Introduction to Functional Therapy Magazine.

Ed Kaine, Publisher of Functional Therapy Magazine introduces the theme of the magazine.

There are a few ideas here:

1. It's time to lead or be left behind.
2. Function is very fashionable... because it works.
3. The CRAFT Model is a holistic model that will help all health care to provide better care.
4. Many disciplines are becoming more functional and Occupational Therapists must work to lead this. It is our responsibility to guide the world to the optimal health we seek.

I have a significant number of people who are interested in helping define function and health care for the future but I want to open it up to anyone from any discipline to join us and help shape the future of health care.

Please Like us on Facebook https://www.facebook.com/FunctionalTherapyMagazine and contact us through facebook if you'd like more information or to contribute an article or promote your point of view.

Yours,

Ed Kaine, OTR/L, RFT
Publisher of Functional Therapy Magazine

P.S. Please check out www.FunctionalTherapy.org for all the latest articles in health care and therapy topics that we and our readers can find.

The CRAFT Model - Dynamic Variations of a Holistic Model - Part 4

Contextual Barriers to Function

Today we'll explore the imbalances in the model as imposed by contextual barriers. Let's review the CRAFT Model as we consider the Context Level.

The CRAFT Model is built on the Context of the individual. One premise advanced by the World Health Organization in 1980 is that environmental, or as we call them contextual, barriers can limit life roles and hold a person back from reaching their full potential. In the CRAFT Model we represent this as unbalancing the person. Let's look at the external barrier as a depiction of contextually imposed imbalance...

With or without any disability or volitional causes, external barriers can impose functional imbalances; let's consider some particular external barriers.

Cultural Barriers

The culture of a people can be hard to define but fresh eyes can often distinguish differences. For instance, in New England some basic premises are that most work days are 8 hours, that men and women work in certain careers that are somewhat gender typed, that racial prejudice is discouraged and that education is valued. In some European cultures a siesta, or afternoon period when work closes for a nap is customary, in other places it is very discouraged for women to work outside the home or even to be educated, and other stark differences in equality between different groups. Imagine the effect of a culture which prevents a little girl from learning to read, or who's family must give a dowry to have their young daughter married. These are just more dramatic examples of how the culture of a place, an institution or even a family may affect an imbalance in the roles you take on.

Temporal or Situational Barriers

The temporal (time based) or situational context is often interpreted through cultural eyes. What happens in the different times of day, times of year, times of life? What happens in a situation where people or events are involved? In the middle of the night, after 'bankers hours', in the winter, or when we're at retirement age in America. In terms of situational barriers, times of war or famine spring to mind as particular situational and temporal barriers to full human potential.

Social Barriers
When there may be many positive people and supports in a person's life imagine the debilitating impact if a harmful person as a parent, or caregiver. A person in a position of trust may betray it; a misleading statement or a lie may lead to disaster. In a group people may make unwise choices, a gang may influence a person to harm others or break the law. In light of these, more and less dramatic mistakes can be made.

Physical Barriers
When a person with a mild limitation in mobility confronts a major physical barrier it can prevent them from participating in activity. Something we now take for granted, like ramps into buildings and at curb sides, can allow a person to enter their workplace, and a lack of them can prevent someone from working, or shopping, or getting into a movie. Our culture has often worked to limit physical barriers, and OTs have often been the catalysts to find other barriers. Not all cultures have such strong advocates or such resourses that they can provide these adaptations. Consider the availability of prosthetics, wheelchairs, reading glasses and other devices to overcome physical ability barriers in the developing world. Consider the availability of clean drinking water, food and shelter as aspects of physical context and we can see part of how this area can expand.

The areas of the 4 contexts overlap in areas and are interpreted through the experience of the person in their context. In this article we only touched the surface of how we might interpret barriers in context; it is for the eyes of the OTs and Functional Therapists along with engineers, architects, governments, businesses, and individuals to find and continue to work for the betterment of personhood through removal or compensation for external barriers.

In light of all the potential limitations that may be caused by external environmental or contextual barriers we may also find where external supports help a person regain balance. That will be the focus of our next discussion as we elaborate on dynamic variations of the CRAFT Model.

Thanks for reading,

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.










 

The CRAFT Model - Dynamic Variations of a Holistic Model - Part 3

The latest posts have depicted imbalances at the Functional level and the Ability pillar level. In this we will identify the change we have made at the Context level; you'll notice that, with a nod to Gary Kielhofner and the Model of Human Occupation, we have added the Temporal Context to the context level.

Each of the contexts influence the effectiveness of the Abilities and the choice and balance of Functions. In previous posts we have reviewed the Physical, Cutural and Social aspects of context; why does the temporal context merit inclusion at the context level? We'll see it plays a particularly important role in our lives.   

Temporal relates to factors of time. On the most rudimentary level that could include the time of day, or time of year, but let's also consider factors like time of life. For instance, we are currently preparing for the start of a new school year. That has aspects of it being August, but also of the time of our lives; it is much different for my children who will be going to school than for me who will be getting them ready in the morning and helping to get them there 'on time'. Also, it will be different at 7am than it will be at 3pm; temporal factors have influence on all other areas.

Time influences us greatly and we initially left it as part of the Abilities as in the time of a person's life (and it certainly remains there) and as a modifier for social and cultural contexts. Now though, considering that we have included it here I hope you can see how well it fits.

If you would like to learn more about the Model of Human Occupation for a thorough look at the multifactorial influences in a persons life I reccommend this link: http://books.google.com/books?id=WOYkTQNvNUgC&pg=PA5&lpg=PA5&dq=temporal+moho+model+of+human+occupation&source=bl&ots=ZL9YhsqRGG&sig=y10u4LhupUoOU1z0c8xu5WNFHTI&hl=en&ei=3ExvTL7DNYK88ga98ZHwCw&sa=X&oi=book_result&ct=result&resnum=3&ved=0CCIQ6AEwAg#v=onepage&q=temporal%20moho%20model%20of%20human%20occupation&f=false. This is Google Book's full version of the text Model of Human Occupation: Theory and Application By Gary Kielhofner. This important text is a core part of an OTs training, and I am proud to reference it here. 

When we graduated from University with our degrees in Occupational Therapy we marvelled at our new eyes for seeing the world. We were given a gift in being able to pull together the many ways that people function and we had tools to help them. It is the gift of seeing a person wholistically and in relation to the many other persons and factors around them. In some ways we are almost constantly surprised at the amazing feats we can acheive and at the relative of simplicity of its 'common sense'. OTs and Registered Functional Therapists and Associates have a very refined and deeply trained 'common sense'; and I want us to share it with the world.

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!

How Language May Shape Our Thoughts.

Please check out this article in the July 9, 2009 Newsweek. What’s in a Word? Language may shape our thoughts. By Sharon Begley It has some very interesting insights into language and how people think about things.


I previously discussed this topic related to the use of our title, in particular asking whether we should use the O-Word (Occupation). The answer was and is, "yes". It allows us to expand the way we think about function. However; with this is a warning that the meaning of this word for most people is not what it is for an Occupational Therapist. What about the O-word?

The challenge is open to try to expand the definition of Occupation. It does not appear that this will be possible in this year or in the next few. I discussed this with a representative of Mirriam Webster's Dictionary and it was not possible. Let's get our definition in the Dictionary!


What does this mean for us? To me it means we need to consider the words we use to promote our profession and that it does matter whether people understand the word we are using.

With only a very limited definition of Occupation available to people how can we blame them for not understanding. It is up to us to reach out to the people. We can do this by using words that have positive meaning and capture the essence of what we do.

In the word "Functional" we have the basic idea of the way we work. We structure our treatments with a focus on the function task you must do. This may involve addressing the cognitive skills, the physical skills, the motivational and social skills that go into the task. Then the functional task itself, be it work, self care or leisure, is can be the focus of our treatment. It is the emphasis on doing something functional (not just fixing the structure) that Occupational Therapy has brought to the world. By using the protected title of Registered Functional Therapist we can more clearly help people understand how we can help them.

Functional versus Occupational on the Visual Thesaurus

It's something to think about.

Yours,

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

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

Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial

This is a very important article for patients anticipating or recovering from ICU stays. In this randomized controlled clinical trial, Occupational And Physical Therapists took ventillated patients through a course of functional tasks. In the process they had a trememdous impact on patient's lives.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60658-9/fulltext

This shows that it is not just about surviving. Healthcare has the technology to save your life, but it's therapy, and particularly "Functional Therapy", that cares about getting you back to a life of purpose and meaning.

Congratulations to the excellent teams at the University of Pennsylvania, University of Chicago and University of Iowa. The effort to take and confirm scientifically things we know (or think we know) intuitively is very appreciated.

Go Therapy, even in this critical and frightening time in a person's life, the worry that you are too sick to do therapy is turned on it's head. You might be too sick not to do therapy.

Yours,

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

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

Change... the easy path.

We were having a meeting the other day about how to increase the awareness of Functional Therapy and get more OTs and COTAs to join. We got to talking about how difficult change is. Lindsay Neumann, RFT, said, "Sometimes it's just easier to go along the way that things are. Most times actually."

Well it didn't take long for it to come around to how difficult it has been for each of us to be Occupational Therapists. There were a cascade of difficulties:

1. To learn about the profession in time to choose it as a career - Very Difficult.
2. To explain to your family what you were studying - Very very difficult... because you barely knew yourself.
3. Graduating, finding a job. Not too difficult... because so many people were beat by #1. Therefore there is a huge shortage of OTs. Easy to find job, but...
4. Staffing for OTs is largely influenced by the difficulty that upper administration has in understanding what OT might do. Incredibly difficult.
5. Then, let's mention the many discussions you'll have trying to explain OT. Difficult but fun.
6. Then, your ears perk up when someone says Occupation or Occupational and you wonder if they are talking about anything related to your profession. They aren't. Our definition still hasn't got into the dictionary - difficult.
7. Then you do this for year after year... it was so much more fun when I started. Difficult.
8. Then you get involved with a group who wants to provide an alternative name and change is difficult.

So, the only thing that would have made this easier would have been to do something about it 89 years ago, or 8 or 9 years ago. There is no time like the present. Make the change now and maybe we'll get past some of this stuff.

Please check us out at www.FunctionalTherapist.org and look at joining us. And if you're already a member let's get to work popularizing Functional Therapy.

Yours,

Ed Kaine, OTR/L, RFT

President of the American League of Functional Therapists

Contact us at: RegisteredFunctionalTherapist@gmail.com

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!

The Challenge: Let's get our definition in the dictionary!

I am an Occupational Therapist and a Registered Functional Therapist. I believe that Functional Therapy will be the best name going forward in terms of helping people to understand what we might be able to do.

I claimed in my last post that our definition was not in the dictionary. Here is a snapshot of Definitions of Occupational and Occupation.

This is the Date: June 2nd, 2009.

Here is the challenge:
Can we get a good definition of Occupation and Occupational into the Dictionary?

Steps:

1. Let's get a definition we are happy with. Send your ideas to OccupationDefinition@gmail.com. (Maybe even for glorious prizes... yet to be determined.)
2. Let's figure out a way to get it in the dictionary. Again, ideas to OccupationDefinition@gmail.com. Maybe you have a friend at Webster's, we need your help.
3. Let's get it into the Dictionary! (Let's do it by December 31st, 2009!)

Here is what we start with for Occupational:

oc⋅cu⋅pa⋅tion⋅al   /ˌɒkyəˈpeɪʃənl/ Show Spelled Pronunciation [ok-yuh-pey-shuh-nl] Show IPA Dictionary.com UnabridgedBased on the Random House Dictionary, © Random House, Inc. 2009.
–adjective
1. of or pertaining to an occupation, trade, or calling: occupational guidance.
2. of or pertaining to occupation: occupational troops.
Origin: 1840–50; occupation + -al 1 Related forms:
oc⋅cu⋅pa⋅tion⋅al⋅ly, adverb

The American Heritage® Dictionary of the English Language, Fourth EditionCopyright © 2006 by Houghton Mifflin Company.Published by Houghton Mifflin Company. All rights reserved.

oc·cu·pa·tion·al (ŏk'yə-pā'shə-nəl) adj. Of, relating to, or caused by engagement in a particular occupation: occupational hazards.oc'cu·pa'tion·al·ly adv.




WordNet® 3.0, © 2006 by Princeton University.
occupational
adjective
of or relating to the activity or business for which you are trained; "occupational hazard"

Merriam-Webster's Medical Dictionary, © 2002 Merriam-Webster, Inc.

Main Entry: oc·cu·pa·tion·alPronunciation: "äk-y&-'pA-shn&l, -sh&n-&lFunction: adjective: relating to or being an occupational disease —oc·cu·pa·tion·al·ly /-E/ adverb

Dictionary.com UnabridgedBased on the Random House Dictionary, © Random House, Inc. 2009.

And todays definition of "Occupation":


occupation

Dictionary: oc·cu·pa·tion (ŏk'yə-pā'shən)
n.
An activity that serves as one's regular source of livelihood; a vocation.
An activity engaged in especially as a means of passing time; an avocation.
The act or process of holding or possessing a place.
The state of being held or possessed.
Invasion, conquest, and control of a nation or territory by foreign armed forces.
The military government exercising control over an occupied nation or territory.
[Middle English occupacioun, from Old French occupacion, from Latin occupātiō, occupātiōn-, from occupātus, past participle of occupāre, to occupy. See occupy.]

Business Dictionary: Occupation
Trade, job, business, or vocation of an individual. An occupation is the principal means by which one earns a livelihood.
Thesaurus: Occupation
noun
Activity pursued as a livelihood: art, business, calling, career, craft, employment, job, line, métier, profession, pursuit, trade, vocation, work. Slang racket. Archaic employ. See action/inaction.
The holding of something, such as a position: incumbency, occupancy, tenure. See place.

Antonyms: occupation
n
Definition: profession, businessAntonyms: entertainment, fun, hobby, pastimen
Definition: seizure, takeoverAntonyms: giving up, surrender, yielding

US Military Dictionary: Occupation
n. the action, state, or period of occupying or being occupied by military force: the Roman occupation of Britain crimes committed during the Nazi occupation.
See the Introduction, Abbreviations and Pronunciation for further details.

Britannica Concise Encyclopedia: Occupation (of Japan)
(1945 – 52) Military occupation of Japan by the Allied Powers after its defeat in World War II. Theoretically an international occupation, in fact it was carried out almost entirely by the U.S. under Gen. Douglas MacArthur. During the Occupation period, Japanese soldiers and civilians from abroad were repatriated to Japan, arms industries were dismantled, and political prisoners were released. Wartime leaders stood trial for war crimes, and seven were executed. A new constitution, vesting power in the people, replaced the Meiji Constitution; in it Japan renounced its right to wage war, the emperor was reduced to ceremonial status, and women were given the right to vote. The Occupation administration also carried out land reform, reducing the number of farmers who were tenants from 46% to 10%, and began the breakup of the zaibatsu (business conglomerates). Labour unions were initially encouraged, but as fears of leftist organizations grew with the advent of the Cold War, stronger governmental control of labour was supported. The education system, seen as elitist, was revised to resemble the U.S. system. Though the U.S. wanted to end the Occupation in 1947, the Soviet Union vetoed a peace treaty with Japan; a treaty was signed in 1951, and the Occupation ended the following year.
For more information on Occupation (of Japan), visit Britannica.com.

Word Tutor: occupation
IN BRIEF: A person's profession. The first step toward success in any occupation is to become interested in it. — Sir William Osler (1849-1919), Canadian physician, M.D., teacher, medical historian.

Quotes About: Occupation
Quotes: "Occupation is the scythe of time." - Napoleon Bonaparte"Monotony is the law of nature. Look at the monotonous manner in which the sun rises. The monotony of necessary occupation is exhilarating and life giving." - Mahatma Gandhi"My mother has always been unhappy with what I do. She would rather I do something nicer, like be a bricklayer." - Mick Jagger"It is neither wealth nor splendor; but tranquillity and occupation which give happiness." - Thomas JeffersonQuotes about Occupation supplied by Quotations Book.-->

Wikipedia: Occupation

Look up occupation in Wiktionary, the free dictionary.
Occupation may refer to:
In business:
Employment, a person's job or work in service of an employer
Profession, an occupation requiring specialized knowledge
Vocation, an occupation pursued more for altruistic benefit rather than for income
Career, a person's occupational history
Day job, an occupation solely for income, while pursuing another preferred career track
List of occupations
Standard Occupational Classification System, developed and used by the U.S. government
Occupational prestige, the relative esteem in which a particular job is held
Occupational therapy, assisting people who have difficulty performing occupational functions
Occupational science, the study of humans as occupational beings
Occupational disease, chronic ailment resulting from work
Occupational crime, opportunistically committed in the course of legal occupation
In a military context:
Military occupation, control of a territory by a military force
Law of occupation, portions of the law of war which relate to military occupation
List of military occupations, notable historical instances of military occupation
In film and television:
Occupation 101, a 2006 documentary film about the Israeli–Palestinian conflict
Occupation: Dreamland, a 2006 documentary film about the Iraq War
Occupation (TV serial), a 2009 television serial about the Iraq War
Occupation Double, a Canadian reality television show
"Occupation" (Battlestar Galactica), an episode in the third season
In music:
Occupation: Foole, a comedy album by George Carlin
"The Beautiful Occupation", a song by the band, Travis
Other meanings:
Occupation (protest), the temporary forceful occupation of a building, space or symbolic site
Occupancy, use of a building for shelter or support of persons, animals, or property

Translations: Occupation Top
Home > Library > Literature & Language > Translations
Dansk (Danish)n. - beskæftigelse, erhverv, besiddelse, besættelse, indtagelseadj. - beskæftigelses-
Nederlands (Dutch)bezigheid, beroep, bezetting, occupatie, inbezitneming, bewoning, activiteit, bezettings-
Français (French) n. - occupation, installation, (Mil, Pol) occupation (de), métier, profession, activité de loisiradj. - d'occupation
Deutsch (German) n. - Beschäftigung, Beruf, Tätigkeit, Besetzung, Besitz, Besatzungadj. - Beschäftigungs...
Ελληνική (Greek) n. - κατάληψη, κτήση, κατοχή, απασχόληση, ασχολία, επάγγελμα, επιτήδευμα, εργασία, κατοίκηση, ενοίκηση
Italiano (Italian) occupazione, presa di possesso, mestiere, professione, presa
Português (Portuguese) n. - ocupação (f), profissão (f)
Русский (Russian) занятие, оккупация
Español (Spanish) n. - ocupación, quehacer, actividad, entretenimiento, profesión, oficio, vocación, habitación, residenciaadj. - relacionado con o perteneciente a la ocupación o actividad
Svenska (Swedish) n. - sysselsättning, yrke, ockupation, besittning, inflyttning
中文（简体）(Chinese (Simplified)) 职业, 占有期间, 占有, 职业的
中文（繁體）(Chinese (Traditional)) n. - 職業, 佔有期間, 佔有adj. - 職業的
한국어 (Korean) n. - 직업, 점유adj. - 점유하는, 직업적인
日本語 (Japanese) n. - 職業, 何かすること, 時間の使い方, 占有, 居住, 占領
العربيه (Arabic) ‏(الاسم) احتلال, مهنه‏
עברית (Hebrew) n. - ‮כיבוש, השתלטות, ישיבה, דיירות, תפיסה, חזקה, עיסוק, החזקה, מקצוע, עבודה, תעסוקה‬adj. - ‮לשימוש הבלעדי של המחזיקים בקרקע שמדובר בה‬

American Sign Languagecommtechlab.msu.edu

So, that is our starting point. I don't know if you agree that it's not defined in these dictionary samples. For me the definition of OT as "assisting people who have difficulty performing occupational functions" doesn't cut it because we already know that will lead to the "vocational" conversion. Mind you, I'm glad it says "functions". Go ahead and check now because the American League of Functional Therapists is seeking to have a working definition within 7 months... by the end of 2009.

So sharpen up your pencils or grab a definition from your college days. You just may be the one who's words grace the pages of history.

We believe in this concept of Occupation, people want to understand. We can help them.

Thank you so much for participating. I'll keep you updated here as to how we are coming along on the project.

Yours,

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


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

email: RegisteredFunctionalTherapist@gmail.com
Check out: http://www.functionaltherapist.org/

The Argument for "Functional Therapy"... straight from the Visual Thesaurus.

This post seeks simply to show how far we have (or have not) come in getting our definition of Occupation out to the rest of the world.

Also, let's consider which word we want to be expanding the definition of?

Hmmm... not too much there.... How about Occupation?

Okay... that's pretty convincing. We are alone in our definition.

But what are the alternatives?

Oh, Functional.


Not bad huh?

So, there you have it! What more needs to be said?

It is clear that we still have something to offer the world in terms of an understanding of how Functional Therapy (or Occupational Therapy) can help the world. We may even find that we help expand the definition of function and introduce people to an alternative definition of Occupation once we gain that trust and understanding.

I'd rather be expanding the definition of "Function" than working too hard at changing people's minds about what "Occupation" can be.

What do you think?

Yours,

Ed Kaine

President of the American League of Functional Therapists

http://www.functionaltherapist.org/

Comments?: Contact us at RegisteredFunctionalTherapist@gmail.com

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