1. PARADIGM SHIFTS IN OT PRACTICE
A review of how history has shaped the profession of OT in today’s practice

2. Paradigm General Definition
Greek origin
Pattern or model
Conceptual framework
Allows explanation & investigation of phenomena
Becomes understood thru professional training & changed via environmental demands

3. THOMAS KUHN (1970)
Paradigm is a universally recognized scientific achievement that temporarily models problems and solutions to practitioners
Sufficiently unprecedented scientific achievement among competing sources
Adequately open to allow exploration of solutions for a variety of problems

4. BARKER (1992)
PARADIGM
Filters perception – contrary info is often left out
“What is defined as ‘impossible’ today is impossible only in the context of present paradigms.”
“Every paradigm will uncover problems it cannot solve & these become a catalyst for a paradigm shift.”

5. Gary Kielhofner (1997)
Paradigm is the cultural core of the discipline & provides professional identity
how professionals view practice
guides questions, solutions, goals of practice

6. KUHN’S PARADIGM SHIFT
Definition – when a discipline abandons one view of the world for another; a revolution; a drastic conceptual restructuring

7. 4 STAGES WITHIN THE DEVELOPMENT OF A PARADIGM
Pre-paradigm phase – various thinking approaches emerge to solve the same problem
Paradigm – “winner”; use of one school of thought
Crisis – not all problems can be solved this way
Resolution – reorganization of the old PLUS new thinking

8. Kielhofner & Burke’s Historical Review
Paradigm of Occupation ( s)
Mechanistic Paradigm (1950s-1970s)
New Emerging Paradigm (1980s-2000)
Paradigm of Occupation ( s)
Mechanistic Paradigm (1950s-1970s)
New Emerging Paradigm (1980s-2000)

9. Paradigm of Occupation (1900-1940s)
Defined by…
Moral treatment (advocating for persons with mental illness by participating in occupations that “normalized” behavior
Origins: Consolation House (1914, NY) a convalescent home founded by George Barton & Eleanor Clark Slagle; Hull House (1915, Chicago) a work program for persons with physical & mental disabilities

10. History and development of OT
Mechanistic Paradigm (1950s-1970s)
New Emerging Paradigm
(1980s-2000)
Paradigm of occupation
( s)
WWII
Pressure to Provide scientific evidence
Away from core beliefs of OT
Unable to treat chronically ill patients
Paradigm of Occupation ( s)
Mechanistic Paradigm (1950s-1970s)
New Emerging Paradigm (1980s-2000)
Medical model
Specialization
Lost commitment to occupational performance
Moral treatment
Consolation house
Holistic view
Balance of art and science

11. Paradigm of Occupation (1900-1940s), cont.
“Occupation” was the central phenomenon of interest referring to balance of work, play, self-care, & rest; holistic view

12. The Paradigm Shift (1940s-1950s)
Crisis Era
The profession comes under pressure from medicine to provide scientific evidence for its practice

13. Mechanistic Paradigm (1950s-1970s)
Medical model (reductionistic) replaces “occupations” of moral tx
OTs seek to gain professional respect as a scientific discipline by focusing on disease
Specialization is a popular trend
Loss – commitment to occupational performance
Gain – new assistive devices, technology, techniques; SI; NDT

14. Paradigm Shift of the 1970s Crisis Era
Reductionism was inadequate for treating chronically disabled
OTs express dissatisfaction over a loss of professional identity & unity

15. NEW EMERGING PARADIGM (1980s)
Recommitment to holistic view and the occupational nature of humans
Client centered practice including active engagement & empowerment
Systems theoretical view
Balance of the art & science of practice