Lecture Notes: Rehabilitative and Compensatory Frames of Reference

Introduction

• Focus on two frames of reference in occupational therapy:
  • Rehabilitative Frame of Reference
  • Compensatory Frame of Reference
• Based on lecturer's research comparing these two approaches

Rehabilitative Frame of Reference

• Usage:
  • Applied when biomechanical frame reaches a plateau or restoration to pre-morbid levels is unattainable
• Assumptions:
  • Independence restored through compensatory techniques
  • Motivation influences regaining occupational performance
  • Rehabilitation involves teaching and learning, requiring cognitive abilities and motivation
• Aims:
  • Restore functional ability to highest possible level
  • Use medical, social, educational, and vocational measures
• Focus:
  • Performance areas (self-care, productivity, leisure) over performance components (joint motion, strength)
• Benefits:
  • Applicable to physical and cognitive impairments
  • Holistic, collaborative, goal-based interventions
• Limitations:
  • Dependent on client motivation
  • Limited alternatives if compensatory approach fails
  • Requires proper equipment and environment

Compensatory Frame of Reference

• Concept:
  • Improvement in occupational performance despite dysfunction
  • Focus on successful completion of occupations
• Methods:
  • Adaptation of abilities, occupation, or use of external aids (assistive technology)
• Assumptions:
  • Daily activity completion is a basic need
  • Individuals can learn alternative methods
  • Compensatory approach needed for long-term dysfunction
• Advantages:
  • Holistic view, familiar strategies, easy explanation to service users
  • Meets both short-term and long-term needs quickly
  • Allows flexibility and creativity
• Limitations:
  • Potential negative psychological impact
  • May be viewed as a shortcut over potential recovery

Comparative Analysis

• Goals:
  • Rehabilitative: Restore to highest level possible
  • Compensatory: Maximize participation despite loss
• Focus:
  • Rehabilitative: Regain abilities, prevent deterioration
  • Compensatory: Use alternative strategies/technology
• Similarities:
  • Use similar strategies (environmental changes, technology)
  • Assessments (top-down, observational, interviews)
• Client Types:
  • Rehabilitative: Potential for improvement
  • Compensatory: Permanent or progressive limitations
• Overlap:
  • Strategies and interventions can be similar
  • Both frames require creativity and similar reasoning pathways

Interventions and Assessments

• Use of assistive technology, adaptive techniques, environmental adaptations
• Cognitive compensatory strategies like memory aids
• Conceptual models can be used with both frames

Conclusion

• Minimal difference in practice between rehabilitative and compensatory
• Decisions based on evidence and practitioner discretion
• Both frames applicable across a wide range of physical and cognitive conditions

References

• Provided by lecturer during the presentation