Edward A.S. Duncan
Foundations for Practice
Foundations for Practice was originally published in 1992. In it Rosemary Hagedorn presented the first comprehensive British introduction to the theoretical foundations of occupational therapy. The book was an instant success. Nineteen years and four editions later, Foundations for Practice remains a popular text. The profession remains greatly indebted to Rosemary Hagedorn for her work, as successive cohorts of occupational therapy students have used her Foundations for Practice to guide their theoretical knowledge development. In 1995, Rosemary’s achievements were rightly acknowledged when she was selected to deliver the prestigious Casson Memorial Lecture at the College of Occupational Therapists’ Annual Conference. In 1998 the honour of becoming a Fellow of the College of Occupational Therapists was conferred on her.
The first three editions of Foundations for Practice were shaped by Rosemary’s personal perspective and based on her lifetime career and experience as an occupational therapist. The 4th edition, whilst maintaining the general aim and shape of previous editions, necessarily took a ‘new’ perspective. It provided an evidence-based introduction to the foundations of occupational therapy, linking theory ever more closely to practice, with the aspiration that practice will become increasingly based on sound theory and evidence. To achieve this, national and international expertise from clinical and academic environments was drawn upon, and the text evolved into an edited international publication. This 5th edition represents another step forward for the text and for the profession.
The purpose of this book
This book is intended for use as an introduction to the theoretical foundations of occupational therapy. Each chapter has been written to provide a comprehensive introduction to its topic, highlighting key contemporary issues and focusing on its specific relevance to practice. Of obvious use to students, the book’s expanded and revised content will also make it a valuable resource for clincians who wish to practise from a sound theoretical and evidence base. It may also assist non-occupational therapists to achieve a better understanding of the scope and practice of the profession.
The contents of this book
This current edition is revised, updated and expanded. It is arranged in four sections.
Section 1 introduces the philosophy, principles and practice of occupational therapy. Key concepts concerning the philosophical and theoretical basis of the profession are defined and summarized. The section outlines some of the main external influences on the profession and places particular emphasis upon the various shifts that have occurred within occupational therapy’s theoretical foundations over time. In order to understand the external influences that continue to shape occupational therapy clearly, this section explores the impact that various philosophical systems have had on its theory and practice.
The section then continues by focusing on the historical and contemporary internal influences that have affected the development of occupational therapy. It provides an overview of occupational therapy definitions, and outlines the practice and skills required of an occupational therapist. This section presents a description of the processes through which occupational therapy is carried out and concludes by introducing frames of reference and conceptual models of practice, outlining their roles and mutually dependent relationships in practice.
Section 2 provides an introduction to conceptual models of practice. Five conceptual models of practice are presented. They do not represent all the available models; a conscious decision was taken to present conceptual models that are evidence-based, reflect popular usage in practice, or are topical. They include the Model of Human Occupation (Chapter 6), the Canadian Model of Occupational Performance (Chapter 7), the Person–Environment–Occupational Performance Model (Chapter 8), the Functional Information-processing Model (Chapter 9) and the Kawa (River) Model (Chapter 10).
Section 3 introduces five frames of reference in occupational therapy practice. Each chapter is written by occupational therapists experienced in their theory and direct reference is made to their application in practice. Chapters are presented on the client-centred frame of reference (Chapter 11), the cognitive behavioural frame of reference (Chapter 12), the psychodynamic frame of reference (Chapter 13), the biomechanical frame of reference (Chapter 14), and the theoretical approaches to motor control and cognitive–perceptual function (Chapter 15).
Section 4 provides an introduction to other important areas of theory. Clinical reasoning is in many ways the ‘glue’ that holds together theoretical reasoning and flexibly responsive practice; Chapter 16 presents a new and engaging overview of clinical reasoning research and practice in occupational therapy. Community-based rehabilitation is a generic theoretical approach that aims to enhance the quality of life of people who have disabilities, by meeting their basic needs and working for inclusion and participation. Whilst this approach is not unique to occupational therapy, the profession is playing an emerging role as it works in this way in communities where the need is greatest; Chapter 17 therefore presents community-based rehabilitation and its relationship with occupational therapy practice. Occupational science has been a prolific focus of research and debate in occupational therapy over the last 20 years; it has been met with both enthusiasm and consternation. Chapter 18 provides an excellent introduction to the field and explores the breadth of occupational science, without shirking from the controversy surrounding it.
Advice to readers
There are several ways in which this book can be read. For those who are particularly new to the area or who have not read about theoretical constructs in occupational therapy for some time, it is strongly advisable to work through Section 1 before moving on to other chapters. However, you may feel familiar enough with these concepts and wish to focus on a particular topic. In this situation it is possible to go directly to the chapter(s) of interest. Do not, however, assume that all your answers will always be covered in one chapter. In order to understand fully what each author is saying, it is often necessary to take a step away from any professional biases one may have and enter fully into the perspective of other contributors: a task that may often prove more challenging in practice than in principle. It is therefore advisable to read across chapters and evaluate differing perspectives. Throughout this process it is important to take a critically evaluative approach to the material presented.