Clinical Reasoning in Occupational Therapy

Occupational therapists work with a wide variety of patients with a multitude of conditions in a range of clinical practice environments. They must be able to work with the varied clinical presentations they encounter and take the most appropriate action for individual patients whilst responding to current practice demands. This book defines clinical reasoning as a process in which the therapist structures meaning, goals and health management strategies based on clinical data, client choices and professional judgement and knowledge. It informs clinicians and undergraduate students about the latest research and thinking on the topic, and examines clinical reasoning as an important aspect of occupational therapy practice and an obligatory component of professional training and assessment. Written by an internationally renowned group of clinicians, educators and academics, this is a valuable resource for students and practitioners which covers the theory and practice of all key topics within clinical reasoning.

List of Contributors vii Foreword ix Preface xi Acknowledgements xv 1 Problem Solving in Occupational Therapy 1 Linda Robertson and Siân Griffiths 2 Abductive Reasoning and Case Formulation in Complex Cases 15 Bronwyn Thompson 3 Ethical Reasoning: Internal and External Morality for Occupational Therapists 31 Mary Butler 4 Occupational Therapists, Care and Managerialism 45 Ruth Fitzgerald 5 Context and How It Influences Our Professional Thinking 63 Susan Ryan and Carol Hills 6 The Novice Therapist 77 Linda Robertson 7 Artistry and Expertise 93 Margo Paterson, Joy Higgs and Catherine Donnelly 8 Kai Whakaora Ngangahau – Ma ¯ ori Occupational Therapists’ Collective Reasoning 107 Jo–Anne Gilsenan, Jane Hopkirk and Isla Emery–Whittington 9 Reasoning That Is Difficult to Articulate 129 Linda Robertson Index 137

Dr Linda Robertson is Principal Lecturer in the Occupational Therapy Department at Otago Polytechnic University in New Zealand.

"An interesting aspect reflected upon by the author is the difference in the clinical reasoning of occupational therapists when treating those from their culture and when practicing in a setting that is ethnically or linguistically different from their own.  The geographical context of New Zealand, used in the example, is an ethnically diverse country where health care is provided within a mixed public/private system.  Cross– cultural factors are addressed in the chapter discussing therapy services for Maori clients in New Zeland. . . Many different aspects of clinical reasoning are covered in this book that would interest an advanced student."  ( Canadian Journal of Occupational Therapy Article , 1 August 2013)