Occupational therapist

An occupational therapist works with a client to help them achieve a fulfilled and satisfied state in life through the use of "purposeful activity or interventions designed to achieve functional outcomes which promote health, prevent injury or disability and which develop, improve, sustain or restore the highest possible level of independence."[1] A practical definition for OT can also be illustrated with the use of models such as the Occupational Performance Model (Australia), known as the OPM(A). At the core of this approach is the ideology that occupational therapists are concerned with the occupations of people and how these contribute to health.[2] Specifically it is a person's occupational performance that influences their health and personal satisfaction of their individual needs. The OPM(A) is constructed on the following definition of Occupational Performance:

The ability to perceive, desire, recall, plan and carry out roles, routines, tasks and sub-tasks for the purpose of self-maintenance, productivity, leisure and rest in response to demands of the internal and/or external environment.[3]

It can be seen that occupational performance, the roles it creates for a client, and the areas it can encompass are so far-reaching that an occupational therapist can work with a wide range of clients of various limitations who are being cared for in an array of settings.[4] Occupational therapy is about helping people do the day-to-day tasks that "occupy" their time, sustain themselves, and enable them to contribute to the wider community. It is these opportunities to "do", which occupational therapy provides, that prove important and meaningful to the health of people.[5][6]

Role

Occupational therapists (OTs) help people of all ages to improve their ability to perform tasks in their daily living and working environments. They work with individuals who have conditions that are mentally, physically, developmentally, socially or emotionally disabling. They also help them to develop, recover, or maintain daily living and work skills. Occupational therapists help clients not only to improve their basic motor functions and reasoning abilities, but also to compensate for permanent loss of function. Occupational therapists assist clients in performing activities of all types, ranging from using a computer to caring for daily needs such as dressing, cooking, and eating. Physical exercises may be used to increase strength and dexterity, while other activities may be chosen to improve visual acuity and the ability to discern patterns. For example, a client with short-term memory loss might be encouraged to make lists to aid recall, and a person with coordination problems might be assigned exercises to improve hand-eye coordination. Occupational therapists also use computer programs to help clients improve decision-making, abstract-reasoning, problem solving, and perceptual skills, as well as memory, sequencing, and coordination —- all of which are important for independent living. Occupational therapists are often skilled in psychological strategies such as cognitive behavioral therapy and Acceptance and Commitment Therapy, and may use cognitive therapy especially when introducing people to new strategies for carrying out daily activities such as activity pacing or using effective communication strategies.

Clients with permanent disabilities

Therapists instruct those with permanent disabilities, such as spinal cord injuries, cerebral palsy, or muscular dystrophy, in the use of adaptive equipment, including wheelchairs, orthotics, and aids for eating and dressing. They also design or make special equipment needed at home or at work. Therapists develop computer-aided adaptive equipment and teach clients with severe limitations how to use that equipment in order to communicate better and control various aspects of their environment.

Some occupational therapists treat individuals whose ability to function in a work environment has been impaired. These practitioners arrange employment, evaluate the work environment, plan work activities, and assess the client's progress. Therapists also may collaborate with the client and the employer to modify the work environment so that the work can be successfully completed.

With children

Occupational therapists may work exclusively with individuals in a particular age group or with particular disabilities. In schools, for example, they evaluate children's abilities, recommend and provide therapy, modify classroom equipment, and help children participate as fully as possible in school programs and activities. A therapist may work with children individually, lead small groups in the classroom, consult with a teacher, or serve on a curriculum or other administrative committee. Early intervention therapy services are provided to infants and toddlers who have, or are at the risk of having, developmental delays. Occupational therapist may specialize in the care of infants in the Neonatal Intensive Care Unit, providing developmental care, addressing specific physical problems, assessing neurological function, and providing care givers with education on the care of their infant and the specific problems of a premature infant. Specific therapies may include facilitating the use of the hands, promoting skills for listening and following directions, fostering social skills, or teaching dressing and grooming skills.

With the elderly

Occupational therapy is very beneficial to the elderly population. Therapists help the elderly lead more productive, active, and independent lives through a variety of methods, including the use of adaptive equipment. Occupational therapists work with the elderly in many varied environments, such as in their homes in the community, in hospital, and in residential care facilities to name a few. In the home environment, occupational therapists may work with the client to assess for hazards and to identify environmental factors that contribute to falls. Occupational therapists are often instrumental in assessing for appropriate wheelchairs for the elderly. In addition, therapists with specialized training in driver rehabilitation assess an individual's ability to drive using both clinical and on-the-road tests. The evaluations allow the therapist to make recommendations for adaptive equipment, training to prolong driving independence, and alternative transport options.

Mental health

Occupational therapists also work with people who have mental health problems and learning disabilities. In this work, therapists choose activities that help people learn to engage in and cope with daily life. Activities include time management skills, budgeting, shopping, homemaking, and the use of public transportation. Occupational therapists also may work with individuals who are dealing with alcoholism, drug abuse, depression, eating disorders, or stress-related disorders. The ultimate aim would be to help people to engage in a personally satisfying and socially adaptive range of occupations.

With terminally ill patients

Occupational therapists work with patients with terminal illness like cancer, Muscular dystrophy,etc. All performance areas including work, play and leisure are widely affected in these sets of patients. An occupational therapist provides various means to these patients to restore or maintain their deteriorating performance components by using their residual capacities and capabilities to give them a sense of self-importance and a measure of confidence.

With people experiencing chronic pain

Occupational therapists often work within interdisciplinary or multidisciplinary teams (professionals such as nurses and doctors) to help individuals with chronic pain develop active self-management strategies. An area of specific concern to occupational therapists is the use of time [7] but it is also common for occupational therapists to help people return to work, and to return to leisure and family activities.[8] Occupational therapists may use a variety of interventions including biofeedback, relaxation, goal setting, problem solving, planning, and carry this out within both group and individual settings.[9] Therapists may work within a clinic setting, or in the community including the workplace, school, home and health care centres. Occupational therapists may assess occupational performance before and after intervention, as a measure of effectiveness and reduction in disability.[10]

Assessment

Assessing and recording a client's activities and progress is an important part of an occupational therapist's job. Accurate records are essential for evaluating clients, for billing, and for reporting to physicians and other health care providers.

Thorough and accurate assessment ensures that Occupational Therapists select appropriate and effective interventions for their clients. Assessment in Occupational Therapy is complex and multifaceted, and is an essential component of the Occupational Therapy Process. Assessment occurs at the beginning of the Process (providing the foundation for effective treatment), at the end (evaluation). Reassessment also occurs throughout intervention.[11]

Hand therapy

Occupational Therapy also plays a major role in the rehabilitation and recovery of patients who have hand or upper extremity injuries. They play a significant role in liaising with Hand Surgeon/Orthopeadic Surgeon and patients employers or case managers in providing the best client centered rehabilitation program. Occupational Therapist treats conditions ranging from soft tissue injuries such as Tennis Elbows to nerve neuropathies such as Cubital Tunnel Syndrome/ Carpal Tunnel Syndrome. An Array of Upper Limb assessment are utilised to provide a treatment care that is effective and appropriate. Treatment modalities such as orthosis/splints, soft braces and education are some of the common treatment tool that an occupational therapist will use during treatment. Hand Therapy is a specialised field of occupational therapy and it requires therapist to be highly skilled and knowledgeable in upper limb anatomy to be able to work in this area. It is definitely an area where Occupational Therapy is famous for due to the therapeutic models that the profession practices which focus on occupation as means and ends and their aim of returning patients to them performing their daily functions.

See also

Footnotes

  1. ↑ AOTA Inc., 1994, p.1073
  2. ↑ Chapparo & Ranka, 1997b
  3. ↑ Chapparo & Ranka, 1997a, p.58
  4. ↑ Punwar, 2000, p.5
  5. ↑ Crepeau, Cohn, & Schell, 2003, pp.27-30
  6. ↑ Brown, Jessica (2006). OCCP1082 assignment. University of Sydney: Australia
  7. ↑ Liedberg, G., Hesselstrand, M., & Henriksson, C. (2004). Time Use and Activity Patterns in Women with Long-term Pain. Scandinavian Journal of Occupational Therapy, 11(1), 26-35.
  8. ↑ Persson, E., Rivano-Fischer, M., Eklund, M., Persson, E., Rivano-Fischer, M., & Eklund, M. (2004). Evaluation of changes in occupational performance among patients in a pain management program. Journal of Rehabilitation Medicine, 36(2), 85-91.
  9. ↑ Strong, Unruh, Wright and Baxter (Eds.)Pain: A textbook for therapists. 2002. Churchill Livingstone: London
  10. ↑ Carpenter, L., Baker, G. A., & Tyldesley, B. (2001). The use of the Canadian occupational performance measure as an outcome of a pain management program. Canadian Journal of Occupational Therapy - Revue Canadienne d Ergotherapie, 68(1), 16-22.
  11. ↑ Laver Fawcett, A. (2007) Principles of Assessment and Outcome Measurement for Occupational Therapists and Physiotherapists: Theory, Skills and Application. West Sussex: John Wiley & Sons Ltd.

References


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