Making first contact: what to do with all that information! part 1
Last post I wrote I said I’d continue with a process for structuring and synthesising the information we gather from the initial contact we make with the person. This process is integral to clinical reasoning, and somewhat surprisingly, there’s not a great deal of research to give us guidance on the best way to do this – and it’s even more challenging for those of us working in an interprofessional team setting, where different professions, personalities and assumptions are part of it.
If we work backwards from the end point, we might get some clues about what to do. Our end point is to help this...
Source: HealthSkills Weblog - November 21, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Assessment Clinical reasoning Interdisciplinary teams Occupational therapy Pain Pain conditions Physiotherapy Professional topics Psychology Science in practice Uncategorized Source Type: blogs
When occupational therapy and public health collide
Presented at NYSOTA ' s Annual Conference. 11/13/21Thanks for stopping by to look at my slides!Click here for slides! (Source: ABC Therapeutics Occupational Therapy Weblog)
Source: ABC Therapeutics Occupational Therapy Weblog - November 13, 2021 Category: Occupational Health Tags: OT Education OT practice Source Type: blogs
Making the first contact
How do we begin working with someone who is asking for help with their persistent pain? In this post I’ll describe some of the considerations I have when I begin, because as Benedetti points out, the “meet the therapist moment” is one of the most potent times in the therapeutic ritual (Benedetti, 2011). It’s the time when the person’s expectations and the clinician’s empathy and competence meet, and the “meaning response” blooms.
My two clinical questions are:
Why is this person presenting in this way at this time, and what’s maintaining their predicament? And wh...
Source: HealthSkills Weblog - October 17, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Assessment Chronic pain Clinical reasoning Science in practice biopsychosocial initial assessment Occupational therapy pain management subjective Therapeutic approaches Source Type: blogs
Pain – or pain-related disability?
I’m struck at how often clinicians focus on pain intensity when how much pain intrudes on life matters more. I wonder whether new therapists might not have read some of the old studies looking at the relationship between pain intensity and disability – because while there is a relationship there, it’s not nearly as strong as we might think.
Let’s define a couple of terms first: pain is, I think most of us can agree, “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”. (click for full definition and not...
Source: HealthSkills Weblog - October 3, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Uncategorized Source Type: blogs
One plus one may not always equal two
If it hurts – take notice, and avoid it. Learn from it. If there are other people around, make sure your behaviour is noticeable so they take care of you and don’t do what you just did. If they look after you, you’ll probably do the same thing again when you hurt, if they don’t you probably won’t.
This is one description of pain behaviour and how it works. It’s the only part of our pain experience that we can share directly with one another (actions and words). The “doing” part is also the part that is most affected by pain – even distress is signalled to others ...
Source: HealthSkills Weblog - September 26, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Uncategorized Chronic pain Clinical reasoning pain management Research Source Type: blogs
Adam ’ s slow recovery
Not long ago I wrote about Adam Meakins back pain, and the astonishing response he’s had from fellow clinicians as he’s documented his recovery. Sadly, the polarised views of how therapists should approach a person with low back pain show me just how appallingly badly we adhere to low back pain guidelines… and worse, the kind of language and attitudes shown to a colleague who knows what he’s doing, demonstrates why change is so very slow.
What do I mean? Well, Adam has been following evidence-based low back pain guidelines that haven’t really changed a great deal since the advent of New Zea...
Source: HealthSkills Weblog - August 22, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Clinical reasoning Coping strategies Low back pain Occupational therapy Physiotherapy Professional topics Psychology Research Science in practice healthcare pain management Source Type: blogs
Why I don ’ t trust my clinical reasoning: and why this matters
“See someone experienced” I hear people with pain say. “They’ll know what’s wrong with you.”
Well, based on the research I’ve read, I wouldn’t be so sure. In fact, I’m certain my own clinical reasoning is biased, prone to errors that I don’t notice, and influenced by factors that most clinicians would be horrified to think they, too, were influenced by.
Let me give you a few to ponder:
I’m interested in women and pain – and there’s a lot of evidence showing that women’s pain doesn’t get the same kind of diagnostic and managem...
Source: HealthSkills Weblog - July 11, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Interdisciplinary teams Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice Chronic pain Clinical reasoning healthcare Source Type: blogs
Will the occupational therapy Academic Leadership Council stand up to the accreditation function of its own organization?
TheAmerican Council of Academic Physical Therapy (ACAPT) recently published a paper entitled " Future of physical therapist education programs in higher education. " This paper should be mandatory reading for anyone interested in the proliferation of some allied health programs, credential escalation, and the intersection of these issues with practice.For starters, it is important to disambiguate ACAPT fromCAPTE (Commission on Accreditation in Physical Therapy Education). CAPTE grants accreditation to entry level programs for the physical therapy profession, and although ' independent ' is also a part of ...
Source: ABC Therapeutics Occupational Therapy Weblog - June 24, 2021 Category: Occupational Health Tags: OT Education OT practice policy Source Type: blogs
Why do people with pain report differently on questionnaires than they do in physical performance testing?
One of the topics thrown around by people who don’t have an up-to-date understanding of pain is why people say one thing on a questionnaire, for example, what they can and can’t do, and perform quite differently when asked to do the same task in a clinic. It’s a good question, on the face of it: after all, people should know what they can and can’t do, and be consistent. If there is a difference, well obviously the physical performance test is far more objective than self-report – the therapist is right there watching, so there’s no room for doubt about which measure is The Most Accurate...
Source: HealthSkills Weblog - June 13, 2021 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Motivation Pain conditions Professional topics Science in practice malingering measurement performance testing Source Type: blogs
In search of an evidence-based approach to occupational therapy practice education that would include simulation experiences
Simulation is a methodology used to replicate real-world tasks. Simulation provides experiences that lead to direct learning or that can be used as an assessment of competence. Such tasks have been used as a primary tactic in occupational therapy and other rehabilitation services since their inception - although they were generally applied in a therapeutic context. For example, an individual would learn how to dress themselves out of context to develop skill, and then that skill would be transferred to contextual learning. Sometimes, more esoterically, a simulated activity broken down into com...
Source: ABC Therapeutics Occupational Therapy Weblog - June 3, 2021 Category: Occupational Health Tags: OT Education OT practice policy Source Type: blogs
“Academic Creep” in the Health Care Workforce
Shirley SvornyGiven my concerns about the growing requirements for a doctoral degree in every medical profession – audiology, physical therapy, occupational therapy, pharmacy, etc., it was refreshing to read the comments after anarticle posted to Facebook about requiring a doctorate of all Physician Assistants. The author had written, “PAs are literally being left behind. Every other healthcare provider has already made the change. Physical therapists have the DPT, nurse practitioners have the DNP, audiologists have the AuD, etc.”Here is a comment by Rob Cee, a physician assistant at the Maine ‐...
Source: Cato-at-liberty - May 21, 2021 Category: American Health Authors: Shirley Svorny Source Type: blogs
Net Health Acquires Casamba
Net Health, a leading provider of cloud-based software for specialty medical providers, today announced that it has acquired Casamba LLC, a provider of electronic medical record (EMR) solutions for physical, speech and occupational therapy providers and home health and hospice agencies. The acquisition strengthens Net Health’s ability to support post-acute care providers as they navigate […] (Source: EMR and HIPAA)
Source: EMR and HIPAA - April 1, 2021 Category: Information Technology Authors: Healthcare IT News Tags: EMR-EHR Health IT Company Healthcare IT LTPAC Billie Nutter Casamba Health IT Acquisition Healthcare Analytics Hospice IT Josh Pickus Net Health Ronnie Amrany SNF SNF EHR SNF EMR Source Type: blogs
Best practices for successful OT/OTA partnerships in NYS
Presented at NYSOTA ' s Dessert& Dialogue Continuing Education Series, January 5, 2021. Thanks for stopping by to look at our slides!Click here for slides! (Source: ABC Therapeutics Occupational Therapy Weblog)
Source: ABC Therapeutics Occupational Therapy Weblog - January 10, 2021 Category: Occupational Health Tags: OT practice Source Type: blogs
2020 Year in Review: nOT so bad!
2020 – An eventful year – pedagogy in a pandemic!Celebrating 33 years of certification as an occupational therapist!A trip to Florida to present on ‘qualitative data sources for narrative analysis’https://nsuworks.nova.edu/tqrc/eleventh/day1/42/(last time I have traveled out of New York State)Final photo of me as I left the college in the Spring 2020, optimistic for a quick return!Sample 2020 Blog posts:Alterio, C.J. (2020, January 27). On so-called ‘Civility Pledges’ and the abolition of free thought and free speech. ABC Therapeutics Blog, http://abctherapeutics.blogspot.com/2020/02/on-so-calle...
Source: ABC Therapeutics Occupational Therapy Weblog - January 4, 2021 Category: Occupational Health Tags: OT Education Too much information Source Type: blogs
Looking beyond the immediate
When I graduated as an occupational therapist, I was told that my profession was “problem-solving” and “motivation”. At the time (early 1980’s) Lela Llorens‘ problem solving process was the fundamental approach taught during our training. This approach is straightforward: identify the problem, identify solutions, select a solution, implement the solution, and review. I’m not sure if this approach is still taught but it’s stayed with me (and those memories of painstakingly completing the problem solving process documentation…).
There’s one small step that I thin...
Source: HealthSkills Weblog - November 15, 2020 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Clinical reasoning Coping strategies Interdisciplinary teams Occupational therapy Pain Pain conditions Professional topics Uncategorized Source Type: blogs
