Biomechanical and Cognitive FOR

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During a literature search to find an operational definition for the concept “frames of reference (FOR)” within occupational therapy (OT), the AOTA’s 2nd edition of the book “Occupational Therapy Practice Framework: Domain and Process” delivered no specific definition despite it’s stated purpose to “present a summary of interrelated constructs that define and guide occupational therapy practice” (AOTA, 2008). Further readings of older and current OT literature, offered conflicting views or definitions for FOR and it is often difficult to distinguish between the meanings of FOR and models, finding oneself in a “semantic minefield” (Hagedorn, 1994): “In summary, model building is composed of five phases which forms a sequence of interlocking systems… the frame of reference, assumptions and concepts are crucial to exploring, organizing and developing the model… [A frame of reference is] a mechanism which can be used to explain the relationship of theory to action… [it] is not the total model, but does form part of the model building process” (Reed, 1984). In a conversation with one of the contributors to “Framework” (AOTA, 2008), one of the reasons why FOR were possibly not defined within the publication and within OT practice, could be due to inconclusive views within the profession in defining the term (Olson, 2010). Looking at the Science of Occupation OTD coursework at USA (Mathena, 2010), the Model of Human Occupations, developed by Gary Kielhofner in the 1980’s, and probably one of the best examples of a model developed unique to the OT profession, is listed in the course notes as an example of FOR. Similarly, Sensory Integration is often, referred to as a FOR, but at other times it is referred to as a model or a th... ... middle of paper ... ...dicine (Dutton, 1984). According to Dutton, it is based on a continuum of “function-dysfunction” such as range of motion, strength, endurance and coordination and evaluation of the FOR is based on individual assessment of the mentioned components. Used in pure form, this FOR is reductionist or mechanistic in philosophical perspective (Reed 1984). The Psychodynamic FOR generate it’s theoretical base from Psychiatry, and Psychology and from the work of Freud, Jung, Adler to name but a few (Reed, 1984). Reed and Hagedorn also describe this FOR as reductionist, as “[the] person is not capable of rational choices…. [but] behavior is being determined by unconscious drives” (Bruce, 1987) as well as feelings. The function-dysfunction criterion is thus based on symptoms the patient is displaying and assessment is through observation and identification of the symptoms.

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