AccoIntroduction The aim of this essay is to explore the Clinical reasoning thinking frame as described by Neistadt (1996). Clinical reasoning is a set of skill performed by occupational therapists which are central to practice and involved throughout the Occupational therapy process (Neistadt, 1996, AOTA, 2008). This will be done in relation to our case study of which the protagonist is Hugh, a 70 year old widower and retired baker, who was managing well an episode of depression but has recently been found apathetic, unwashed and in soiled clothes by the public mental health nurse, and referred to see an occupational therapist.
Narrative Reasoning
The first element of this process we will discuss is narrative reasoning which concerns itself with the construction and subsequent analysis of the client’s occupational story (Neistadt, 1996, Duncan, 2006). This process is developed through allowing the client the opportunity to create a narrative image through story-telling, this can manifest itself in an adumbration of their life experience and how it has been altered through disability, disease or transition (Duncan, 2006, Neistadt, 1996). The importance for a practitioner to explore the client’s narrative is not only in the development of their story but it also gives the therapist insight into the person and a possible future for them (Higgs, 2008). The use of certain assessments can be particularly effective in the development of a client’s narrative, one of which being
In the field of occupational therapy a lot of writing is required from doctors and students becoming therapists. The question that constantly crossed my mind was why do they need to write? Before I began to research the writing styles and practices that took place in the field, I knew I needed to educate myself about Occupational therapy. I scheduled interviews with a licensed occupational therapist and a student studying to be one to help me understand what took place in their field of work as a student and as an experienced therapist. In addition to studying and reading magazines, medical journals, etc. to spread my understanding of occupational therapy. So, I could understand why they use certain types of writing styles and
In practice, occupational therapists may use one or more frames of reference to help guide them as they plan out interventions and goals. Two examples of the frames of reference used are the cognitive behavioral frame of reference and the biomechanical/rehabilitative frame of reference. The cognitive behavioral frame of reference looks at how thoughts and behaviors affect the participation or performance of occupations (Cole & Tufano, 2008; Davis, Eshelman, & McKay, 2008; Giles, 2003). The biomechanical/rehabilitative frame of reference involves the establishment or restoration of functional skills; however, if full establishment or restoration is not possible, the modification of tasks or environments is also included (Cole & Tufano, 2008).
To be able to participate in one 's own life, to do the things we want to do, and to competently perform the activities that form part of our daily, weekly or monthly routines, is a common goal for most people. This not only includes taking part in the basic activities of self-care, such as grooming and dressing, but also extends to our work and leisure activities. It is through doing things that we learn and develop as human beings. The occupational therapy profession believes that being prevented or hindered in some way from participating in the activities that are important to us could adversely affect our health and wellbeing.
My goals for the session were to introduce myself to the client, understand the client’s concerns, learn her background and current situation for several areas relevant to her life and her concerns, such as medical, family, legal, educational, and vocational. I
This papers purpose is to describe to the reader an Occupational therapy treatment plan and therapy session using the OTPF as its base to describe client’s performance. It is based off a case study of a 26 year old male racecar driver who suffered a traumatic brain injury and is now admitted into the hospitals ICU unit under a coma. The paper begins with a brief overview of the clients Injuries and occupational profile. It continues with goals that the therapist has set for the client and caregivers and concludes with the client’s treatment plan, along with a SOAP note which explains the client’s treatment and gives other healthcare workers information about the therapists goals and progress of the client
Occupational therapy was founded on the principle that participation in meaningful activity is important to the health of individuals. Mental health is very important to the well-being of an individual and those around them. 450 million people experience mental and neurological disorders around the world. These disorders are the leading 5-10 causes of disability worldwide. As services for individuals with mental illness have shifted from the hospital to the community, there has also been a shift in the philosophy of service delivery. In the past, there was an adherence to the medical model; now the focus is on incorporating the recovery model. (2) Occupational therapy’s focus that taking part in engaging and meaningful activities benefits the mental well-being of the individual.
Theories are essential in occupational therapy (OT) practice as they provide a conceptual foundation and framework for enhancing growth of clients, justifying reimbursement for care, and validating intervention applications to family and patients (Baum, Bass, & Christiansen, 2015). Theories provide knowledge and an explanation for how and why certain interventions would be more beneficial than others. Theories can be used to support the understanding of a client’s symptoms and environmental impacts. The theories used in OT can be classified as models, frames of reference, or paradigms (Baum, Bass, et al., 2015). After visiting Paxton Ministries and interacting with several residents, I identified the following theories, models, and perspectives
They were simple and short enough that they can be done quickly and the client does not become overwhelmed or frustrated. Using reflection and affirmation while engaging in the questions also makes it easier for the client to feel relaxed and not threatened or judged. As a social worker it can sometimes be difficult to use assessments, but the AUDIT is very user friendly. This assessment is one that this student will want to use when working with clients in the proper setting. It is believed that MI goes well with this assessment, because it shows the client the facts and does not leave it open for interpretation. This student works in an environment where very personal questions are asked and dealt with on a daily basis, so asking these brief questions were not a difficult task. However, this student feels it is best to let the client know that there is no judgment and questions are only being asked to benefit the client and better their
Clinical Reasoning is an essential part of the assessment, treatment and evaluation process in occupational therapy (Neistadt, 1996). This reasoning is the skill set that the occupational therapist draws from when working with clients in related to function and performance. Neistadt (1996) suggested that clinical reasoning is the combination of five interacting components (Ward, 2003). This will be explained in the following essay and applied to a case study about a girl named Maria.
Narrative used as a linguistic device has the potential to construct and transform the self, communicate identities with disorder to others (Thompson, 2012), and constitutes a social pedagogy about identity and ways of healing (Harter, 2005) that support psychological dialectical therapy. Explaining ones story, triggers sense making strategies allowing individuals to explore self identity in relation to illness, eventually developing a system of understanding where one begins to recognize and understand patterns in behavior (Thompson,
As the client was struggling to tell his story, I offered the suggestion of working collaboratively on a timeline (Appendix A) which might help us gain a shared understanding of what was going on for him and would help to formulate goals and highlight his strengths and resources, which he willingly agreed to (McLeod & McLeod, 2016). This process evolved over a couple of sessions and I remained empathic, curious, open-minded and respectful whilst continually monitoring the client's verbal and non-verbal communication (Cooper & McLeod, 2011). I used Socratic and open-ended questioning which elicited a collaborative discussion and allowed the client’s story to unfold. The client never felt loved or wanted by his parents and their constant verbal
Occupations are central to a client’s identity, it gives meaning and value to that client and creates a sense of competency (AOTA, 2014, p. 5). This paper is based on the application of occupational theories in practice, the case of Mary (not her real name) will be discussed. Mary was a 68-year-old female admitted to a skilled nursing facility after left above knee amputation. The interdisciplinary team members that collaborate at a skilled nursing facility includes physical therapists, occupational therapists, speech therapists, physicians, nurses, social workers, activities coordinator, case manager, third party insurances, dietary manager. In this particular case, a certified prosthetist was also involved. An average length of stay for the clients in the skilled nursing setting is between two to three weeks. Most of the treatment
The intervention approached should be gentle with caution to translate what the client’s story means to them and guide them towards change in a meaningful and productive way (Phipps & Vorster, 2015). For example, the this particular client may explain their series of events as devastating and life altering. Using a narrative theoretical approach externalizing the words the client uses. The client expresses
O'Hanlon (1994) summarized the narrative approach into seven steps, which are outlined below. However, I feel that before these steps can be implemented, the story needs to be heard. While the client is telling their story, the counselor needs to be on the lookout for contradictions or "gaps" in the story. It is helpful to ask specific questions to elicit information about the client's experience that does not fit their telling of the dominant, problem-saturated story (Zimmerman & Dickerson, 1996). Remember any contradictions that you notice so that they can be brought to the attention of the client. Problem-saturated stories exert a powerful influence on people's lives. These stories act as restraints by limiting choices and even responsibility. Narrative therapist views these problem-saturated stories as standing in the way of the clients.
This assignment is about identifying the core concepts behind reasoning given by individuals, facing opposition by a party that has challenged their right/way of life/moral obligations and so on and so forth. This is to look at the matter from an ethical viewpoint where environmental preservation is involved. To identify the nature of reasoning and categorize it under a sub banner. To psychologically analyze what people hold certain types of beliefs in which they feel it’s alright to carry on what they are doing and how they have convinced themselves of its moral and ethical standings.