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

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.

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

The OT Process Map

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Applying the OT Process

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!