1. Chapter 23: Overview of the Occupational Therapy Process and Outcomes
Denise Chisholm and Barbara A. Boyt Schell

2. Learning Objectives Describe the components of the OT process.
Discuss how evidence from research and practice is integrated in the OT process.
Explain the professional reasoning typically associated with components of the OT process.
Apply the OT process to a client cases.

3. OT as a Process Occupation is the central focus of OT services
OT services incorporate the therapeutic use of occupation to promote client’s engagement and performance of their preferred daily activities
The use of occupation as:
an end goal; and
a means to achieve OT’s unique contribution to health services

4. The OT Process Map

5. Components of the OT Process
The starting point of the OT process is evaluation, followed by intervention and reevaluation
Outcomes are inherent in the process and serve as goals to guide the therapy process
Evidence provides background that supports OT process
Each component of the process will be described in more detail in subsequent slides

6. Evaluation
OT decision: “Who is my client and does my client need OT services?”
Evaluation includes:
occupational profile;
analysis of occupational performance; and
targeted outcomes

7. Occupational Profile
The occupational profile provides a summary of client’s history, resources, and performance
Focus on understanding and describing client’s occupational performance
The OT collects and organizes data on client’s occupational:
history;
contexts; and
goals

8. Analysis of Occupational Performance
The analysis of occupational performance is collection, organization, and synthesis of objective data on client’s occupational performance
The ideal performance situation reflects client’s real-life situation
The OT has client perform selected activities important to their occupations using valid and reliable assessment tools

9. Targeted Outcomes
After occupational profile and analysis of occupational performance are completed, final task of evaluation is to define targeted outcomes
client’s occupational performance problems that OT interventions can appropriately target
The OT and client:
create short-term and long- term goals; and
determine procedures to measure progress toward goals

10. Evidence Focus during Evaluation
Considerations include:
theories most relevant for client and clinical setting;
available research regarding reliability and validity of appropriate assessment tools; and
preferences of client

11. Intervention
The primary question or therapy decision OT has to make during intervention is “What OT interventions can best help my client?”
Intervention includes:
Intervention plan; and
Intervention implementation

12. Intervention Plan Determine range of interventions appropriate to:
address client’s occupational performance problems; and
select those with potential to improve performance and match client’s occupational profile
The intervention plan determines selection of specific OT activities to address client’s targeted outcomes
The intervention plan is developed in collaboration with client

13. Intervention Implementation
The OT:
observes and examines client’s performance while engaging in interventions; and
adjusts as needed to achieve targeted outcomes
The intervention implementation puts plan into action
carrying out interventions and monitoring client’s response

14. Evidence Focus during Intervention
Considerations include:
the relationship between selected intervention and theories relevant for client and clinical setting;
available research about benefits of selected interventions;
experiences of the OT; and
preferences of the client

15. Reevaluation
OT decision during reevaluation is “How has OT affected my client’s performance?”
Reevaluation includes:
Re-analysis of occupational performance;
Review of targeted outcomes; and
Identify action

16. Re-analysis of Occupational Performance
Imperative: use same measures during reevaluation as used in evaluation
The re-analysis of occupational performance includes systematically measuring and re-collecting of data
The OT compares data obtained from original evaluation with reevaluation findings

17. Review of Targeted Outcomes
The review of targeted outcomes determines whether OT interventions achieved intended targeted outcomes through goal attainment
The OT determines changes in client’s occupational performance relevant to measurable goals established during evaluation

18. Identify Action
Based on re-analysis of occupational performance and review of targeted outcomes the OT:
determines to continue therapy;
refers client to another service or specialty; or
discontinues services

19. Evidence Focus during Reevaluation
Considerations include:
Available research regarding reevaluation for specific type of client and assessment tools administered at evaluation
Combining evaluation and intervention research

20. Applying the OT Process

21. Try it out on a case in the text, online, or in your fieldwork!
Application
The OT process is:
A cycle which may repeat; and
Requires regular attention to both evaluation and intervention
Try it out on a case in the text, online, or in your fieldwork!