How Do Occupational Therapists Think?
How do occupational therapists get their clients from point A to point B? How do they determine the best way to approach a problem, and find a solution? And how do they take action to meet their goals? The answer to all of these questions is in the OT process.
The occupational therapy process, or OT process, covers all aspects and stages that an occupational therapist goes through from the point of referral, to the point of discharge. You will encounter some variation of the OT process when working with an occupational therapist, either as a colleague, or a client.
There are a few key stages in the OT process, which are: referral, screening, assessment/evaluation, planning and goal-setting, intervention, reevaluation, and discharge. However, before we go on, it is essential to note that this process isn’t linear. From goal-setting through to reevaluation, the cycle may repeat itself as necessary until the overall therapy goals are met. Only at this point will the process move on to discharge planning and eventually self-management.
The OT process also takes into account contexts such as personal circumstances, emotion, psychological state, financial state, social support, and living environment, to list a few. It considers how all these factors interact and how they can influence their client’s progress toward their goals.
Now, let’s dive a little deeper into what each of the stages in the OT process entails:
Referral: There are two options when it comes to referrals; referrals from doctors, and self-referrals. When a doctor evaluates you, if they feel you require attention from an occupational therapist, they’ll do one of two things. Send a referral directly, or give you a referral to take to the occupational therapist’s office. In the case of a self-referral, once you’ve determined that you need attention from an occupational therapist, you can contact them to set up an appointment. It is important to note, however, that self-referrals aren’t an option is always available.
Screening: During the screening process, the occupational therapist will familiarise themselves with the client’s medical history, condition and the circumstances surrounding their referral. This screening serves two purposes; allowing the occupational therapist to gain a better understanding of their potential client, and determining if occupational therapy services are appropriate for them. Should occupational therapy services be deemed inappropriate, the occupational therapist will send a referral to a better suited professional.
Assessment/Evaluation: This is the stage where the occupational therapist will conduct standardised, or non-standardised tests, and interview their client to develop a basis for intervention. These assessments provide a baseline which will be referred to during the reevaluation process. They also allow the therapist to understand their client’s roles, abilities, personal context (emotional, social, psychological, etc.), environment, motivations, and the expectations of their care better.
Planning & Goal-Setting: This is one of the most critical parts of the OT process. Why? Because the occupational therapist, and their client, come together to determine what the goals of therapy will be. As occupational therapy is a client-centred profession, the client must be involved in this process. They will work together to form an intervention plan which is designed to meet the client’s needs in a way that preserves their dignity and is meaningful/purposeful to them. Also, ensuring that the intervention which is chosen is evidence-based, and occupation-focused is an essential factor in this stage of the OT Process.
Intervention: This is the part of the OT process that is the most obvious. It is what people see an occupational therapist doing with their client, and it is, in essence, the ‘face’ of the OT process. The interventions in this stage will follow the plans previously set, with the occupational therapist making any necessary adjustments as they progress. The nature of intervention chosen is as variable as there are conditions to address. So the occupational therapist will always strive to ensure that the intervention is appropriate for the setting, sustainable, and is suitable for the outcomes outlined in the last stage.
Reevaluation: This happens after a set amount of time in the intervention phase. At this point, the occupational therapist will re-assess their client to determine if they have achieved their goals or not. If they have, then the client will move forward to discharge planning. However, if they haven’t, the occupational therapist and client will jointly consider what contributed to them not meeting their goals. Could it be that the wrong intervention was chosen? Or the client’s adherence to home recommendations need to be improved? Or a different focus of treatment needs to be addressed first? There is a litany of possible reasons. At this point, the occupational therapist and the client will move back to the planning stage to create a new game plan. The main point of the reevaluation is to ensure goals are being met, and inform changes promptly if they aren’t.
Discharge Planning: This is the final stage of the OT process, where the focus is ensuring that the client successfully transitions out of the care of the occupational therapist. This process can include meeting with family, select friends, work/school, referrals to community support, or even home adaptations as necessary. The occupational therapist’s focus will be to make any essential preparation needed to support the client in transitioning to self-management before discharge. The client may also be scheduled for a review after a given amount of time to ensure they are continuing to thrive independently. Only after all the necessary preparation has been made, will the client be officially discharged.
Self-Management: This isn’t an official part of the OT process, but it is the goal of all occupational therapy support where possible. The ability of the client to self-manage and thrive independently can range from full independence to the client receiving some help from friends, family and community services. As long as the client has a good quality of life that they are satisfied with, then this goal has been met.
Here is a handy poster that covers each of the stages of the OT Process.
So, these are the stages that go into the OT process. Although it hasn’t been mentioned yet, informed consent is exceedingly vital throughout this process. Informed consent is ensuring that the client has full knowledge of the reasons and alternatives to a decision before making it. It also covers the client being in a position where they don’t feel coerced into any decision. The only instance in which this is not observed directly with the client is when they have assessed legally as not having the capacity to make safe decisions for themselves. In this case, their guardian will be required to give consent.
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This article is for informational and educational purposes only and reflects the views of the writer alone. Do not take anything written in this post as a substitute for advice/information from a trained professional familiar with the specifics of your situation.
