OT in Community Contexts

OT in Community Contexts

• A community consists of individuals linked by shared occupational engagement and a collective sense of purpose.
• A community serves as a significant environment that either enables or restricts an individual's capacity to engage in activities.
• Community based practice: occupational therapist skills are brought into the community
• Community built practice: the practice is fuelled by the community

Community-Based Practice Skill Sets

• Skills easily transferable from clinical settings include focus on occupation, client-centeredness, clinical reasoning, education, teamwork, and advocacy.
• Skills necessitating supplementary development and experience are consultancy, autonomy, health promotion/disease prevention, networking, managing and program evaluation skills, cultural competence and sensitivity, navigating community resources, and volunteer management.

Enablement Foundations and Community Practice Challenges

• Definition of occupational therapy in community practice
• Needs and health disparities within a community and the need to prioritize these
• The Australian health and social care systems as related to new and changing systems
• Funding, resources and sustainability in community practice
• Facilitating change within the community
• Advocacy and need justification
• Complex procedures and related documentation
• Justification to those outside of allied health who control funding
• Travel demands
• Developing a base of evidence
• Support, mentoring and continuing professional development

Person-Centered Practice

• Person-centred care considers more than just a diagnosis and takes into account the social model of disability
• In person-centred care, it is important to build rapport, provide options, and treat clients with respect.
• Person-centred care prioritizes understanding the individual, working collaboratively, respecting the person as a whole, sharing authority, and promoting self-determination.
• 3 main ideas for a person-centred approach include looking at a person's biological (physical), emotional (psychological) and social well-being rather than just their condition
• Communications responsiveness to individual's values, beliefs, and environment
• Focus on empowerment while respecting patients autonomy

Benefits and Outcomes of Person-Centered Practice

Intangible results include increased client confidence, empowering them to advocate for themselves, and actively participate in their therapy.

Challenges to Person-Centered Practice

Older frameworks were designed for the mentality of doing for, not with

• Older frameworks did not suit the consumer
• Systematic- NDIS puts a monetary value on occupational therapy, previously a free service
• It can be difficult to be knowledgeable but not perceived as an expert, and to navigate consumer differences relating to individual needs, preferences and the level of agency they desire
• Navigating consumer differences where their preference outweighs physical needs

Addressing Therapy Inconsistencies

• Standardised evaluations may require neutral delivery or be irrelevant to non-Western societies.
• Contributing factors include holistic models, meaningful goal-setting, collaborative decision-making, and attentive listening.

Structuring Sessions

• Establish the encounter's goal and resources, and orient to the session format, when opening it
• Analyzing concerns, exchanging information and expertise,
• Discuss viable solutions, resolve issues, and choose the best plan of action during interventions
• End the session with a summary and an action plan

Contrasting Orientations

Person-centred practice encompasses a profound grasp of lived experience vs other-oriented perspective

• Includes change the way the process is conceived and operationalized

Instrumental Communication

• The process and sequence are shaped, and actions are directed whether within or after the session
• Directing actions is part of instrumental communication

Behavioral and Content Engagement

• Behavioral engagement includes contributions to focus and structure of the session
• Content communication includes shapings the information exchanged

Relational Communications

• Minimal encouragers are relational communication behaviours
• There's an emphasis on cultivating genuine connections in relationship between individuals and in-session dynamics

Emotional Connection

Emotional Engagement in sessions:

• Positive emotional states contribute to emotional expression, connection between parties
• Negative feelings detract from the emotional connection

Facilitating Engagement

To support clients' needs for emotional engagement:

• Focus on orientating and negotiating
• Acknowledge processing styles

Agency in Therapy

Individuals who actively seek experiences, information, and feedback demonstrate what Agency looks like

• Are reflective and actively shaping session/outcomes

Community

• It is an important environment that facilitates or inhibits the possibility to participate in occupations.
• A community includes an individual that is connected through significance and commitment.
• Community practice and traditional medical practice vary
• Community practice exists in the real world and it can promote treatment outcomes.
• The external environment and health infrastructure affect wellness and illness

Community Practice Skills

Including skills to build and develop an understanding of a communities potential

• Including those affected by ailments

Understanding and Addressing Community Needs

OTs working in community practice must build relationships of trust and respect to foster partnership

Key Aspects

• It is also important to consider cultural sensitivity
• Ensure equitable distribution and service delivery

Australian Healthcare

• Public funding comes from the government, uses taxes and social insurance
• Private funding is private health insurance
• The government develop health policies and subsidise health

My Aged Care (MAC) Program

Medicare: The government also regulates products alcohol and tobacco

Private Healthcare Insurance

Gives options outside the public system Avoid high income tax

NDIS System

• The NDIS provides supports for all kinds if disbilities
• The NDIS Is a scheme
• The NDIS provides supports for people with disabilities for their everyday

Visual Representation

Ecomaps visually symbolize information. It is about getting to know family

• Identifiers sources and reasons to use Ecomaps

NDIS Goals

Identify clients needs in their everyday lives

• Disability is information that needs information for a specific range

ECEI Approach

An NDIS approach Implemented for early interventions for a child who has a disability or delay

• Supports provided with an increase of social and economic participation

Service Providers

Health professionals support completing and providing the need for early intervention

Access Framework

Access is allowed for people even if there is no assistance from the community

Goal Planning

The clients plan will include government supports to assist meet goals

Steps from Approval

Step required are to follow clients need for a variety of needs

Strict Guidelines

Strict guidelines are in place with NDIA support

Financial Security

Those who are more equipped for financial stability may not qualify

NDIS Supports

In terms to identify what will be better and not

• As well as whether they are reasonable

A Clear Plan

There has to be a clear plan for a client to receive a client centered review

Funding of Support

Need to understand the clients individual goals to help them achieve their full potential

When a Functional capacity is lowered and when can support to provided

Assistive equipment is available

Assessment of clients

How the process should work in order to receive equipment

NIDA

Has standards of ethics to be aware

Access to Services

Services can be available but not easy to make

What To Understand

What kind of services and business is needed

What To Maintain

Maintain ethics and considerations to run a practice

Acknowledge

Acknowledge services from AHAPRA and national bodies

Models for Support

There are financial responsilibities such an to follow for different bodies or financial models

• Those that use MAC or medicare

NDIS Info

Those that fall inside NDIS can have support funded

Advocacy:

• A tool for enablement that relates to justice to uphold the client's personal and professional power
• As a core professional duty it is relevant during placement

Skills in Advocacy

It can be useful to be a good advocate, some key elements, like to listen well

• Its often requires having the ability to listen and implement change
• Can take specific challenges

How To Uphold The Ethics

Following ethical considerations

The Team

How to implement curriculum to continue development of support

What It Means To Support

What the specific terms and definitions of disability mean

What Models for Services to Provide

Are there ways to set goals well and provide help for better success and engagement.