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Psychosocial And Psychological Motor Framework in Occupational Therapy

Rethink OT Podcast

Transcript of Episode

Today’s topic is understanding the importance of Psycho-social and psychological components of motor function of OT Practice….and forgive me for an extra short call today but this is important and there is not much to say! I mean, there is a lot to say, but that would be me just droning on about research articles! So today I am going to explain these elements of practice and offer you an example of how important they are to achieving great therapeutic outcomes. 

 If you have been following my blog or calls, you know that implementing psycho-social and perceptual-motor elements into every evaluation and treatment session is extremely important to me. I believe these things separate us from the pack and its way for an OTP to use their intuitive nature to foster growth, healing, and confidence in the lives of our patients.  

What is psycho-social? 

As an OTP, we first learn about the importance of psycho-social needs on human development when we learned Erik Erikson’s stages of psycho-social development. These stages tell us that psychological components have an effect on how an individual interacts with his physical and social environments. Knowing human development and psychological approaches to care are crucial in physical rehabilitative outcomes. As we also know through the KAWA River model, PEO, and P-E Fit  – psycho-social factors of an individual in any kind of recovery will dictate outcomes and how long those outcomes will be maintained. 

What are the psychological components of motor function? 

In this call and previous calls, we have already identified occupational therapy as a holistic and transactional practice. A practice that understands the leading role the human psyche and environments play in physical rehabilitative outcomes. Therefore, we can deduce that psychological factors also affect an individual’s ability to perform motor-related tasks. An example of this would be kinesiophobia. Have you ever heard of it? The fear of movement. This condition is debilitating and actually prolongs the rehabilitative process. Your body is so fearful of becoming hurt again that it fights the movement that led to the injury in the first place. How about a psycho-somatic response? I have had patients that have been thoroughly tested and given raving results of recovery, yet still believe they are having chest pain during any amount of physical activity. These symptoms are very real and present as barriers to recovery and independence. Ultimately, these psychological factors decrease our patients’ quality of life. 

Okay – Action steps. 

The question is how in the world do we as occupational therapy practitioners even find out or deduce that these concerns may be a problem? Then, how do we address these concerns in our treatments? 

    1. We listen. We learn from the evaluation while we build our patient’s occupational profile. We listen to the goals they are choosing for themselves and then we press them up against what we know of their environmental and role needs. 
  • We adapt our treatment when we see incorrect execution, concern, hesitation, or confusion. Be observant! Please do not give someone an activity and walk away! Don’t tell them to put 10 pegs in a board, move 10 rings across a range of motion arc, or let them continue to fail during an ambulation or standing exercise. Do not push your treatment plan or creative activity when there is something amiss! There have been many times when I have learned some treatment-altering conditions and impairments my patient has not mentioned to anyone because I have stopped mid-way through activity and said, “Okay, let’s talk. This is what I am seeing……What do you think about this activity?”

We let them speak. Leave room for reflection at the end of every treatment. This is not patient education. As an occupational therapist, this act is a therapeutic activity to evoke a physical response. It is within our scope of practice to address these elements of care.