Models of Health Care

Question 1

Which models of health care impact the OT profession on both a national & global level by providing a further context for understanding practice in the millennium

Answer 1

Medical Model
World Health Organization Model
Client-centered practice
American OT Practice Frame work

Question 2

Medical model entails?

Answer 2

Patient care
Treatment team
Medical Insurance
Medical Diagnosis - symptom based
Prescriptions
Scientific Evidence-reductionistic & mechanistic i in perspective

Question 3

What is the OT’s Role?

Answer 3

Restoring a state of health, normalcy, and homeostasis
These approaches were developed for the treatment of specific disabilities and focused on performance components (NOT occupation based)

Question 4

What are the OT theories?

Answer 4

Psychoanalytic
Behavioral
NDT
SI
Cognitive disabilities
Bio-mechanical
Motor Control

Question 5

Client-Centered Practice

Answer 5

Emerged in 1960’s & Deinstitutionalization

Question 6

How was Client Centered Model found?

Answer 6

By the Canadian OT Association

Basic Therapy model for AOTA practice frame work

Question 7

Client Centered Practice

Answer 7

Resembles Carl Roger’s “person-centered” approach

It is where the client SEEKS advice of a professional for life management

Question 8

What is client centered practice intended to be?

Answer 8

Holistic, global, & collaborative partnership

Question 9

ASSUMPTIONS OF CLIENT-CENTERED PRACTICE

Answer 9

Client knows what they want and need
Ultimate relevance of the clients perspective on problems
Professional dominance is counter-therapeutic
Therapist CANNOT be the instrument of change, only the facilitator

Question 10

Canadian Model of Occupational Performance

Answer 10

Client-centered practice follows CMOP which illustrates how occupational performance evolves from the interactions between the person, the environment, and the occupation itself.

Question 11

What are some of the general points of CMOP?

Answer 11

Functioning ability is based on interactive effects between P.E.O
Changes in ANY part of the system can impact occupational performance
Motivation is considered to be INTRINSIC, and facilitated by clients participation in identifying meaningful goals and occupational priorities.

Question 12

What are some of the general points of CMOP? Continued

Answer 12

There is no specific plan for how to apply the therapeutic process
“Facilitating, guiding, coaching, prompting, listening, reflecting, encouraging, or otherwise collaborating with people are general intervention strategies.
Therapeutic process is guided by the SIX general principles of client-centered practice

Question 13

6 Principles of Client-Centered Practice

Answer 13

1. ) The client is capable of CHOICE
2. ) Flexibility & individualized approach
3. ) Therapist’s role as enabler (therapist shares power & empowers client)
4. ) Success measured by clients attainment of goals (clients own priorities)
5. ) Needs for contextual congruence - (interventions have meaning in clients own life settings)
6. ) Client readiness to use therapist expertise

Question 14

Pros and Cons of Client Centered Model (from her PP)

Answer 14

Pros: science driven, attention to client, avoids diagnosis and focuses on patients needs.
Cons: Limited attention from caregivers, has to be practiced by well trained professionals

Question 15

What is ICF?

Answer 15

International Classification of Functioning

Question 16

Who was ICF created by?

Answer 16

World Health Organization

Question 17

What does the ICF reflect?

Answer 17

Reflects the shift to a holistic and systems perspective of global health care from a reductionist view

Question 18

What is the purpose of ICF?

Answer 18

To provide scientific basis for studying health and its determinants
Establish a common language
Allow comparisons across countries, disciplines, and time
Provide systematic coding for purposes of record keeping and research

Question 19

New definitions by ICF:

Handicap

Answer 19

Participation restriction

Question 20

Disability

Answer 20

Activity limitation

Question 21

Impairment

Answer 21

Health Condition
This is a umbrella term for not only disease, disorder, injury, or trauma but ALSO conditions such as pregnancy, aging, stress, congenital anomaly, and genetic pre-disposition

Question 22

General Points

Answer 22

WHO broadened the horizons of health related research, service provisions, and policy making, beyond the constraints of the medical model in 2001

Question 23

Is ICF only for people with disabilities?

Answer 23

FALSE. It is about ALL people

Question 24

How does ICF conceive a person’s functioning or disability?

Answer 24

They view it as a dynamic interaction between a health condition and contextual factors

Question 25

Impact on OT

Answer 25

ICF reflects integration of the medical and social models by using a bio-psycho-social approach
ICF language resembles OT practice framework

Question 26

What does the ICF view as the main determinant of disability?

Answer 26

Activities

It validates OT practice principles

Question 27

American OT practice framework

Answer 27

2 parts: Domain and Process

Categories: Performance areas of occupation, performance skills, performance patterns, contexts, activity demands, and client factors.

Question 28

General Points

Answer 28

Framework collaborative process model illustrates the way OT’s deliver services in collaboration WITH clients
Client-practitioner relationship determines flow of evaluation, intervention, & outcome