theory knowledge + concepts

Question 1

Paradigm of Occupation

Answer 1

(1900-1940s)

Question 2

Mechanistic Paradigm

Answer 2

(1950s-1970s)

Question 3

New Emerging Paradigm

Answer 3

(1980s-2000)

Question 4

What is a paradigm shift?

Answer 4

when a discipline abandons one view of the world for another; a revolution; a drastic conceptual restructuring

Question 5

4 stages within the development of a paradigm

Answer 5

Pre-paradigm phase
various thinking approaches emerge to solve the same problem

Paradigm
“winner”; use of one school of thought

Crisis
not all problems can be solved this way

Resolution
reorganization of the old PLUS new thinking

Question 6

Paradigm of Occupation (1900-1940s), advocating for what?

Answer 6

Moral treatment (advocating for persons with mental illness by participating in occupations that “normalized” behavior

Question 7

was the central phenomenon of interest referring to balance of work, play, self-care, & rest; holistic view

Answer 7

Occupation

Question 8

Paradigm of Occupation (1900-1940s) originates from

Answer 8

Consolation House (1914, NY) a convalescent home founded by George Barton & Eleanor Clark Slagle; 
Hull House (1915, Chicago) a work program for persons with physical & mental disabilities

Question 9

The Paradigm Shift (1940s-1950s) is what era?

Answer 9

Crisis Era

The profession comes under pressure from medicine to provide scientific evidence for its practice

Question 10

Mechanistic Paradigm (1950s-1970s)

Answer 10

Medical model (reductionistic) replaces “occupations” of moral treatment

OTs seek to gain professional respect as a scientific discipline by focusing on disease

Specialization is a popular trend

Loss – commitment to occupational performance

Gain – new assistive devices, technology, techniques; SI; NDT

Question 11

Paradigm Shift of the 1970s

Answer 11

Crisis Era
Reductionism was inadequate for treating chronically disabled
OTs express dissatisfaction over a loss of professional identity & unity

Question 12

Emerging Paradigm (1980s & on)

Answer 12

Recommitment to holistic view and the occupational nature of humans
Client centered practice including active engagement & empowerment
Balance of the art & science of practice

Question 13

MODELS OF HEALTH CARE is a context of?

Answer 13

… a context for understanding the changes occurring in the OT profession, both nationally and globally.

Question 14

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

Answer 14

Medical model
World Health Organization model (WHO, 2001)
Client-centered practice
American Occupational Therapy Practice Framework (AOTA, 2014).

Question 15

MEDICAL MODEL

Answer 15

Patient Care
Treatment Team
Medical Insurance
Medical Diagnosis – symptom based
Prescriptions
Scientific Evidence – reductionistic & mechanistic in perspective

Question 16

OT’s Role in the Medical Model

Answer 16

Restoring a state of health, normalcy, and homeostasis

Treatment approaches were developed

Question 17

Client-Centered Practice emerged when?

Answer 17

Emerged in 1960s & Deinstitutionalization

Question 18

Client Centered Model (OT) founded by

What is it?

Answer 18

founded by the Canadian Occupational Therapy Association (CAOT, 1997)

It is the basic therapy model for the AOTA Practice Framework (2014)

Question 19

CLIENT-CENTEREDPRACTICE is what?

Answer 19

Resembles Carl Roger’s “person-centered” therapy approach
A client seeks the advice of a professional for life management
Intended to be holistic & global
Collaborative partnership

Question 20

ASSUMPTIONS OF CLIENT-CENTERED PRACTICE

Answer 20

Clients know what they want & need from therapy
Ultimate relevance of the client’s perspective on problems
Professional dominance is counter-therapeutic
Therapist cannot be the instrument of change, only the facilitator

Question 21

6 Principles of Client-Centered Practice

Answer 21

Client Autonomy & Choice
Respect for Diversity
Therapeutic Partnership & Shared Responsibility
Enablement & Empowerment
Contextual Congruence
Accessibility & Flexibility

Question 22

ICFInternational Classification of Functioning was created by and reflects?

Answer 22

Created by the World Health Organization

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

Question 23

Purpose of ICF

Answer 23

Scientific basis for study
Common language
To allow comparison
To provide systematic coding

Question 24

new definations for ICF

Answer 24

Handicap
Disability
Impairment

Question 25

ICF general points

Answer 25

2001 revision broadens the horizons
“There is a widely held misunderstanding that ICF is only about people with disability; in fact, it is about all people” (WHO, 2001, p. 7)

Question 26

AOTA OT Practice Framework consists of

Answer 26

Consists of two parts: Domain and Process 
The categories include
occupations (8)
performance skills (3)
performance patterns (4)
contexts (6)
client factors (3)

Question 27

framework general points

Answer 27

The Framework Collaborative Process Model illustrates the way occupational therapists deliver services in collaboration with clients.
The client–practitioner relationship determines the flow of evaluation, intervention, and outcome.

Question 28

What is Theory?

Answer 28

A description
An explanation
A prediction
Relationships

Question 29

Kathlyn Reed: two models

Answer 29

Conceptual Models & Practice Models

Question 30

Conceptual Models explain…

Answer 30

Two types of models in OT:
1. Conceptual Models – explain WHY OT works, validate value of OT but tend to be generic and do not address specific areas of practice (Occupation Based Models)

Question 31

Practice Models explain…

Answer 31

2. Practice Models – explain HOW OT works, gives guidelines for specific types of evaluation and intervention (Frames of Reference)

Question 32

Mosey’s Model

Answer 32

“Occupational Therapy Loop”

Question 33

OT theory organization

Answer 33

paradigm –> occupation-based model –> frames of references

Question 34

a set of interrelated, internally consistent concepts, definitions, and postulates that provide a systematic description of and prescription for a practitioner’s interaction within a particular aspect of a profession’s domain of concern.”

Answer 34

Mosey’s definition of a frame of reference

Question 35

How a Frame of Reference is organized:

Answer 35

Focus
Basic Assumptions
Function-Disability Continuums
Postulates of change
Example

Question 36

Frame Organization, cont.

Answer 36

Evaluation
Each frame of reference has specific tools for evaluating the extent of function/dysfunction.

Interventions
Each frame of reference has specific strategies for intervention which have been developed and researched

Question 37

What are we doing NOW?

Answer 37

Integration!
Occupation based models – guiding principles
Frames of Reference – tools to strengthen our approach

Question 38

Theories Guide Our

Answer 38

Professional Reasoning

They help practitioners reason about:
what to assess;
how to understand occupational performance problems;
how to intervene; and
what to expect from the intervention

Question 39

The Vocabulary of Theory

Answer 39

Assumptions
beliefs that are accepted without question
Constructs
The elements of a model or theory
Principles
The relationships between the constructs

Question 40

Theories Vary in Specificity

Answer 40

Broad theories provide an overarching model or framework
Serve to organize
Do not provide precise information

Discrete theories describe specific causal relationships
Propose the specific causes
Guide specific actions

Question 41

Key Points

Answer 41

Whenever you make a decision in practice you are acting on theory, although that theory may be implicit rather than explicit.
In order to examine whether the evidence supports the validity of your theory, you need to make the key assumptions explicit.
As evidence accumulates, theory should evolve. If key assumptions of the theory are not supported by current evidence, the theory needs to be discarded.