Just like any other profession, an occupational therapist desires to become proficient in his or her field. The capacity to provide quality healthcare to clients would undoubtedly increase their satisfaction in the service provided. But more importantly expertise in care means the less chance of error. A Zen master was able to put it succinctly when he said, “In the beginner’s mind there are many possibilities, but in the expert’s mind there are few” (Suzuki, 2009, p.1). In other words a person having a broad view of the profession and well-informed regarding current practices would be able to make the right decision much quicker than others (McColl, 2003, p.5). It is a skill necessary in the context of helping those who are in grave need of assistance. In order to transform a beginner into an expert, mentoring and other training strategies should just be the beginning. It is also important to understand how human beings think and learn. A theoretical framework is therefore necessary to enhance research and practice in the field of occupation therapy.
Background
The baby boomers, the ever popular demographic are entering the latter stages of their lives, the part where they are going to feel the impact of being old and gray. And as a result they will need expert medical care. At the same time the realities of modern living, the pressure of working in a highly competitive world has taken its toll on the physical and mental well-being of the workers. This has created problems such as the inability to cope with job requirements, injury in the workplace, and failure to achieve efficiency. In worst cases workers are laid off because of performance issues. In the case of occupational therapists they do not only battle this kind of issues but there is also the need to please demanding clienteles.
There are tremendous expectations when it comes to the work output of occupational therapists. This easily adds to their mounting frustration. The problem is acute when it comes to those who are new to the job. They have not yet acquired the experiences required to become a competent therapists. Nevertheless, their work requires focus and competence because mistakes can lead to very serious consequences. But they must not be overwhelmed by the pressure of the new job. This can be addressed by understanding certain theoretical frameworks regarding occupational therapy. An insight into a particular framework enables a therapist to develop a system to tackle a particular problem. It must also be pointed out that those applying the techniques and strategies they learn in a nursing home setting or in clinical practice are not the only people who benefit from theory. Those who are in research are in need of the same access to a theoretical framework. Theory enables them to know what to study and intensifies their focus.
Occupational therapists must be trained to think and learn from observing the connection between human beings and their environment. This view is not new and according to one study, “Mastery of psychomotor, cognitive, and affective skills necessary for nursing practice must be acquired through experience in the work situation (Anderson, 1975, p.1). The process of emotional maturity and intellectual growth can be enhanced by realizing that there are at least three types of thinking: a) critical; b) reflective; and c) through the power of networking (Anderson, 1975, p.1). This may be easy to understand but it is no easy to come up with this realization without a clear theoretical framework. The same thing is true when it comes to researchers trying to learn more about the science of occupation and what goes inside the workplace. They need a theoretical framework not only as a foundation for their studies but to guide them in the right direction.
The novice stage is a difficult process. It is also a humbling experience for many and yet after working so hard for a period of time, the beginner does not automatically become an expert in his or her field. There is a need to go though the next learning phase. The length of time spent in this level is dependent on the discipline, determination, and resources available for the occupational therapist. He or she must learn to adjust to the reality of being a practitioner. At the same time they need to formulate principles that will help him or her make correct decisions in the workplace such as a nursing home or clinic.
Practice
Therapists need to move from being a novice to an expert and this can only be achieved if they reached the stage where they competent to handle different issues with regard to their clientele. According to one commentary, “Occupational therapists, like other health care professionals, are challenged to inform decision-making in their clinical practice using appropriate research evidence” (Craik & Rappolt, 2003, p.267). At the same time it must be made clear that “the pressing need to translate research knowledge into practice is spurred on by increased demands for effectiveness and efficiency in health care delivery, the practitioner’s need to demonstrate clinical competence” (Rappolt, 2003, p.267). There are many ways to reach this goal but one of the most effective is knowledge about a particular theory that can be used a framework for their strategies.
There are many who are chiming in to the benefits of learning theory first before constructing a more concrete framework that guides their practice. Experts are in agreement that, ““professional and academic leaders exhort the importance of research-based practice, stressing that in order to maintain professional credibility, occupational therapists must provide supporting evidence, and in particular, reliable research evidence as the foundation for their clinical practice” (Craik & Rappolt, 2003, p.267). This can be seen as form of shortcut eliminating the need for costly trial and errors.
Consider for instance the theoretical framework that “a person does not exist in a vacuum; the physical environment as well as social, cultural, and temporal factors all influence behavior” (Dunn, Brown, & McGuigan, 1994, p.595). Occupational therapists can be extremely focused on their patients that they have become oblivious to the impact of the environment. Thus, they can be treating the symptoms but not the root cause of the problem, something that is counterproductive in the learning. But if they have paid attention to the importance of learning theory first then they would come to realize that “a recurring theme in the occupational therapy literature is the concept that environment (i.e., context) is a critical factor in human performance” (Dunn, Brown, & McGuigan, 1994, p.595). Therefore they can adjust their strategies accordingly. Consider for a moment the realization that many people in nursing homes “lack the ability and opportunities for choosing and engaging in a balanced array of meaningful occupations each day as a means of promoting health and well-being” (Nilsson & Townsend, 2010, p.59). Knowledge of this concept can greatly enhance the ability of a therapist to improve on strategies that are already in place.
Once an occupational therapist has become knowledgeable of a particular theoretical framework he or she begins to develop the correct mindset regarding a particular problem. For instance, they are no longer reacting to situations but are also sensitive to other factors, “from this perspective, occupation may be conceptualized as the multiple, interwoven processes which occur as the actor and the environment interact, and the occupation progresses” (Hocking, 2000, p.61). At the same time they come to realize that, “to achieve a desired level of participation, people and groups require the support of enablers and must overcome barriers that limit their participation in activities, tasks, and roles that are important and meaningful to them” (Christiansen, Baum, & Haugen, 2005, p.4). This can bring a novice to another level of expertise. This can reduce the frustrations in the workplace because the occupational therapist is now more aware of the inner-workings of the job.
Research
Researchers on the other hand are faced with a different problem set than clinical practitioners. They may not be concerned with the progress of a patient in front of them but they are bogged down the voluminous data that they have to deal with. In other cases they have no clear strategy on how to proceed. An established theoretical framework is their guide and provides clarity of purpose. This is crucial when it comes to determining problem areas that requires improvement. Consider for instance the creation of a model that yielded the following target areas to study: a) occupational performance; b) occupational performance areas; c) occupational performance components; d) occupational performance roles; and e) occupational performance environment (Chapparo & Ranka, 1997, p.24). This is not possible without having a clear theoretical framework.
Theory is the gateway for more learning, “for occupational scientists, this suggests a need to understand what happens as people work together to align their occupational performance towards a shared goal and how that is renegotiated over time; how individuals attune their occupational performance as they move between family, friendship and work” (Hocking, 2000, p.63). There is now an impetus to move the research process to a particular direction and expect to know more about a certain phenomenon.
Researchers are also prodded to investigate new areas that have not been investigate before, consider for instance the interlocking systems that affect behavior in the workplace must be investigated. According to experts, “the capacity of these systems to support occupational performance and participation must be determined” (Christiansen, Baum, & Haugen, 2005, p.6). This comes from the realization that
“interventions must be guided by basic neurobehavioral principles so that individuals can derive optimal benefit from therapy” (Christiansen, Baum, & Haugen, 2005, p.6). For instance an occupational therapist can only develop an intervention program if the following are ware already covered: a) occupational adaptation data gathering; b) occupational adaptation programming; and c) evaluation of the occupational adaptation process” (Schkade & McClung, 2001, p.1). This is a clear first step.
Theory is also critical when dealing with the intricacies of research design. Researchers must have clear grasp of the discoveries in the past. They need not start from scratch. A theoretical framework enhances their research by eliminating unnecessary activities. There is no need to go through a particular path knowing that it would not yield anything of significance. A theoretical framework is a helpful tool in the beginning of research work.
A theoretical framework can also be combined with other related theories in order to develop something new. It can be used like a scaffolding to create a novel solution to a particular problem. Theory can therefore be seen as component parts to a whole structure. A competent researcher can recognize a particular pattern and has the capacity to use a particular theoretical framework to address a particular need.
Conclusion
A clear understanding of a theoretical framework enhances the capability of both researcher and practitioner. When it comes to the practice of occupational therapy, a therapists has an advantage if he or she is aware of the basis of a particular strategy or treatment that used. This provides not only a certain level of expertise but also confidence that a particular action would yield positive results. A practitioner armed with principles gleaned from a particular theoretical framework does not only react to what can be observed but also develop strategies that deal with other factors that may not be obvious to the naked eye but affects the situation nonetheless. Researchers on the other hand are given a clear blue print on how to proceed with their work. They do not need to start from scratch. Researchers are also being led to the right direction. They also are aware of the gaps in learning and are directed to address these problems. There is focus and clarity in their work because of a theoretical framework used as guide.
References
Anderson, S. et al. (1975). The new graduate in the operating room. Web.
Chapparo, C. & J. Ranka. (1997). Towards a model of occupational performance: model development. Monograph, 24-26.
Christiansen, C., C. Baum, & J. Haugen. (2005). Occupational therapy: performance, participation and well-being. Occupational Therapy. 1-28.
Craik, J. & S. Rappolt. (2003). Theory of research utilization enhancement: a model for occupational therapy. Canadian Journal of Occupational Therapy, 70(5), 266-275.
Dunn, W. C. Brown, & A. McGuigan. (1994). The ecology of human performance: framework for considering the effect of context. The American Journal of Occupational Therapy, 48(7), 595-606.
Hocking, C. (2000). Occupational Science: a stock take of accumulated insights. Journal of Occupational Science, 17(2), 58-67.
McColl, M. (2003). Theoretical Basis Occupational Therapy. New Jersey: Slack Incorporated.
Nilsson, I. & E. Townsend. (2010). Occupational justice – bridging theory and practice. Scandinavian Journal of Occupational Therapy, 55, 57-63.
Schkade, J. & M. McClung. (2001). Occupational Adaptation in Practice: Concepts and Cases. New Jersey: Slack Incorporated.
Suzuki, S. (2009). Shunryu Suzuki quotes: Japanese Zen priest. Web.