Neuro Occupational Therapy in Context

 Understanding a Client’s Value and Belief Systems

Neuro OT – understanding a client’s value and belief systems - an evidence-based approach

Effective rehabilitation and, specifically, Neuro OT are only beneficial if time has been taken to understand the person before commencing rehabilitation. Understanding an individual’s values, motivators and aspirations are an essential foundation to effective outcomes.

Occupational Therapists use activities within a rehabilitation framework to promote health and wellbeing. We know that activities have to be relevant and meaningful to the individual to be effective.

The need for activities to be relevant is especially important after brain injury, where the focus of rehabilitation is to help an individual return to activities they undertook prior to their injury. The Neuro OT has to take time to understand the person and what makes them unique; it is essential that consideration is given to the person as a whole, before and after their injury, with the starting point being their view of themselves.

 

opening quotation mark to brain injury quote  ... as difficult and painful as life can be, it is worth something to be in the present, alive, and doing ones daily bit. Closing quotation mark to brain injury quote

 Kathleen Norris  

A unique view

We are all unique in our view of the world, or to put it another way, our view from the inside and our view of the outside. These two perspectives are bound together and contribute to our thoughts, perception, sense of self and our day-to-day performance. This view refers to the experience of being and knowing the world through a particular body.

Our view of the outside is the objective perspective, in other words our ability to view the world from outside of our body. Our view from the inside is the subjective perspective, i.e. our inner thoughts, feelings and perceptions. These two views feed into our occupational performance.

Your beliefs become your thoughts, your thoughts become your words, your words become your actions,
your actions become your habits, your habits become your values, your values become your destiny 

Gandhi

Neuro OT in context

Imagine the scene of a very young girl using a watering can to water some small seedlings in a raised bed, her mother and father are watching on. Quite possibly, our immediate image is that of a family gardening together, but if we consider this further within the context of each person’s individual ‘view’ of the world, the context of this scene will change.

For the toddler, this is possibly one of the first times she has gardened or even used a watering can. She has little experience to draw upon and maybe has no preconceived ideas regarding what to expect or how she is going to perform. She is learning to use the tools available to her to complete the task at hand.

For her mother and father, in this context they have multiple views:

  • they are viewing their world as a parent, acting alongside their daughter while she completes the task
  • receiving and responding to their environment from their previous experiences
  • interpreting what they see and feel and anticipating what may happen next on behalf of themselves and their daughter.

Both the mother and father will have their own individual views of the world from their own ‘lived body’.

Performance and participation in activities

The philosopher Morris Merleau-Ponty (1908-1961) had a view of human performance and he paid careful attention to experience. He considered that:

‘human experience as fundamental to understanding human perception, cognition and action’.

So, our performance and participations are affected by our own ‘view’ but also by our experience or what we expect to happen or how it makes us feel, e.g. happy, sad, anxious, cross, or the thoughts we have about ourselves, e.g self-doubt and self-confidence. Experience refers to the immediate thoughts and feelings that emerge while completing an activity and we draw upon this experience, whether it be positive or negative, to inform future actions.

So, our performance is affected by:

  • Our interpretation of a situation or how we reflect and interpret on an experience
  • Our feelings of anticipation prior to completing an activity, what we predict will happen or the immediate and future possibilities for action

All of the above, in turn, ultimately, influences our performance within activities, our occupational choices and our behaviour.

Professor of Philosophy Drew Leder has written at length about the relationship between the mind and body. He stated;

‘….I receive the surrounding world through my eyes, my ears, my hands…..My legs carry me towards a desired goal seen across the distance. My hands reach out to take up tools……My actions are motivated by emotions, needs and desires. Relations with others are based upon our mutuality of gaze and touch, our speech, our resonance of feeling and perspective.’

We employ Drew Leder’s concept of the ‘lived body’ to refer to the experience of being and knowing the world through a particular body. First and foremost, mind and body are not seen as separate but as part of a single being; this is never more so relevant than when we engage in activities.

What matters is not the idea a person holds, but the depth at which they hold it

Anon

The importance of considering values and beliefs as part of the Neuro OT process

Having an awareness of an individual’s belief and value concepts are important especially when working with clients with complex needs and their families who have experienced significant trauma, or where an individual is unable to express themselves fully due to communication difficulties.

Values are concepts that we rate as important and help us to define who we are as an individual. They govern the way we behave, communicate and interact with others, and help us to define what is important and meaningful to do. Beliefs and values determine our attitudes and opinions; they guide our thoughts and feelings about ourselves and others in our world.

As competent adults, we are free to practice our core values and beliefs as part of our day-to-day life. Whilst our core beliefs and values may be questioned by others, our values guide our choices and the decisions we make are generally within our control. This, however, is not always the case when we have a disability. To illustrate this, you can meet ‘Ronny’ here. 

Further reading

From the history of our profession through to current day practice you can find all you need to know here...

A Guide to Neuro OT

A Guide to Neuro OT

OTs use activities to improve health and wellbeing, they work with all age groups and understand the concept of human occupation and behaviour, they understand activities, human function and the impact of the environment on individual abilities. Let’s put this theory into some context.
Neuro OT in Context

Neuro OT in Context

OTs use activities to improve health and wellbeing, they work with all age groups and understand the concept of human occupation and behaviour, they understand activities, human function and the impact of the environment on individual abilities. Let’s put this theory into some context.


Neuro OT in Practice

Neuro OT in Practice

Effective rehabilitation and, specifically, Neuro OT are only beneficial if time has been taken to understand the person before commencing rehabilitation. Understanding an individual’s values, motivators and aspirations are an essential foundation to effective outcomes.
Our Blog and News feed

Our Blog and News feed

Our resources pages are full of interesting reads, award winners, competition winners and the latest conference visits. Get yourself a cup of tea, sit back and enjoy all things neuro OT!

 

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