The Philosophical Base of Occupational Therapy

1. The Philosophical Base of Occupational Therapy Emily K. Schulz, Ph.D. OTR/L OT 606 Lecture 1, Part 2

2. The Philosophical Base Presentation Overview

3. Overview of this Presentation Background of events leading up to the development of the Philosophical Base. Direct Quote of the Philosophical Base. A Verbal Analysis of the Philosophical Base. A Paraphrasing of the Philosophical Base. A Visual Model of the Philosophical Base. Practice using the Philosophical Base with 4 case studies Comparison between The Philosophical Base & the World Health Organization - ICF Review and Concluding Remarks. Questions and Answers

4. The Philosophical Base Background

5. Background: What Occupational Therapy is Versus What it is Not: Reductionistic: Reductionism - A theory that all complex systems can be completely understood in terms of their components Holistic: Holism- Emphasizing the importance of the whole and the interdependence of its parts. Holism asserts that phenomena can never be fully understood in isolation; it asserts that reductionism can only give us a partial view of anything it dissects.

6. Background: What Occupational Therapy is Versus What it is Not: Mechanistic: Mechanism - The philosophical doctrine that all natural phenomena are explicable by material causes and mechanical principles. www.dictionary.com Ecological: Ecology - The branch of sociology that is concerned with studying the relationships between human groups and their physical and social environments. Also called human ecology. www.dictionary.com

7. Background: What Occupational Therapy is Versus What it is Not: Positivistic Positivism - is a way of seeing the world, a philosophical orientation, that views the material world as the only reality. The scientific method is used to find new information about the material world. Positivists depend on underlying patterns that humans can discover accurately. Once we find these patterns, then we can divide them into smaller parts to learn something about the whole. The scientific method is perceived as an objective, value-free way to view the world. http://www.edb.utexas.edu/faculty/scheurich/proj2/text/positivism.htm Interpretivistic Interpretivism - conceives of a world where there is a multiplicity of realities. Each individual perceives, understands, experiences and makes meaning of that reality in different ways. For this reason, research in this paradigm focuses in on studying individual lives and their significance. The overall aim of this paradigm is to understand others' experiences and relate them to one's own reality. http://www.edb.utexas.edu/faculty/scheurich/proj2/text/interpretivism.htm

8. Background Occupational Therapy Founded as a profession in 1917. Roots lie in the service of persons with mental illness. Began as a community-based profession. Used an holistic approach to treatment. Became diversified because of societal demands and medical advances.

9. The Philosophical Base Adopted in 1979 by the Representative Assembly to increase unity within the profession.

10. The Philosophical Base Direct Quote

11. The Philosophical Base of Occupational Therapy Man is an active being whose development is influenced by the use of purposeful activity. Using their capacity for intrinsic motivation, human beings are able to influence their physical and mental health and their social and physical environment through purposeful activity. Human life includes a process of continuous adaptation. Adaptation is a change in function that promotes survival and self-actualization. Biological, psychological, and environmental factors may interrupt the adaptation process at any time throughout the life cycle. Dysfunction may occur when adaptation is impaired. Purposeful activity facilitates the adaptive process.

12. The Philosophical Base of Occupational Therapy (Continued) Occupational therapy is based on the belief that purposeful activity (occupation), including its interpersonal and environmental components, may be used to prevent and mediate dysfunction and to elicit maximum adaptation. Activity as used by the Occupational Therapist includes both an intrinsic and a therapeutic purpose (AOTA, 1979, p.785).

13. The Philosophical Base Verbal Analysis

14. Five Concepts From The Philosophical Base The Nature of Humankind The Environment Adaptation Dysfunction, and Purposeful Activity (Occupation).

15. Concept # 1: The Nature of Humankind The Nature of Humankind is: To be Active To be Developmental To be engaged in Purposeful Activity To be Intrinsically Motivated To be able to use Purposeful Activity to Influence Mental & Physical Health To be able to use Purposeful Activity to Influence the Social & Physical Environment To be able to Continuously Adapt.

16. Concept # 2: The Environment The Environment: Is both social and physical in nature Is influenced by human beings Is influenced by the purposeful activity of human beings May be a factor that interrupts the adaptation process throughout the life cycle Is a component of purposeful activity.

17. Concept # 3: Adaptation Adaptation: Is a continuous process Is a change in function Promotes Survival Promotes Self-Actualization May be interrupted by biological, psychological, or environmental factors.

18. Concept # 4: Dysfunction Dysfunction: May occur when adaptation is impaired May be prevented through the use of purposeful activity May be mediated through the use of purposeful activity.

19. Concept # 5: Purposeful Activity Purposeful Activity: Is also known as Occupation Facilitates the Adaptive process Has Interpersonal and Environmental Components Includes an Intrinsic Purpose and a Therapeutic Purpose when used by an Occupational Therapist.

20. The Philosophical Base Paraphrasing

21. A Paraphrasing of The Philosophical Base It is the nature of human beings to be involved in intentional, goal-oriented, engrossing, task-oriented action. It is also the nature of human beings to interact with and have an effect upon the environment, and to do so with intention. Taking action in this deliberate fashion impacts an individual�s natural maturation process and state of well being. Taking action in this deliberate fashion also impacts others and the external environment.

22. A Paraphrasing of The Philosophical Base (continued) Another fundamental aspect of the nature of human beings is their ability to be adaptive. Adaptation involves an ongoing internal process of change that assists in and supports the sustaining one�s mere existence or the fulfilling of one�s maximum potential. Without the internal ability to adapt, people would not be able to fully express in action, in the tangible world, who they truly are.

23. A Paraphrasing of The Philosophical Base (Continued) The adaptation process is strengthened by the use of purposeful activity, and as a result, humans have the ability to choose to address their basic survival needs and/or to aspire to and to strive for their highest potential. The need for constant adaptation is a given in this life, and therefore the ability to adapt is of paramount importance.

24. A Paraphrasing of The Philosophical Base (Continued) When an event occurs either within the individual or within the environment that prevents a person from being adaptive, dysfunction may be the result. When dysfunction occurs, intervention may be required. Occupational therapists use occupation to promote adaptation and to prevent dysfunction in the lives of the people with whom they work.

25. The Philosophical Base Visual Model

28. The Philosophical Base Conceptual Exploration

29. The Philosophical Base Illustrative Case Studies

30. Case Studies:Impeding Biological and Psychological Factors In the Next Four Case Studies: The individual experiences a problem with his/her physical and/or mental health. The person�s adaptation process is interrupted. The person experiences dysfunction. The person requires intervention from an occupational therapist.

31. Case Study 1 A Boy with Sensory Integrative Dysfunction Unable to tie his shoes Unable to write like the rest of the children in his class Other children make fun of him He experiences low self-esteem Lashes out at others when they touch him unexpectedly. He enjoys banging on objects in the room. Has difficulty sitting still Spends a lot of time daydreaming.

32. Case Study 1 Interrupting Location of Purposeful Factors Intervention Activity

34. Case Study 2 An Elderly Woman with Parkinson�s Disease Resides in a nursing home. Experiencing increased tremors from her Parkinson�s Disease. Feels embarrassed when she spills her food Declines to eat in the dining room. Eats in her room in the dark by herself Feels depressed. Was once an avid gardener and church choir member.

35. Case Study 2 Interrupting Location of Purposeful Factors Intervention Activity

37. Case Study 3 An Adolescent with Anorexia A teenage girl with anorexia nervosa has lost so much weight that she is in the hospital and on an i.v. to keep her alive. She is unable to raise her head or roll over in bed by herself because of weakness. Before she became ill, she enjoyed talking on the phone with her best friend and putting on make-up.

38. Case Study 3 Interrupting Location of Purposeful Factors Intervention Activity

40. Case Study 4 An Adult with Acute Spinal Cord Injury A young man sustained a spinal cord injury. He is able to move his upper body but unable to move his legs. He is in shock and feels depressed over the change in his body and abilities. He used to be very active in sports and enjoyed rock climbing, surfing, and basketball.

41. Case Study 4 Interrupting Location of Purposeful Factors Intervention Activity

43. The Philosophical Base & The World Health Organization - ICF

44. World Health Organization (WHO) and ICIDH-2, or ICF The World Health Organization (WHO) published new guidelines to classify health and disability in 2001. These guidelines replaced the former International Classification of Impairments, Disabilities, and Handicaps (ICIDH) classifications, which viewed disability from a medical model perspective, and as being a problem with the individual person.

45. World Health Organization (WHO) and ICIDH-2, or ICF The new guidelines were formerly called ICIDH-2. They have been re-named: The International Classification of Functioning, Disability and Health (ICF), as of May 22, 2001. The newest Frameworks of Practice for Occupational Therapy, which replace Uniform Terminology III, correspond closely to this new ICF document from WHO.

46. ICF Overview

47. ICF Definitions of Components

48. World Health Organization - ICFKey Constructs of Functioning & Disability(Adapted from work done by Donald J. Lollar, EdD. Centers for Disease Control and Prevention Disability and Health Branch) Body Function Activities Participation BODY PERSON SOCIETY Function/ Activities Participation Structure (Limitation) (Restriction) Severity, Localization, Difficulty with and degree Duration without assistance ENVIRONMENTAL FACTORS BARRIERS (Physical & Social) & FACILITATORS (Physical & Social)

49. Current WHO Understanding of Interactions Between the Components of ICF

50. Current WHO Understanding of Interactions Between the Components of ICF with Concepts from Philosophical Base

52. The Philosophical Base Review and Concluding Remarks

53. Review and Concluding Remarks The Philosophical Base was adopted in 1979 to increase a sense of unity in a diverse profession. The Philosophical Base clarifies Occupational Therapy�s beliefs about the nature of humankind, the environment, adaptation, dysfunction, and purposeful activity. It explains why we believe purposeful activity facilitates the adaptation process in human beings, and why we believe facilitating the adaptation process is important.

54. Review and Concluding Remarks The Philosophical Base is congruent with a universal way of conceptualizing the adaptation process as a continuum. It is also congruent with the contemporary and international view of disability found in the ICF. The Philosophical Base can be used as an integrative set of ideas to provide a foundation for practice in both traditional and non-traditional settings. The Philosophical Base of Occupational therapy has been offered here today as a foundation for practice.

55. The Philosophical Base

56. The Philosophical Base

57. The Philosophical Base Questions and Answers ?

58. The Philosophical Base References

59. References American Occupational Therapy Association (1979). The philosophical base of occupational therapy. The American Journal of Occupational Therapy,33, p.785. Peloquin, S.M. (1991). Occupational therapy service: Individual and collective understandings of the founders, part 2. The American Journal of Occupational Therapy, 45(8), 733-744. Reilly, M. (1962). Eleanor Clarke Slagle Lecture: Occupational therapy can be one of the great ideas of the 20th Century. The American Journal of Occupational Therapy,16(1), 1-9.

60. References Serrett, (1985). Another look at occupational therapy's history: Paradigm or pair-of-hands? Occupational Therapy in Mental Health, 5(3), 1-31. Shannon, P. (1977). The derailment of occupational therapy. The American Journal of Occupational Therapy, 31(4), 229-234. Quiroga, V.A.M. (1995). Occupational therapy: The first 30 years -1900 to 1930. Bethesda, MD: The American Occupational Therapy Association, Inc.