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PARADIGM SHIFTS IN OT PRACTICE. A review of how history has shaped the profession of OT in today’s practice. Paradigm General Definition. Greek origin Pattern or model Conceptual framework Allows explanation & investigation of phenomena
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PARADIGM SHIFTS IN OT PRACTICE A review of how history has shaped the profession of OT in today’s practice
ParadigmGeneral Definition Greek origin Pattern or model Conceptual framework Allows explanation & investigation of phenomena Becomes understood thru professional training & changed via environmental demands
THOMAS KUHN(1970) Paradigm is a universally recognized scientific achievement that temporarily models problems and solutions to practitioners Sufficiently unprecedented scientific achievement among competing sources Adequately open to allow exploration of solutions for a variety of problems
BARKER(1992) PARADIGM Filters perception – contrary info is often left out “What is defined as ‘impossible’ today is impossible only in the context of present paradigms.” “Every paradigm will uncover problems it cannot solve & these become a catalyst for a paradigm shift.”
Gary Kielhofner (1997) Paradigm is the cultural core of the discipline & provides professional identity how professionals view practice guides questions, solutions, goals of practice
KUHN’S PARADIGM SHIFT Definition – when a discipline abandons one view of the world for another; a revolution; a drastic conceptual restructuring
4 STAGES WITHIN THE DEVELOPMENT OF A PARADIGM Pre-paradigm phase – various thinking approaches emerge to solve the same problem Paradigm – “winner”; use of one school of thought Crisis – not all problems can be solved this way Resolution – reorganization of the old PLUS new thinking
Kielhofner & Burke’s Historical Review Paradigm of Occupation (1900-1940s) Mechanistic Paradigm (1950s-1970s) New Emerging Paradigm (1980s-2000)
Paradigm of Occupation(1900-1940s) Defined by… Moral treatment (advocating for persons with mental illness by participating in occupations that “normalized” behavior Origins: Consolation House (1914, NY) a convalescent home founded by George Barton & Eleanor Clark Slagle; Hull House (1915, Chicago) a work program for persons with physical & mental disabilities
History and development of OT New Emerging Paradigm (1980s-2000) Paradigm of occupation (1900-1940s) Mechanistic Paradigm (1950s-1970s) WWII Pressure to Provide scientific evidence Away from core beliefs of OT Unable to treat chronically ill patients • Medical model • Specialization • Lost commitment to occupational performance • Moral treatment • Consolation house • Holistic view • Balance of art and science
Paradigm of Occupation(1900-1940s), cont. “Occupation” was the central phenomenon of interest referring to balance of work, play, self-care, & rest; holistic view
The Paradigm Shift (1940s-1950s) Crisis Era The profession comes under pressure from medicine to provide scientific evidence for its practice
Mechanistic Paradigm (1950s-1970s) Medical model (reductionistic) replaces “occupations” of moral tx OTs seek to gain professional respect as a scientific discipline by focusing on disease Specialization is a popular trend Loss – commitment to occupational performance Gain – new assistive devices, technology, techniques; SI; NDT
Paradigm Shift of the 1970s Crisis Era Reductionism was inadequate for treating chronically disabled OTs express dissatisfaction over a loss of professional identity & unity
NEW EMERGING PARADIGM(1980s) Recommitment to holistic view and the occupational nature of humans Client centered practice including active engagement & empowerment Systems theoretical view Balance of the art & science of practice