Scientific Reasoning
straightforward, understand the nature of the condition and figure out a treatment plan. Apply scientific methods like hypothesis testing, pattern-recognition, theory-based decision making, statistical evidence
Diagnostic Reasoning
a sub-category of scientific reasoning. Involves identifying and defining occupational issues. Information is gained from scientific knowledge and also from the client
Procedural Reasoning
Characterized by therapist using therapy regimes or routines thought to be effective with problems identified and that are typically used with clients in that setting. May be scientific reasoning, as well as based on the habits and culture of a practice setting (led by OT's experience)
Narrative Reasoning
Focuses on understanding the client’s experience and the meaning they attach to illness, disability, disease and/or life changes
Considers past, present and future
Supports a collaborative and empathic intervention process, as the therapists seeks the client’s perspective and incorporates client meanings and values into the process
In close relation with Kawa model process, focuses on client’s subjective experience and life story
Interactive Reasoning
Reasoning directed toward building positive interpersonal relationships with clients and engaging them in the practice process
Therapeutic process relies heavily on the client-therapist relationship
Supports collaborative problem solving
Intentional and intuitive
Integral in building rapport and trust with clients
Pragmatic Reasoning
Practical considerations as they affect practice process
Practice: e.g. scheduling, equipment availability, therapist’s skills, management directives
Personal: e.g. practice competency, preferences related to assessment and treatment, life demands, values
Ethical Reasoning
Directed toward analyzing and acting in response to an ethical situation or dilemma-what should be done?
Generates options and determines a defensible course of action
Systematic approach to moral conflict
Can use OT code of ethics to help guide ethical reasoning
Conditional Reasoning
Requires experience, it is related to knowing what type of reasoning to use in certain situations or what combinations of reasoning to employ when necessary in considering outcomes or informing potential shift in occupation or roles of clients.
Reflection-on-action
reflecting on actions or practice after the fact, taking time to think critically about what went well or what didn’t later on.
Reflection-in-action
This involves the practitioners’ ability to think in the midst of action and adapt to meet the demands of the situation. Reflection in action most often occurs when the usual approaches are not working.
Barriers to Professional Reasoning (7)
- Early hypothesis generation
- Time pressures
- Over-reliance on standard techniques
- Increased client caseload (increased workload demands)
- Reduction of clients length of time to stay in hospital
- Therapist has inaccurate assumptions or expectations regarding the client
- Expectations of employers
Straightforward thinking processes to gather information
- observations
- theoretical knowledge (practice frameworks)
- contextual factors (impact of setting)
Whole body process of gathering information
- body-based knowledge
- relying on 5 senses to gather information
- touch (with consent), visual, smell, auditory, verbal
Practical/tacit knowledge
implicit knowledge that you draw on somewhat unconsciously or without being overtly aware of your thinking process. Usually “hard to articulate what I did” type stuff
Why are theories important?
- inform/guide our thinking in practice about occupation and enablement
- provide a foundation for our practice and assist us in justifying our work
Why use theory?
- Provides structure in intervention
- Facilitates processes involved in the action plan
- Assists in formulating and reflecting on assumptions/core beliefs about clients
- Justifies our practice
- Informs our decision making
- Guides our clinical problem solving
- Provides language to communicate to colleagues and clients
- Frames occupation and occupational performance for ourselves and for our clients
- Avoids unjustified assumptions
- Reflects on how experiences in therapy are similar of different than theoretical understandings
- Guides thinking about justice, equality, power, collaboration, advocacy, culture…
Ecological View of Reasoning (what the OT brings)
Therapists reasoning is shaped by personal and professional perspectives:
- Personal: Life experience, personal characteristics (physical capacities, personality, values, and beliefs), worldview
- Professional: Education, skills and abilities, past professional experiences, professional values and beliefs
Ecological View of Reasoning (what the client brings)
The client also brings their personal perspectives and views on performance problems and past experiences with therapy.
Ecological View of Reasoning
the professional reasoning process and the resulting therapy actions represent transactions that occur among the practitioner, the client, the therapy context, and the actual therapy activity. (intersections of these spheres
How does one develop their professional reasoning?
How you think + your experiences + reflection= expertise
Reflecting, or ‘thinking about our thinking’ is key in becoming competent!
Cue Acquisition
Searching for the helpful and
targeted information through observation and
questioning
Pattern Recognition
Noticing similarities and differences
among situations
Limiting the Problem Space
Using patterns to help focus cue acquisition and knowledge application on the most fruitful areas.
Problem Formulation
Developing an explanation of what is going on, why it is going on, and what a better situation or outcome might be.
