Overview of the Occupational Therapy Process
a) Service delivery approaches
Service delivery approaches refer to the variety of ways in which occupational therapy services can be provided, of which inter and intraprofessional collaborations are a key component. The location of services can include settings such as hospitals, skilled nursing facilities, outpatient clinics, homes, communities, workplaces, and schools. The recipient of services may be the client, caregiver, family, employer, government agency, etc. Services may be provided 1) individually or in a group, 2) in person or via telehealth systems, and 3) directly to the client or indirectly on their behalf via consultation or advocacy efforts.
Related ICE Videos
ICU, Co-treatment, Part 4
Search the ICE Video Library for the titles below, or for keywords such as: Intensive Care Unit (ICU), Acute Care, Skilled Nursing, Outpatient, Home, and Community.
ICU, Co-treatment, Parts 1-5
Self-Care: Bedside Grooming & Hygiene in Acute Care
Femur Fracture, 5 Weeks Post Surgery: Safety During Meal Preparation, Parts 1-3
Rotator Cuff Repair, Parts 1-7
Peds Assessment: Administration of the Test of Visual Motor Skills
Questions
Ask these questions when watching the related videos.
In what ways are occupational therapy services different across settings and in what ways are they the same (e.g., patient goals, level of activity, activity choice, etc)?
What are the strengths and limitations of each setting?
Many practitioners in the acute care spend a majority of their time on making appropriate discharge recommendations. Why is this so important in acute care?
b) Clinical and professional reasoning
Professional reasoning is the “broad term to encompass reasoning that occurs in all settings” (Schell, 2019) and is inclusive of clinical reasoning. Professional reasoning involves the thoughtful integration of theoretical principles, the best available evidence, and awareness of the client’s condition and occupational profile in order to develop a treatment plan that maximizes participation. Professional reasoning should be utilized during each client encounter so that adjustments can be made as the client progresses.
Related ICE Videos
Search the ICE Video Library for the titles below, or for related keywords.
IADLs: Sweeping the Sidewalk
Radial Fracture, Patient Education 2: Improving Soft Tissue Elasticity with Heat
Total Knee Replacement, 7 days post: Lymphatic Drainage, 1-2
Self-Care: Dressing in Acute Care
Outpatient Assessment, Part 5: Edema of the Hand
Questions
Ask these questions when watching the related videos.
How does professional reasoning help the therapist develop a greater understanding of the interrelationship between client factors, performance skills, and contexts?
How does clinical reasoning help the practitioner identify the meaning of the occupation and the demands to complete the occupation?
Describe how the practitioner maximizes treatment outcomes by finding the just right challenge for the client’s level of skill and participation.
c) Therapeutic use of self
Therapeutic use of self is one of the greatest tools a practitioner can use and requires that they “develop and manage their therapeutic relationships with clients by using professional reasoning, empathy, and a client-centered, collaborative approach to service delivery” (Taylor & Van Puymbrouck, 2013).
Related ICE Videos
Search the ICE Video Library for the titles below, or for keywords such as: therapeutic use of self, interview, evaluation, and treatment.
Interview with Dick
Peds, Mat Activity: Intervention Begins
Self-Care, Part 2: Washing at the Sink in Acute Care
Ventilator Part 1: Breathing and Suctioning with Respiratory Therapy
Family Considerations
Questions
Ask these questions when watching the related videos.
How does the practitioner connect with the patient on an emotional level? Notice how different patients may benefit from different approaches.
How does the respiratory therapist involve the patient in his care? In what other ways could he involve the patient?
What do you notice about the practitioner’s body language, facial expressions, and touch communication that facilitate the patient’s participation in treatment?
How can the practitioner involve the family in the therapy process?
d) Occupational and Activity Analysis
Occupational and activity analysis is a process that helps determine what skills are necessary to complete the occupation or activity based on the required demands, such as:
"Relevance and importance to the client,
Objects used and their properties,
Space demands,
Social demands,
Sequencing and timing,
Required actions and performance skills, and
Required underlying body functions and body structures” (AOTA, 2020, S57-58).
Related ICE Videos
Search the ICE Video Library for the titles below, or for keywords such as: function, task, ADL, and occupation.
Spinal Stenosis 3 months post surgery: ADLs during breakfast
Dementia Part 1: Grooming and Hygiene
Multiple Sclerosis, Problems observed in the home
Peds, fine motor: letter formation with playdough
Questions
Ask these questions when watching the related videos.
What are the components of each activity in the videos? Which components are promoting participation and which are inhibiting participation?
