1991-2011

Nikita JonasMegan RibakJoanna StumperBen Wiechman

1991-2011BEN1OutlineHistorical/Current EventsTrends in Occupational TherapyModels and Theories Used in OTVision for the Profession

BEN2Historical/Current events1990s2000s

MEGAN3Worldwide 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 & ethicsMEGAN6Trends in Occupational TherapyGlobal Trend Cultural Awareness and New RolesImpact of the ADAOccupational JusticeFocus on PreventionThe Virtual Context Influence of Technology on OT Practice

MEGAN7Global trendWorld Occupational Therapy Daylaunched on October 27th 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.8

Cultural Awareness and New RolesMore aware of different culturesRising number of immigrantsEg. The spirit catches you and you fall downWar Veterans (Gulf War, Iraq War, etc.)OTs role in Natural disastersPlanning and preparationPost disasterExamples:Ensuring accessibility for allOrganize daily routines in displaced persons campsFacilitating recovery with everyday occupations

NIKITAAs 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)

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

9Impact 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 DesignMEGAN10Occupational JusticeEngagement in occupation as a right

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

Rise in Advocacy

Image taken from: http://lolgal13.blogspot.com/2010/10/to-kill-mockingbird-anticipation-guide.htmlBEN 11Focus on PreventionWell-Elderly Study (Clark et al., 1997)Concept of Lifestyle RedesignPublic Health Concerns

Backpack Awareness DayBullying

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

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 TherapyFocuses of PracticeOther Models

JOANNA15Focuses of PracticeEvidence Based PracticePerson-Environment-Occupation Interaction (PEO)Occupation Centered PracticeInternational Classification of Functioning, Disability and Health (ICF)Client Centered Practice

JOANNA: EBP: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)JOANNA: PEOWho?JOANNA: OCPAn 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 JOANNA: ICF:WHO16Client-Centered PracticeUnderstanding Clients Environment/ContextFamily as client

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. 17Other 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 careAutism Spectrum Disorders 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)18Vision for the ProfessionSlagle LecturesCentennial VisionNew Directions of the Centennial VisionJob Opportunities

MEGAN19Eleanor Clarke Slagle Lecturers2011: Karen Jacobs2010: Janice P. Burke2009: Kay Schwartz2008: Wendy Coster2007: Jim Hinojosa2006: Betty Risteen Hasselkus2005: Suzanne M. Peloquin2004: Ruth Zemke2003: Charlotte Brasic Royeen

2001: Winnie Dunn2000: Margo B. Holm1999: Charles H. Christiansen1998: Anne G. Fisher1996: David Nelson1995: Catherine A. Trombly1994: Ann P. Grady1993: Florence ClarkNo lectures in 2002, 1997, 1992, and 1991MEGAN 20Eleanor Clarke Slagle Lecturers2011: Karen Jacobs 2010: Janice P. Burke2009: Kay Schwartz2008: Wendy Coster 2007: Jim Hinojosa2006: Betty Risteen Hasselkus2005: Suzanne M. Peloquin2004: Ruth Zemke2003: Charlotte Brasic Royeen

2001: Winnie Dunn2000: Margo B. Holm1999: Charles H. Christiansen1998: Anne G. Fisher1996: David Nelson 1995: Catherine A. Trombly1994: Ann P. Grady1993: Florence ClarkNo lectures in 2002, 1997, 1992, and 1991

MEGAN: = mentioned in this presentation21Centennial VisionWe envision that occupational therapy is a powerful, widely recognized, science-driven, and evidence-based profession with a globally connected and diverse workforce meeting societys occupational needsAOTA goals by 2017Want to be able to improve the health and well-being of the broader society, become more creative innovators, and promote membership in AOTA as part of professional responsibilityExpanding research, increasing advocacy, and the creation of model curriculums for OT and OTA programsJOANNA22Centennial VisionParallels with the Founding Vision give practitioners a sense of continuity with earlier generations of OTsThe Founding Vision states:The particular objects for which the occupation is formed are as follows: The advancement of occupation as a therapeutic measure, for the study of the effect of occupation upon the human being, and for the scientific dispensation of this knowledgeFounding vision was created by Susan Cox Johnson, George Edward Barton, Eleanor Clarke Slagle, William Rush Dunton Jr, Isabelle Newton Barton, and Thomas B. Kinder at the 1917 meeting of NSPOTMajor shared focuses between the Founding and Centennial visions:Successful promotion of occupation as a vital force to meet societys needsEngagement in and dissemination of scientific research that supports the effectiveness of occupational therapy

JOANNA23New Directions of the Centennial VisionMajor points of the Centennial Vision which differ from the Founding VisionActive engagement in research, rather than an aspiration to involve the professionIncorporation of a social perspective into the view of engagement in occupationsLinking OT in the U.S. to the global community, with the goal of the each countrys practice and research supporting and informing one anotherJOANNA24Why are we MSOT students?April 1998 ACOTE meetingdeveloped position statement urging post-baccalaureate study for occupational therapistsAOTAs April 1999 Annual Conference & ExpoEventually require post-baccalaureate entry-level occupational therapy educationAugust 1999 ACOTE meetingvoted that professional entry-level occupational therapy programs must be offered at the post-baccalaureate level by January 1, 2007 to receive or maintain ACOTE accreditation status.MEGAN get rid of most of slide text and say itPosition statement: Given the demands, complexity, and diversity of contemporary occupational therapy practice, ACOTEs position is that the forthcoming educational standards are most likely to be achieved in post-baccalaureate degree programs.

April 1999: the Representative Assembly passed Resolution J, Movement to Required Post-baccalaureate Level of Education

25Job OpportunitiesJob demand is increasingIncrease 26 percent between 2008 to 2018significantly faster than other fieldsIncreased demand in early intervention programs due to Disabilities Education Improvement ActBaby boom generation retires

Median Salary : $69,630 in 2009

NIKITA: 1) (1st pointhttp://www.bls.gov/oco/ocos078.htmAccording to the Bureau of Labor statistics,.point one) point two: the demand for occupational therapy services in early intervention programs and in schools that enroll children with disabilities who are served under the federal Individuals with Disabilities Education Improvement Act of 2004 remains strong. (http://www.aota.org/Students/Prospective/Outlook/38231.aspx?FT=.pdf) As the baby boom generation retires in growing numbers, demand for occupational therapists specializing in elderly treatment will be particularly strong.2) The median annual salary for occupational therapists was $69,630 in 2009, according to the Labor Department. The highest-paid 10 percent earned more than $100,000 (http://www.bls.gov/oco/ocos078.htm)

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Image from: http://memekatie.wordpress.com/2010/06/13/13610-the-birth-of-my-little-one/JOANNA INTRODUCE27References

Questions?MEGAN29