Domain & Process 3rd Edition

OCCUPATIONAL THERAPY PRACTICE

Framework:

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OutlinePreface IntroductionDomainProcessConclusion Reference

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Preface

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The Therapeutic Use Of Everyday Life Activities (Occupations) With Individuals Or Groups For The Purpose Of Enhancing Or Enabling Participation In Roles, Habits, And Routines In Home, School, Workplace, Community, And Other Settings.

Occupational Therapy Services Are Provided For Habilitation, Rehabilitation, And Promotion Of Health And Wellness For Clients With Disability- And Non–disability-related Needs.

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Occupational therapy

Preface

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Evolution of This Document first edition: Occupational Therapy Product Output Reporting

System and Uniform Terminology for Reporting Occupational Therapy Services (AOTA, 1979).

second edition of Uniform Terminology for Occupational Therapy (AOTA, 1989).

The third and final revision of Uniform Terminology for Occupational Therapy (AOTA, 1994)

Occupational Therapy Practice Framework: Domain and Process (AOTA, 2002b).

second edition of the Framework (AOTA, 2008, pp. 665–667). 2013…

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Preface

Introduction

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Purpose of framework The Occupational Therapy Practice Framework:

Domain and Process describes the central concepts that ground occupational therapy practice and builds a common understanding of the basic tenets and vision of the profession.

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Introduction

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client

persons groups populations

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Introduction

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OTPF

Domain

Occupations

Client factors

Performance skills

Performance patterns

Contexts and environments

Process

Evaluation

Intervention

Targeting outcomes

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9 Introduction

Domain

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Domain

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Occupations

ADL

IADL

Rest and Sleep

Education

Work

Play

Leisure

Social participation

Client factors

Values, beliefs, and spirituality

Body functions

Body structures

Performance skills

Motor skills

Process skills

Social interaction

skills

Performance patterns

Habits

Routines

Rituals

Roles

Contexts and environment

Cultural

Personal

Physical

Social

Temporal

Virtual

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Occupation “In occupational therapy, occupations refer to

the everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do”

(World Federation of Occupational Therapists, 2012).

Occupation and activity Co-occupation

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ADL

Bathing, showerin

g Toileting and

toilet hygiene

Dressing

Swallowing/

eating

FeedingFunction

al mobility

Personal device care

Personal hygiene

and groomin

g

Sexual activity

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IADL

Care of others

Care of pets

Child rearing

Communication

management

Driving and community

mobility

Financial managementHealth

management and

maintenance

Home establishment

and management

Meal preparation and cleanup

Religious and spiritual

activities and expression

Safety and emergency

maintenance

Shopping

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Rest and Sleep

Rest

Sleep preparation

Sleep participation

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PlayPlay exploration

Play participation

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LEISURE

LEISURE exploration

LEISURE participation

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Valu

e • Honesty with self and others

• Commitment to family

• Freedom of speech

Bel

ief • Hard work

pays off.• Some

personal rights are worth fighting for Sp

iritu

ality

• Daily search for purpose and meaning in one’s life

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Bod

y Fu

nctio

nsMental functions

Sensory functions

Neuromusculoskeletal and movement-related functions

Cardiovascular, hematological, immunological, and respiratory system functions

Voice and speech functions; digestive, metabolic, and endocrine system functions; genitourinary and

reproductive functions

Skin and related structure functionsMohsen Eslampanah

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Mental functions (affective, cognitive, perceptual)

Specific mental functions

1.Higher-level cognitive2.Attention3.Memory

4.Perception5.Thought

6.Mental functions of sequencing complex movement

7.Emotional 8.Experience of self and time

Global mental functions

1.Consciousness2.Orientation

3.Temperament and personality4.Energy and drive

5.sleep

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Body Structure

Structure of the nervous system

Eyes, ear, and related structures

Structures involved in voice and speech

Structures of the cardiovascular, immunological, and respiratory systems

Structures related to the digestive, metabolic, and endocrine systems

Structures related to the genitourinary and reproductive systems

Structures related to movement

Skin and related structuresMohsen Eslampanah

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Performance Skills

Motor Skills

Process Skills

Social Interaction Skills

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HabitsSpecific, automatic behaviors

that can be useful, dominating, or impoverished

RoutinesEstablished sequences of

occupations or activities that provide a structure for daily

life.

RolesSets of behaviors expected by

society, shaped by culture, and may be further conceptualized

and defined by the client.

RitualsSymbolic actions with spiritual, cultural, or social meaning that

contribute to the client’s identity and reinforce the client’s values and beliefs.

Performance patterns

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CONTEXT• Cultural: customs, beliefs, activity patterns, behavior standards,

and expectation accepted by the society• Personal: demographic feature of the individual such as age,

gender, socioeconomic status, and educational level • Temporal: stage of life, time of day or year, duration, rhythm of

activity, or history.• Virtual: interaction in simulated, real-time, or near time

situations absent of physical contact.

ENVIRONMENT• Physical: natural and built nonhuman environment and objects

in them. • Social: relationships, and expectations of persons, groups, and

organizations Mohsen Eslampanah

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Process

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Overview of the Occupational therapy process Service delivery models Clinical reasoning Therapeutic use of self Activity analysis

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Process

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Acti

vity

and

oc

cupa

tion

al

Dem

ands

Relevance And Importance To Client

Objects Used And Their Properties

Space Demands (Related To The Physical Environment)

Social Demands (Related To The Social Environment And Virtual And Cultural Contexts)

Sequencing And Timing

Required Actions And Performance Skills

Required Body Functions

Required Body Structures Mohsen Eslampanah

Process

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Process

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EVALUATION

OCCUPATIONAL PROFILE

ANALYSIS OF OCCUPATIONAL PERFORMANCE

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Occupational profile Why is the client seeking service, and what are the client’s current

concerns relative to engaging in occupations and in daily life activities? In what occupations does the client feel successful, and what barriers are

affecting his or her success? What aspects of his or her environments or contexts does the client see as

supporting engagement in desired occupations, and what aspects are inhibiting engagement?

What is the client’s occupational history (i.e., life experiences)? What are the client’s values and interests? What are the client’s daily life roles? What are the client’s patterns of engagement in occupations, and how

have they changed over time? What are the client’s priorities and desired targeted outcomes related to

occupational performance, prevention, participation, role competence, health and wellness, quality of life, well-being, and occupational justice?Mohsen Eslampanah

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Analysis of occupational performance Synthesizing information from the occupational profile to focus on specific occupations and

contexts that need to be addressed Observing a client’s performance during activities relevant to desired occupations, noting

effectiveness of performance skills and performance patterns Selecting and using specific assessments to measure performance skills and performance

patterns, as appropriate Selecting and administering assessments, as needed, to identify and measure more

specifically the contexts or environments, activity demands, and client factors that influence performance skills and performance patterns

Selecting outcome measures Interpreting the assessment data to identify supports and hindrances to performance Developing and refining hypotheses about the client’s occupational performance strengths

and limitations Creating goals in collaboration with the client that address the desired outcomes Determining procedures to measure the outcomes of intervention Delineating a potential intervention approach or approaches based on best practices and

available evidence.Mohsen Eslampanah

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Intervention process

INTERVENTION PLAN

INTERVENTION IMPLEMENTATI

ON

INTERVENTION REVIEW

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Intervention plan 1. Developing the plan

Objective and measurable occupation focused goals with a timeframe

Occupational therapy intervention approaches

Methods for service delivery2. Considering potential discharge

needs and plans3. Making recommendation or

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Create, promote (health promotion)

Establish, restore (remediation, restoration)

Maintain

Modify (compensation, adaptation)

Prevent (disability prevention)

Occupational therapy intervention approaches

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Intervention implementation1. Determining and carry out the type of OT

intervention 2. Monitoring the client’s response to

interventionsTypes Of

Occupational Therapy

Interventions

Occupation And

Activities

Prepratory Methods And Tasks

Education And

TrainingAdvocacy

Group Interventi

ons

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Intervention review Re-evaluating the plan Modify the plan Determining the need for continuation or discontinuation

of OT services and for referral to other services

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Outcomes process stepsSelecting types of

outcomes and measures

• Occupational performance• Improvement• Enhancement

• Prevention• Health and wellness• Quality of life• Participation• Role competence• Well-being• Occupational justice

Using outcomes to measure progress and

adjust goals and interventions

• Comparing progress toward goal achievement

• Assessing outcome use and results to make decisions about the future direction of intervention

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Conclusion

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Conclusion

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Reference American Occupational Therapy Association.(2014). Occupational

therapy practice framework: Domain and process (3rd ed.).American Journal of Occupational Therapy, 68(Suppl.1), S1 S48.http://dx.doi.org/10.5014/ajot.2014.682006

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Thank You For Your Attention