“ Client-centered occupational therapy is a kind of partnership between the client/patient and the therapist, which allows empowerment of the patient to engage in functional performance to fulfill his/her occupational roles in a variety of environments.(1) Philosophy of client-centered therapy includes empowerment and guiding of patients to achieve a cure by means of a balance of power between the therapist and patient. In this approach, the therapist acts as an educator”
“When a client-centered approach can be administered completely, the patient makes decisions alone based on his/her targets. In addition, the power is transferred from the therapist to the patient. In such a case, the therapist supports the decision-making period of the patient and accepts his/her decisions” -TONGA,, E., DÜGER, T. AND KARATAŞ, M.
What i really enjoy about OT is that we don’t just treat the patient, we get the patient involved in the process of healing. We work hand in hand with patients. Patients can set goals for themselves. We empower patients ! We are merely there to help guide them through this process.
Reflection on planning for intervention
Choosing a functional activity for treatment could be up there as one of the hardest decisions you will have to make !
I was able to decide fairly quickly this week what activities I wanted to do with my patients. I say fairly quickly because usually this process takes hours ! By getting collateral information from the nurses, OT and notes in the file I was able to get an idea of the patients level of function in ADL’s. Starting with basic ADL’s or self care tasks are vital as they will help to promote the feeling of autonomy for the patient if they are able to help or perform these tasks independently. I also went back to all the problem statements and assessment findings I had gathered so far to see how the activity will help to facilitate problem areas. I think I have almost gotten the hang of moving from using areas of occupations as just assessments (which was done last year) to now using them as therapeutic activities.
Reflection on implementing of intervention for your client
I decided on doing a very basic series of self care tasks with my patient as she required maximum assistance from the nurses. She preformed tooth brushing, face washing as well as grooming of the face which involved applying lotion and lip cream. The patient was able to help with part of the set up of the activity which involved taking out all the relevant items needed and clean up. I feel as though the session went relatively well. I was able to assess different types of prehensile hand function as well as bilateral hand function which the patient has an issue with. The structuring of the session could have been better as the space was limited in the room and the bathroom would have been a more appropriate setting. However the patient and I got through the activity without crying so that is a success for me !
Reflection on feedback from supervisor
This week I was able to get feedback on the SOAP notes and the implementation of treatment.
My supervisor was able to give me constructive feedback on how I can improve my SOAP notes which will make it easier for other health professionals to get an idea of how the patient is doing at a glance of the notes. I learnt that if SOAP notes are done effectively and efficiently, other health professionals will be able to compare them and deduce whether the patient is improving, has plateaued or is deteriorating. I now have a new found respect for SOAP notes and appreciation for them. They are not just another item of work lecturers want to pile on us !
The feedback I received for my treatment session was to give the patient time to react before assisting them in the task. The supervisor showed me the importance of this during the session. We were able to watch the patient see how she would deal with putting on the lid of a tube without any assistance. Initially I was positioning the tube in the patients hand in such a way she did not have to use a tip pinch (I assumed she did not have this function as she has decreased finger flexion) however when left on her own the patient performed the tip pinch and with minimal hand over hand facilitation she was able to perform the task. Therefore by giving the patient enough time to react one can observe even more of the patients abilities such as motor planning and problem solving.
How will this change the intervention you will provide next week
I will definitely use the feedback to improve the quality of the SOAP notes i do in the future as well as implementing this new handling method of giving the patient time to react. I am excited to see what more I can learn about my patient using the new skill my supervisor has taught me !
“Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.”— Mary Reily, OTR, EdD
Inside the mind of a 4th year OT student 