The CRAFT Model - Dynamic Variations of a Holistic Model - Part 5

Restoring Balance To The Platform

In the preceding scenarios we reviewed the sources of imbalance, now we will discuss a central principle of Functional Therapy, supporting function.

Let's revisit the model as it is unbalanced by a deficit in abilities. No matter the ability pillar we can upset the balance of functions. Most often healthcare professionals work to restore the physical body, in fact, most of medicine is working towards addressing physical complaints, symptoms and problems. The deficits from mental, social and motivational impairments can lead to similar imbalances.

Let's return to the person with the deficit of the motivational pillar. This might have been caused by a depression or perhaps the depression is caused by the imbalance of functions; by not performing a balance of functions you can lose your motivation. Consider the lack of balanced function as a risk for other deficits.

The CRAFT Model is a snapshot of the status of an individual; consider personal history an elucidation of which caused which, in other words we get to find out if it was 'the chicken or the egg'. I wish to popularize the idea that an imbalance in functions could lead to other deficits any of the other areas. 

In order to most effectively help a person we work to restore balance to function. In this case we depict an external support, possibly a social support, to help restore balance to the platform of functions. 

"The worst place to decide whether to get up and get dressed is in bed." - Unknown  

By supporting a person doing functional things we allow them to use their mental, social, physical and motivational abilities in  functional way. In short, "the more you do, the more you can do." They also engage with their physical environment, social supports, temporal situation and consider their cultural background more deeply. The Functional Therapist and Functional Therapy Associate works to assess the limitations and then seeks to expediently restore balance. The ability to call on the whole model and more gives Functional Therapy its strength.

OTs and Functional Therapists might occasionally find themselves off the course of purely a functional or occupational approach to care; the CRAFT model seeks to help get us back to the value of doing functional things in therapy. We must consider the paths of remediation and compensation as ways to restore function along with external support and means to seek balance in function as a reasonable jump off point for a return to living.

Thank you for reading.

Yours,


Ed Kaine, OTR, RFT
President of the American League of Functional Therapists, LLC

P.S. If you would like to join our emailing list and get updates and newsletters about ALOFT and the International LOFT please email ALOFTMail@FunctionalTherapist.org and enter "Subscribe" in the subject line. 

CRAFT Model - Functional Therapy's Expansion of the Wholistic View of Personhood

This is a snapshot of an interactive presentation we are developing to help consumers and therapists to better understand the interaction of Functions, Abilities and the Context in which we live.

 It embodies a globe which contains the Context of the person; the pillars represent four domains of Abilities; and the pillars support the platform of Functions or 'Things we do'. These are also known as Occupations.

In the interactive presentation we represent external supports by additional pillars and external burdens as weights. The new adage 'The more you do the more you can do!' plays into this system by the performance of functions feeding back into the diameter of the pillars; doing more means you develop more ability. The system works to try to maintain a balance and the old adage 'All work and no play makes Jack a dull boy' is represented by relative sizes of the Functions, with too much of one unbalancing the others.

This is an adaptation of several models with painstaking effort to add a significant reworking so as to avoid infringing anyone's copyrights. The CRAFT model is a reimagining of how we can propound a more integrated vision in Healthcare. It is published under a Creative Commons Copyright and we would ask that you reference us and http://www.functionaltherapist.org/ when you copy or adapt it.

"Don't worry about people stealing your ideas. If your ideas are any good, you'll have to ram them down people's throats."
- Howard Aiken

I hope you enjoy this preview of our interactive presentation as much as we are proud to present it to you.

Yours,

Ed Kaine, OTR, RFT

President of the American League of Functional Therapists

RegisteredFunctionalTherapist@gmail.com

Functional Therapy... the Next Generation of Occupational Therapy!

A gift in a question... what have you always wanted to do?

We have long had "Patient Goals" on all our assessment documentation. We always ask patients what they want to acheive in their therapy. As an OT and RFT we would still get the most common answer "I want to be able to walk." Instead of ever being discouraged by this response (and especially if ambulation seemed like a distant possibility) I would try to get the functional aspects of why the patient wants to walk. The patient's goal would rapidly become "to be able to walk into the kitchen and make myself a sandwich" or up to "walk into the woods to sit by a stream". Then if ambulation was a long way off I'd see if there were a way to meet the functional need from another level, hence independent at wheelchair level could be more palatable. Again, if ambulation was appropriate and the functional barrier to the goal, it has always seemed that functional mobility is right up OT's alley.

I was reading a thread on the OTNow list about a particular patient's goals when I recalled an old lesson that I have incorporated many times since. When the patient cannot come up with any goal, or only states a raw task like walking with no functional reason for it, I've asked the more "bucket list" type question. "What is something you always wanted to do?" It had been put to me in university as "what is something you've always wanted to do before you die?" I haven't always used the weight of "before you die" but having it in my mind keeps me focused on what I want them to think about. What a gift if we can get someone out of ruminating on the physical limitations and seeing the possibilities.

In particular this has played out in patients with paraplegia/quadriplegia. Where the "I just want you to get me walking again!" can really turn into a new and positive direction if we open up this type of conversation. Also, having it can remind people that they always wanted to play an instrument or write a book.

We have so much to offer, sometimes it may just be a simple question that helps someone think about a future that isn't dealing with an acute illness or injury.

Yours,

Ed Kaine, OTR, RFT
President of the League of Functional Therapists
http:www.FunctionalTherapist.org

Functional Therapy... the Next Generation of Occupational Therapy!

We are opening up Comments as of June 4th, 2009.

I was asked if I would consider opening comments up on our Blog. We talked about it and here it is.

As a trial of the commenting process we are looking to see what you think about our content. You can go back to former articles and post comments or you can just use this feature going forward.

We have a lot we'd like to say and we'd like to hear it in a public forum too. Please be open and courteous. A differing opinion is just that. It is really an opportunity to learn more about another person's perspective.

As always, you can email us directly at RegisteredFunctionalTherapist@gmail.com or check us out at www.FunctionalTherapist.org. Thank you for all your support so far.

Yours,

Ed Kaine
President of The American League of Functional Therapists

Functional Therapy... the Next Generation of Occupational Therapy!