Lecture 5: Theoretical Basis of OT

Question 1

What is “big-T” theory?

Answer 1

formalized and widely known theories, such as MOHO or cognitive behavioural therapy

Question 2

What is “small-T” theory?

Answer 2

important knowledge that is less formalized, but informative in our daily functioning as OT. (ex. use of a time diary as a way of assessing occupational engagement)

Question 3

What is the difference between conceptual models and models of practice?

Answer 3

Conceptual models refer to models that help us think and models of practice refer to models that tell us what to do

Question 4

What are difference determinants of occupation?

Answer 4

physical, psychological-emotional, cognitive-neurological, socio-cultural, environmental

Question 5

What are the consequences of occupation?

Answer 5

health, well-being, participation, community integration

Question 6

What does the “OT filing cabinet” refer to?

Answer 6

represents a drawer for each determinant:

• Physical: arise from the MSK system, strength, ROM, endurance
• Psycho-emotional - psychological or emotional experience of occupation, can be affected by thoughts or feelings (coping, identity, mood, motivation)
• Cognitive-neurological: central processing of internal/external stimuli by CNS (motor control, perception, attention, concentration)
• Socio-cultural - learned beliefs, attitudes, roles and behaviours that result in socialization and upbringing. Organizing one’s occupation in to social patterns or habits that conform to the social and cultural roles on fulfills. (role, habit, values, beliefs, spirit)
• Environmental: both physical and social env’t. Three levels (Micro, Meso & Macro)

Question 7

What are ways that occupation can change to meet needs of the person?

Answer 7

Development - intrinsically programmed changes that are sequential and predictable

Adaptation - changes in response to internal/external processes

Accommodation - environmental changes aimed at supporting occupation

Question 8

What are ways that occupation can be used therapeutically

Answer 8

remediation - therapeutic efforts aimed at fixing a problem

compensation - adaptive strategies aimed at working around a problem

advocacy - therapeutic initiatives undertaken in the environment to promote accommodation

Question 9

Provide examples of each type of therapeutic intervention (remediation, advocacy, compensation) for all the determinants of occupation

Answer 9

Physical - R=exercise, graded activity, splinting
C= work simplification, energy conservation,
assistive devices
A= physical accessibility
Psych-emote - R= coping strategies, stress management
C=task adaptation
A= public education, community, inclusion
Cog-Neuron - R= cognitive rehab, self-regulation
C= assistive technology
A = public education, community, inclusion
Socio-Cult - R=social skills training, habit training, time
management
C= role reorganization, value shifts, family
therapy
A = role negotiation, social support
Environmental - A= human rights, adapted housing, transportation