PARADIGM SHIFTS IN OT PRACTICE A review of

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 ¢ 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 l Sufficiently unprecedented scientific achievement among competing sources l Adequately open to allow exploration of solutions for a variety of problems

BARKER (1992) ¢ PARADIGM l Filters perception – contrary info is often left out l “What is defined as ‘impossible’ today is impossible only in the context of present paradigms. ” l “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 l how professionals view practice l 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 1. Pre-paradigm phase – various thinking approaches emerge to solve the same problem 2. Paradigm – “winner”; use of one school of thought 3. Crisis – not all problems can be solved this way 4. Resolution – reorganization of the old PLUS new thinking

Kielhofner & Burke’s Historical Review Paradigm of Occupation (1900 -1940 s) Mechanistic Paradigm (1950 s-1970 s) New Emerging Paradigm (1980 s 2000)

Paradigm of Occupation (1900 -1940 s) Defined by… l Moral treatment (advocating for persons with mental illness by participating in occupations that “normalized” behavior l 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 Mechanistic Paradigm of occupation (1900 -1940 s) (1950 s-1970 s) WWII Pressure to Provide scientific evidence • Moral treatment • Consolation house New Emerging Paradigm (1980 s-2000) Away from core beliefs of OT Unable to treat chronically ill patients • Medical model • Specialization • Lost commitment to occupational performance • Holistic view • Balance of art and science

Paradigm of Occupation (1900 -1940 s), cont. ¢ “Occupation” was the central phenomenon of interest referring to balance of work, play, self-care, & rest; holistic view

The Paradigm Shift (1940 s 1950 s) ¢ Crisis Era The profession comes under pressure from medicine to provide scientific evidence for its practice

Mechanistic Paradigm (1950 s-1970 s) l l l 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 1970 s Crisis Era Reductionism was inadequate for treating chronically disabled OTs express dissatisfaction over a loss of professional identity & unity

NEW EMERGING PARADIGM (1980 s) 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 ¢