Professional competence for private practitioners in occupational therapy

The aim of the present study was to investigate the meaning of professional competence for occupational therapy private practitioners and their experience of the barriers to professional competence. Semi-structured interviews with 16 key informants from private practice in Victoria elicited diverse opinions and experiences. However, the difficulty of assessing competence, and the lack of standards that identify competent practice for occupational therapy were major themes in the findings. The role of theory in competent practice was evident in discussion but it was not clearly articulated by many participants. Experiences of professional socialisation varied yet participants perceived input from peers as contributing to assuring competence. Major barriers to professional competence were identified as professional isolation, time and finances. The present study highlights the complexity of current attempts to assess professional competence for practising occupational therapists including the implementation of an accreditation program by The Australian Association of Occupational Therapists Inc. (OT AUSTRALIA), the peak body representing occupational therapists.     

Occupational therapists' skills and attitudes regarding use of computers and assistive technology

The purpose of this study was to examine the skills and attitudes of a sample of practicing occupational therapists regarding the use of computers, and to explore their agreement with the Foundation Level Technology Competencies proposed for adoption in the United States of America (American Occupational Therapy Association, 1991; reported in Hammel and Smith, 1993). Out of a sample of 250 subjects, 89 occupational therapists in the USA completed a questionnaire regarding their experiences with, and attitudes towards computers, and their agreement with the proposed Competencies. The results indicated that while the majority of therapists had had some exposure to computers, they wanted to learn more—particularly how a computer could aid management tasks. While 50% or more of the therapists ‘Agreed’ or ‘Strongly Agreed’ with 19 of the 21 Competencies, the level of therapist ‘Indecision’ or ‘Disagreement’ with several of the Competencies suggests that either these Competencies require revision, or that if the Competencies are nationally adopted, many therapists may require intensive continuing education programmes to bring their skills to a competent standard. Adoption of these Competencies has many implications for international standards of occupational therapy practice and levels of computer education. Copyright © 1997 Whurr Publishers Ltd.     

1982 Sylvia Docker Lecture Occupational Therapists must be Facilitators not Inhibitors of Action

After briefly reviewing the lecturer's 30 years as an occupational therapist, the proposition is discussed that occupational therapists are lucky people because of the role they have played and must continue to play as active people in professional associations and in the community. The need to extend therapists influence more widely in the community both as members of their own profession and of multidisciplinary teams is discussed. Reference is made to new and different areas of concern in South Australia in which occupational therapists have been and are actively involved.     

The quality of occupational therapy evaluated in six outpatients

The purpose of the study was to analyse the content and evaluate the quality of clinical occupational therapy in outpatients as reported by their respective therapists. An inductive and interpretive technique with special study protocols was developed in Sweden for the study of six patients. Each therapist kept a protocol of the patient's 2–3 months' participation in occupational therapy. The protocols were subsequently interpreted independently by another occupational therapist and a physician. At the end of the study, function and ability had improved in four cases and quality of life in five out of six cases as demonstrated by their ability in activities of daily living.     

What occupational and physical therapists know about farmers’ health

Farmers are at high risk for losing their occupation because of their susceptibility for developing chronic conditions and incurring injuries. Although, occupational and physical therapists have basic education in return-to-work methods, specialty training is needed to help farmers with disabilities. The North Carolina AgrAbility Partnership, part of the U.S. Department of Agriculture’s supported AgrAbility Program, implemented an exploratory survey of North Carolina occupational and physical therapists before developing training curricula for working with farmers. State occupational and physical therapy association members were surveyed on what types of conditions they could treat, how comfortable they were in treating these conditions and making recommendations for environmental modifications, and what resources are available for farmers related to work site accommodations. Findings showed that less than one third of therapists had farm exposure or had ever treated farmers. Significant differences in identifying farmers’ typical conditions were found between therapists who had treated and those who had not treated farmers. Physical therapists were more comfortable than occupational therapists in treating farmers for repetitive stress syndromes, work-related trauma, and musculoskeletal disorders while occupational therapists were more comfortable in treating farmers for social isolation and low vision. More physical therapists also rated themselves as competent in farm environmental assessment and adaptation. On the other hand, occupational therapists were aware of more agencies that aid farmers. Finally, few therapists had education on working with farmers or had heard of AgrAbility. To create farmer-centered intervention, therapists should take continuing education courses and investigate resources for helping farmers with chronic conditions and disabilities return to their chosen occupation.     

Strategies for understanding. A case study of occupational therapists' communication behaviour

This study focuses on the communication strategies of occupational therapists. Many recent studies in occupational therapy emphasize the importance of having a client-oriented perspective; the needs and wishes of the patient should form the basis for treatment. Such a perspective brings to the fore the capacity of the therapist to enter into the life-world of the patient. Communication, dialogue between patient and therapist, is the basic source of such knowledge. In this paper, understanding verbal acts is seen as fundamentally problematic. The purpose is to analyse what strategies and tactics occupational therapists use to create a basis for their interpretation of patients' messages. What kinds of questions and other forms of verbal behaviour are utilized to check and verify these interpretations? A case-study of communication behaviour during five meetings between patients and therapists in the homes of the patients was undertaken. Seven types of tactics were observed and categorized as belonging to two different strategic dimensions: active-passive and abstract-concrete. Although active strategies were predominant, only one therapist consistently used a combination of ‘asking open questions’ and ‘verifying’ interpretations, the two most active tactics. Most therapists also asked the patients to concretely ‘show in action’ what they meant, but to a varying degree. A consistent use of active-concrete strategies is arguably an ideal way of seeking knowledge and understanding. Empirically, therapists differ in how closely they fit this ideal. This may be a result of training and experience, but also of degree of empathy. This study points to the importance of carefully developing communication strategies in order to fully understand the problems of the patients. Copyright © 1997 Whurr Publishers Ltd.     

Inpatients' perspectives of occupational therapy in acute mental health

Background:  Research into service users' views of occupational therapy in acute mental health is extremely limited. This collaborative study by the South West London and St George's Mental Health NHS Trust and the Brunel University (UK) obtained inpatients' perspectives of occupational therapy.
Methods:  Service users and occupational therapists were involved in designing a self-report questionnaire and, following training, in recruiting participants and collecting data.
Results:  Sixty-four (28.6%) inpatients responded and most had met an occupational therapist who had explained the purpose of the intervention. The most frequent group interventions were arts and crafts, relaxation, community meetings, cookery, sports and gym, with the latter two rated as the most beneficial. There was much less choice about individual goals and interventions. A highly significant and positive correlation was found between occupational therapy meeting the needs of individuals and it improving the inpatients' daily functioning and quality of their admission.
Conclusions:  Occupational therapists need to provide more individual interventions and more fully involve inpatients in deciding on individual goals. Group interventions, which are meaningful, relevant and with an occupational focus, are most beneficial. Further research examining the effectiveness of cookery and sport and gym and establishing the benefits of engaging in group and individual interventions in acute wards is warranted.     

A Swedish survey of occupational therapists' involvement and performance in driving assessments

The purpose of this study was to examine the extent to which occupational therapists (OTs) are involved in driving assessments in Sweden and how these assessments are performed. A questionnaire was sent to 154 geriatric, rehabilitation, and neurological clinics, and additionally directly to 19 OTs who had purchased a test battery specifically used for driving assessments. The response rate was 60%. Of those responding, 57% reported being involved in fitness-to-drive assessments. However, such assessments were carried out in various manners and diverse methods were used, ranging from unstandardized activity assessments to a test developed specifically for driving assessments. Only 19% used on-road driving tests as a complement to the clinical assessments. Apart from the lack of appropriate methods, the respondents said that they did not have sufficient knowledge to perform driving assessments and expressed a need for further education. In the future it seems necessary for OTs in Sweden to undergo specialized training and perform the assessments on a regular basis to maintain a high level of competence as driving assessors.     

Patients' perceptions of home health occupational therapy

Home health occupational therapy plays an important and growing role in patients' recovery. Home health treatment is unique in that the therapist is a visitor in the patient's home environment. A phenomenological approach was used to examine perceptions of five individuals who were interviewed twice to collect their impressions of home health occupational therapy. Participants' goals for therapy as solicited by home health occupational therapists and participants perceived goals were not always pursued collaboratively. Therapeutic and compensatory occupations were incorporated less often than purposeful exercise. Participants valued those occupations engaged in, despite limited physical recovery. Participants' perceptions of occupational therapists were generally positive. Participants were unprepared for discharge, which was perceived as significant and they as helpless to prevent it despite desire for continued services. Few occupations reported in their treatment coincided with participants' difficulty distinguishing between occupational and physical therapies. Continued research focused on patients' perceptions of home health occupational therapy would be useful in further examining this phenomenon and would enlighten home health occupational therapy practice.     

Multicompetent allied health professionals: current approaches and suggestions for baccalaureate level programs

A study of the need for multicompetency was conducted by the University of Florida College of Health Related Professions among the graduates of its baccalaureate programs in dietetics, medical technology, occupational therapy, and physical therapy. Most responding dietitians, physical therapists, and occupational therapists said they had felt a need during their professional practice to be competent in areas outside their profession, while most responding medical technologists did not feel such a need. The respondents listed those areas outside their profession in which they had felt a need for competency. This article also describes current approaches to the education of multicompetent allied health professionals and suggests new strategies for educating these personnel at the baccalaureate level.     

The Contribution of Occupational Therapy to Alcohol and Drug Rehabilitation: A Descriptive Review

Occupational therapists work as members of multidisciplinary teams in the assessment and treatment of people experiencing alcohol and drug related difficulties. In the context of “team” treatment, the role of the occupational therapist often appears unclear. Although there is a paucity of available literature regarding occupational therapy roles and functions in this field, the importance of activity based interventions to promote the development of living skills and for facilitating lifestyle changes is well documented. Occupational therapists employed at Pleasant View Centre, Victoria, aim to assist people with addiction problems in reducing or abstaining from drug use within a psychosocial framework. They assist clients in both the detoxification and rehabilitation phases of treatment and provide appropriate follow-up and support. Occupational therapists contribute both their group and individual counselling skills and, in addition, provide a unique focus on maximsising self-efficacy and competence to perform life skills. They provide activity based programmes which enhance existing skills and the acquisition of new skills. The complex nature of addiction requires a diverse range of orientations and skills to which the occupational therapist contributes a philosophy and practice of learning skills for living through “doing” and activity.     

Work Related Programs in Occupational Therapy

This paper addresses occupational therapists who would like to become involved in work related programs for the industrially injured. The authors review the historical and philosophical bases that support occupational therapy's use of work as an evaluative and therapeutic medium. The workers' compensation process is outlined and key professionals in the system are identified. Three services that the occupational therapist can provide are defined. They are work tolerance screening, work capacity evaluation, and work hardening. An example of basic program structure, including evaluative tools, is given for each of the three services.     

Transitioning From Occupational Therapy Student To Practicing Occupational Therapist: First Year of Employment

This research examined the transition from occupational therapy student to practicing occupational therapist over the course of one's first year of professional employment, as recalled by a sample of occupational therapists. Surveys were mailed to 500 occupational therapists randomly selected from membership in the American Occupational Therapy Association resulting in 202 returned surveys. Median year of graduation was 1998, ranging from 1967 to 2014. In general, respondents indicated the transition was positive. Having a mentor was related to high job satisfaction and good clinical fit, while supervising an occupational therapy assistant and low self-confidence were viewed as negative impact factors. Recent graduates presented with lower ratings of a positive transition and higher ratings of likelihood of experiencing burnout and initial job stress than earlier graduates. Recommendations for improving the transition experience are presented.     

A Swedish survey of occupational therapists’ involvement and performance in driving assessments

The purpose of this study was to examine the extent to which occupational therapists (OTs) are involved in driving assessments in Sweden and how these assessments are performed. A questionnaire was sent to 154 geriatric, rehabilitation, and neurological clinics, and additionally directly to 19 OTs who had purchased a test battery specifically used for driving assessments. The response rate was 60%. Of those responding, 57% reported being involved in fitness-to-drive assessments. However, such assessments were carried out in various manners and diverse methods were used, ranging from unstandardized activity assessments to a test developed specifically for driving assessments. Only 19% used on-road driving tests as a complement to the clinical assessments. Apart from the lack of appropriate methods, the respondents said that they did not have sufficient knowledge to perform driving assessments and expressed a need for further education. In the future it seems necessary for OTs in Sweden to undergo specialized training and perform the assessments on a regular basis to maintain a high level of competence as driving assessors.     

A Survey of Occupational Therapy Practice in Beijing,China

There is an increasing demand for rehabilitation services in China as a result of the growing number of people with physical and mental challenges, as well as the growing population of older adults. The purpose of this study was to explore the current occupational therapy (OT) resources available in Beijing, China, to serve as the first step in planning the response to increasing demand for OT services from the people of China. Specifically, using the snowball sampling survey method, we explored the work practice, including years of working experience, work setting, weekly work hours, annual income and factors related to job satisfaction among occupational therapists in Beijing, China. A total of 44 occupational therapists currently working in the Beijing area responded to our survey. The results demonstrated that most of the therapists working in Beijing area were young and inexperienced. Despite the fact that the participants had an average age of 31 years old and an average of 8 years' working experience, 61.4% of therapists were under 30 years old and more than half of therapists had less than 5 years of OT experiences. Among those included in the study sample, 50% had earned degrees in OT, and the rest of the OT personnel received OT‐related on‐the‐job training in various forms and lengths of time. A majority of the participants worked in hospital settings with adults or children with physical disabilities and used therapeutic activities and therapeutic exercises. Being an occupational therapist is not a high‐paying job. Education satisfaction, work experience and annual income are the factors related to job satisfaction for the participants. The majority of occupational therapists expressed the need to receive more support for clinical‐related trainings. We plan to expand this pilot study nationwide to gain an in‐depth and comprehensive understanding of the OT workforce in China. Copyright © 2016 John Wiley & Sons, Ltd.     

Quality of life: An overview of issues for use in occupational therapy outcome measurement

The concept of quality of life (QOL) has been used as an outcome measure to indicate the global health, functioning and wellbeing of a person following illness, injury or disability, and to evaluate the effectiveness of therapeutic interventions. Whilst QOL has been widely used for these purposes by researchers and practitioners in the health and social sciences, it has had limited application by occupational therapists. This has occurred despite the obvious links to occupational therapy philosophy, with both having a multifaceted, holistic, and client-centred approach to people's lives, and a concern with the roles and functions that give life meaning and value. This paper reviews QOL literature in order to introduce occupational therapists to the issues involved with using this construct, from its conceptualization to its measurement. A guide to the decision-making processes involved in selecting an appropriate QOL outcome measure for use in occupational therapy practice is provided.     

The Occupational Performance History Interview in community mental health case management: Consumer and occupational therapist perspectives

Background/aim:  This study aimed to explore the use of the Occupational Performance History Interview from the perspectives of mental health consumers and occupational therapist case managers in community mental health settings.
Methods:  This qualitative study, based on naturalistic inquiry, involved 10 participants: four occupational therapists who interviewed six mental health consumers, using the Occupational Performance History Interview. All participants participated in follow-up interviews or in focus groups to gain an understanding of their perspectives of this experience. Transcribed data were analysed using the constant comparative method.
Results:  Consumer participants valued telling their occupational stories. Occupational therapist participants described the interview as supporting them to be more occupationally focused within their case management roles.
Conclusion:  The findings suggest that the Occupational Performance History Interview can potentially enhance client-centred and occupationally focused practice in community mental health case management.     

A pilot study on attitudes toward making reasonable accommodations for occupational therapists with disabilities

The Americans with Disabilities Act (ADA) ensures that persons with disabilities in the United States are entitled to reasonable accommodations in five areas including employment. This pilot study (1) tested the reliability and validity of a questionnaire, which (2) explored how much training American occupational therapists had in the ADA and (3) investigated the attitudes of occupational therapist supervisors toward occupational therapist employees with disabilities. A questionnaire consisting of 20 statements was designed by the researcher. The questionnaire was mailed to 18 occupational therapy administrators. Ten participants who completed the mailed questionnaire were included in the results. Participants with ADA training had a more positive attitude towards making reasonable accommodations than those without training. Only participants working in psychosocial settings claimed to have occupational therapy employees with disabilities. Six of the administrators made reasonable accommodations for employees who had disabilities. Further study of a larger sample of occupational therapy administrators is recommended to determine the attitude towards reasonable accommodations for employees with disabilities. Copyright © 1996 Whurr Publishers Ltd.