The profession of occupational therapy, our point of view

The key question that the occupational therapist asks himself is: “How can this client perform his roles or resume performing them within the social and physical environment in which he takes part?”
Occupational therapy is a paramedical intervention, destined for everyone who, as the result of an illness, trauma, over- or underexertion, insufficient or delayed development, is no longer capable of performing the roles he should be performing as he wishes to perform them. Examples of these roles include the role of husband, employee and friend. Occupational therapy helps to reduce and/or solve problems people experience in the performance of meaningful activities that are part of these roles. This involves making use of the basic concept that people have or should obtain insight into their own capabilities and sources from their social and physical environment in order to be able to (once again) optimally perform their roles.

At the basis of the occupational therapy profession lies a distinctive vision of mankind. The most important points of this vision of mankind are:
-           Man is an individual who has his own unique capabilities
-           Man is a person within whom the physical, mental and social aspects are inextricably bound to one  another and influence one another, and that give his life independent meaning and should therefore also be treated as such
-           Man is a creature who acts independently
-           Through his actions, man can manifest and develop himself
-           Living, working and recreation all play an important role in people’s lives

Whenever a disruption in function occurs as the result of an illness or disorder for example, the client will, together with the occupational therapist, analyse the situation that is preventing activities from being performed. On the basis of the client’s roles, a determination will be made of what the meaningful activities are for the client and his environment. This will be viewed as the starting point in order to determine, in consultation with the client, which steps should be taken in order to arrive at an optimal fulfilment of these roles and performance of the corresponding activities. This will be recorded in an occupational therapy plan. In order to be able to propose relevant occupational therapy goals and to achieve them, the occupational therapist must, in addition to an analysis, also be able to create an interpretation of meaningful and focused action, the performance of activities and the environment in which this occurs. The competencies that correspond to the performance of occupational therapeutic interventions must also be managed (see under 1.3).

In addition to direct treatment, the occupational therapist also has supervisory and advisory tasks with regard to the client and his immediate environment. The occupational therapist also has advisory tasks with regard to third parties, such as professional social workers and client organisations.

The occupational therapist acts on the basis of a referral from a physician and is usually part of a multidisciplinary (treatment) team, for example in a rehabilitation centre or a nursing home. To an increasing degree, occupational therapists also work in private practises. In addition, the occupational therapist may perform his duties within work environments such as the municipality, an advisory body or a reintegration company, for example as an advisor within the scope of the new Social Support Act (WMO).

Occupational therapy derives its perceptions, methods and techniques from research data from its own discipline as well as the research field of Occupational Science. Occupational therapists also apply knowledge from scientific fields such as anatomy, physiology, pathology, psychology, neurology, biomechanics, ergonomics, sociology and psychiatry.

Education, our point of view

The tasks the occupational therapist performs in practise constitute the starting point for the education programme. The education focuses on the acquisition of skills which are necessary for the performance of these tasks.

The occupational therapy study programme has set as its main goal the preparation of students such that they can acquire those skills that will enable them to work as beginning professional practitioners upon completion of the study programme. The skills to be developed relate to the following three occupational therapeutic professional segments: working with and for clients, working in and from an employment organisation and working on the development of the profession. The study programme lays the foundation for the independent performance of the tasks involved in the occupational therapy profession in a variety of professional contexts.

An occupational therapist who has graduated from a study programme obtains a bachelor’s degree and may then continue his studies within the university educational system at a Master’s degree level. In addition, he may pursue advanced training programmes within the post-graduate level.

In order to do justice to the different learning styles of students and in order to offer a motivating variety of topics, the study programme employs a mix of work forms in the instruction. This also includes choices in the programme. Students are free to determine part of the individual study programme themselves. During the first two years, this involves choices in terms of the sequence of the programme and choices with regard to assignments, case studies, and target groups. During the last phase of the study programme, students make a well-founded choice for field work posts and gain more in-depth knowledge through subsidiary subjects in fields which they feel are important for their future individual careers. Students are supported by their supervisor in all of these choices.

The first two years of the study programme students work in blocks of 10 weeks on projects, courses and training programmes.
-           Professional topics are central themes in the projects, and practising occupational therapists are involved directly in these projects, in which students work together in small groups. There are also various extracurricular activities involved in one of the projects.
-           In the classes, students gain more in-depth theoretical knowledge which an occupational therapist is expected to have a command of. This occurs on the basis of an assignment from the occupational therapeutic professional practise.
-           The learning of skills occurs via the skills lab method. This is a method in which the student acquires occupational therapeutic skills in a systematic manner during training sessions, under the supervision of an instructor, but also independently and during contacts with simulation patients.
-           During the meetings and performance of tasks assigned by the educational career guidance supervisors, students work on charting their own course with the aid of a personal development plan. In this plan, each student reflects on newly acquired competencies, formulates new learning objectives and creates a plan describing how he or she plans to achieve these goals. The students record this data in a portfolio. During this process, the students receive support from group members and their supervisor.

The last two years of the study programme consists of the field work period (FWP), a field work year with two long field work periods and the final examination period during which the student is able to gain more knowledge regarding specific professional topics.

The substance of the study programme corresponds to the current professional practise. Current visions and recent developments are integrated into the curriculum on a continuous basis. The study programme also definitely acts in anticipation of future developments in the occupational therapy field.

The curriculum is designed on the basis of the American Model of Human Occupation (MOHO) and the Canadian Process Model (OPPM).

Competencies of Occupational Therapists in the Netherlands

An occupational therapist who has completed the occupational therapy programme at the Hogeschool Zuyd is capable of applying the "Occupational Therapy Professional Competences (2005)", regardless of the setting in which he or she is employed as an occupational therapist. Summarised, these competencies encompass the following:

Segment: working with and for clients

-           Diagnosis: the occupational therapist formulates a profession-specific assessment of the functional disability experienced by the client and the degree to which this disability may be influenced.
-           Treatment and supervision: the occupational therapist treats, supervises and advises the client in a methodical manner which ensures that the client’s functional competency will be improved and/or maintained.
-           Consultancy: the occupational therapist provides recommendations in a methodical manner to clients regarding care or treatment, aids, the client’s facilities or employment conditions by which the client’s functional competency will be improved and/or maintained.

Segment: working in and from an employment organisation

-           Collaboration: the occupational therapist makes a professional contribution to the multidisciplinary team and takes an active and proactive position in group practise contexts.
-           Management and policy design: the occupational therapist manages means and materials, initiates policy and anticipates social developments.
-           Supervision: the occupational therapist supervises learning processes of trainees and (new) colleagues.
-           Entrepreneurship: the occupational therapist takes market-oriented, business and commercial initiatives.
-           Quality assurance: the occupational therapist monitors the level of products and services in a systematic and cyclical manner.

Segment: working on the development of the profession

-           Innovation: together with other occupational therapists, the occupational therapist initiates, develops and implements methods, protocols, norms and guidelines.
-           Promoting expertise: the occupational therapist actively develops his or her own professional expertise and that of others.