Introduction to Occupational Therapy PDF

INTRODUCTION TO OCCUPATIONAL THERAPY Introduction to Occupational Therapy Occupational Therapy Areas of Occupation ➔ A practice that uses goal-directed activity to promote independence in function. Occupation ➔ An activity in w...

INTRODUCTION TO OCCUPATIONAL THERAPY Introduction to Occupational Therapy Occupational Therapy Areas of Occupation ➔ A practice that uses goal-directed activity to promote independence in function. Occupation ➔ An activity in which one engages Therapy ➔ Treatment of an illness or disability ➔ Various life activities including Definition of Terms activities of daily living (ADLs) , instrumental activities of daily living (IADLS), education, work, Goal play, leisure and social ➔ End toward which effort is participation. directed. Activity ➔ State or condition of being involved. Purposeful Activity Independence ➔ State or condition of being self-reliant (independent). Function ➔ Action for which a person is specifically fitted.  INTRODUCTION TO OCCUPATIONAL THERAPY ➔ An activity used during Definition of Terms intervention that is goal-directed and may or may not be viewed as Tasks meaning to the client. These ➔ Are basic units of an activity activities typically involve an end product and are goal-directed. Activities ➔ Are are parts of an occupation. It Occupational Performance can be meaningful or not. Occupations ➔ Are the many things people do that are meaningful to them. An activity should be meaningful for it to be considered as an occupation of the client. ➔ The ability to carry out activities of daily life (including activities in the areas of occupation). ➔ Capacity of an individual to do his/her occupations. Classification of Occupations ➔ These are the skills that he/she carries out in daily activities. Activities of Daily Living (ADLs) ➔ Refers to activities involved in Occupations taking care of one’s own body and include things such as dressing, bathing/showering, personal ➔ Tasks and activities or (work) hygiene and grooming, bowel and ➔ Describes many activities that bladder management, functional people do in their daily lives. mobility, eating, feeding, personal device care, toileting and sexual activity. Instrumental Activities of Daily Living (IDLs)  INTRODUCTION TO OCCUPATIONAL THERAPY ➔ Refers to activities that may be Play considered optional and involve ➔ Refers to any “spontaneous or the environment. IADLs include organized activity that provides care of others, care of pets, child enjoyment, entertainment, rearing, communication device amusement, or diversion.” use, community mobility, health ➔ OT practitioners work with clients management, financial on play exploration and management, home participation. establishment, meal preparation, ➔ Play is the main occupation of a safety and emergency child. procedures, religious activities and shopping. Leisure ➔ Refers to non-obligatory activity. Rest and Sleep This area of occupation includes ➔ Are restorative activities that planning as well as participating support healthy participation in in the activity. Exploring areas of occupations. These activities interest is considered part of include all of those tasks to get leisure occupations. ready for sleep, such as ➔ Scheduled grooming, undressing and ➔ More structured and organized establishing sleep patterns. ➔ Less spontaneous Education Social Participation ➔ An area of occupation that ➔ Refers to activities involving includes formal (school, interactions with others, university, coursework) and including family, community, and informal (obtaining topic-related peers/friends. OT practitioners information or skills, examining social participation instruction/training in areas of analyze the behaviors and interest) learning. standards for given social situations. Work ➔ Refers to paid or volunteer activities and includes the entire range of employment activities Areas of Practice and Treatment Settings such as interests, pursuits, job seeking and job performance, to Biological job retirement preparation and ➔ Refers to medical problems adjustment, as well as volunteer caused by disease, disorder or exploration and participation. trauma. OT practitioners who work in this area address loss of capacity, loss of sense,  INTRODUCTION TO OCCUPATIONAL THERAPY developmental limitations and Psychological Area Treatment Settings neuromuscular disorder. Psychological Institutions ➔ OTs who practice in this area ➔ These institutions may offer address emotional, cognitive, traditional psychiatric affective and/or personality occupational therapy programs disorder. wherein the practitioner plans ➔ Schizophrenia, dementia, bipolar, activities for the purpose of depression etc. self-care, skill development, self-awareness, leisure Sociological explorations, and social ➔ OTs in this area address client participation. issues related to failure to meet ➔ Hospitals the society. Community Mental Health Centers ➔ Such centers may offer Biological Area Treatment Settings medication clinics and counseling, crisis units, or day treatment programs at a community level. Hospital ➔ Clients in hospitals receive care Supervised Living for acute illness. They are ➔ Refers to partially or fully admitted in the hospital and supervised housing for people receive services in their wards. whose problems do not warrant ➔ In-patient care institutional care but who are not ready or able to manage their Clinics own. ➔ Clients generally service clients ➔ Home for the agent with disabling conditions on an out-patient basis. Sociological Area Treatment Settings Home Health Agencies ➔ OT practitioners in this setting provide care in the client’s home. Schools and Social Education ➔ OT practitioners in this setting assist clients in their studies and to fulfill their roles as students. ➔ Children who have developmental delays ➔ e.g., autism, attention hyperactivity disorder, cerebral palsy, down syndrome etc.  INTRODUCTION TO OCCUPATIONAL THERAPY Day Treatment ➔ An OT should be empathic with ➔ OTs in this setting provide the client to improve client’s daytime supervision to clients engagement in their occupations who are able to live in the while expecting and demanding community but require some effort from them. assistance. ➔ Interactual homes Have a interest in teaching ➔ OT practitioners educate clients Workshops and stakeholders all the time. ➔ OTs provide special workshops for ➔ Educate people who are not able to seek employment in a competitive job Be committed and dedicated market. ➔ OT is a lifelong profession. An OT practitioner is never finished with education but must always invest The OT Practitioner (Personality Traits of an OT) in growing with the field and continually maintaining competency. An OT Should… ➔ Certification or specialization Be a people person courses in the field of OT. ➔ An OT should have a desire to help others. ➔ An OT should be able to relate to both individuals and small groups. Levels of An OT Practitioner ➔ An OT should appreciate diversity and people’s ability to change. ➔ Need to be more sociable Occupational Therapy Practitioner ➔ Is an umbrella term that refers to Be a resourceful and creative two levels of clinicians. ➔ An OT should be creative and are skilled problem-solvers Occupational Therapist ➔ An OT should be able to handle ➔ An OT has more extensive their personal problems and education and training in theory feelings before trying to help and evaluation. others— just like other healthcare ➔ In the PH, an OT should have a professionals bachelor's degree in Occupational ➔ An OT should be able to find new Therapy and is a registered ways of doing things and licensed occupational therapist flexibility in approaching under PRC. situations. Occupational Therapist Assistant Be empathic (OTA)  INTRODUCTION TO OCCUPATIONAL THERAPY ➔ Occupational Therapy Technician or Occupational Therapy Aide. Supervisor ➔ An OTA performs at the technical ➔ Manages the overall daily level of practice and works under operation of OT services in the supervision of an OT. defined practice areas. ➔ An OTA can only perform ➔ Scheduling, decking, inventory. intervention methods prescribed by an OT and cannot perform Administrator evaluations. ➔ Manages department, program, ➔ An OTA can only practice in an services or agency providing area he/she is trained with. occupational therapy services. ➔ Policy making, program development of a clinic or an Roles and Responsibilities of an OT institution. Consultant Different OT Roles: ➔ Provides occupational therapy consultation to individuals, OT Practitioner groups or organizations. ➔ Provides evaluation, intervention, ➔ Hourly consultation program planning and discharge planning services. Academic Fieldwork Educator ➔ Manages student fieldwork OTA Practitioner programs within the academic ➔ Provides intervention services setting. under supervision of an OT. ➔ Employed to a university that offers an OT program. Educator ➔ Develop and provide education Faculty offering to OT clients, peer and ➔ Provides formal academic community individuals or groups. education for OT or OTA students. ➔ Employed to a university that Fieldwork Educator offers an OT program. ➔ Provides OT students with ➔ Curriculum opportunities to practice and carry out practitioner Academic Program Director competencies. ➔ Manages the educational program ➔ Referred most of the time to for OT or OTA students. clinical preceptors/supervisors ➔ Intermediate level OTs that Researcher/Scholar trained/teach entry level OTs or ➔ Performs scholarly work of the OT interns and OT students profession, including examining, ➔ Hospital, clinic developing, refining and  INTRODUCTION TO OCCUPATIONAL THERAPY evaluating the profession’s body ➔ Refinement of specialized skills of knowledge, theoretical base, ➔ Understanding of complex issues philosophical foundations. affecting role functions. Entrepreneur ➔ Entrepreneurs are partially or fully self-employed individuals who provide occupational therapy services. OT Responsibilities ➔ Built their own clinic ➔ Employ other employees ➔ Selling toys or worksheets Evaluation: Occupational Therapist ➔ Directing evaluation process. Levels of Performance ➔ Delegates tasks to OTAs. Occupational Therapist Assistant Level 1: Entry Level ➔ Contributing to the evaluation process by implementing delegated assessments. (fresh graduates and newly licensed OTs) ➔ Development of skills Intervention Planning: ➔ Socialization in the expectations Occupational Therapist related to the organization, peer ➔ Overall development of the OT and profession. intervention plan. ➔ More responsible Level 2: Intermediate Level Occupational Therapist Assistant ➔ Provides input in the development of the intervention plan. ➔ Increased independence ➔ Mastery of basic role functions Intervention Implementation: ➔ Ability to respond to situations Occupational Therapist based on previous experience ➔ Overall Implementation of the ➔ Participation in the education of intervention plan. personnel ➔ Providing supervision to the OTA while implementing the Level 3: Advanced Level intervention plan. Occupational Therapist Assistant ➔ Knowledgeable about the client’s OT goals.  INTRODUCTION TO OCCUPATIONAL THERAPY ➔ Selecting, implementing and modifying therapeutic activities and intervention relative to the practice setting. Intervention Review: Occupational Therapist ➔ Determining the need for continuing, modifying or discontinuing occupational therapy service. Occupational Therapist Assistant ➔ Contributing to this process by exchanging information with and providing documentation to the OT about the client’s responses to and communications during intervention. Outcome Evaluation: Occupational Therapist ➔ Selecting, measuring and interpreting outcomes that are related to the client’s ability to engage in occupations. Occupational Therapist Assistant ➔ Being knowledgeable about the client’s targeted OT outcomes and providing information and documentation related to outcome achievement. ➔ Implementing outcome measurements and providing needed clients discharge resources.  INTRODUCTION TO OCCUPATIONAL THERAPY Occupational Therapy Across Lifespan Infancy: 0-2 years old and Therapeutic use of occupations and activity. 4. Consulting Exploration phase: ➔ Explores self and environment. Childhood: Early Childhood: 4-6 years old Motor milestone: ➔ Integration of primitive reflexes. Competency phase Oral motor control: Differentiates choices based upon ➔ Learning to eat different textures inner images and types of food. Fluctuates in behavior Refinement skills Fine motor development: Symbolic and Fantasy play ➔ Holding and releasing objects, Learns sex differences picking up objects. Learns concepts of social and physical reality Social trust develops; smiling and Relates emotionally as they interaction with others. distinguish right from wrong while developing their conscience. Regulates sleep/wake cycle. Engages in solitary play and sensory movements. Childhood: Late Childhood: 7-12 years old Common Diagnoses Achievement stage: ➔ Children enter their student role, increase concern for standards of 1. Motor abnormalities performance and academic skills. 2. Developmental delays 3. Congenital anomalies Develops concepts of everyday living. Learns physical skills for ordinary games Intervention Increases speed, accuracy and coordination Learns to have a good 1. “Close the gap”. relationship with peers 2. Use of Developmental frame of Learns appropriate masculine or reference feminine social role 3. Family Develops conscience, morality ➔ Centered care Direct intervention and scale of values include: Therapeutic use of self Separates from family environments  INTRODUCTION TO OCCUPATIONAL THERAPY Develops wholesome attitude Common Diagnoses toward self, social groups and institutions 1. Mental health issues and psychological disorders Common Diagnoses 2. Intellectual disorder 3. Adolescence with physical disabilities Intervention 1. Neurodevelopmental disorders 2. Intellectual disorder 3. Developmental coordination Vocational Rehabilitation delays such as down syndrome and cerebral palsy 1. Assisting the adolescence in transitioning to high school or Intervention with work readiness. 2. Requiring firm limits, choice, understanding and positive role 1. Play Development models. Adolescence: 10-19 years old Intervention Learns habits 1. Aware of the client’s motivation Role transition and goals. Selects and prepares for 2. Group therapy occupation 3. Adapting tasks Develops more mature 4. Work-related activities relationships as they prepare for marriage and family life Acquires set of values and ethics Transition from adolescence to adulthood Desires and achieves socially responsible behavior Puberty is the most important “Early adulthood is the developmental marker of the beginning of period for establishing personal and adolescence. Masculine/feminine economic independence, advancing in a social roles are defined. career, and building a more intimate Acceptance of one’s physique relationship to start a family." (Santrock, Achieves assurance of economic 2011) independence. Develops intellectual skill and "Early adulthood is characterized by concepts necessary for civic peaking biological development, the competencies assumption of major social roles, and the evolution of an adult self and life structure." (Sadock et al., 2007)  INTRODUCTION TO OCCUPATIONAL THERAPY Young Adulthood: 22 to 40 years old ongoing emotional turmoil for the individual. Establishing and maintaining an Functioning independently as economic standard of living they select and establishing a Assisting teenaged children to career. become responsible, happy adults Formation of signiFIcant Adult leisure activity relationships Accepting and adjusting to Development of self-identity physiological changes Acceptance of parents’ Adjusting to aging parents limitations Sandwich generation Personal grooming and hygiene Empty nest syndrome is the Managing a home process that middle adults Establishing a family and Child undergo as a result of their child's rearing. absence. ➔ Average age of marriage is 28 for ➔ It may include a decline in males and 26 for females. marital satisfaction. It can also be Therefore, emerging adulthood is the time to increase marital the time frame in which most satisfaction as partners have time individuals are both sexually to pursue career interests and active more time for each other. ➔ "Refilling" of the empty nest Emerging adults have few chronic happens when young adults move health problems. However, there back to their parents after an are cases that show emerging unsuccessful career or divorce. adults are not as healthy as they seem due to: Ongoing Financial responsibility 1. Inactivity/ Lower levels of Woman lose capacity to bear physical activity children 2. Eating more fast food/ Less intake of fruits and vegetables 3. Unhealthy weight control Common Diagnoses Middle Adulthood: 45- 60 years old 1. Heart disease is the leading cause of death worldwide followed by stroke and COPD. Carl Jung referred to middle ➔ In the US, heart disease is adulthood or the midlife as the followed by cancer as the leading afternoon of life and it serves as cause of death. an important preparation for late 2. Chronic disorders increase among adulthood/ evening of life. middle adults and become Legacy common in late adults. Midlife crisis is the major, 3. Neurological impairments revolutionary turning point in life 4. Orthopedic disabilities involving changes in commitments 5. Psychological disturbances to career, or spouse or both and accompanied by significant  INTRODUCTION TO OCCUPATIONAL THERAPY Intervention 8. Risk for having diseases of the eye such as: a. Cataracts 1. Re-engage in meaningful ➔ involve thickening of the lens of occupations. the eye that leads to cloudy, ➔ This involves examining opaque, and distorted vision. neuromusculoskeletal, social, b. Glaucoma psychological and cognitive ➔ involves pressure created by a aspects of occupations. buildup of fluid in the eye. c. Macular degeneration ➔ involves deterioration of the macula. Late Adulthood: 65- 84 years old Intervention Adjustment to: 1. Life review 2. Decreasing physical strength and 1. Safety in the home and health community ➔ Shorter due to decrease in bone 2. Wellness programs density in the vertebrae. 3. Learned helpless ➔ Weight drops due to decreased muscle bulk which gives the sagging look Generations ➔ Percentage of fat increases. ➔ Retirement and reduced income ➔ Death of spouse and peers Generation W ➔ One’s own impending death Wrinkles and age spots are the most noticeable changes in late adults. Baby Boomers Establishing affIliations with age 1946 - 1964 (1949 - 1961) groups ➔ Baby boomers are said to be Meeting social obligations healthier, wealthier, better Volunteerism educated and more political Independent living savvy. ➔ Born after World War II and just entering old age, have greater expectations of themselves and Common Diagnoses society. ➔ Gender roles were more traditional than they are now. 1. Alzheimer’s disease Fewer women worked outside the 2. Parkinson’s disease home. More parents dressed and 3. Stroke treated girls and boys differently. 4. Cardiac conditions 5. Pulmonary 6. Rheumatoid arthritis 7. Diabetes  INTRODUCTION TO OCCUPATIONAL THERAPY Generation X ➔ Better multi-taskers as compared to previous generations. Baby Bust , MTV Generation 1965 - 1980 ➔ Called the baby bust generation due to the drop of birth rates after the baby boom generation. ➔ The first generation to experience the emergence of music videos as teenagers. ➔ Described as active, balanced, and happy as they were able to achieve work-life balance. Generation Y Millennials 1981 - 1996 ➔ Described as “Lazy Narcissistic and prone to jump from one job to another." ➔ They are more civically and politically disengaged, more focused on materialistic values, and less concerned about helping the larger community. ➔ Regarded as being more open minded and more supportive of gay rights and equal rights for minorities. ➔ Confident, self-expressive, liberal, upbeat, and receptive to new ideas and ways of living. Generation Z igeneration/ igen 1997 - 2010 ➔ Defined by competitiveness as they want to work on their own and be judged on their merits rather than those of their team.  INTRODUCTION TO OCCUPATIONAL THERAPY Trends of Practice, Professional such an association from three other countries. Organizations, Laws in relation to ➔ These ten founding associations Occupational Therapy from Australia, Canada, Denmark, India, Israel, New Zealand, South Africa, Sweden, United Kingdom (England and Scotland), United Employment Settings States of America, inaugurated the WFOT. 1. Pediatric Care Is the official international 2. Adult Physical Dysfunction organization representing the 3. Adult Psychosocial Dysfunction occupational therapy profession. 4. Academe and Research Collaborating with many partners in our work and have been in official relations with the World Professional Organizations Health Organization since 1959. Recognized by united nations by 1963 International Council meetings every 2 years 1. World Federation of Occupational ➔ Joint International Congress and Therapists, Inc. (WFOT) council meetings every 4 years. Local 1. Philippine Academy of Philippine Academy of Occupational Occupational Therapists, Inc. Therapists, Inc. (PAOT) (PAOT) 2. Occupational Therapy Students Assembly (OTSA) “The organization safeguards and 3. Professional Regulation promotes the profession in the Commission (PRC) local context and in accordance with the laws of the Republic of the Philippines to create impact World Federation of Occupational Therapists, Inc. to the Filipino society; while fostering a strong fellowship and (WFOT) unity among our members and chapters, and acting as a consultative body in all matters First meeting in England by June pertaining to the profession.” 1951 Established in 1965 Established in Liverpool Formerly the Occupational ➔ England in 1952, attended by Therapy Association of the representatives from seven Philippines (OTAP) countries with occupational therapy associations or Changed its name to Philippine organizations and written Academy of Occupational approval for the organization of Therapy,  INTRODUCTION TO OCCUPATIONAL THERAPY ➔ Incorporated (PAOT) on August Occupational Therapy Students Assembly 19, 2015. (OTSA) Goal: ONE - 2025 0.5 OTs per 10,000 Filipino stakeholders by the year 2025. The official student-arm of PAOT Membership Types: that is composed of OT students a. Regular from all over the Philippines ➔ Graduate of an OT school, holds a diploma in OT, licensed OT, paid membership fee. Professional Regulation Commission (PRC) b. Lifetime member ➔ Regular member for at least 5-10 Professional Regulatory Board of consecutive years and has paid Occupational Therapy. the due stipulated by the board 1 Chairperson, 2 Board Members appointed by the President of the c. Affiliate member. Philippines. ➔ OTS of foreign countries and I. Enforce rules and regulations of members of the OT association in the law. their colleges, OTAP members II. Investigate any violations to the who are residing or working law. abroad and have paid dues III. Oversee registration and regularly. licensure, administer exam IV. Prescribe criteria for CPD d. Honorary member programs. ➔ People who are concerned and V. Ensure compliance to CHED contributed to the advancement policies. of OT in the Philippines, members VI. Grant registration without of the rehabilitation team, examination. humanitarian group and civil VII. Issue a special temporary permit. service. e. Graduate member Qualification of Board Examiners: 3 ➔ Those graduate OTS who are still years as examiner unlicensed. I. Filipino citizenship of at least 5 f. Student years. ➔ Enrolled in an OT school, paid II. At least 35 years old for membership fees. chairmanship, 30 years old for members. g. Technical III. Of good moral character, no ➔ Without a bachelor's degree. conviction of crime involving moral turpitude. IV. A physiatrist if he is a chairman, or with bachelor's degree with at least 5 years of experience, not a faculty of any school conferring a degree in PT/OT.  INTRODUCTION TO OCCUPATIONAL THERAPY Qualification of board examinee: PRC validated for 3 years I. 75% (< 60% section) II. Citizen of Philippines III. At least 21 years old IV. Received Pt/OT degree school recognized by the government V. Completed a 9 month internship Process To Take Before Entering Practice The Philippine OT Law of 2018: RA 11241 1. Apply for the licensure exam 2. Take and pass the licensure exam Republic Act (RA) 11241 3. Register as an occupational therapist 4. Take an oath An Act Regulating the 5. Hold a Professional Identification Registration, Licensure, and Card (PIC) and a Certificate of Practice of Occupational Therapy, Registration (COR) Providing Funds Therefore and for. Date approved: March 11, 2019 A Person Can Practice Occupational Therapy If Date of publication: March 19, She/He: 2019. Republic Act 5680 The Philippine PT - OT Law (June 21, 1969) 1. Passed the OT Licensure Exam Main government body 2. Take an OATH for OT Professional Regulation 3. Has a valid registration as an OT Commission (PRC) 4. Has a Valid PIC Only graduates of Bachelor of Science in Occupational therapy programs offered by higher Responsibilities of an Occupational Therapist education institutions recognized by CHED are qualified to take the examination. 1. Maintain a valid professional Foreign-licensed OTs engaged as identification card. professors, lecturers, or critics 2. Abide by the OT code of ethics may apply for a Special 3. Abide with the requirements, Temporary Permit (STP). rules, regulations and continuing professional development. Scope of Examination for 4. Signed documents pertinent to occupational therapists covers the practice of an OT w/ required basic sciences and health science notations. foundations integrated in the 5. Pay membership fees and dues following domains: required by accredited and integrated professional organizations to receive all the  INTRODUCTION TO OCCUPATIONAL THERAPY benefits and privileges of a doing, making friends member. Impairment: ➔ Any loss, diminution, or Prohibitions: Those who cannot practice OT aberration of psychological or physiological function with or without an accompanying 1. A board passer with suspended or anatomical structural defect. revoked certificate of ➔ Eg: Partial loss of sight, registration. amputated leg, deaf hearing loss, 2. A board passer with an expired license. Disability: 3. A graduate of a bachelor’s degree ➔ Interaction between persons with in occupational therapy. impairments and attitudinal and 4. An individual who uses another environmental barriers that person’s: hinders their full and effective a. Certificate of Registration (COR) participation in society on an and/or a valid. equal basis with others b. Professional Identification Card Psychosocial and Behavioral (PIC), disabilities. c. or a Special Temporary Permit ➔ Eg: Visual disability, movement, (STP). mobility, communication skills, social interaction skills: I. Chronic illnesses with disabilities Laws Encompassing the OT Practice in II. Learning disabilities the Philippines: RA 7277 III. Mental disability IV. Visual/seeing disability RA 7277 – Magna Carta Of The Disabled Person V. Orthopedic/moving disabilities VI. Communication disabilities VII. Hearing Disability An Act Providing For The Rehabilitation, Self-Development And Self-Reliance Of Disabled Government body in charge: DOH Person And Their Integration Into DSWD DECS DOLE NCWDP The Mainstream Of Society And ➔ DOH is the main government body For Other Purposes in charge. Categorized PWDs are “those Fracture not included, delays not suffering from restriction of included unless GDD different abilities, as a result of a mental, physical, or sensory Discounts impairment, to perform an ➔ 20% on lodging, restaurants, activity in the manner or within theaters, medicines, medical and the range considered for a normal dental services (professional human being”. fees), domestic travel, toll fees ➔ 5% on basic necessities and prime Handicap: commodities. ➔ Eg: difficulties in actual use, difficulty climbing, cooking, Employment opportunities  INTRODUCTION TO OCCUPATIONAL THERAPY Laws Encompassing the OT Practice in ➔ All government agencies shall reserve at least 1% of all positions the Philippines: BP 344 for PWDs. ➔ Private corporations with more BP 344 or the Accessibility Law than 100 employees are encouraged to reserve at least 1% of all positions for PWDs. An Act to Enhance the Mobility of Disabled Persons by Requiring Other privileges Certain Buildings, Institutions, ➔ Express lanes in all commercial Establishments, and Public and government establishments. Utilities to Install Facilities and ➔ PWD-friendly public attorneys, Other Devices. accessible voter's registration. DPWH and DOTC (dept of ➔ Persons with Disability Affairs transportation and Office in every province, city, and communication). municipality. NCWDP/ National Council of the Welfare of Disabled person Laws Encompassing the OT Practice in Now: Council on Disability Affairs the Philippines: RA 9442 Scope: 1. Private and public buildings RA 9442 – “Magna Carta For Disabled Persons, (constructed, repaired, or renovated) And For Other Purposes” 2. Streets and highways 3. Public transport vehicles 4. Public telephones An Act Amending Republic Act No. 5. Public transport terminals 7277, Otherwise Known As The “Magna Carta For Disabled Basic Physical Planning Persons, And For Other Requirements: Purposes”. 1. Accessibility 2. Reachability ➔ An act amending magna carta 3. Usability that grants additional privileges 4. Orientation for persons with disability. 5. Safety ➔ July 24, 2006 6. Work ability and efficiency ➔ Government body in charge: Department of finance, BIR, Accommodations on public DSWD, NCDA (the department to transport: be reported to once 20% discount ➔ Airplanes: 2 PWDs is not granted). ➔ Regular buses: 5 PWD ➔ The barangay captain and/or ➔ Aircon buses: 4 PWD mayor signs the PWD card. ➔ Jeepneys: 2 PWDs ➔ PWD cards can be claimed in the ➔ Trains: 6 PWDs barangay/city hall. ➔ Airplane, regular bus, aircon bus, ➔ Miscellaneous fees not included. trains entrance and exit Jeepneys: beside the driver Auditorium Seating:  INTRODUCTION TO OCCUPATIONAL THERAPY a. 4 – 50: 2 for PWDs ➔ Female: circle b. 51-300 : 4 c. 301-500:6 Ramps ➔ 1: 12 (height : run) inches max Railings ➔ 0.9 m , 0.7 m 4. Outswinging doors ➔ required in: I. Closet II. Storage area III. Washrooms IV. Toilet ➔ Too crowded in space and won’t be able to help the person. Parking space: ➔ Minimum width:3.7 m ➔ Minimum length: 5 m ➔ For every 25 cars: 1 for PWD ➔ Walkway: 1.2 m width Stairs ➔ Riser: 150 mm ➔ Tread: 300 mm ➔ Preferably slanted ➔ not projected nosings ➔ Tactile strip: 0.3 mm Washroom ➔ 1.7 x 1.8 m Toilet ➔ Max height of lavatory: 0.8 m ➔ Max height of toilet seat = 0. 45 m ➔ Flush = 1.20 m from floor ➔ Max height water closet = 0.45 m ➔ 1:20 (for every 20 stalls, 1 disabled) For visually impaired females, the sign should be placed ➔ Male: equilateral triangle with vertex pointing upward.  INTRODUCTION TO OCCUPATIONAL THERAPY Philosophical Principles and Values in Occupational Therapy Philosophy they desire. ➔ Open system - Continuous interaction between person and A set of basic principles and environment. concepts underlying somebody’s practice or conduct. c. Humans As Occupational Beings e.g., Lasallian Philosophy, Occupations Thomasian Philosophy ➔ Refers to the ordinary and familiar things that people do everyday. Professional Philosophy ➔ Should be meaningful to a person. ➔ Contributes to well-being. A set of values, beliefs, truths Redefining Occupations and principles that guide the ➔ Areas of Occupation practitioner’s actions. ➔ Performance Skills It is where theories, models of ➔ Client Factors practice, frames of reference, ➔ Performance Patterns and intervention approaches that ➔ Environment and Context guide OT practice are derived ➔ Activity Demands from. Occupational Profile 3 Areas of Concern Occupational Performance 1. Metaphysical 2. Epistemology 3. Axiology Epistemology Metaphysical How individuals acquire knowledge. Related to the nature, origin and Questions concerned with the limits of human knowledge. nature of humankind. - How do we know things? a. Holistic view of humankind - How do we do things? ➔ Views a person, not by part, but as a whole. a. Human Learning ➔ A dynamic and harmonious Learning through experiences interaction of biological, ➔ Feeling psychological, sociocultural and ➔ Thinking spiritual elements. ➔ Doing Sense of time b. Humans As Active Beings ➔ Past, present, future ➔ Can Control and Determine their Creating opportunities for own behavior and change it as learning  INTRODUCTION TO OCCUPATIONAL THERAPY ➔ Using purposeful activities to ➔ Develop greater independence in improve or maintain health. the performance of any area of Activities occupational behavior. ➔ General class of human actions that are goal directed. Example: b. Humanism Basketball A belief that a client should be Task treated as a person, not an ➔ Basic units of behavior object. ➔ Simplest form of action From the humanistic perspective ➔ e.g., Throwing a ball emerged the core values of OT practice: b. Occupation as Means and End 1. Altruism Occupation as a means 2. Equality ➔ Use of a specific occupation to 3. Freedom bring about change in the client’s 4. Justice performance. 5. Dignity ➔ May be equivalent to activity. 6. Truth Occupation as an end 7. Prudence ➔ Desired outcome or product of intervention. c. Core Values of OT Practice ➔ It is derived from the person’s Altruism values, experiences and culture. ➔ Unselfish concern for the welfare of others. c. Human’s Potential for Adaptation Equality Adaptation ➔ Treating all individuals equally ➔ A change in function that ➔ Attitude of fairness and promotes survival and self impartiality actualization. ➔ Respecting each individual’s ➔ Promotes mastery to the beliefs, values, and lifestyle. environment which contributes to a feeling of competency. Freedom ➔ Utilizes “...feedback from both ➔ An individual’s right to exercise human and non-human objects.” choice and to demonstrate End Goal: Competence and independence, initiative and Intrinsic Worth self-direction. ➔ Provide support and encouragement to nurture Axiology inherent potential. ➔ Less controlling and directing, more nurturing. a. Client-centered Care The client, his/her family and Justice significant others as active ➔ All OT practitioners should abide participants throughout the by the law that governs the therapeutic process. practice and to respect the legal ➔ Identifies goals and preferences rights of the client. for treatment. End Goal: Improve quality of life  INTRODUCTION TO OCCUPATIONAL THERAPY Dignity ➔ Emphasis is given to the uniqueness of each individual. ➔ Empathy and respect for each person. Truthfulness ➔ Behavior should be accountable, honest, accurate and maintain professional competence. Prudence ➔ Ability to demonstrate sound judgment, care and discretion. Derived from these core values are the professions: 1. Standards of Practice 2. Code of Ethics  INTRODUCTION TO OCCUPATIONAL THERAPY Standards of Practice technician must receive supervision and guidance from a registered occupational therapist Standards of Practice in the Philippines 6. Shall provide direct and indirect services in accordance with OTAP’s standards and policies. Philippine Academy of 7. Shall maintain current knowledge Occupational Therapists, Inc. of legislative, political, social, (PAOT) cultural issues that affect the ➔ Recommended guidelines to assist profession. occupational therapy practitioners in the provision of OT services. Referral ➔ Minimum standard of OT practice. ➔ Composed of 10 standards applicable to registered OT and 1. Shall accept referrals in OT technicians. accordance with OTAP’s Statement of Occupational Requirements for occupational Therapy Referral therapists for the delivery of 2. May accept referrals for services. assessment or assessment with Level of practice that expects intervention in performance members to abide by and follow. areas, performance components, May be used as an aid to or performance contexts when discussions in the workplace. individuals have or appear to Demonstrates the value and have dysfunctions or potential for uniqueness of your professional dysfunction. contribution. 3. May accept cases within the parameters of the law. 4. Shall assume responsibility for Professional Standing determining the appropriateness of the scope, frequency, and duration of services within the 1. Maintain a current license, parameters of the law. registration, or certification as 5. Shall refer individuals to other required by the law. appropriate resources when the 2. Practice and manage occupational therapist determines that the therapy programs in accordance knowledge and expertise of other with applicable national laws and professionals is indicated. 6. Shall regulations. educate current and potential 3. Maintain and abide by PAOT’s referral sources about the process Occupational Therapy Code of of initiating occupational therapy Ethics. referrals. 4. Maintain and update professional knowledge, skills, and abilities through appropriate continuing education or in-service training or higher education. 5. Certified occupational therapy  INTRODUCTION TO OCCUPATIONAL THERAPY Screening results in the individual’s records, noting the specific evaluation methods and tools used. 1. Shall conduct screening to 8. Shall complete and document determine whether intervention results of occupational therapy or further assessment is necessary assessments within the time and to identify dysfunctions in frames. occupational performance areas. 9. Shall communicate assessment 2. Shall screen independently or as a results, within the boundaries of member of an interdisciplinary client confidentiality, to the team. appropriate persons. 3. Shall select screening methods 10. Shall refer the individual to the that are appropriate to the appropriate services or request individual. additional consultations if the 4. Shall communicate screening results of the assessments results and recommendations to indicate areas that require appropriate individuals. intervention by other professionals. Assessment Intervention Plan 1. Shall assess an individual’s performance areas; conduct 1. Shall develop and document an assessments individually/part of a intervention plan based on team of professionals. analysis of the occupational 2. Shall educate the individual, or therapy assessment data and the the individual’s family or legal individuals expected outcome guardian, as appropriate, about after the intervention. the purposes and procedures of 2. Goals: clear, measurable, the occupational therapy behavioral, functional, and assessment. appropriate to the individual’s 3. Shall select assessment to needs, personal goals and determine the individual expected outcome after functional abilities and problems intervention. 4. Occupational therapy assessment 3. Occupational therapy methods shall be appropriate to intervention plan shall reflect the the individual; may include some philosophical base of combination of skilled occupational therapy; should observation, interview, record include: review, or the use of standardized ➔ Formulating a list of strengths or criterion- referenced tests. and weaknesses. 5. Shall follow accepted protocols ➔ Estimating rehabilitation when standardized tests are used potential. 6. Shall analyze and summarize ➔ Identifying measurable short term collected evaluation data to and long-term goals. indicate the individual’s current ➔ Collaborating with the individual, functional status. family members, other 7. Shall document assessment caregivers, professionals and  INTRODUCTION TO OCCUPATIONAL THERAPY community resources. with changes in the individual’s ➔ Selecting the media, methods, response to the intervention. environment, and personnel 8. Shall document the occupational needed to accomplish the therapy services provided, intervention goals. including the frequency and ➔ Determining the frequency and duration of the services within duration of occupational therapy the time frames. services. ➔ Identifying a plan for reevaluation. Transition Services ➔ Discharge planning 4. Shall prepare and document the 1. Shall provide community- intervention plan within the time referenced services, as necessary; frames according to the standards to identify occupational established. performance needs related to transition. 2. Shall participate in preparing a Intervention formal individualized transition plan based on the individual’s needs and shall assist in the 1. Shall implement a program fulfillment of life roles through according to the developed activities in such a plan. intervention plan. 3. Shall facilitate the transition ➔ The plan shall be appropriate to process in cooperation with the the individual individual and the multidisciplinary team or other 2. Shall implement the intervention community support systems. plan. 4. Shall determine the effectiveness 3. Shall be knowledgeable about of transition programs and the relevant research in the extent to which individuals have practitioner’s area of practice; achieved desired transition ➔ shall interpret research findings outcomes. as appropriate for application to the intervention process. Discontinuation 4. Shall educate the individual, the individual’s family or legal guardian in activities that support 1. Shall discontinue service when the established intervention plan. the individual has achieved 5. Shall maintain current predetermined goals or has information on community achieved maximum benefit from resources relevant to the practice occupational therapy services. area of the practitioner. 2. Shall prepare and implement a 6. Shall periodically reassess and discharge plan that is consistent document the individual’s level of with occupational therapy goals; functioning. ➔ Shall address appropriate 7. Shall formulate and implement community resources for referral program modifications consistent for psychosocial, cultural, and  INTRODUCTION TO OCCUPATIONAL THERAPY socioeconomic barriers and limitations that may need modification. 3. Shall document the changes between the initial and current states of functional ability and deficit in performance areas. 4. Shall allow sufficient time for the coordination and effective implementation of the discharge plan. 5. Shall document recommendations for follow-up or re-evaluation when applicable. Continuous Quality Improvement 1. Shall monitor and document the continuous quality improvement of practice. 2. Shall monitor all aspects of individual occupational therapy services for effectiveness and timeliness; ➔ must be justified by peer review or other appropriate means within the practice setting. 3. Shall systematically assess the review process of patient care to determine the success or appropriateness of interventions. Management 1. Shall provide the management necessary for efficient organization and provision of occupational therapy services.  INTRODUCTION TO OCCUPATIONAL THERAPY Code of Ethics Code of Ethics truth. Fidelity Provides OT practitioners ➔ Faithfulness in professional guidelines to help them recognize relationships between the OT and resolve ethical dilemmas, to practitioner and his/her practice at expected standard colleagues. using guiding principles, and to educate the public. PAOT: 6 principles AOTA: 7 principles Ethical Principles Beneficence ➔ OT practitioners shall contribute to the good health and welfare of the client. Nonmaleficence ➔ OT practitioners should not inflict harm on the client. Autonomy and Confidentiality ➔ Freedom to decide or freedom to act. ➔ Information should be private and exclusive. ➔ Informed Consent Social Justice ➔ OT Practitioners shall provide services in fair and equitable manner. Procedural Justice ➔ OT Practitioners are obligated to comply with the laws and regulations that guide the profession. Veracity ➔ Refers to the duty of the health care professional to tell the  INTRODUCTION TO OCCUPATIONAL THERAPY History of Occupational Therapy William Rush Stuntin Jr. William Tuke (1732 - 1822) ➔ Father of Occupational Therapy ➔ Founded a place called the York ➔ Psychiatrist Sheppard Asylum in Retreat in 1796 Baltimore. ➔ He began to implement the moral ➔ Started a course for nurses arts treatment approach. and crafts as a means of habit training. ➔ Book: Prescribing Occupational Therapy Benjamin Rush (1746-1813) The Moral Treatment Movement ➔ Believed that all people are entitled to compassion. ➔ Also promoted moral treatment. ➔ Establishing a structure and engaging in work tasks promoted better health. ➔ Signed the declaration of independence. ➔ “Father of American Psychiatry”. Philippe Pinel (1745 - 1828) Dr. Herbert Hall (1870 - 1923) ➔ First activists ➔ Took over an insane asylum after ➔ Arts and Crafts Movement (1880 - the French Revolution. 1910) ➔ First to organize programs of ➔ Pottery, weaving and carpentry activity and occupation. workshop ➔ To treat hysteria and neurosis and neurasthenia, — chronic fatigue syndrome ➔ Through progressive and graded manual occupation.  INTRODUCTION TO OCCUPATIONAL THERAPY George Edward Barton (1877 -1923) Eleanor Clarke Slagle (1871 - 1942) ➔ Was the one who coined the term ➔ Mother of Occupational Therapy occupational therapy. ➔ Mental Hygiene Movement ➔ Used therapeutic occupation on ➔ Promoted the idea of Habit himself. Training: replace lost or bad ➔ Consolation House habits with new positive ones. ➔ Developed “National Society for the Promotion of Occupational Therapy” — March 15, 1917 Thomas Bessell Kidner (1866 - 1932) ➔ Recognized the connection of occupational therapy with vocational rehabilitation by way of his position as vocational secretary. Susan Johnson (1876 - 1932) ➔ Arts and crafts teacher who worked to adapt crafts to help ➔ They are the National Society for the sick and disabled in their the Promotion of Occupational recovery in 1916. Therapy: I. Eleanor Clarke Slagle II. Willian Rush Stuntin Jr. Susan Trace (1864 - 1928) III. Thomas Bessell Kidner IV. Susan Johnson V. Susan Trace ➔ Nurse ➔ They changed it to “American ➔ Wrote the very first book about Occupational Therapy Occupational Therapy in 1910. Association” in 1921. ➔ Called “Studies in Invalid Occupations” ➔ Developed first structured training to teach patient activities. ➔ “Mother of OT Education”  INTRODUCTION TO OCCUPATIONAL THERAPY Isabel Newton ➔ George Barton’s secretary that eventually become his wife ➔ Works side by side with George in teaching occupations to the disabled. Adolf Meyer (1866 - 1950) ➔ Provided with philosophical base ➔ Holistic perspective ➔ Book: Philosophy of Occupational Therapy