paradigms in OT
paradigm
-Typical way in which an academic discipline defines its current theoretical system, field of study, methods of research, & standards for acceptable solutions at any given time or -conceptual framework/Compilation of a unique set of shared ideas, values, & beliefs about a discipline, which create the foundation & vision of the profession (temporarily provides model problems and solutions to a community of practitioners) -2 characteristics: open ended + unprecedented scientific achievements among competing sources -provides professional identity/cultural core of the discipline -temporary; wont work forever
4 developmental stages of paradigm (continuous)
-preparadigm stage: problems emerge with current way of thinking, various strategies proposed (brainstorming occurs) - some work some don't -paradigm stage: eventually one theory emerges as the best solution (best practice) -crisis: uh oh new issues emerge that current paradigm cant solve, naturally occurs over time because one paradigm cant solve all problems, creates opportunity for a paradigm shift and leads to.... -resolution: n=a new and improved paradigm get created that is a reorganization of the old plus the new thinking
Paradigm of Occupation
1900s-1940s; occupation at the center; habit training, "reconstructionist movement" of the 1920s - vocational training emerges in retraining war vets after world war 1; reconstruction also extended to factory workers who sustained any injuries from industry - goal was to retrain and reeducate and restore mental and physical functions so they could get back to the work force 1930s- biomechanical approach from scientific evidence, emerges from the industrial revolution, applied to ADL; illnesses, institutions, behavioral modification 1940s - kinetic model, rehab model, sheltered workshops, sciencey....segwaying into the crisis period where profession under pressure from medicine for more scientific evidence...late 1940s to 50s comes in the 2nd pre-paradigm
2nd paradigm mechanistic paradigm
1950s-70s: reductionist, medical model, focus on inner mechanisms of disease and disability, specializations in kinesiology, psychology, neuropsych, rehab, children, development etc... loss: commitment to occupational nature of humans and occ performance and so many specializations drifted apart from a unified identity (crisis) gain: new assistive devices, new techniques (ayres and sensory integration, rood with neuro reflex, psychotropic drugs, object relations theory and using the self as a therapeutic tool/psychoanalytic) 1960s: social reform: deinstitutionalization; Reilly's occupational behavior model
crisis of second paradigm
1970s, reductionism inadequate for chronically disabled, dissatisfaction with loss of professional identity, disunity; need for uniform terminology...leads to preparadigm of third paradigm
whats next? 4th paradigm?
AOTA framework document, WHOs new classification ICF, systems perspective, centennial vision (EBP, science driven, occupation focused interventions, engagement in global advocacy and visisbility to ensure funding for OT, pop health) entry level doctorate, bach level COTA
paradigms in OT
Kielhofner traced OT through history and identified paradigm shifts -Moral treatment with its humanistic focus as the pre-paradigm to treat mentally ill with occupations to normalize disorganized habits/behaviors...this led to the first paradigm of OT - the paradigm of occupational therapy (1900s-1940s)
paradigms in OT and dates
Paradigm of Occupation: 1900s-1940s (crises in 1950s) Mechanistic Paradigm: 1950s-1970s (crises in 1970s) New Emerging Paradigm: 1980s-2000s
first person to introduce paradigm/original source
Thomas Kuhn
4 probs that emerged during 3rd paradigm
accountability (insurance reform); manpower shortage (licensure and registration); lack of unified theoretical base (emergence of various frames of reference); and lack of research = theses problems needed to be solved (1980s)
paradigm effect
barker 1992 - tunnel vision, filters perception bc any contrary info to the paradigm is left out, whats defined as impossible today is only impossible in the context of the paradigm, every paradigm encounters probs it cant solve and this is the catalyst for a paradigm shift
2nd pre paradigm
getting more aligned with medical model, adopting medical paradigm of reductionism, OT to be seen as a scientific discipline; lit is more pervasive with kines, neuropsych, psychoanalytic; vocational training, rehab, kinetic model, sheltered workshops
crisis of paradigm of OT
late 1940s and early 1950s, when increasing pressure from medicine to be more scientific led to the questioning of the paradigm of occupation.
3rd new emerging paradigm
recommitment to holistic view and occupational nature of human beings -client centered practice -systems theory -balance of art and science 1980s: birth of occ science, clinical reasoning, uniform terminology II 1990s: move to entry level master's degree, evidence based practice, occupational performance models -ADA is passed easier for OT to advocate and highlights our value
Pre-paradigms of Occupation
set the stage for the paradigm of occupation, influenced by slagle, dunton, barton, etc..., mental hygiene; habit training "holistic approach-meyer" ex. hull house work programs (community outreach); consolation house as a convalescent home
paradigm shift
when a discipline abandons one worldview for another; a revolution; a drastic conceptual restructuring occurs. -change occurs drastically not so much gradually (according to KUHN) often reluctance to embrace paradigm -occurs in paradigm stage of "crisis"