Models of Health Care Flashcards
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
Medical Model
World Health Organization Model
Client-centered practice
American OT Practice Frame work
Medical model entails?
Patient care Treatment team Medical Insurance Medical Diagnosis - symptom based Prescriptions Scientific Evidence-reductionistic & mechanistic i in perspective
What is the OT’s Role?
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)
What are the OT theories?
Psychoanalytic Behavioral NDT SI Cognitive disabilities Bio-mechanical Motor Control
Client-Centered Practice
Emerged in 1960’s & Deinstitutionalization
How was Client Centered Model found?
By the Canadian OT Association
Basic Therapy model for AOTA practice frame work
Client Centered Practice
Resembles Carl Roger’s “person-centered” approach
It is where the client SEEKS advice of a professional for life management
What is client centered practice intended to be?
Holistic, global, & collaborative partnership
ASSUMPTIONS OF CLIENT-CENTERED PRACTICE
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
Canadian Model of Occupational Performance
Client-centered practice follows CMOP which illustrates how occupational performance evolves from the interactions between the person, the environment, and the occupation itself.
What are some of the general points of CMOP?
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.
What are some of the general points of CMOP? Continued
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
6 Principles of Client-Centered Practice
- ) The client is capable of CHOICE
- ) Flexibility & individualized approach
- ) Therapist’s role as enabler (therapist shares power & empowers client)
- ) Success measured by clients attainment of goals (clients own priorities)
- ) Needs for contextual congruence - (interventions have meaning in clients own life settings)
- ) Client readiness to use therapist expertise
Pros and Cons of Client Centered Model (from her PP)
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
What is ICF?
International Classification of Functioning
Who was ICF created by?
World Health Organization
What does the ICF reflect?
Reflects the shift to a holistic and systems perspective of global health care from a reductionist view
What is the purpose of ICF?
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
New definitions by ICF:
Handicap
Participation restriction
Disability
Activity limitation
Impairment
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
General Points
WHO broadened the horizons of health related research, service provisions, and policy making, beyond the constraints of the medical model in 2001
Is ICF only for people with disabilities?
FALSE. It is about ALL people
How does ICF conceive a person’s functioning or disability?
They view it as a dynamic interaction between a health condition and contextual factors
Impact on OT
ICF reflects integration of the medical and social models by using a bio-psycho-social approach
ICF language resembles OT practice framework
What does the ICF view as the main determinant of disability?
Activities
It validates OT practice principles
American OT practice framework
2 parts: Domain and Process
Categories: Performance areas of occupation, performance skills, performance patterns, contexts, activity demands, and client factors.
General Points
Framework collaborative process model illustrates the way OT’s deliver services in collaboration WITH clients
Client-practitioner relationship determines flow of evaluation, intervention, & outcome
