Occupational Therapy Manual for the EASA Model Developed by Valerie Wen, OTS With contributions by: Ashley Craig, OTDR/L Marrissa Gottlob, MOTR/L Tania Kneuer, OT/L Christina Perry, OTR/L Emily Piper, MOTR/L Halley Read, MOTR/L Heidi Romero, OTR/L Sean Roush, OTD, OTR/L Tamara Sale, MA Sue Wimmer, OTR/L Table of Contents Introduction ................................................................................................................................... 1 What is Occupational Therapy? .................................................................................................. 1 Philosophy and Vision of Occupational Therapy ....................................................................... 1 The Importance and Function of Occupational Therapy in Mental Health ................................ 2 The Distinct Value of Occupational Therapy in EASA ............................................................. 3 Roles of the Occupational Therapist in EASA............................................................................ 6 How Occupational Therapy Complements Other Disciplines .................................................... 7 Case Example .............................................................................................................................. 7 Educational Resources ................................................................................................................ 8 Overview of Occupational Therapy Services within EASA ...................................................... 8 Promotion of and Referral to Occupational Therapy Services ................................................... 9 Screening in Occupational Therapy Services............................................................................ 10 Evaluation.................................................................................................................................. 10 Treatment Planning and Intervention ........................................................................................ 11 Transition Planning ................................................................................................................... 11 Levels of Occupational Therapy Services ................................................................................. 12 Individual .................................................................................................................................. 12 Group ......................................................................................................................................... 12 As Needed ................................................................................................................................. 13 Consultation .............................................................................................................................. 13 Billing and Reimbursement ....................................................................................................... 13 Relevant Oregon Laws and Administrative Rules .................................................................... 13 Documentation Related to Billing Codes .................................................................................. 13 How to Acquire and use Occupational Therapists .................................................................. 14 Hiring an Occupational Therapist ............................................................................................. 14 Integration with Treatment Team .............................................................................................. 16 How to Support Occupational Therapists ................................................................................ 17 Supervisor.................................................................................................................................. 17 Other Resources ........................................................................................................................ 18 References .................................................................................................................................... 19 Table of Appendices .................................................................................................................... 21 Appendix A: Occupational Therapy Models of Practice .......................................................... 22 Appendix B: Literature Summary of Resources ....................................................................... 23 Appendix C: Occupational Therapy Referral Form Example ................................................... 25 Appendix D: Occupational Therapy Screening Tool Example ................................................. 27 Appendix E: Occupational Therapy Evaluation Form Example ............................................... 30 Appendix F: Required and Recommended Assessments to Have Available ............................ 31 Appendix G: Supplemental Tools and Resources ..................................................................... 36 Appendix H: Treatment Plan Examples of Occupational Therapy Goals ................................ 37 Appendix I: Billing Codes Used in Oregon Related to Occupational Therapy Services .......... 39 Appendix J: Occupational Therapist Job Description Examples .............................................. 41 Introduction This manual was developed after several EASA teams identified the need for more formal guidelines and information regarding the role of occupational therapy in EASA programs. It is intended for use by all EASA programs and provides information relevant to occupational therapists, administrators, and teams. This document describes the occupational therapy profession and its connection to mental health practice, the roles and services that can be provided on EASA teams, information related to billing and reimbursement, the hiring and supervising process, as well as many resources. What is Occupational Therapy? Occupational therapy is a health profession focused on promoting health and well-being through engagement in meaningful occupations (American Occupational Therapy Association [AOTA], 2014). Occupations are defined as the activities of everyday life in which we all participate. The main goal of occupational therapy is to enable individuals to engage in daily activities that they need, want, or are expected to do. These are activities that have meaning and value to the individual. Occupational therapists can support individuals in developing, improving, sustaining, or restoring a level of independence that is desired by the individual by using activities throughout the assessment and treatment process. Occupational therapy services are provided by qualified professionals with knowledge, clinical reasoning, and decision making skills related to occupational performance (National Board for Certification in Occupational Therapy [NBCOT], n.d.). Occupational therapists must have a deep understanding of the nature of occupations, in addition to knowledge of anatomy, neurophysiology, development, social processes, personality, and medical conditions (Hooper & Wood, 2014). Philosophy and Vision of Occupational Therapy Occupational therapy relies on a philosophy and vision to guide the profession. The following are gathered from The Philosophy of Occupational Therapy: A Framework for Practice (Hooper & Wood, 2014), and the Occupational Therapy Practice Framework: Domain and Process, 3rd edition (AOTA, 2014). Core Philosophical Assumptions Humans are occupational beings: Humans need occupations in order to survive, develop, and be healthy and well. Humans are interconnected with environments: Humans can be understood in the context of their environments, and therefore environments must be taken into consideration. Human transformation comes from actions and environments: Humans continuously change over time based on their actions and the changes within their environments. Health is seen as a changing state of meaning, satisfaction, well-being, and quality of life. Occupational Therapy Manual 1 Vision The vision of occupational therapy is based on the belief that therapeutic occupations can improve illness and restore or preserve health. This vision includes a practice that is: Occupation-based: Occupational therapists focus on what an individual wants, needs, or is expected to do, and uses these activities as interventions. The focus is on occupational performance issues and experiences, which incorporates the idea that humans are dynamic occupational beings who are interconnected with their environments. Client-centered: Occupational therapists collaborate with individuals to understand their development over time, and to explore occupations and environments that have been meaningful and engaging. These occupations may serve as therapeutic experiences. This is often referred to as client-centered, or person-centered, practice because it focuses on the relationship and individual needs, rather than solely on the expertise of the professional. Contextual: Occupational therapists see individuals as linked with their environments through occupation, meanings, roles, and routines. This can impact the transfer of skills to different environments. All environments must be considered, including where services are received and where the individual lives. Evidence-based: While occupational therapists learn a variety of content in their education, the focus is on the understanding