Gretchen Kempf: OT 501 Article Critique Assignment

Davis, J. (2011). The Power of Occupation: The Key to Inspired Intervention. Home &
Community Health, 1-3.

Area of Concern & Relevance to Occupational Therapy Practice
Davis (2011) describes the need for, and challenges of, occupation-based practice and
notes the historical changes in the role that occupation-based practice has played within
the profession of occupational therapy. She emphasizes the importance of cognizance of
the founding roots of occupational therapy and those unique characteristics that
differentiate occupational therapists from other health care practitioners. According to
Davis, using occupation as a therapeutic tool is a complex, creative process involving
much more than the mere use of functional activities and occupation. In this article,
Davis identifies, what she terms, a Key to Excellence in creating effective
interventions, criteria for selecting activities, and environmental considerations that must
be taken into account when treating a patient with the best possible practice.

Identification of the Leader: Jan Davis
Jan Davis is President and founder of Clinical Educators, Inc. and also is the founder and
developer of strokehelp.com and ICELearningCenter.com. She holds an MS in Health
and Rehabilitation Science and has extensive working experience as an occupational
therapist both in the U.S. and in Europe. Davis is an internationally recognized leader in
stroke rehabilitation and has held numerous university faculty positions.

Specific Contributions of the Author
For over a decade, Davis has developed and produced multimedia educational materials
to aid occupational therapists in their implementation of evidence-based practice and
occupation-based practice in client interventions (Davis, The Power of Occupation: The
Key to Inspired Intervention, 2011). Her strong passion and belief that occupation
creates the fundamental basis of all therapy has led Davis to point out how a lack of
occupation-based practice can be detrimental to occupational therapy as a profession.

Supporting health and participation in life through engagement in occupation is the
overarching statement that describes the domain of occupational therapy (American
Occupational Therapy Association, 2008). Occupation can be defined as groups of self-
directed, functional tasks and activities in which a person engages over their lifespan
(Law, Cooper, Strong, Stewart, Rigby, & Letts, 1996) Occupational therapy uses the term
occupation to identify and reveal the meaning in everyday activities that are unique to
each individual (American Occupational Therapy Association, 2008). Historically,
occupation-based practice was a distinguishing hallmark of the profession of
occupational therapy, In the 1980s, however, there was a shift from functional activities
to a more science-based approach and the use of occupation-based practice began to
wane. (Davis, The Power of Occupation: The Key to Inspired Intervention, 2011). It
wasnt until the 1990s, when third-party payers began demanding that functional progress
be achieved, that occupation-based practice reentered the lime light as an intervention
strategy.

Potential Conflicts/Barriers to this Contribution
Gretchen Kempf: OT 501 Article Critique Assignment
One conflict/barrier to using occupation-based practice was identified in a 1981 study
conducted by Van Deusen-Fox, which found that recently graduated therapists had very
limited knowledge of occupational therapy theory (Van Deusen-Fox, 1981). The study
determined that new therapists in the U.S., Canada, Sweden, and Israel only possessed, at
best a modest level of knowledge of theory (Van Deusen-Fox, 1981). A study published
in 2000 supported Deusen-Foxs study by concluding that there is still room for
improvement in the integration of theory into occupational therapy practice (Banks, Bell,
& Smits, 2000). Without basic knowledge of the underpinnings of the profession,
evidence-based practice, research, and best possible practice may be difficult to achieve.

A second conflict/barrier is that the occupational therapy theory model only provides a
general framework for interventions rather than providing a structured procedure (Law,
Cooper, Strong, Stewart, Rigby, & Letts, 1996). This makes universal use of the model
quite challenging and the broad, generalized nature of the model actually may allow the
importance of occupation to be more easily overlooked.

A third conflict/barrier is that current healthcare is oftentimes controlled and limited by
the demands of insurance companies. Some insurers may look solely for functional
progress to determine reimbursement and the time-consuming paperwork burden placed
on therapists may leave little time to creatively utilize occupation-based interventions.

Potential Assets/Supports to this Contribution
The Occupational Therapy Practice Framework looks at the importance of incorporating
occupation into interventions. Several practice models have been identified that propose
occupation-focused practice as the best possible practice including the model of human
occupation (MOHO), person-environment-occupational performance (PEOP), ecology of
human performance model, and the occupational adaptation model. (Lee J. , 2010). These
models underscore the need for occupation-based practice and provide a broad
framework for practitioners (Lee J. , 2010).

Significant support for maintaining, as well as integrating, occupation-based practice
back into occupation therapy is also demonstrated by the sheer number of studies into the
matter in recent years. These studies have enabled the tangible benefits of occupation-
based interventions to be identified and measured. In a 2008 study which examined the
concepts and tools most often used by therapists, a number of contemporary scholars
concluded that occupation should be the central construct underlying the field and its
practice (Lee, Taylor, Kielhofner, & Fisher, 2008).

Summary Statement
The pendulum of occupational therapy has swung in many different directions when it
comes to intervention methods, but through current evidence, acknowledged by policy
makers and insurance companies and reflected in AOTAs Centennial Vision, it is
evident that practice should focus on occupation-based interventions (Davis, Our Time is
Now, 2010). Through Davis training modules and educational journal articles, she
strives to change the way newly graduated therapists view the realm of practice and
encourages them to focus on activities of daily living as crucial intervention strategies.
Gretchen Kempf: OT 501 Article Critique Assignment

American Occupational Therapy Association. (2008). Occupational therapy practice
framework: Domain and process (2nd Edition ed.). American Journal of
Occupation.

Davis, J. (2010). Our Time is Now. OT Practice , 14-17.

Davis, J. (2011). The Power of Occupation: The Key to Inspired Intervention. Home &
Community Health , 1-3.

Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., & Letts, L. (1996). The person-
environment-occupation model: A transactive approach to occupational
performance. Canadian Journal of Occupational Therapy , 9-23.

Lee, J. (2010). Achieving Best Practice: A review of evidence linked to occupation-
focused practice models. Occupational Therapy in Health Care , 206-222.

Lee, S. W., Taylor, R., Kielhofner, G., & Fisher, G. (2008). Theory use in practice: A
national survey of therapists who use the model of human occupation. The
American Journal of Occupation , 106-117.

Stroke Help. (2008). Retrieved from International Clinical Educators, Inc.:
http://www.icelearningcenter.com/about-us/jan-davis

Van Deusen-Fox, J. (1981). Occupational therapy theory development: Knowledge and
values held by recent graduates. Occupational Therapy Journal of Research, 1,
7993.


















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