The American journal of occupational therapy : official publication of the American Occupational Therapy Association
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A primary aim of occupational therapy education is to teach students how to think like practitioners, that is, how to engage in clinical reasoning. Since the early 1980s, occupational therapy clinical reasoning research has elucidated a language that describes the various types of thinking therapists use in clinical practice, a language that has the potential to make previously tacit thought processes accessible to conscious examination and improvement. ⋯ This article examines occupational therapy teaching methods using the language of clinical reasoning, categorizing them by the types of clinical reasoning they promote. Current clinical reasoning language is reviewed, and teaching strategies to facilitate the various types of clinical reasoning are described.
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Historical Article
Outcomes research: the history, debate, and implications for the field of occupational therapy.
The field of occupational therapy, as with all facets of health care, has been profoundly affected by the changing climate of health care delivery. The combination of cost-effectiveness and quality of care has become the benchmark for and consequent drive behind the rise of managed health care delivery systems. ⋯ Outcomes management is the application of outcomes research data by all levels of health care providers. The challenges facing occupational therapists include proving our value in an economic trend of downsizing, competing within the medical profession, developing and affiliating with new payer sources, and reengineering our careers to meet the needs of the new, nontraditional health care marketplace.
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The rehabilitation of this client with chronic back pain was successful secondary to the efforts of her entire medical team. As demonstrated by the termination letter written by the employer when the client's medical leave exceeded 1 year, this client could not have returned to her former position without work hardening. With implementation of the Americans With Disabilities Act, changes in such employer policies might be forthcoming. ⋯ The client did not acquiesce to a therapist's goal; she actively formulated her own. Typically, a client with chronic low back pain, a history of knee problems, and an absence from work of more than 1 year has a low probability of successful rehabilitation and return to work (Isernhagen, 1988). Yet this woman was able to overcome those obstacles to return to both work and a more active life-style.(ABSTRACT TRUNCATED AT 250 WORDS)
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This article describes issues of sexism in the mental health profession. Theoretical bias in psychiatry and the sociopolitical status of women are both linked to the inappropriate mental health treatment of women. A relational model of women's psychological development is offered as an alternative theoretical perspective for understanding the mental health needs of women. Ways to integrate this perspective in occupational therapy practice are included.