Occupational Therapy Treatment Process

Shamima AkterBOT, MRS (candidate)

Lecturer, Department of Occupational Therapy

Bangladesh Health Professions InstituteCentre for the Rehabilitation of the Paralysed

Chapain, Savar

Screening

Referral

Process

ReferralBuild up rapportAssessmentTreatment planTreatment implementationEvaluation

Referral

It can be provided by doctor, nurse, physiotherapist, relatives of patient, patient himself, social work, community based rehabilitation technician and occupational therapist.

Screening

To check the eligibility of providing occupational therapy

Build up rapport

It also means therapeutic relationship or therapeutic use of self.

Assessment

Assessment refers to the process of gathering as much information as possible about a client. Assessment is an important aspect of the occupational therapy process, as it enables the therapist to gather thorough information, so that he/she is able to plan appropriate and relevant treatment for the client.

For example:

To identify functional problem use Functional Independence Measure (FIM)

To determine motor problem use Goniometer for measuring Range of Motion and

Modified oxford muscle grade scale for measuring muscle strength

Modified Asworth sclae for measuring hypertonicity

Treatment plan

Now that the therapist has developed a list of client problems and strengths, and established treatment priorities, they are ready to develop a treatment plan. A treatment plan is an important part of treatment as it ensures that the therapist has an idea of how they can address the treatment priorities in the timeframe that they have.

Problem Statement

Client has difficulty to do upper half dressing independently due to:

- Unable to put on right hand into sleeve for limited range of motion in shoulder and elbow

Therapeutic goal

a) Long-term goalClient will be able to do upper half dressing independently (FIM 7) after accomplishing 90 treatment sessions.

b) Short term goal Client will be able to achieve 145 degree shoulder abduction to reach for sleeves after accomplishing 5 days treatment sessions.

Treatment

Grading activity to improve range of motion practice reaching activity from 1 cm away

(which needs to abduct shoulder 10 degree) practice reaching activity from 2 cm away

(which needs to abduct shoulder 20 degree)

Treatment implementation

Treatment implementation means to give the treatment. This is where occupational therapists actually use their treatment skills to assist the patient to achieve their aims and objectives. You will learn many types of treatment that you can implement over the next 5 years. For now it is important just to realize where this stage fits in the OT process. Occupational therapists have a broad education in the medical, social behavioral, psychological, psychosocial and occupational sciences which equips them with the attitudes, skills and knowledge to work collaboratively with people, individually or in groups or communities.

Treatment evaluation

When we talked about occupational therapy beliefs about humans in an earlier lecture, we found that OT believes that humans are all unique and that they change. Therefore it is important to be flexible in the implementation of a treatment plan. There are many things that can change while we are treating a patient which influence our treatment. It is important to recognize these changes and to change our treatment accordingly. This process is called evaluation.

References

Pedretti LW 1996, Occupational Therapy: Practice skill for physical dysfunction, 4th ed, Mosby-Year Book, Inc, Philadelphia

Trombly CA 1996, Occupational Therapy for Physical Dysfunction, 5th ed, Mosby Company, Philadelphia

Hagedorn R 1992, Occupational Therapy: Foundation for Practice, 1st ed, Churchill Livingstone, New York.

ANY QUESTION