OTIPM: A model for implementing top–down, client-centered, and occupation-based assessment, intervention, and documentation

Based on her Eleanor Clarke Slagle Lectureship, Professor Fisher brings together 40 years of experience to present a model for professional reasoning. The Occupational Therapy Intervention Process Model
(OTIPM) (Fisher, 2009) is a professional reasoning model that occupational therapists can use to ensure that we adopt an occupation-centred perspective to guide our reasoning as we plan and implement
occupation-based and occupation-focused services.

In the OTIPM, the occupational therapy process is depicted as occurring over three global phases, evaluation and goal-setting, intervention, and reevaluation, and each step in the process may be occupation-based, occupation-focused, or both (Fisher, in press). The steps of the occupational therapy process defined in the OTIPM are represented schematically below.

A basic premise of the OTIPM is that the effective use of occupation as a means (intervention) and as end (immediate outcome) depends on a concurrent commitment to true top–down and client-centered
practice. Occupational therapists can also become better advocates for promoting occupational therapy to consumers, third-party payers, and other professionals if they understand the unique contributions of
occupational therapy to health care, and ensure that they document measureable, occupation-focused, baselines, goals, and outcomes Stressing occupational performance in evaluations, interventions, and
documentation is an important mechanism for promoting our clients’ quality of life while communicating who occupational therapists are and how what they do is unique.

Course Description
The OTIPM course is 3 days, and includes both theoretical and practical components with an emphasis on individual and group activities that introduce the occupational therapist to (a) nonstandardized
occupation-based evaluations of quality of a person’s occupational performance, including the performance of daily life tasks that involve social interaction, and (b) occupation-focused documentation.

Course Objectives
At the conclusion of a 3-day OTIPM workshop, the participants will understand:
• The occupation-centered professional reasoning process defined in the OTIPM
• Distinctions between restoration, acquisition, and compensation, as well as the distinctions
between preparation, rote exercise or practice, simulated occupation, restorative occupation,
acquisitional occupation, and adaptive occupation
• How to apply true top–down reasoning in occupation-based and/or occupation-focused
occupational therapy assessment, intervention, and documentation
• How to link other occupational therapy models of practice and evaluation methods into the
occupational therapy intervention process

Selected References
Fisher, A. G. (in press). Occupation-centred, occupation-based, occupation-focused: Same, same or different? Scandinavian Journal of Occupational Therapy.

Fisher, A. G. (2009). Occupational Therapy Intervention Process Model: A model for planning and implementing top–down, client-centered, and occupation-based interventions. Ft. Collins, CO: Three Star Press.

Fisher, A. G., & Griswold, L. A. (2013). Performance skills: Implementing performance analyses to evaluate quality of occupational performance. In B. B. Schell, G. Gillen, M. Scaffa , & E. Cohn (eds.), Willard & Spackman’s occupational therapy (12th ed.). Philadelphia: Lippincott Williams & Wilkins. 

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