1991-2011

Nikita JonasMegan RibakJoanna StumperBen Wiechman

1991-2011OutlineHistorical/Current EventsTrends in Occupational TherapyModels and Theories Used in OTVision for the Profession

Historical/Current events1990s2000s

Worldwide Events in the 90sAftermath of collapse of Soviet UnionEnd of Cold WarWest and East German reunification issuesCommunists kidnap Gorbachev & revolt; resignation; 1992 end of Soviet Union & political independenceYugoslavia: Slovenia & Croatia (ethnic cleansing until UN ceasefire)RwandaPresident assassinatedHutus, Tutsis, governmentUN estimated 800,000 died April-July 1994Aftermath of Iran-Iraq WarIraq in debt; asked Kuwait & Saudi Arabia to negotiate; oil; border disputesIraq invaded Kuwait in 1990; UN economic sanctions; US and Arab countries bombed in 1991South AfricaMarch 1991: mandate to end White-minority rule1994: Black people vote: African National Congress (ANC) won majority of seats in parliament, Nelson Mandela presidentMEGAN4Events in the USA in the 90sTerrorism93: car bomb in underground parking garage in World Trade Center96: truck bomb outside of U.S. military barracks97: 2 U.S. embassies in Africa bombed95: Oklahoma City bombing99: Columbine High Shooting

Dr. Jack KevorkianAssisted suicideGuilty verdict in 9991 & 92: Race Riots in Los Angeles98: Bill Clinton and Monica Lewinsky97: MiCASSA (Medicaid Community Attendant Services and Supports Act) first introduced to CongressStill not passedMEGAN5Key Events in the 2000sworldwideUnited statesNuclear WeaponsRussia and US reducedFear shifts to other powers (Asia & Middle East)Era of Globalization?Transculturation: merging and converging of culturesGlobalization= Westerniztion/ Americanization?TerrorismAfrica: AIDS/HIV2000 election results: George W. Bush & Al GoreRefugees & illegal immigrantsSeptember 11, 2001War on Terror & Iraq: weapons of mass destruction, Sadaam HusseinHurricane Katrina2007: Virginia Tech shootingPresident ObamaHealthcare & ethicsMEGAN: elaborate on healthcare and ethics?6Trends in Occupational TherapyImpact of the ADAGlobal Trend Cultural Awareness and New RolesOccupational JusticeFocus on PreventionThe Virtual Context Influence of Technology on OT Practice

Impact of the ADA90: Americans with Disabilities Act (ADA) passedAlso: Education for All Handicapped Children Act amended & renamed Individuals with Disabilities Education Act (IDEA) 95: Helen L. v. SniderU.S. Court of Appeals ruled that publicly funded institutionalization of a disabled woman in a nursing home violates her rights under the ADA since not medically necessary and state could offer her home care97: Medicaid Community Attendant Services and Supports Act (MiCASSA) introducedproposed shifts in the proportion of Medicaid long-term care dollars spent in community and institutional servicesnational program of community-based attendant services and supports for people with disabilitiesIndependent LivingUniversal DesignMEGAN8Global trendWorld Occupational Therapy Day launched in 2010.AwarenessFundsStart of OT in other countriesGeorgiaChileUgandaEgypt

NIKITA:WFOT launched World Occupational Therapy Day is the opportunity to heighten the visibility of the professions development work and to promote the activities of WFOT locally and nationally. Also to organise events that attract publicity and raise funds. It will be held annually on October 27th.(http://www.wfot.org/AboutUs/WorldOTDay.aspx)With help from the European Network of Occupational Therapy, eight Georgian students were educated and graduated in 2004, and the Georgian Occupational Therapy Association was formed. Georgia then became a member of WFOT in 2006. Similarly, Chile and Uganda joined WFOT in 2005 and 1998 respectively (each has only one approved OT program in the entire country). WFOT is currently trying to help Egypt set up programs in three of their universities.9

Cultural Awareness and New RolesMore aware of different culturesRising number of immigrantsWar Veterans

OTs role in Natural disastersNIKITAAs the world gets smaller(more immigrants) OTS more aware of cultural differences bet client and them esp as we become more client entered. Eg the spirit catches you and you fall down. Continuing awareness of war vetrans and the issues they bring back with them from the frontline ( gulf war, Iraq war,etc). Yes, weve always had to deal with this issue but each war is different and brings with it different problems.Ots can be involved in all stages of planning and preparation at local districts and national level for disaster management as well as post-disaster. Some of the things we can do are ensuring accessible environments post disaster at all stages of recovery, organization of daily routines in displaced persons camps and surviving communities to include persons with disabilities, women, elderly and children , use of everyday occupations including play and sports to facilitate recovery(http://www.wfot.org/Practice/DisasterPreparednessandResponseDPR.aspx)

10Occupational JusticeArose in the mid- 1990sRelationship between health outcomes and sociopolitical/cultural determinants (Wilcock, 1993)Enabling client empowerment through occupation (Townsend, 1993)

Rise in Advocacy

Engagement in occupation as a right

Image taken from: http://lolgal13.blogspot.com/2010/10/to-kill-mockingbird-anticipation-guide.htmlBEN : IS IT OK THAT I SWITCHED THE ORDER OF THE BOTTOM TWO BULLET POINTS?11Focus on PreventionWell-Elderly Study (Clark et al., 1997)Concept of Lifestyle RedesignPublic Health Concerns

Backpack Awareness Day

Images taken from: http://empirestatephtc.org/videos.cfm ; http://www.aota.org/Practitioners/Awareness/School-Backpack-Awareness.aspx http://blackboard.bu.edu/webapps/portal/frameset.jsp?tab_id=_2_1&url=%2fwebapps%2fblackboard%2fexecute%2flauncher%3ftype%3dCourse%26id%3d_36330_1%26url%3d

BEN12The Virtual ContextUtilization of the virtual context has increased dramatically Use of facebook and twitter to increase OT awareness and promote the professionAvailability of Skype, googledocs, and wikispaces all allow for expanded professional development and involvementex: World OT Day virtual 24 hour conference

I was thinking on this page we could put some facebook/twitter logos, something from the world ot webpage, and maybe a tweet of karens?JOANNA13Influence of Technology on OT Practice Wii-habilitation has been used in many different research studies Literature shows that the Wii is being implemented in hospital, rehab, and school settings, with clients with CP, Parkinsons disease, motor delays, and many other diagnosesUsed to reach therapeutic goals such as increasing strength, endurance, ROM, and the building of social relationshipsClients engaging in Wii-habilitation are also more motivated and willing to participate in therapeutic activities for a longer time

JOANNA14Models and Theories Used in Occupational TherapyEvidence Based PracticeOccupation-Centered PracticeClient-Centered PracticePEO ICFOther Models

Evidence-Based PracticeRecent trend in OTClient-centered practiceRapid speed of medical discoveries

Global growth

NIKITA:The growing requirement to base intervention decision on the current best evidence. This way we are able to integrate research evidence into the clinical-reasoning process to explain the rationale behind interventions. (From W&S).. In response to become more Client-centered and also in response to how fast medical discoveries are being made these days ( constantly in need of new data).A group of occupational therapy scholars, educators and practitioners from 13 countries met in July 2004 to determine the state-of-the-art in evidence-based occupational therapy practice and to organize collaborative international efforts to support and enhance evidence-based practice.(http://www.aota.org/Educate/Research/39451.aspx)16Occupation-Centered PracticeAn emphasis on engagement in occupation of the clients choice, occurring in their typical settingsBased on the professions beliefs that occupations are central to an individuals identity Views occupations not as isolated activities, but as connected in a web of meaning in peoples daily lives Occupations are central part of both the means and the ends of therapeutic interventions (do you think I should add another bullet point explaining this or just keep that as something in my notes to say out loud?)JOANNA17Client-Centered PracticeUnderstanding Clients Environment/Context

Collaborative Approach

Therapy as a Narrative Process (Mattingly, 1994)Growth of Occupational Storytelling Occupational Storymaking (Clark, 1993)

Image taken from: http://hellolindsey.com/projects/shilo1.htmlBEN: Coming from a dehumanized and highly technological approach to healthcare. Narrative turn initially occurred in the mid 1980s, as the result of research by Mattingly, but lots of research has since been done to examine narrative from the perspective of clients, therapists, and families. 18PEO

Image taken from Professor Gael Orsmonds lecture on 9/14/11MEGAN19ICFInternational Classification of Functioning, Disability and HealthWorld Health Organization (WHO)Social model of disability

Image taken from Professor Gael Orsmonds lecture on 9/14/11MEGAN20Other Models New and emerging modelsToglias Multicontext Approach to Perceptual Cognitive ImpairmentsMotor control and Motor learning Models of PracticeOther models being redefined/developedAlzheimers disease and their caregiversHandwriting problems of childrenPremature infantsHospice care Trend towards moreWellness models of practiceModels for public healthHospital based models

NIKITA:The first model is about enhance the adaptational capacity of clients with neurological impairments through the use of the everyday world of our community put forward by Joan Toglia a professor at mercy College in NY. The second model has come in more focus in the past 10 years. In the past OTs looked at the clients physiology and movements but now we focus more on their occupational synthesis which is the occupational forms that the client needs to engage in active occupational performance.(1996 ECS lecture)Many OT models of practice are being redefined for theses areas as more information comes to light. (1996 ECS lecture)Trend towards an increased emphasis on wellness, health promotion and disease prevention Like backpack awareness!. Also a trend to for OT to take a role in public health issues such as bullying, childhood obesity, homelessness, etc. Ots are also playing a more essential role in hospitals esp as they downsize and are starting to discharge patients earlier than before.(1996 ECS lecture)21Vision for the ProfessionSlagle LecturesCentennial VisionNew Directions of the Centennial VisionJob Opportunities

Eleanor Clarke Slagle Lectures: 1990s1999: Defining Lives: Occupation as Identity: An Essay on Competence, Coherence, and the Creation of Meaning1998: Uniting Practice and Theory in an Occupational Framework1997:1996: Why the Profession of Occupational Therapy Will Flourish in the 21st Century1995: Occupation: Purposefulness and Meaningfulness as Therapeutic Mechanisms1994: Building Inclusive Community: A Challenge for Occupational Therapy1993: Occupation Embedded in a Real Life: Interweaving Occupational Science and Occupational Therapy1992:1991:

MEGAN Get rid of this?23Eleanor Clarke Slagle Lectures: 2000s2011:2010: Whats Going on Here? Deconstructing the Interactive Encounter2009: Reclaiming our Heritage: Connecting the Founding Vision to the Centennial Vision2008: Embracing Ambiguity: Facing the Challenge of Measurement2007: Becoming Innovators in an Era of Hyperchange2006: The World of Everyday Occupation: Real People, Real Lives2005: Embracing Our Ethos, Reclaiming Our Heart2004: Time, Space, and the Kaleidoscopes of Occupation 2003: Chaotic Occupational Therapy: Collective Wisdom for a Complex Profession2002:2001: The Sensations of Everyday Life: Empirical, Theoretical, and Pragmatic Considerations2000: Our Mandate for the New Millennium: Evidence-Based Practice

MEGAN Get rid of this?24Slagle Lectures