Neuro Occupational Therapy in Context

Understanding a Client’s Value and Belief Systems

Neuro OT: an evidence-based approach

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. This is especially important for neurological occupational therapy, where the focus of rehabilitation is to help an individual return to activities they undertook prior to their injury or illness.

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 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 may be the first time she has used a watering can. She has little experience to draw upon and no preconceived ideas on what to expect or how she is going to perform. 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.

Participation and Performance

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’. This highlights how our performance is affected by our interpretation of a situation, how it makes us feel and what it makes us think, and our feelings of anticipation prior to an activity as well as what we predict will happen.

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 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.

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

Anon

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.

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