Interventions

OT Dude Academy’s Free NBCOT® Exam Prep Course Process Interventions

Contents of an Intervention Plan1 

  • Long-term goals
    • What activities must change in order to reach occupational performance outcomes?
    • What is the reason for these changes?
    • What functional changes will occur?
    • Is it client- or family-centered?
  • Short-term goals
    • Are they related to long-term goals?
    • Will impairments change to achieve occupational performance outcomes?
    • What functional ability will result from the decreased impairments?
    • Will the change occur in a brief moment of time?
    • Is it client- or family-centered?
  • Intervention procedures
    • Are activities, tasks, or occupations chosen related to the goals?
    • Are families or caregivers involved in the training process?
    • Have assistive, adaptive equipment, and durable medical been identified to meet the client’s needs (environmentally as well)?
  • Type, amount, frequency, duration
    • Can the skills and performance areas be addressed within these parameters to accomplish the client’s goals?
  • Recommendations and Referrals
    • Have additional occupational therapy or other referrals and services been made?
    • Are the clients, family, or caregivers aware of these recommendations?

Intervention Outcomes

Definition of outcome: the results of production processes that precede them in space-time, acting on inputs in a given environment. In health care, the term ‘outcome’ usually refers to postintervention results or measurements — the observed outcomes of an intervention — whether or not one can confidently attribute those results to the preceding intervention (process).2 

Classifications3 

  • Disease – Health condition, absence of disease versus disease
  • Impairment – function or structure vs impairment
  • Disability – activity versus activity limitation
  • Handicap – participation versus participation restriction

Intervention Approaches1 

  • Remediation/Restoration – changing biological, physiological, psychological, or neurological processes by teaching or training
  • Compensation/Adaptation – changing the task or the context
  • Disease and Disability Prevention – primary, secondary, and tertiary prevention
  • Health and Wellness Promotion – purposeful and meaningful occupations that balance rest, work, and play or leisure with a healthy environmental interaction
  • Environmental Adaptations and Modifications4 5 
  • Family/Caregiver Training – prepare and assist caregivers in fulfilling the occupation of caregiving.6 
  • Ecology of Human Performance Framework7 
    • Establish/Restore
    • Alter
    • Adapt
    • Prevent
    • Create

Outcome Measure Selection Criteria3 

  • Is suitable for the client’s population (age, diagnostic group, time to administer)
  • Is suitable for the client’s setting (inpatient, outpatient, long-term, etc.)
  • Meets the needs of the client (purpose of the tool, time to administer, quality of the data obtained, ease of communication, sensitivity to changes)
  • Standardized
  • Examples: Canadian Occupational Performance Measure (COPM)8 , Rivermead Rehabilitation Centre Life Goals Questionnaire, Goal Attainment Scaling (GAS), Pediatric Evaluation of Disability Inventory (PEDI), Milwaukee Evaluation of Daily Living Skills (MEDLS), Barthel Index/Modified Barthel Index, Functional Independence Measure (FIM), CARE Tool, Assessment of Motor and Process Skills (AMPS), Life Satisfaction Questionnaire (Fugel-Meyer, Branholm & Fugel-Meyer (1991)), Craig Handicap Assessment and Reporting Technique(CHART).
  1. Moyers, P. A. (1999). The guide to occupational therapy practice. American Journal of Occupational Therapy, 53(3), 247-322.[↩][↩]
  2. Boyce, N., McNeil J., Graves, D., & Dunt, D. (1997). Quality and outcome indicators for acute healthcare services.
    Canberra: Australian Government Printing Service.[↩]
  3. Unsworth, C. (2000). Measuring the outcome of occupational therapy: Tools and resources. Australian Occupational Therapy Journal, 47(4), 147-158.[↩][↩]
  4. Lund, M. L., & Nygård, L. (2004). Occupational life in the home environment: The experiences of people with disabilities. Canadian Journal of Occupational Therapy, 71(4), 243-251.[↩]
  5. Harris, S., James, E., & Snow, P. (2008). Predischarge occupational therapy home assessment visits: Towards an evidence base. Australian Occupational Therapy Journal, 55(2), 85-95.[↩]
  6. Moghimi, C. (2007). Issues in caregiving: The role of occupational therapy in caregiver training. Topics in geriatric rehabilitation, 23(3), 269-279.[↩]
  7. Dunn, W., Brown, C., & McGuigan, A. (1994). The ecology of human performance: A framework for considering the effect of context. American Journal of Occupational Therapy, 48(7), 595-607.[↩]
  8. Law, M., Baptiste, S., McColl, M., Opzoomer, A., Polatajko, H., & Pollock, N. (1990). The Canadian occupational performance measure: an outcome measure for occupational therapy. Canadian Journal of Occupational Therapy, 57(2), 82-87.[↩]
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