Sharon Brintnell

Developing Guidelines for Client-Centred Occupational Therapy Practice

The Canadian Guidelines for the client-centred practice of occupational therapy are national, generic, consensus guidelines developed to address growing concerns inside and outside the profession for assuring the quality of health services. From 1979 to 1987, successive Task Forces, sponsored by the Department of National Health and Welfare and the Canadian Association of Occupational Therapists, developed three volumes of guidelines. A pivotal guideline in Volume 1 is a conceptual framework of occupational therapys central concern: occupational peiformante within an individuals physical, cultural and social environment. Volume I also outlines stages in the process of client-centred occupational therapy practice, and specific assessment and program planning guidelines. Volume II covers issues, concepts and fundamental elements of intervention, as well as specific guidelines for intervention, discharge, follow-up and evaluation. Volume III reviews issues in outcome measurement given occupational therapys primary concern for occupational performance. The authors, members of the Task Forces, provide an overview of the development of and their hopes for the Guidelines. Uses and influences of the Guidelines have not been formally documented. However, projects are arising from the Guidelines and a new CAOT Client-Centred Practice Committee is proposing an updating process for the three volumes.

Student Values and Preferences: What Do They Tell Us about Programme Selection?

Allied health professionals are thought to acquire their orientation through professional socialization and education, but it is likely that they share similar values before being admitted to any educational programme. The results of a study involving occupational therapy, physical therapy, and speech pathology / audiology students (N=276) support this contention. The Life Roles Inventory, Vocational Preference Inventory and a student information sheet were the Instruments employed. Using discriminant analysis, the results demonstrate that although respondents endorse the same values, the level of that endorsement differs significantly between the three student groups. Similarly, the same Holland Code was generated for each group, but again the level of endorsement for the six primary scales varies in each case. The more allied health educators know about the values and preferences their students endorse, and how they seek to implement them, the better prepared educators should be to recruit, place, teach and counsel them.

Electroconvulsive therapy in a major teaching hospital: diagnoses and indications.

The use of ECT over an eleven year period in the University of Alberta Hospitals is reviewed. Five percent of patients received ECT, the mean number of treatments per course was 5.2, and the most frequent type of treatment was bilateral ECT. Discharge diagnoses showed that three-quarters of the patients had affective psychoses and one-fifth were schizophrenic. All patients had had a mandatory consultation before treatment and the most frequent reasons for choosing ECT were given as: failed antidepressant treatment, previous good response to ECT, failure to respond to other treatment, uncontrollable delusions or psychotic behavior, acute suicidal risk requiring a rapid response, and adverse reaction to medication. The mandatory consultation process has worked well and has helped to clarify the situations where ECT may be used with benefit. It is hoped that this may assist those who may be responsible for defining guidelines for the use of ECT.

One Nation or Ten Provinces: The Relationship between the National and Provincial Associations

This paper considers the relationship between the Canadian Association of Occupational Therapists and the provincial occupational therapy associations with a view to strengthen this collaboration by means of affiliate status for provincial bodies. Recommendations are made concerning the functions and responsibilities of both levels of professional organizations as well as the direct benefits to the members.