Client-centered
It is very important that the deliverance of the occupational therapy service is client-centered. To be client-centered the occupational therapist must analyze the person as an individual. They cannot make assumptions that what works for one client will work for another. Every client has a different set of occupations that are meaningful and important to them. It is the therapist job to find out what occupations are important to the client, their likes and dislikes, family and cultural background, availability of resources/support, insurance/financial circumstances, and so on. Together the practitioner and the client develop interventions and goals that are specific to the client and geared toward success. It is a collaboration of the client's understanding and motivation towards the therapeutic process and the practitioners skilled knowledge and experience.
Evidence-Based Practice
This is the integration of research evidence into the clinical setting. It is the foundation for valid and reliable interventions and probable outcomes. The occupational therapist needs to know how to evaluate research evidence and apply it to therapeutic processes. Additionally, they should also be able to collect their own data to support the intervention process. They should use research to communicate expected outcomes of specific interventions (Crepeau et al, 2009). The American Journal of Occupational Therapy offers a wide variety of occupational specific research. This is an excellent tool for occupational therapy professionals.
Supporting health and participation in life through engagement in occupation
Sunday, October 3, 2010
Practice areas and settings
- Children & youth (Pediatrics)
- Health and Wellness
- Mental Health
- Productive Aging (Geriatrics)
- Rehabilitation, Disability, and Participation
- Work and Industry
(AOTA, n.d.)
Practice Settings
(Google Images)
- Schools
- Hospitals (Including Children Hospitals & NICU's)
- Inpatient rehabilitation
- Outpatient rehabilitation
- Home Health
- Skilled Nursing Facilities
- Assisted Living Facilities
- Private Practices
- Mental Health Facilities
- Jails
- Social Service Organizations
- Academic fields
- Homeless shelters
- VA Hospitals
(Google Images)
Occupational Therapists - Qualified Health Care Professionals
AOTA
American Occupational Therapy Association (AOTA)
(Google Images)
- U.S. member organization
- Develops and maintains standards and ethics of practice
- New York 1917 - Originally called the Society for the Promotion of Occupational Therapy
- 1927 - Name changed to AOTA
- There are a variety of leadership roles and functions of AOTA members
- National office building in Bethesda, Maryland
- Each spring the AOTA holds an Annual Conference and Exposition
FOTA
Florida Occupational Therapy Association (FOTA)
- October 7, 1977 incorporated
- Provides sources for online education, continuing education, Florida schools, Job links, information about licensure, etc.
- "The mission of FOTA is to serve as a collective body to support, develop and represent the occupational therapy profession for the advancement of the practice and to better serve the consumer" (Florida Occupational Therapy Association, n.d.).
WFOT
World Federation of Occupational Therapy (WFOT)
(Google Images)
- Occupational Therapy's official international organization
- 57 countries belong
- AOTA and other countries official associations collaborate to meet common goals and address common concerns
National & State Licensing for OTs and OTAs
National Board for Certification in Occupational Therapy (NBCOT)
- Credentialing body for OTs and OTAs
- Initial certification exam following Level II fieldwork
- Exam based on practice analysis of OTs
- Items reflect evaluation and intervention on different populations and environments
- Must have a passing score to obtain a license
- Designated OTR for occupational therapist (registered) and COTA for occupational therapy assistants (certified)
Different states have different licensure and regulation. For Florida:
The Florida Department of Health Regulates the Florida Board of Occupational Therapy
To be a Licensed Occupational Therapist (OTR/L)
- Graduated from Accredited OT program
- Completed minimum 6 months supervised fieldwork
- Passed NBCOT exam (New grads can receive temp license before exam results)
Professional Education/Credentialing:
Occupational Therapy practitioners are required to have continuing competency. Competency is indicated by credentials (licensing/registration) that tells the public that the health care practitioner is capable of providing skilled services within the scope of practice (Crepeau et al., 2009). The field of occupational therapy is continuously growing and changing. For instance, occupational therapy continues to cross a variety of disciplines, standards and protocols change, research and occupational science become more abundant, new therapeutic interventions are found effective, and new assessments show validity and reliability. Professional development is the process of learning new skills to further career (Crepeau et al., 2009). An occupational therapist can develop their professional education by taking continuing education courses, attending conferences, doing research, and continuing their formal education (such as getting a DOT).
Renewal of NBCOT to maintain intials OTR:
Collection and documentation of professional development units (Crepeau et al., 2009).
Renewal of Florida license to maintain OT/L :
- Every 2 years
- 26 hours of continuing education credits
- Approved continuing education providers at CE broker
- Detailed renewal information: here
What is the difference between OT, OTA, and OT Aides?
Occupational Therapist
Occupational Therapists have the most responsibility when it comes to assisting the client. They have a higher level of education, more academic preparation, and spent a greater amount of time doing fieldwork.
Academic preparation:
Responsibilities include but are not limited to:
Occupational Therapy Assistant
Qualified to work directly with the client under the supervision of an Occupational Therapist
Responsibilities include but are not limited to under the supervision of an OT:
Supervision:
In order to deliver services to the client, the occupational therapy assistant must be supervised by an occupational therapist. OTs must provide guidance, oversight, and ensure therapy services are safe and effective. OTs need to review documentation of services in accordance with agency and state requirements (AOTA, 2009).
Occupational Therapy Aides
Occupational Therapists have the most responsibility when it comes to assisting the client. They have a higher level of education, more academic preparation, and spent a greater amount of time doing fieldwork.
Academic preparation:
- Professional Level
- As of 2007, at least a Master's degree is required (previously BA was minimum)
- Master of Science
- Entry level - Had received a bachelor's degree in related field and/or completed prerequisite coursework
- Post-professional (to enhance OT skills) - already holds a professional degree
- Academic coursework and field work Levels I and II (6 months for level II)
- Doctorate level (not currently required)
- Professional/clinical and research
- Fewer schools offer
- Types of doctorate degrees (entry level & post-professional)
- OTD (most common) or DrOT - doctor of occupational therapy
- PhD - rehabilitation sciences
- ScD - occupational science
- Schools accreditation: ACOTE
- ACOTE is responsible for developing and implementing standards for OT's and OTA's (Crepeau, Cohn, & Boyt-Shell, 2009).
Responsibilities include but are not limited to:
- Responds to referrals
- Evaluation and screening of clients occupations
- Refers clients to other professionals/services
- Responsible for intervention process - development, implementation, modification
- Ensures documentation is within given time frames and standards
- Evaluates safety and effectiveness of process and intervention
- Responsible for determining/documenting expected or achieved outcomes related to occupations
- Facilitates collaboration with family, friends, and community
(Crepeau et al., 2009)
Supervision:
Recommended but not required; OTs are considered independent practitioners. However, many companies will have a designated supervisor. Occupational therapists are encourage to seek supervision or mentoring of an advanced OT (American Occupational Therapy Association [AOTA], 2009). New graduates or OTs with only a few years of experience are highly encouraged. Even an OT with advanced experience can benefit from seeking advice and discussing knowledge and research with another practitioner.
Occupational Therapy Assistant
Qualified to work directly with the client under the supervision of an Occupational Therapist
- Technical level
- Entry-level Associates/technical degree - usually offered at community college, junior colleges, and some 4 year universities and colleges
- Academic preparation and fieldwork (3 months Level II)
- Schools accreditation: ACOTE
Responsibilities include but are not limited to under the supervision of an OT:
- Contributed to evaluation and documentation
- Educates referral sources about occupational therapy services
- Implements and modifies therapeutic activities and interventions in areas of competency
- Reviews intervention plan with client
- Involved with collaboration of family, community, and friends
Supervision:
In order to deliver services to the client, the occupational therapy assistant must be supervised by an occupational therapist. OTs must provide guidance, oversight, and ensure therapy services are safe and effective. OTs need to review documentation of services in accordance with agency and state requirements (AOTA, 2009).
Occupational Therapy Aides
- Has on the job training and supervision.
- Roles of supplementing occupational therapy services.
- Not certified
- To support OT or OTA in non-client related tasks
- Clerical
- Maintenance activities
- Preparation of work area/equipment
- Minimum client-related tasks that are routine and will not require judgment by aide.
- Supervision is required. Occupational therapist must oversee tasks of aides. OTAs can also supervise the aide (AOTA, 2009).
(Google Images)
Saturday, October 2, 2010
8 Areas of Occupations and Examples
The American Occupational Therapy Association (2008) identifies 8 areas of occupations in the Occupational Therapy Practice Framework, 2nd ed.
1. Activities of Daily Living (ADLs)
Essential and fundamental needs to take care of oneself. Self-care activities generally include toileting, dressing, grooming, mobility, transferring, and eating. Many people perform their ADLs automatically, habitually, and easily. However, basic self-care is not easy for everyone.
Example: An elderly woman entered a Skilled Nursing Facility because she fell at home on her bathroom floor and sustained a hip fracture. She has been using a wheelchair since she entered the facility, but now is working with an occupational therapist to regain her ability to walk. She has altered gait and fatigues easily. The occupational therapist uses a walker with a gait belt to increase the functional mobility of the client, while focusing on strength and balance.
Complex activities in caring for self and others
Example: A Veteran got injured in Iraq and had to have his right leg amputated. He dislikes having to have his family drive him around because he is unable to. An occupational therapist realizes how important this is to him and assists in finding ways for him to get around the community independently.
Activities for learning including formal and informal education.
Example: An 8 year old boy has ADHD and appears to be "bouncing off the walls" while the teacher is trying to teach the class. An occupational therapist might suggest specific sensory stimulation for the child that provides comfort to him and allows him to relax and stay attentive.
Engaging in employment of volunteer activities
Example: A middle-aged man works at a factory, lifting heavy object. He entered an outpatient facility for rehabilitation due to a herniated disc. He can no longer work due to his back pain. The occupational therapist works with him to find a job that is based on his assets, likes, and limitations.
An activity that provides enjoyment. Can be organized or spontaneous.
Example: Play is usually considered a child's main occupation. Drawing with a child that has cerebral palsy can help to develop fine motor skills of the hand.
An intrinsically motivated activity that is nonobligatory.
Example: In assisting a client with anxiety disorder, it may be useful to incorporate a schedule fitted to the client's needs that includes time for a leisure activity that the client finds important, such as reading a romance novel.
Involvement and interaction with family, community, and friends.
Example: Children with autism typically have difficulty with social skills. An occupational therapist might suggest to the parent a social setting geared towards the needs of children with autism, such as horseback riding therapy.
8. Rest and Sleep
Includes preparation and participation
Occupational Therapy - Helping people do the ordinary
Occupational therapy helps to enable people from a variety of populations to perform their day to day activities that are meaningful and important to them. "Occupational therapy practitioners apply theory, evidence, knowledge, and skills regarding the therapeutic use of occupations to positively affect the client's health, well-being, and life satisfaction (American Occupational Therapy Association, 2008). Occupations can be described as everything a person does to occupy themselves. Occupations are goal-driven, unique to each individual, and constantly changing. Occupational therapy services are often provided to those with an illness, injury, or disability to help them achieve independence in their occupations. In lay terms, it is helping people do the ordinary things. When they accomplish what is ordinary it becomes extraordinary. Occupational practitioners help their clients reach their goals through evaluation and intervention. Evaluation comprises of getting to know the client, finding out what is meaningful and important occupations to them, and understanding the client's cultural, socioeconomic, and societal influences. Often assessments of client are performed to address their physical limitations, cognitive skills, and emotional condition. Their ability to perform in their occupations in analyzed and the practitioner develops an intervention. Generally, interventions are goal-directed, client-centered, and activity-based for a successful outcome.
Remember:
As the profession continues to evolve, the understanding of occupational therapy will likely continue to evolve as well.
Remember:
As the profession continues to evolve, the understanding of occupational therapy will likely continue to evolve as well.
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