OT 304 OT ETHICS STANDARDS OF PRACTICE FOR OCCUPATIONAL THERAPY

Preface The Standards of Practice for Occupational Therapy are requirements for the occupational therapy practitioner for the delivery of occupational therapy services that are client centered and interactive in nature (American Occupational Therapy Association [AOTA], 1995). The registered occupational therapist supervises the certified occupational therapy assistant, and both work together in a collaborative manner to meet the needs of the client. However, the registered occupational therapist is ultimately responsible and accountable for the delivery of occupational therapy services. This document identifies minimum standards for occupational therapy practice. The minimum educational requirements for the registered occupational therapist are described in the current Essentials and Guidelines of an Accredited Educational Program for the Occupational Therapist (AOTA, 1991a). The minimum educational requirements for the certified occupational therapy assistant are described in the current Essentials and Guidelines of an Accredited Educational Program for the Occupational Therapy Assistant (AOTA, 1991b). DEFINITIONS Evaluation. The process of obtaining and interpreting data necessary for understanding the individual, system, or situation. This includes planning for and documenting the evaluation process, results, and recommendations, including the need for intervention and/or potential change in the intervention plan (Hinojosa & Kramer, 1998). Assessment. Specific tools, instruments, or interactions used during the evaluation process. An assessment is a component part of the evaluation process (Hinojosa & Kramer, 1998). Client. A person, group, program, organization, or community for whom the occupational therapy practitioner is providing services (AOTA, 1995). Occupational therapy practitioner. Any individual initially certified to practice as an occupational therapist or occupational therapy assistant or licensed or regulated by a state, district, commonwealth, or territory of the United States to practice as an occupational therapist or occupational therapy assistant (AOTA, 1997). Performance areas. Broad categories of human activity that are typically part of daily life. They are activities of daily living, work and productive activities, and play or leisure activities (AOTA, 1994c). Performance components. Elements of performance required for successful engagement in performance areas, including sensorimotor, cognitive, psychosocial, and psychological aspects (AOTA, 1994c). Performance contexts. Situations or factors that influence an individual's engagement in desired

and/or required performance areas. Performance contexts consist of temporal aspects (chronological, developmental, life cycle, disability status) and environmental aspects (physical, social, political, cultural) (AOTA, 1994c). Screening. Obtaining and reviewing data relevant to a potential client to determine the need for further evaluation and intervention. Transition. Process involving actions coordinated to prepare for or facilitate change, such as from one functional level to another, from one life stage to another, from one program to another, or from one environment to another.

Standard I: PROFESSIONAL STANDING AND RESPONSIBILITY 1. An occupational therapy practitioner delivers occupational therapy services that reflect the philosophical base of occupational therapy (AOTA, 1979) and are consistent with the established principles and concepts of theory and practice. 2. An occupational therapy practitioner delivers occupational therapy services in accordance with AOTA's standards and policies. The nature and scope of occupational therapy services provided must be in accordance with laws and regulations. 3. An occupational therapy practitioner maintains current licensure, registration, or certification as required by laws or regulations. 4. An occupational therapy practitioner abides by AOTA's Occupational Therapy Code of Ethics (AOTA, 1994a). 5. An occupational therapy practitioner assures continued competency by establishing, maintaining, and updating professional performance, knowledge, and skills. 6. A registered occupational therapist provides supervision for a certified occupational therapy assistant in a collaborative manner as defined by official AOTA documents and in accordance with laws or regulations. 7. A certified occupational therapy assistant seeks and follows supervision from a registered occupational therapist in the delivery of occupational therapy services. 8. An occupational therapy practitioner is knowledgeable about AOTA's Standards of Practice for Occupational Therapy; the Philosophical Base of Occupational Therapy (AOTA, 1979); and other AOTA, state, and federal documents relevant to practice and service delivery.

9. An occupational therapy practitioner maintains current knowledge of legislative, political, social, cultural, and reimbursement issues that affect clients and the practice of occupational therapy. 10. A registered occupational therapist is knowledgeable about research in the practitioner's areas of practice. A registered occupational therapist applies timely research findings ethically and appropriately to evaluation and intervention processes and discusses applicable research findings with the certified occupational therapy assistant. 11. A registered occupational therapist systematically assesses the efficiency and effectiveness of occupational therapy services and designs and implements processes to support quality service delivery. 12. A certified occupational therapy assistant collaborates with the registered occupational therapist in assessing the efficiency and effectiveness of occupational therapy services and assists in designing and implementing processes to support quality service delivery. Standard II: REFERRAL 1. A registered occupational therapist accepts and responds to referrals in accordance with AOTA's Statement of Occupational Therapy Referral (AOTA, 1994b) and in compliance with laws or regulations. 2. A registered occupational therapist accepts and responds to referrals for evaluation or evaluation with intervention in performance areas, performance components, or performance contexts when clients may have a functional limitation or disability or may be at risk for a disabling condition. 3. A registered occupational therapist refers clients to appropriate resources when the needs of the client can best be served by the expertise of other professionals or services. 4. An occupational therapy practitioner educates current and potential referral sources about the scope of occupational therapy services and the process of initiating occupational therapy services. Standard III: SCREENING 1. A registered occupational therapist screens independently or as a member of a team in accordance with laws and regulations. A certified occupational therapy assistant may contribute to the screening process under the supervision of a registered occupational therapist. 2. A registered occupational therapist selects screening methods appropriate to the client's performance context.

3. A registered occupational therapist communicates screening results and recommendations to the appropriate person, group, or organization. A certified occupational therapy assistant may contribute to this process under the supervision of a registered occupational therapist. Standard IV: EVALUATION 1. A registered occupational therapist evaluates performance areas, performance components, and performance contexts. A certified occupational therapy assistant may contribute to the evaluation process under the supervision of a registered occupational therapist. 2. An occupational therapy practitioner educates clients and appropriate others about the purposes and procedures of the occupational therapy evaluation. 3. A registered occupational therapist selects assessments to evaluate the client's level of function related to performance areas, performance components, and performance contexts. 4. An occupational therapy practitioner follows defined protocols when standardized assessments are used. 5. A registered occupational therapist analyzes, interprets, and summarizes assessment data to determine the client's current functional status and to develop an appropriate intervention plan. The certified occupational therapy assistant may contribute to this process under the supervision of a registered occupational therapist. 6. A registered occupational therapist completes and documents occupational therapy evaluation results within the time frames, formats, and standards established by practice settings, government agencies, external accreditation programs, and payers. A certified occupational therapy assistant may contribute to documentation of evaluation results under the supervision of a registered occupational therapist and in accordance with laws or regulations. 7. A registered occupational therapist communicates evaluation results, within the boundaries of client confidentiality, to the appropriate person, group, or organization. A certified occupational therapy assistant may contribute to this process under the supervision of a registered occupational therapist. 8. A registered occupational therapist recommends additional consultations when the results of the evaluation indicate that intervention by other professionals would be beneficial. Standard V: INTERVENTION PLAN 1. A registered occupational therapist develops and documents an intervention plan that is based

on the results of the occupational therapy evaluation and the desires and expectations of the client and appropriate others about the outcome of service. A certified occupational therapy assistant may contribute to the intervention plan under the supervision of a registered occupational therapist. 2. A registered occupational therapist ensures that the intervention plan is documented within time frames, formats, and standards established by the practice settings, agencies, external accreditation programs, and payers. 3. A registered occupational therapist includes in the intervention plan client-centered goals that are clear, measurable, behavioral, functional, contextually relevant, and appropriate to the client's needs, desires, and expected outcomes. A certified occupational therapy assistant may contribute to this process. 4. A registered occupational therapist includes in the intervention plan the scope, frequency, duration of services, and the needs of the client. 5. A registered occupational therapist reviews the intervention plan with the client and appropriate others. A certified occupational therapy assistant may contribute to this process. Standard VI: INTERVENTION 1. A registered occupational therapist implements the intervention plan through the use of specified purposeful activities or therapeutic methods that are meaningful to the client and are effective methods for enhancing occupational performance. A certified occupational therapy assistant may implement the intervention plan under the supervision of a registered occupational therapist. 2. An occupational therapy practitioner informs clients and appropriate others regarding the relative benefits and risks of the intervention. 3. An occupational therapy practitioner maintains or seeks current information on resources relevant to the client's needs. 4. A registered occupational therapist reevaluates during the intervention process and documents changes in the client's goals, performance, and needs. A certified occupational therapy assistant may contribute to the reevaluation process. in 5. A registered occupational therapist modifies the intervention process to reflect changes

client status, desires, and response to intervention. A certified occupational therapy assistant may identify the need for modifications and may contribute to the intervention modifications under

the supervision of a registered occupational therapist. 6. An occupational therapy practitioner documents the occupational therapy services provided within the time frames, formats, and standards established by the practice settings, agencies, external accreditation programs, and payers.

Standard VII: TRANSITION SERVICES 1. A registered occupational therapist prepares a formal transition plan that is based on identified needs. A certified occupational therapy assistant may contribute to the preparation of a formal transition plan. 2. An occupational therapy practitioner facilitates the transition process in cooperation with the client, family members, significant others, team, and community resources and individuals, when appropriate. Standard VIII: DISCONTINUATION 1. A registered occupational therapist discontinues services when the client has achieved predetermined goals, has achieved maximum benefit from occupational therapy services, or does not desire to continue services. A certified occupational therapy assistant may recommend discontinuation of occupational therapy services to the supervising registered occupational therapist. 2. A registered occupational therapist prepares and implements a discontinuation plan that addresses appropriate follow-up resources. A certified occupational therapy assistant may contribute to the implementation of a discontinuation plan under the supervision of a registered occupational therapist. 3. A registered occupational therapist documents changes in the client's status between the initial evaluation and discontinuation of services. A certified occupational therapy assistant may contribute to the process under the supervision of a registered occupational therapist. 4. A registered occupational therapist documents recommendations for follow-up or reevaluation, when applicable. ___________________________________
References: American Occupational Therapy Association. (1979). The philosophical base of occupationa therapy. American Journal of Occupational Therapy, 33, 785.

American Occupational Therapy Association. (1991a). Essentials and guidelines of an accredited educational program for the occupational therapist. American Journal of Occupational Therapy, 45, 1077-1084. American Occupational Therapy Association. (1991b). Essentials and guidelines of an accredited educational program for the occupational therapy assistant. American Journal of Occupational Therapy, 45, 1085-1092. American Occupational Therapy Association. (1994a). Occupational therapy code of ethics.American Journal of Occupational Therapy, 48, 1037-1038. American Occupational Therapy Association. (1994b). Statement of occupational therapy referral.American Journal of Occupational Therapy, 48, 1034. American Occupational Therapy Association. (1994c). Uniform terminology for occupationaltherapy-Third edition. American Journal of Occupational Therapy, 49, 1047-1054. American Occupational Therapy Association. (1995). Concept paper: Service delivery inoccupational therapy. American Journal of Occupational Therapy, 49, 1029-1031. American Occupational Therapy Association. (1997). Bylaws. Article III, Section 1. Bethesda, MD: Author. Hinojosa, J., & Kramer, P. (Eds.). (1998). Occupational therapy evaluation of clients: Obtaining and interpreting data. Bethesda, MD: American Occupational Therapy Association. Author: Commission on Practice Linda Kohlman Thomson, MOT, OT(C), FAOTA, Chairperson Adopted by the Representative Assembly 1998M15 NOTE: This document replaces the 1994 Standards of Practice for Occupational Therapy. 1998 by the American Occupational Therapy Association, Inc. Permission to reprint for nonprofit, educational use only.