Paradigm Shifts

What is a 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" (Mosey, 1981, p 123) "Compilation of a unique set of shared ideas, values, & beliefs about a discipline, which create the foundation & vision of the profession (Kielhofner, 2004 based on work of Kuhn, 1970) -Explains how professionals view practice -Guides questions, solutions, goals of practice

3rd Paradigm in the 1990s

-ADA passed -occupation performance models -move to masters degree -evidence-based practice (well elderly study)

3rd paradigm- 4 problems of the 1980s

-Accountability (insurance reform), -manpower shortage (registration & state licensure), -lack of unified theoretical base (emergence of various frames of reference), -lack of research

Influential figures of first paradigm

-Eleanor Clarke Slagle -George Barton -William Dunton -Adolf Meyer

1st paradigm defined by...

-Moral treatment -Mental hygiene movement (consolation house, hull house)- community practice! "Occupation" was the central phenomenon of interest referring to balance of work, play, self-care, & rest; holistic view -Biopsychosocial- holistic!

4 stages of a paradigm

-Pre-paradigm phase- brainstorming new ideas -Paradigm- "best solution" -Crisis (shift)- not all problems solved, causes a paradigm shift -Resolution- new and improved paradigm, old+new thinking

What next? Influences to the OT paradigm

-WHO's ICF -AOTA Framework document -systems perspective -Centennial vision -Vision 2025- global advocacy, evidence based, population health, doctoral degree, occupation focused interventions

Pre-paradigm phase in 1970s

-lack of professional identity -specializations emerged -3 Frames of Reference - behavioral, developmental & psychoanalytic -Uniform Terminology- important- before practice framework- allowed all to speak the same language.

what came about in the 80s?

-occupational science (Yerxa) -Uniform terminology II- updated -clinical reasoning

3rd Paradigm

1980s -holistic view recommitment (biopsychosocial) -recommitment to occupational nature of humans -client-centered practice; not reducing people to illnesses -collaboration -art and science balanced -systems theory

Paradigm effect- person, year, and definition

Barker, 1992 -Paradigms can filter our perception and create tunnel vision, leaving out other possible solutions to problems

What 3 frames of reference emerged in the 70s?

Developmental, psychoanalytic, behavioral

Why is paradigm important to OT?

Kielhofner: -provides a cultural core of the discipline -provides professional identity

Paradigm shift- definiton, person

Kuhn Definition - when a discipline abandons one worldview for another; a revolution; a drastic conceptual restructuring occurs.

2nd Paradigm

Mechanistic- Medical model -Disease model and specialization -Medical model (reductionistic) replaces "occupations" of moral treatment & humanism -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 1970s

Problems that could not be solved by the mechanistic paradigm were... 1. Reductionism was inadequate for treating chronically disabled 2. OTs express dissatisfaction over a loss of professional identity & unity

1st Paradigm- 1920s

Reconstructionistic Movement -beginning of biomechanics approach -rehab- physical and mental -physical reconditioning -maintenance of hope -back to work force

1st Paradigm- 1930s

Scientific method -biomechanical and behavior modification frames of reference -scientific method applied to behavioral modification

2nd paradigm 1960s

Social reform -deinstitutionalization -Demise of institutions (asylums, prisons,etc -De-institutionalization & re-socialization -Therapeutic milieu (Edelson) -Mary Reilly and occupational behavior model- brings us back to occupation

Three paradigms of OT and dates

The paradigm of occupation (1900-1940)- crisis late 40s early 50s Mechanistic Paradigm (1950-1970)- crisis 70s New emerging paradigm (1980-2000) what next?

Paradigm shift (1940s-50s)

The profession comes under pressure from medicine to provide scientific evidence for its practice

What drives practice?

Theory. But sometimes practice and social and political issues stimulate change and new ways of thinking

Original source, year, and definition of paradigm

Thomas Kuhn, 1970 "Universally recognized scientific achievements that for a time provide model problems and solutions to a community of practitioners"

What document developed in the 70s allowed all OTs to speak the same language?

Uniform Terminology

How long does a paradigm last?

Until the solutions are no longer effective. No set time frame. No longer meets benefits of its generation. New thinking and a shift will occur

Pre-paradigm phase 1940s

Vocational Training - WWII & vets Extended to both physical & mental health Sheltered workshops Kinetic model (biomechanical approach) & Rehabilitation model **biomechanical and rehab model

What kind of cycle is paradigm development?

continuous cycle

2nd paradigm 1950s

psychoanalytic and sensory motor -many special tests developed -psychotropic drugs