Occupation-based Practice Final Reflection

I knew that occupational therapy used meaningful activities prior to coming to Touro
University Nevada (TUN) from interpreting, my occupational therapist observations, and
personal study of occupational therapy. What I did not understand was how much effort went in
to choosing occupations and grading them to create a just right challenge in an environment that
will help clients achieve their goals. It looked pretty straightforward as a bystander. It made
perfect sense. If you use something that is meaningful to the client they will be more engaged,
use more of their own problem solving, give more effort, be more motivated, and improve faster.
However, there is more involved in the application. I was unaware of the fact that I would have
to justify every occupation-based intervention to clients, administrators, supervisors, family
members, and other health care professionals. I did not realize how difficult it could be to
analyze activities and demonstrate how multiple client factors would be addressed with the
intervention. Occupation-based practice is definitely not the easy choice when designing
intervention. It is much easier to use therapeutic exercise or preparatory methods. However, I
have seen the power in occupation-based practice first-hand and can attest to its efficacy. I truly
believe in the value of occupational therapy because we treat the mind, body, and spirit using
occupation-based evaluations and interventions. Occupation-based is not just a buzz word to me,
it is how I help people achieve their individual goals of living life the fullest.
Teaching clients new or adapted behaviors is at the core of everything occupational
therapists do. Neural plasticity, and more specifically, cortical reorganization, is the science
behind how we teach our clients both with intact and damaged brains new or adapted behaviors.
In my studies at TUN, I have discovered that many of the principles that have been proven to
influence cortical reorganization are inherent within occupation-based practice. For example, we
know that salience matters, therapy must be important and meaningful to the client in order to
induce plasticity; transference is important, therapy must incorporate similar behaviors;

interference plays a role, therapy needs to begin with minimal distractions and be graded up to
include normal amounts of interference similar to real life. These principles describe occupationbased practice. All other principles important for optimal cortical reorganization (e.g. use it or
lose it, use it and improve it, specificity, repetition, intensity, and time) outlined by Kleim and
Jones, 2008 can easily be incorporated into any occupation-based practice. Prior to my studies at
TUN I knew that occupation-based interventions were beneficial but I did not know how to
explain the rationale behind their efficacy to a variety of audiences. I can now advocate for
occupation-based practice and have evidence to show that what I am doing is capitalizing upon
the proven principles of increasing neural plasticity, improving rehabilitation efforts, and
optimizing functional outcome. I can now articulate why occupation-based practice is at the core
of client-centered health care and essential for habilitation and rehabilitation. I have seen how
my understanding of occupation-based practice and implementation can be effective in all
practice settings with all populations. Besides physical rehabilitation, I used occupations to treat
adults suffering from mental illness and older adults with memory loss during group therapy at
my non-traditional fieldwork and was able to get more participation and improve occupational
performance faster than the interventions that were used by other health care practitioners.
Although it was difficult to incorporate occupation-based practice in an outpatient hand
therapy setting, I found ways to do it. I have been provided with the resources necessary and will
continue to utilize my creativity and motivation to focus on occupation-based interventions for
the rest of my career. My professors have effectively illustrated the importance of occupationbased practice and taught me why they are superior. I have witnessed the efficacy in my many
fieldwork experiences. Because of this strong foundation, I will be advocating for occupationbased practice in every setting I work in. I will strive to be innovative, creative, fun, meaningful,
and exciting as I design reimbursable, client-centered, occupation-based interventions using
current evidence.

References
Kleim, J. A., & Jones, T. A. (2008). Principles of experience-dependent neural plasticity:
Implications for rehabilitation after brain damage. Journal of Speech, Language, and
Hearing Research, 51(1), S225-S239. doi:10.1044/1092-4388