Using Occupational Therapy Theory in Practice E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 420

Veröffentlichungsjahr: 2011

Beschreibung

Competence in any profession depends upon an understanding of the theory that underlies it. This concise and practical text for students and practitioners bridges the gap between occupational therapy theory and clinical practice, offering highly practical advice on using theory in practice in a wide range of settings. It considers the nature of professional practice and the need for a sound theoretical basis from which to plan, implement and justify interventions, and investigates the practical use of occupational therapy theory and the issues such use raises in health and social care settings from a European perspective.

Every occupational therapy student worldwide needs to know about the underlying theory of their profession and its application to practice. The book particularly debates the nature of the theory of occupational therapy via the introduction of the concept of models of the profession as an umbrella for practice, all of which is brought to life via case studies incorporating expert advice, reflection exercises and assessment and evaluation forms.

Leseprobe

Contents

Cover

Title Page

Copyright

Contributor biographies

Editors

Contributors

Foreword

References

Section 1: Theory

Chapter 1: Introduction

The nature of professions and professional practice

The theory of occupational therapy and its place in an evidence-based practice world

Discussion of the different ways in which occupational therapists, their support staff and other professionals use theory

Investigation into the practical use of occupational therapy theory and the issues such use raises in health and social care settings from a European perspective

Investigation into the ways in which occupational therapists and their students learn how to use occupational therapy theory in practice

Relationship of the use of theory to the nature of the individual therapist as a person

Consideration of the place of reflection as a concept to help the occupational therapist get to grips with their understanding of their own theory base

Conclusion

References

Chapter 2: Reconfiguring professional thinking and conduct: a challenge for occupational therapists in practice

Introduction

Professions and professionalism

How professionals use models in practice: thinking like a professional

The nature of theory

The nature of models and their hidden dangers

The role of models within theory and practice

Conclusion

References

Further reading

Chapter 3: Defining occupational therapy theory

Introduction

What might make occupational therapy a profession?

Theory development and the profession of occupational therapy

Models of occupational therapy

Use of the models in occupational therapy

Conclusion

References

Further reading

Chapter 4: From Strands to The Invisibles: from a technical to a moral mode of reflective practice

Introduction

The development of Strands

The technical and the moral modes of practice

The development of The Invisibles

From talking to clinical reflective writing

Conclusion

References

Further reading

Chapter 5: The use of self in occupational therapy

Introduction

Defining the use of self

Using theory in practice: a personal account

Psychodynamic theory

Challenges of using the self in occupational therapy practice

Developing and supporting the use of self in occupational therapy practice

Conclusion

References

Further reading

Section 2: The Use of Theory in Practice: Some Practitioner Narratives

Chapter 6: Developing the use of the Model of Human Occupation in a mental health service

Introduction

Setting the scene

The impetus for change: strategic

The impetus for change: operational

The impetus for change: practitioners

Developing the use of theory in practice

The journey to date and the future

Conclusion

Acknowledgements

References

Further reading

Chapter 7: Using Reed and Sanderson's Model of Adaptation through Occupation: a journey

Introduction

Model of Adaptation through Occupation: basic assumptions and concepts

The development of the Model of Adaptation through Occupation within an occupational therapy service

Implementation of the model

The debate

The Morriston Occupational Therapy Outcome Measure

Summary: where are we in 2011?

Acknowledgements

References

Further reading

Chapter 8: Using the Canadian Model of Occupational Performance to reconfigure an integrated occupational therapy service

Introduction

The local context

Creating a learning organisation

Training opportunities and tools

The interface of occupational therapy practice within the wider organisation

Conclusion

References

Further reading

Chapter 9: Dealing with the barriers to change whilst implementing the Canadian Model of Occupational Performance

Introduction

The challenge of working with an organisation

The challenge of working with individuals

The challenge of working in an inter-professional team

The challenges of using theory in professional practice

Facilitation of more seamless care

Conclusion

References

Chapter 10: Developing occupational therapy theory in Poland

Introduction

Development of rehabilitation and occupational therapy in Poland

Occupational therapy in Poland today

How occupational therapy could improve in Poland through the use of theory

Conclusion

References

Chapter 11: Using occupational therapy theory in Croatia

Introduction

History of the creation and development of occupational therapy in Croatia

Issues with the terminology, and a question: what is occupation?

Development of occupational therapy theory through the perspective of education

External influences on the development of theory of occupational therapy

The creation and the role of the Croatian Association of Occupational Therapists

Conclusion

Acknowledgements

References

Further reading

Chapter 12: Personal reflections on understanding and using the Model of Human Occupation in practice

Introduction

What are the drivers for using a model in occupational therapy practice?

How has the model influenced my theoretical knowledge of occupational therapy?

The impact of the model on the therapeutic relationship with a service user

How the problem-solving process and the outcome of therapy are influenced by the model

How the model impacts on the management of practice and resources

Conclusion

References

Further reading

Section 3: Contemporary Discussions on the Use of Theory in Occupational Therapy Practice

Chapter 13: Using occupational therapy theory within evidence-based practice

Introduction

What is evidence-based practice?

Theory and evidence-based practice

Conclusion

References

Further reading

Chapter 14: Occupational science and occupational therapy: a contemporary relationship

Introduction

Occupational science: an emerging discipline

Is occupational science research too individualistic?

From theory to practice

Occupational science theory and occupational therapy models

Understanding and analysing occupation

Occupational identity

Occupational balance, choice and control

Occupational deprivation and justice

Conclusion

References

Further reading

Chapter 15: Myths around using theory in occupational therapy practice

Introduction

Does using a model restrict my practice?

Will using a model be too time consuming when my service setting demands specific assessments?

Yes, but using a model duplicates documentation and conflicts with generic service frameworks, for example Unified/Single Assessment Process and the Care Programme Approach, ‘how can I do both?’

Are models compatible with care pathways?

Using the headings of a model as a loosely based checklist

Attempting to make the person fit the model

Confusing a model with a associated assessment

Why doesn't a model give more guidance on intervention?

Conclusion

References

Index

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Library of Congress Cataloging-in-Publication Data

Using occupational therapy theory in practice / edited by Gail Boniface, Alison Seymour. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4443-3317-6 (pbk. : alk. paper) I. Boniface, Gail. II. Seymour, Alison. [DNLM: 1. Occupational Therapy. 2. Models, Theoretical. WB 555] LC classification not assigned 615.8′515-dc23 2011034240

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Contributor biographies

Editors

Gail Boniface

PhD, MSc in Medical Education, DipCOT, Cert Ed, Certificate in Supervisory Management

Gail has worked in occupational therapy education for 23 years and is currently working in the School of Health Care Studies Cardiff University as an occupational therapy programme lead. She has a long-standing interest in the use of occupational therapy theory in practice and has been very much involved in providing courses on the use of models of occupational therapy and supporting practitioners in their use.

Alison Seymour

MSc, Postgraduate Certificate in University Teaching and Learning, FHEA, BSc, DipCOT

Alison has worked in occupational therapy education for 7 years and is currently working in the School of Health Care Studies at Cardiff University. Previous to this, she worked for 19 years in a variety of mental health services including forensic, child and adolescent mental health, community mental health and eating disorder services. She has used a range of occupational therapy models of practice within these settings.

Contributors

Andreja Bartolac qualified in physiotherapy, occupational therapy and psychology. Andreja has been working as a teacher at the Occupational Therapy Department of University of Applied Health Studies in Zagreb, Croatia, since 2001. Her professional interests are in the field of occupational therapy assessment, ergonomics and occupational science. For more than 10 years, she has actively participated in all major events associated with development of the occupational therapy profession in Croatia, through the work in the main board of national association of occupational therapists, establishment of Croatian Chamber of Health Professionals and curriculum development.

Sarah Cook (BSc in occupational therapy) is a Clinical Specialist Head of Occupational therapy in the Acute and Crisis Services at South London and Maudsley NHS Trust. She has worked in a variety of NHS trusts across South Wales and London after completing her qualification in 1999. Most of her experience has been in Acute in-patient and Crisis Services, Forensic settings and Assertive Outreach Teams. She is passionate about the use of MOHO in practice and regularly provides workshops on various aspects of the model. She is a visiting lecturer at South Bank University.

Tamsin Fedden (DipCOT, PGCert HE, MSc) has worked as an occupational therapist for 28 years. She has worked in Mental Health, Learning Disability, Physical Health and Social Care settings with adults and children and has been employed as a senior lecturer at the University of the West of England. Tamsin is particularly interested in the links between theory and practice and in practitioners’ continuing development. She is a member of the Gloucestershire CMOP (Canadian Model of Occupational Performance) steering group.

Della Fish (MA, MEd, PhD, Dip Ed, FAcadMed) taught in schools and then in university teacher education for 24 years before becoming an educational consultant in health care education. Her interests are in curriculum design and development and in teaching and learning in the clinical setting. She has worked for The College of Occupational Therapy as an adviser and as their representative in various validation processes, for the Acupuncture Accreditation Board, transitioning private colleges into universities and for The Royal College of Surgeons, helping them to design their first formal curriculum for surgery. She holds chairs in Swansea University, Chester University and Charles Sturt University in Sydney.

Heather Hurst (DipCOT, MSc in occupational therapy) has worked in a variety of health and social care settings over the past 20 years. Currently, she is Head Occupational Therapist to a team who provide occupational therapy services for two community hospitals and is studying for a Professional Doctorate. She is very much interested in developing links between the use of occupational therapy theory and clinical practice. She continues to play an active role in implementing a theoretical model within her organisation and chairs the Gloucestershire CMOP (Canadian Model of Occupational Performance) steering group.

Louise Ingham qualified as an occupational therapist in 1985. She specialised in adult mental health and was one of the first group of occupational therapists to become established in community mental health teams. In her current clinical role as an advanced practitioner, she supports occupational therapists in North West Wales to retain and develop their professional occupational focus whilst being core MDT members. She also works as a lecturer practitioner in Bangor University.

Sharon James (MPhil, DipCOT, Certificate in Supervisory Management) is currently the deputy head of occupational therapy services for Abertawe Bro Morgannwg University Health Board at Morriston Hospital Swansea. She completed a project on outcome measures, which led to the creation of an occupational therapy professional model-led outcome measure: the MOTOM.

Lisa John (MSc, BSc (Hons)) is currently Head Occupational Therapist for Adult Mental Health Service in Swansea (ABMU). She previously worked in, and managed a variety of, mental health settings in England and Wales including, forensic, substance misuse and general mental health. She is currently involved in developing an occupational therapy service to the Prolific and Persistent Offenders Programme with South Wales Probation Service.

Linda Keelan (DipCOT) is an occupational therapist who has worked with people accessing mental health services for 27 years. Her clinical role has been mainly within community mental health settings, and also includes in-patient work with adults, older people's mental health and mental health rehabilitation. Her current role is as lead for occupational therapy and other therapies for mental health services in Abertawe Bro Morgannwg University Health Board, which offers extensive local and regional mental health services. Linda has maintained occupation at the core of her practice and incorporates the occupational therapy philosophy within people and service development.

Karen Lewis (MSc, DipCOT) is currently the Occupational Therapy Manager for Morriston Hospital, Swansea, which is part of Abertawe Bro Morgannwg University Health Board. She has worked in a diverse range of settings throughout her career including local authority, mental health and latterly specialising in physical settings. Her areas of practice have more recently included palliative care and neurosciences, during which she was instrumental in setting up a Parkinson's disease Assessment and Treatment Centre in Swansea.

Magdalena Loska (PhD, MA, BA) currently works as a senior lecturer at The Maria Grzegorzewska Academy of Special Education and is the head of the Occupational Therapy Department there. She is also a special education teacher, specialising in working with people with physical disabilities and has a number of additional neuro-developmental and sensory integration qualifications. She has contributed to a number of books and written articles on the subject of enabling children with disabilities to become more autonomous. She is also engaged in educating teachers on this topic. Her current interests are in assessing levels of autonomy for children with cerebral palsy and identifying barriers to that autonomy.

Margot Mason (BSc, Postgraduate Diploma in Occupational Therapy) has worked in Adult Social Care occupational therapy for 16 years and is currently working as a Community Occupational Therapy Manager for NHS Gloucestershire Care Services. She takes an active interest in service development and the use of evidence-based practice and is a member of the Gloucestershire CMOP steering group.

Caroline Phelps qualified in 2002 with a BSc (Hons) in occupational therapy from the school of health professions and rehabilitation sciences in Southampton. Caroline has worked at Gloucestershire Royal Hospital since 2004. Caroline became involved at the very beginning of Gloucestershire's journey in implementing the Canadian Model of Occupational Therapy and was one of the members of the original steering group.

Ania Pietrzak (MA in Pedagogical Education, Dip Social Work, Cert Ed, Dip OT) is currently studying for her PhD. Ania has worked in a reformatory school as an occupational therapist. Currently, she works in the Academy of Special Education in Warsaw (Poland) as a lecturer and occupational therapy curriculum co-author. Her field of interest is to develop and adapt Polish occupational therapy to meet the required world standards. She is in the course of creating a new assessment tool for measuring adaptive skills for people with learning disabilities.

Carly Reagon (PhD, BSc in occupational therapy) is a lecturer and researcher in the School of Health Care Studies, Cardiff University, Wales. In 2006, she completed a PhD exploring perceptions of evidence-based practice amongst a group of occupational therapists in England.

Jill Riley (PhD, MSc in occupational therapy, PG Dip (social science research methods), DipCOT) has been a lecturer in occupational therapy since 1998 and is currently a research coordinator and programme lead for the MSc in occupational therapy in the School of Health Care Studies, Cardiff University. Jill has a special interest in Occupational Science and especially creative occupations and their relationship to health and well-being.

Gillian Thistlewood (MSc, DipCOT) currently leads and manages an occupational therapy service over two acute hospitals. After qualifying in 1987 as an occupational therapist, Gillian went on to gain a Master's in Health Sciences (University of London) in 1994. She brings experience, over 23 years, in occupational therapy practice, in a range of clinical and managerial settings. She has worked across teams and inter-professional boundaries and challenges with a range of health care workers. Gillian has an interest in clinical ethics and performance management and is a member of the Gloucestershire CMOP steering group.

Jane Walker (MSc, DipCOT) leads and manages an occupational therapy service over a range of health and social care settings, including community hospitals, intermediate care, social care and wheelchair services. She qualified as an occupational therapist in 1984 and gained a Master's in Advanced Occupational Therapy (Plymouth University) in 2008. Her particular interest lies in social care and developing the role of occupational therapists within this practice setting. She is a member of the Gloucestershire CMOP steering group.

Siân Waygood (MA in Management and Leadership in Health and Social Care, DipCOT) is currently the Professional Head of Occupational Therapy Services in Gloucestershire. During her time in Gloucestershire, Siân has worked with colleagues and key stakeholders from a range of statutory and voluntary organisations in Gloucestershire on a number of projects to enhance services for Gloucestershire residents including Integration of the Occupational Therapy and Community Equipment Services, introducing Telecare Services and Development of Client-Centred Practice models. Siân is currently a key member of the Gloucestershire CMOP steering group.

Foreword

The notion of the theory/practice divide and the challenge of applying theory into practice is not new and is something that academics, practitioners and students all struggle with. There are texts about theory but what have been missing are the stories of how to put theory into practice. Whilst the reflectors and theoreticians amongst us might be able to use the strengths of their learning styles to work out how to put theory into their practice, those of us who are pragmatists need to see examples to help us put ideas into practice. Gail Boniface and Alison Seymour and their team of practitioner colleagues have given us the tools and the stories to help cross the theory/practice divide and have combined the ‘ivory tower’ of the academic world with the ‘real life’ of practice.

As occupational therapists we see ourselves as practical, pragmatic, hands-on people who get the job done. How many of us when we buy flat-pack furniture skim through the instructions but then just get stuck in trying to build the thing? Practice can seem to be like that, but without the theory and the evidence we cannot articulate our clinical reasoning, as Sarah Cook says in Chapter ; we might get ‘found out’, but more importantly we might not be able to give a clear rationale for our role and so we will cease to exist. We need the theories and we need to be able to do as the practitioners in this book have done – we need to be able to tell the story of how theory and models underpin our practice and our actions.

In Chapter , Gail Boniface reminds us of the theory of occupational therapy and defines the relevant terms (e.g. model, approach, paradigm) and uses the metaphor of an umbrella to illustrate how theory, models and the professional self must be integrated within practice. Occupational therapists are often accused of being ‘jack of all trades’ (Drummond 2010) and eclectic. However, the metaphor of the umbrella might help practitioners who feel drawn to an eclectic approach to articulate and justify why eclecticism is appropriate and useful within their practice concept.

One of the key tools for linking theory and practice is evidence-based practice. However, the notion of ‘evidence’ is contested, as Carly Reagon discusses in Chapter . Whilst the use and application of quantitative research evidence, such as RCT and systematic review evidence, is well documented (e.g. Taylor 2007), the integration of the practitioner's experiential knowledge is much more complex and less well articulated. Della Fish, in Chapter , explores reflective writing and presents the idea of ‘Clinical Reflective Writing’ and particularly the idea of the ‘rainbow draft’ (www.ed4medprac.co.uk/papers.htm) as a potentially valuable tool for articulating the experiential evidence for EBP, as well as supporting evidence for HPC re-registration.

Models and approaches provide us with the toolkit for our occupational therapy practice, irrespective of the practice context or area. They provide us with the tools that underpin clinical reasoning and help us to articulate our practice and to identify the appropriate outcomes, measurements and assessments to utilise. But any tool needs illustration and an instruction manual, with practical examples of how to use it. The seven fascinating and varied chapters that make up Section 2 provide us with just such examples of the challenges and processes of utilising a model within a practice context. Whilst most of the examples are from a relatively narrow geographical area, Chapters and give a broader perspective of occupational therapy within an Eastern European context, providing a fascinating counterpoint to the much more established context of the UK.

Throughout this book, the links between the ‘academics’ (Gail and Alison) and the practitioners are emphasised. This serves to reiterate the need for academics and practitioners to develop collaborative links, which are not just one way from the university to practice but are two way collaborations building on the skills and strengths of both partners.

I would like to congratulate all of the authors on the development of this text, which I am sure will act as an inspiration for students and practitioners alike in developing their understanding, articulation and use of theory and models within the practice context.

Dr M. Clare Taylor DipCOT, BA (Hons), PGCert, MA (Distinc), PhDLead Therapist School of Health & Social Care Bournemouth University

References

Drummond, A. (2010) The Elizabeth Casson Memorial Lecture 2010: ‘Jack of all trades and master of none’ – the future of occupational therapy? British Journal of Occupational Therapy 73(7): 292–299.

Taylor, M.C. (2007) Evidenced-Based Practice for Occupational Therapists, 2nd edn. Oxford: Blackwell.

Chapter 1

Introduction

Gail Boniface and Alison Seymour

In this book (divided into three sections), we invite you to participate in a discussion and debate with us on the use of theory by occupational therapists in relation to today's health and social care settings. A key message throughout the book is our belief that, in order to be able to use theory in practice, it is first necessary to get to grips with that theory and This would appear obvious; but in our experience, we have sometimes found that, for many reasons, when using their theory, practitioners have jumped straight to the use of assessments associated with occupational therapy practice models rather than really understanding the underpinning theory first of all. When this has happened (see Chapters 6, 8 and 12), the model itself has been left behind, a superficial understanding of the use of theory has resulted and the model has eventually been abandoned.