OCCUPATIONAL THERAPY 378
UNIT 1: FOUNDATIONS OF OCCUPATIONAL THERAPY
1. FRAMES OF REFERENCE
,FRAMES OF REFERENCE:
1. REHABILITATIVE FRAME OF REFERENCE
OUTCOMES:
• Be able to define rehabilitation
• Have knowledge of the 5 major assumptions of the Rehabilitative FoR
• Have knowledge of the strengths and weaknesses of the Rehabilitative FoR
• Be able to apply the Rehabilitative FoR
EVALUATION:
• How will your knowledge and understanding of the Rehabilitative FOR be assessed? :
° Tests and/or examination of B OT III.
° Applicability to diseases and occupational therapy treatment - B OT III and IV.
° Skills - Clinical work B OTIII and IV.
UNDERSTANDING CONCEPTS IN OT PROCESS AND PRACTICE:
• What is a Model of Practice in OT?
° A way of organising that takes the philosophical base of the profession and provides terms
to describe practice, tools for evaluation, and a guide for intervention
• What is a Frame of Reference (FoR)?
° A system that applies theory and puts principles into practice, providing practitioners with
specifics on how to treat specific clients
• Definition of Rehabilitation:
° the process of restoring the individual’s capacity to participate in functional activities when
his/her capacity has been altered or limited by a physical or mental impairment
WHAT IS THE REHABILITATIVE FoR:
• Being able to live and work with one’s remaining capabilities, strengths and weaknesses.
• The use of:
° assistive devices,
° activity adaptation,
° environmental modifications and
° compensatory strategies.
• For client’s whose impairments are considered permanent (not expected to improve).
Permanence can be static or progressive. (e.g. Parkinson's, dementia, MS)
• Focusing on occupational performance and not on disability and impairment.
madri van wyk (22731202) !1
, REHABILITATIVE FRAME OF REFERENCE:
• Client is required to be part of the team. (client centred)
• Treatment programs to occur in environment that is most natural to client.
• Includes the creative application of compensatory strategies and environmental modifications.
• Includes consideration of the teaching/learning process. (e.g. learning adaptive strategies)
5 ASSUMPTIONS — REBECCA DUTTON:
• Assumption 1:
° Person can regain independence through compensation.
- Where person has impairments that impacts their ability to engage in personally
meaningful activities — teach adaptive ways of doing, offering Assistive devices,
adapt environments
• Assumption 2:
° Motivation is a basic requirement for the independence.
° Motivation is based on values, roles, and interest.
- The client needs to be actively involved in the planning & execution of interventions
— this motivates the client to learn new ways of doing, use assistive devices, or
engage in environmental adaptations that are recommended.
• Assumption 3:
° Environmental factors also play an important role in independence/rehabilitation.
- The OT needs to look at both the person and the context in which the person has
to function
• Assumption 4:
° Rehabilitation involves the teaching-learning process.
° Person needs sufficient cognitive skills to learn and to apply compensatory methods.
° Motivation enables the individual to participate fully in the teaching-learning process.
- e.g. have stroke, still have to dress — would then teach the one-handed dressing
technique — for this they need sufficient cognitive skills
- Person also needs to be motivated to learn & apply this adapted skill
• Assumption 5:
° Clinical reasoning, used by the practitioner, begins with the individual’s goals and functional
capabilities (what can they still functionally do)
° moves to the environments in which the person will function (how can the environment be
adapted)
° and then to the types of compensatory strategies the person needs to use his or her
capabilities (assistive devices/new adapted skills)
madri van wyk (22731202) !2
, APPLICATION IN OT:
• Use the Rehab FoR to restore the client’s ability to function independently in activities.
• Compensate for disability by learning to live with one’s capabilities in all aspects of life; adapt
environment to obtain independence.
• Compensatory strategies and adaptive devices: one-handed dressing/shoe tying, prosthetics,
assistive devices, home/work/school modifications.
• Therapist collaborates with client to determine priority with personal and community living skills,
work, leisure, play and social interaction activities.
EVALUATION / ASSESSMENT IN THE REHABILITATIVE FoR:
• Emphasises occupational roles, functional limitations/ barriers, and environmental/ contextual
factors
• COPM
• Observations during participation in activities
• Self-reporting from the client (client centred) — self-assessment
• Interviewing to determine valued occupations
STRENGTHS & WEAKNESSES OF THE REHABILITATIVE FoR:
• Strengths:
° Focuses on the core values of OT
° Holistic perspective on client
° Goal-based intervention
° Collaboration between therapist and client
• Weaknesses:
° Client must have some level of motivation to improve independence
° Little to no alternative if compensatory methods fail to work
° Access to equipment and environment to teach the skills
° Mainly for physical impairments
LEARNING ACTIVITY:
• SUNLearn Task:
• Read the 2 cases. For each of the 2 cases briefly answer the following:
° a) Would you use the Rehabilitative FoR for this particular client?
° b) Motivate your answer in a).
• Post your responses on the Forum by Friday 15 January 2021.
• I will read through your responses and provide general feedback.
madri van wyk (22731202) !3
UNIT 1: FOUNDATIONS OF OCCUPATIONAL THERAPY
1. FRAMES OF REFERENCE
,FRAMES OF REFERENCE:
1. REHABILITATIVE FRAME OF REFERENCE
OUTCOMES:
• Be able to define rehabilitation
• Have knowledge of the 5 major assumptions of the Rehabilitative FoR
• Have knowledge of the strengths and weaknesses of the Rehabilitative FoR
• Be able to apply the Rehabilitative FoR
EVALUATION:
• How will your knowledge and understanding of the Rehabilitative FOR be assessed? :
° Tests and/or examination of B OT III.
° Applicability to diseases and occupational therapy treatment - B OT III and IV.
° Skills - Clinical work B OTIII and IV.
UNDERSTANDING CONCEPTS IN OT PROCESS AND PRACTICE:
• What is a Model of Practice in OT?
° A way of organising that takes the philosophical base of the profession and provides terms
to describe practice, tools for evaluation, and a guide for intervention
• What is a Frame of Reference (FoR)?
° A system that applies theory and puts principles into practice, providing practitioners with
specifics on how to treat specific clients
• Definition of Rehabilitation:
° the process of restoring the individual’s capacity to participate in functional activities when
his/her capacity has been altered or limited by a physical or mental impairment
WHAT IS THE REHABILITATIVE FoR:
• Being able to live and work with one’s remaining capabilities, strengths and weaknesses.
• The use of:
° assistive devices,
° activity adaptation,
° environmental modifications and
° compensatory strategies.
• For client’s whose impairments are considered permanent (not expected to improve).
Permanence can be static or progressive. (e.g. Parkinson's, dementia, MS)
• Focusing on occupational performance and not on disability and impairment.
madri van wyk (22731202) !1
, REHABILITATIVE FRAME OF REFERENCE:
• Client is required to be part of the team. (client centred)
• Treatment programs to occur in environment that is most natural to client.
• Includes the creative application of compensatory strategies and environmental modifications.
• Includes consideration of the teaching/learning process. (e.g. learning adaptive strategies)
5 ASSUMPTIONS — REBECCA DUTTON:
• Assumption 1:
° Person can regain independence through compensation.
- Where person has impairments that impacts their ability to engage in personally
meaningful activities — teach adaptive ways of doing, offering Assistive devices,
adapt environments
• Assumption 2:
° Motivation is a basic requirement for the independence.
° Motivation is based on values, roles, and interest.
- The client needs to be actively involved in the planning & execution of interventions
— this motivates the client to learn new ways of doing, use assistive devices, or
engage in environmental adaptations that are recommended.
• Assumption 3:
° Environmental factors also play an important role in independence/rehabilitation.
- The OT needs to look at both the person and the context in which the person has
to function
• Assumption 4:
° Rehabilitation involves the teaching-learning process.
° Person needs sufficient cognitive skills to learn and to apply compensatory methods.
° Motivation enables the individual to participate fully in the teaching-learning process.
- e.g. have stroke, still have to dress — would then teach the one-handed dressing
technique — for this they need sufficient cognitive skills
- Person also needs to be motivated to learn & apply this adapted skill
• Assumption 5:
° Clinical reasoning, used by the practitioner, begins with the individual’s goals and functional
capabilities (what can they still functionally do)
° moves to the environments in which the person will function (how can the environment be
adapted)
° and then to the types of compensatory strategies the person needs to use his or her
capabilities (assistive devices/new adapted skills)
madri van wyk (22731202) !2
, APPLICATION IN OT:
• Use the Rehab FoR to restore the client’s ability to function independently in activities.
• Compensate for disability by learning to live with one’s capabilities in all aspects of life; adapt
environment to obtain independence.
• Compensatory strategies and adaptive devices: one-handed dressing/shoe tying, prosthetics,
assistive devices, home/work/school modifications.
• Therapist collaborates with client to determine priority with personal and community living skills,
work, leisure, play and social interaction activities.
EVALUATION / ASSESSMENT IN THE REHABILITATIVE FoR:
• Emphasises occupational roles, functional limitations/ barriers, and environmental/ contextual
factors
• COPM
• Observations during participation in activities
• Self-reporting from the client (client centred) — self-assessment
• Interviewing to determine valued occupations
STRENGTHS & WEAKNESSES OF THE REHABILITATIVE FoR:
• Strengths:
° Focuses on the core values of OT
° Holistic perspective on client
° Goal-based intervention
° Collaboration between therapist and client
• Weaknesses:
° Client must have some level of motivation to improve independence
° Little to no alternative if compensatory methods fail to work
° Access to equipment and environment to teach the skills
° Mainly for physical impairments
LEARNING ACTIVITY:
• SUNLearn Task:
• Read the 2 cases. For each of the 2 cases briefly answer the following:
° a) Would you use the Rehabilitative FoR for this particular client?
° b) Motivate your answer in a).
• Post your responses on the Forum by Friday 15 January 2021.
• I will read through your responses and provide general feedback.
madri van wyk (22731202) !3
