Occupational therapy is a profession of many dimensions. The faculty of this Program believe there is a unifying paradigm that ties the wide diversity of occupational therapy practice together. This unifying paradigm consists of three basic themes; 1) the use of occupation as a unique health giving tool, 2) the interactive view of man and his environment, and 3) the importance of common values in the profession. Furthermore, the faculty strongly believe that research and service are essential to support the viability of these values within the profession.
Theme 1: Occupations are meaningful person-centered activities. Often viewed as work, leisure/play, and/or daily living tasks, occupation is the dominant activity of human beings. These areas of occupation influence the biological, psychological, cognitive and social nature of each individual during the process of normal human development not only creating unique individuals, but influencing human cultural evolution as well. Basic to this concept of occupation are certain assumptions. First, is the assumption that human beings have an occupational nature. That is, occupation is essential to the human species and the need to engage in purposeful occupation is innate and related to health and survival (Wilcox, 1993). Being part of the human condition, this occupational nature consists of underlying performance components and therefore is a determinant and a product of development. A disruption of performance components may affect the individual's interaction with his/her environment and thus results in lost potential, stress to the individual, and decreased quality of life. Further, because impairment or disability may disrupt the occupational nature of man, this magnifies the condition of the impairment or disability and further disruption evolves.
Another assumption is that occupation, used as a therapeutic tool, may promote health or well being. This is the basic dynamic of occupational therapy. Professional guidance by an occupational therapist toward participation in purposeful and meaningful occupation is restorative and can prevent or stop the loss of ability and facilitate the performance of occupational roles. The therapeutic element becomes the interaction of the individual's performance component (the underlying capabilities of engaging in occupation) and the form of the occupation. It is essential in the therapeutic use of occupation that the process be relevant to the uniqueness of the individual and his/her cultural heritage. Moreover, it requires the individual's personal experience of meaningfulness.
Theme 2: The individual functions within a context and is seen as both a product and producer of his environment. People are believed to have motivation to engage in occupation and strive toward competence. Concurrently, the social, physical, and cultural environment "press" the individual to engage in occupation. This perspective attempts to focus on the interdependent aspects of the person and the environment, realizing that both have adaptive capabilities and limitations. Further, rather than focusing on the end products of these interactions, the focus is on enabling the individual to experience competence within his or her environment.
Theme 3: The existence of common values shared by the faculty. Values are believed to influence practice and clinical reasoning of occupational therapists and therefore need to be explicit and emphasized throughout the program of study. If individuals are viewed with dignity, respect, and seen as unique sociocultural human beings, we believe that occupational therapy should: 1) be person-centered, 2) consist of meaningful occupations, 3) maximize function with individualized intervention, 4) prevent impairment and enhance wellness, 5) consider the whole person within his/her environment, and 6) help a person gain a sense of self, self worth, and/or life satisfaction.
The faculty believes that an effective curriculum must achieve a balance between technical skills, theoretically based knowledge, service learning, and scientific inquiry. For example, students must be able to understand theoretically how to use occupation as a health giving tool to enhance quality of life. They also need to learn the underlying performance components and how to perform and teach the occupational activities such as dressing, communication, or leisure skills, and investigate the outcomes of occupational therapy intervention. Additionally, the faculty are committed to developing professionals who are life long learners and able to implement independent inquiry. Thus, because of the holistic nature of the profession and the Program's philosophical view, the Program constantly strives to achieve a balance between technical skill acquisition necessary for satisfactory performance on the job, theoretically based knowledge which will result in the student's ability to solve clinical problems in an adaptive and flexible way, a sense of commitment to the community, and the utilization of research skills and knowledge.
Finally, the faculty believe that along with the technical, investigative, and theoretical knowledge, students must learn to be competent in the art of using caring relationships in a helping and ethical manner. We believe that students benefit from significant role taking experiences. Therefore, service to communities is seen as essential to the student's learning. There is an expectation that students will participate in variety of roles that serve the community, as role modeled by faculty performing service in a diversity of settings.
Competence in the art of the use of caring relationships and occupation implies a high level of problem solving and clinical reasoning abilities which must be instilled and taught to occupational therapy students in the educational program within a relatively brief period of time. The use of a developmental model of clinical reasoning will be the Program's basis of providing the grounding for the development of clinical reasoning with facilitation of the more complex levels of clinical reasoning applied when students indicate the readiness. The facilitation of clinical reasoning must be individualized based on the fact that students have a diversity of learning styles and come to the program with a variety of life experiences. The occupational therapy faculty strive to promote the student's individual learning in the necessary skills and abilities for an entry-level professional and to facilitate personal growth through the structure of the curriculum, course objectives, and fieldwork experiences including those unique to eastern North Carolina.
In summary, the occupational therapist is a competent and caring expert in the use of occupation. With knowledge based in physiological, cognitive, social, and psychological dimensions, the occupational therapist fosters self determination in the patient or client. The therapist acts as an agent of change by engaging people in occupation that is meaningful and adds satisfaction to the individual's life. This Program's goal is to facilitate development of professional mastery in the use of occupation, balanced with technical, theoretical, service, and research abilities, with the perspective "that man, through the use of his hands as energized by mind and will, can influence his state of health." (Reilly, 1962).
Reilly, M. (1962). Occupational therapy can be one of the great ideas of the 20th century medicine. American Journal of Occupational Therapy, 16, 1-9.
Wilcock, A. (1993). A theory of the human need for occupation. Occupational Science:Australia, 1, 17-24.