Improving Function and Quality of Life Through Occupation - NYAPRS by zhouwenjuan


									Improving Function and Quality of
Life Through Occupation: The Role
    of Occupational Therapy in

                        Presented by:
                 Sean M. Getty, MS, OTR/L
                       Rehab Director
    Roads to Recovery PROS/ Pathways to Recovery PROS
Learning Objectives
•   Identify the role of the occupational
    therapist in facilitating recovery for
    people with mental illness
•   Identify the fundamentals of occupational therapy and how
    these align with the core components of mental health
•   Identify treatment approaches utilized by occupational
    therapists utilized at various stages of recovery.
•   Identify some of the recovery-based, client-centered
    assessments utilized by occupational therapists to facilitate
•   To understand the importance of meaningful occupation in
    the recovery process.
What is Occupational Therapy?
 “The practice of occupational therapy
means the therapeutic use of occupations,
  including everyday life activities with
   individuals, groups, populations, or
organizations to support participation,
performance, and function in roles and
situations in home, school, workplace,
    community, and other settings.”
              (AOTA, 2004)
   “Occupational therapy services are
provided for habilitation, rehabilitation,
    and the promotion of health and
wellness to those who have or are at risk
for developing an illness, injury, disease,
     disorder, condition, impairment,
      disability, activity limitation, or
 participation restriction.” (AOTA, 2004)
 “Occupational therapy addresses the
   physical, cognitive, psychosocial,
sensory-perceptual, and other aspects of
performance in a variety of contexts and
environments to support engagement in
  occupations that affect physical and
mental health, well-being, and quality of
         life.” (AOTA, 2004)
           Basic Tenets of OT
•   Occupation-Based Practice
•   Empowerment
•   Client-Centered Approach
•   Holistic Approach
•   Strengths-Based
•   Context-Based Practice
•   Cultural Diversity
What is Recovery
• 10 Fundamental Components of Recovery
  –   Self-Direction
  –   Individualized and Person-Centered
  –   Empowerment
  –   Holistic
  –   Non-Linear
  –   Strengths-Based
  –   Peer Support
  –   Respect
  –   Responsibility
  –   Hope
                     - U.S. Department of Health and Human Services (2005)
Areas of Assessment
& Treatment
•    Areas of Occupation
    1.   Activities of Daily Living
    2.   Instrumental Activities of Daily Living
    3.   Rest and Sleep
    4.   Education
    5.   Work
    6.   Play
    7.   Leisure
    8.   Social Participation

•    Activity Demands
•   Client Factors-
    1. Values, Beliefs, & Spirituality
    2. Body Functions
    3. Body Structures

•   Performance Skills
    1.   Motor & Praxis Skills
    2.   Sensory-Perceptual Skills
    3.   Emotional Regulation Skills
    4.   Cognitive Skills
    5.   Communication & Social Skills
•    Performance Patterns
    1.   Habits
    2.   Roles
    3.   Rituals
    4.   Routines

•    Context and Environment
    1.   Cultural
    2.   Personal
    3.   Temporal
    4.   Virtual
    5.   Physical
    6.   Social
            Intervention Approaches
1. Create or Promote
    – Creating intervention strategies without assuming that a disability is present or that any
       factors would interfere with performance
    – Resembles health promotion model

2. Establish or Restore
    – Leads to re-establishment of a lost skill
       or ability
    – Examples: money management,
       parenting, leisure skills

3. Maintain
    – Preservation of performance

4. Modify
    – Revise the current context or task demands to support performance in the natural setting
    – Examples: social networks can be changed; temporal modifications like duration or
      sequence of a task can be changed; backward chaining
    – Match a context or task to the person’s abilities
    – Nothing is changed about the person

5. Prevent
•   Activities of Daily Living
•   Behavioral Assessments
•   Cognitive Behavioral Assessments
•   Evaluations of Social Interactions
•   Vocational Assessments
•   Sensory Processing Assessments
            Treatment Settings
•   Acute & Long Term Care Facilities
•   Residential and Day Programs
•   Skilled Nursing Facilities
•   Community-Based Mental Health Centers
•   Schools
•   Military Installations
•   Employment Practice
     OT in an Acute Facility
• Evaluation
• Managing Symptoms through Occupation
• Alternatives to Restraints
    OT in Community Settings
• Evaluation
  – Identifying the underlying skills impeding goal
• Improve Function
  – Carrying out a plan to
     improve function and
     achieve the individual’s
• Wellness
•   Social          •   Spiritual
•   Environmental   •   Occupational
•   Physical        •   Intellectual
•   Emotional       •   Financial
                               (Swarbrick, 2006)
•   American Occupational Therapy Association (2004) Definition of occupational
    therapy practice for the AOTA Model Practice Area. Bethesda, MD: Author.
    (Available from the State Affairs Group, 4720 Montgomery Lane, PO Box 31220,
    Bethesda, MD 20824-1220)
•   Dornan, D.H., Felton, C., Carpinello, S. (November 14, 2000) Mental Health
    Recovery from the Perspectives of Consumer/Survivors. Presentation at the
    American Public Health Association Annual Meeting, Boston, MA.
•   New York State Office of Mental Health (2010). Part 512 PROS Regulations.
    Retrieved from
•   Substance Abuse and Mental Health Services Administration. (2010). Mental
    Health, United States, 2008. HHS Publication No. (SMA) 10-4590, Rockville MD:
    Center for Mental Health Services, Substance Abuse and Mental Health Services
•   Swarbrick, M. (2006) A Wellness Approach. Psychiatric Rehabilitation Journal,
    29(4) 311-314
•   U.S. Department of Health and Human Services (2005) National Consensus
    Statement on Mental Health Recovery. Retrieved from

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