brain conservation
- task equivelance
- task demand
- task environment
brain conservation
T/F: Task demands in ACL FOR coincide with activity demands in OTPF?
True
T/F: Grading an activity up or down to decrease client frustration in an example of just right challenge.
True
T/F: Extrinsic factors are info that can be implied or interpreted (i.e. visual spatial, verbal propositional and memory)
False
T/F: All children can achieve age appropriate skills.
F
T/F: You must know normal development to apply developmental frames and theories appropriately?
True
T/F: Lifespan developmental FOR are only to be used for children and older adults.
False
T/F: It is appropriate to look only at developmental stages/phases with OT evaluation.
False
Name this founder described below:
architect, cured self through woodworking & gardening, first President of OT Association
George Barton
Name this founder described below: Johns Hopkins (worked with Adolph Meyer, psychiatrist (philosophy of OT), New York State Hospital, “Habit Training”
Eleanor Clarke Slagle
Name this founder described below:
edited first journal: Maryland Psychiatric Quarterly, believed in healing potential of occupation
William Rush Dunton, MD
Name this founder described below:
secretary, Consolation House, married Mr. Barton
Isabel Newton
Name this founder described below:
architect, Canadian
Thomas Kidner
Name this founder described below:
nurse, wrote book on OT
Susan Johnson
Name this founder described below:
nurse, not in photograph
Susan Tracy
What year?
Moral treatment
Mental Hygiene, humanitarian
Invalid Occupation, Susan Tracy
Arts & Crafts movement
1917 AOTA founded, Clifford Springs, New York (Consolation House)
Reconstruction Therapy, William Dunton
Re-education after injury, George Barton
World War I, rehabilitation of wounded soldiers (biomechanical, restoration model)
1900-1919
What year?
Economic Boom – age of invention
Philosophy of OT: Adolph Meyer
Humanistic & Pragmatic
Habit Training: Eleanor Clarke Slagle, use of normal daily activities with mentally ill
Pre-industrial training (WWI soldiers), Thomas Kidner
Number of occupational therapists expanded across both mental and physical interventions for the disabled
1920-1929
What year?
The Great Depression
Trend toward scientific approach continued
Behaviorism (Skinner) applied scientific method to all aspects of human activity
Birth of Behavior Modification as therapy
OT used to help patients adjust to hospital life (long-term treatment, polio, tuberculosis, etc.)
1930-1939
What year?
World War II
Baby Boom began
Growth in post-war vocational rehabilitation
Kinetic model, range of motion studies
OT activities seen as “cure”
Attempts to match OT activity to diagnosis
Medical Model prominent – Rehabilitation model in OT
1940-1949
What year?
Widespread use of phenothiazines (thorazine, etc.) to treat mental illness
Psychoanalysis – Freudian theory prominent
OT groups (Fidler) used to treat ego skills
Projective or creative arts commonly used by occupational therapists, Azima battery
Crafts, adapted looms, adapted tools, prominent in treating physical disabilities
Sensory Motor Therapy – Margaret Rood
1950-1959
What year?
De-institutionalization movement
Shift to community mental health
Gail Fidler – Communication Process (Task Groups)
Therapeutic communities used as treatment for mental illness
Blurred roles for medical staff members
Offshoots of OT: art therapy, music therapy, horticulture therapy, dance therapy, etc.
Bobaths, NDT & other motor control theories emerged
Reflex Development: Mary Fiorentino
First “Willard & Spackman” used as text
A. Jean Ayres – Sensory Integration introduced
1960-1969
What year?
Decade of Frames of Reference
Occupational therapist’s search for professional identity
Many extremes of specialization in OT
Growth & Development model, Lela Llorens
Activity Therapy, Anne Mosey
Developmental Groups, Anne Mosey
Cognitive Behaviorism flourished
PL 94-142, education for handicapped kids
1970-1979
What year?
Occupational Science expands rapidly
Further expansion of research & publication in OT
Many new developing programs for OT, COTA to accommodate greatly increased numbers
Brain research, genetic engineering
Neuroscience and cognitive theories predominate
Psych & physical disability areas of OT practice merge
De-specialization, use of same skills across specialty areas
1990-1999
What year?
Occupational Adaptation Model: Schkade & Schultz
Ecology of Human Performance: Winnie Dunn
Person-Environment-Occupational Performance Model: Christiansen & Baum
Multicontextual Approach (Cognitive Perceptual): Joan Toglia
Occupational Performance Process Model: Mary Law, et al.
1990+
What year?
OT Practice Framework replaces Uniform Terminology
OT Paradigm Shift is confirmed
Community practice replaces “medical model” (patient client, etc.)
Non-traditional OT roles emerge
Client-centered model embraced, definition of client expands to include families, caregivers, social & cultural contexts, groups
Evidence-based practice: Margo Holm
OT Education moves to Masters Entry Level
2000+
What year?
Decade of Clinical Reasoning
MOHO, Gary Kielhofner, Janice Burke
Spatiotemporal Adaptation, Grady & Gilfoyle
Clinical Reasoning, Joan Rogers
Client Centered practice, in Canada (CAOT)
Rapid expansion of research, standardized assessments
1980-1989
Describe the Medical Model
Expertise focused on using activities to
- relieve symptoms,
- to adapt task demands, -compensate for disability.
Rehab ends when the pt has met functional goals established by therapist and/or medical treatment team.
Describe the Client-centered model
Collaborates with client to identify:
- occupational problems
- priorities
- set goals
- enable client
- participation through supporting skill development
- and taking preventive actions and/or through adaptation of tasks and environments.
What principles are listed below:
- Client Autonomy and Choice
- Respect for Diversity
- Therapeutic Partnership and Shared Responsibility
- Enablement and Empowerment
- Contextual Congruence: Recognizing Environmental Conditions and Demands
- Accessibility and Flexibility
Client-centered practice principles
What is a frame of reference?
FOR is a system of compatible concepts from theory that guide a plan of action for assessment and intervention within specific OT domains. Address specific disability areas.
*NOT occupation-based.
What are the levels of OT theory?
1 - fundamental body of knowledge: philosophical assumptions, an ethical code, a theoretical foundation of both theories and empirical data, a domain of concern, and legitimate tools. OT’s professional paradigm and OTPF fall into this category.
2 - applied body of knowledge: sets of guidelines for practice. Occupation-based models fall into this category.
3 - practice: action sequences, use of applied knowledge, the clinical reasoning process, and the art of practice. FORs, assessments, and intervention techniques fall into this category.
Who states: the barriers to OT transitioning to community practice model is the profession’s smallness, gender imbalance, dependence on medicine, its difference, and the difficulty of explaining or understanding its promise without an appreciation of its origins and rich philosophical history.
Wilcock: is a strong proponent of the role in OT community practice and argues that OTs should direct attention and advocate for change within the educational, political and social venues of our national systems.
Identify Wilcocks 5 health promotion models
1) Wellness: closest to traditional, medical practices within OT, offering conventional perspectives. Synonymous with health promotion and ill health prevention.
2) Preventative medicine: closest to public health; defined as the application of Western medical and social science to prevent disease, prolong life, and promote health in the community through intercepting disease processes. It is an illness model.
3) Social justice: promotion of social and economic change to increase individual, community, and political awareness, resources, and equitable opportunities for health. Ill health is often an outcome of disparities related to resources and power, economy, national priorities and policies, and cultural values. These factors are aka underlying occupational factors in the hierarchy of social determinants of health.
4) Community development: community consultation, deliberation, and action to promote individual, family, and community-wide responsibility for self-sustaining development, health, and well-being. A holistic approach, whose therapeutic aim is directed toward the better end of entire community thru strategies that encourage social and economic development, a community analysis, use of local resources, and self-sustaining programs.
5) Ecological sustainability: promotion of healthy relationships between humans, other living organisms, their environments, habits, and modes of life. Based on biological and natural sciences.
What is described below FIM or Barthel?
- includes a seven-level scale that designates major gradations in behavior from dependence to independence.
- This scale rates patients on their performance of an activity taking into account their need for assistance from another person or a device.
-This instrument is a measure of disability, not impairment.
This instrument is intended to measure what the person with the disability actually does, whatever the diagnosis or impairment, not what (s)he ought to be able to do, or might be able to do under different circumstances.
FIM
What is described below FIM or Barthel?
- values assigned to each item are based on time and amount of actual physical assistance required if a patient is unable to perform the activity.
- Full credit is not given for an activity if the patient needs even minimal help and/or supervision,
- ie, if he cannot safely perform the activity without someone present in the room with him. Because of the time required to attend an incontinent patient and since he is not socially acceptable, continence was weighted heavily.
Barthel
What area of practice is described below from the Practice Framework:
Activities of daily living (ADLs)* Instrumental activities of daily living (IADLs) Rest and sleep Education Work Play Leisure Social participation
OCCUPATIONS
What area of practice is described below from the Practice Framework:
Values, beliefs, and
spirituality
Body functions
Body structures
CLIENT
FACTORS
What area of practice is described below from the Practice Framework:
Motor skills
Process skills
Social interaction skills
PERFORMANCE
SKILLS
What area of practice is described below from the Practice Framework:
Habits
Routines
Rituals
Roles
PERFORMANCE
PATTERNS
What area of practice is described below from the Practice Framework:
Cultural Personal Physical Social Temporal Virtual
CONTEXTS AND
ENVIRONMENTS
What is Activity Analysis?
• Activity Analysis is an important process OT practitioners use to understand the demands a specific activity places on a client:
- It looks at the typical demands of an activity
- The range of skills involved in its performance
- Various cultural meanings that may be attributed to it
Code of ethics: What principle is described below:
“Occupational therapy personnel shall demonstrate a concern for the well- being and safety of the recipients of their services” (AOTA, 2010b, p. S18).
Principle 1, Beneficence
Code of ethics: What principle is described below:
“Occupational therapy personnel shall intentionally refrain from actions that cause harm” (AOTA, 2010b, p. S19).
Principle 2, Nonmaleficence
Code of ethics: What principle is described below:
“Occupational therapy personnel shall respect the right of
the individual to self-determination” (AOTA, 2010b, p. S20).
Principle 3, Autonomy/Confidentiality
Code of ethics: What principle is described below:
“Occupational therapy personnel shall provide services in a fair and equitable manner” (AOTA, 2010b, p. S21).
Principle 4, Social Justice
Code of ethics: What principle is described below:
“Occupational therapy personnel shall comply with institutional rules, local, state, federal, and international laws and AOTA documents applicable to the profession of occupational therapy” (AOTA, 2010b, p. S22).
Principle 5, Procedural Justice
Code of ethics: What principle is described below:
“Occupational therapy personnel shall provide comprehensive, accurate, and objective information when representing the profession” (AOTA, 2010b, p. S23).
Principle 6, Veracity
Code of ethics: What principle is described below:
“Occupational therapy personnel shall treat colleagues and other professionals with respect, fairness, discretion, and integrity” (AOTA, 2010b, p. S24).
Principle 7, Fidelity
