Role of Occupational Therapy in Promoting Self-Determination Through Consumer-Directed Supports

Abstract

Consumer-directed services (CDS) are a type of support system designed to increase the quality of life and self-determination of clients, such as adults with developmental disabilities. Occupational therapists can play an important role in facilitating people's involvement in CDS supports. This paper describes CDS, evidence that supports their use, and ways that occupational therapists use their training in person-centered practice to enhance CDS supports and self-determination. A case study is used to illustrate the application.

Occupational Therapy Practice with Adults with Intellectual Disability: What More Can We Do?

“…Transition services, including occupational therapy, should work with youth to determine the strengths, needs, interests, and specific preferences of the adolescent with consultation from the family. This is an ongoing process that often starts with conversations with adolescents with ID and their families about their concerns and future goals, as few individuals with ID are asked what they want in life, compared to individuals without ID (Dean et al, 2015). Occupational therapists may also consult with group homes and developmental centers by designing and implementing special training courses focusing on cooking, homemaking, personal care, leisure activities, and other areas of interest for adults with ID (AOTA, 2013).…”

“…Advocacy on a client level begins with understanding each individual's unique strengths, needs, and priorities (Dean et al, 2015). Occupational therapists can use a variety of person-centered planning tools (e.g., Supports Intensity Scale-Adult Version [SIS-A]) to assist adults with ID in setting and monitoring individualized goals (Thompson et al, 2015).…”

“…The ADA and Olmstead Decision created greater opportunities for community inclusion for individuals with ID. As a result, adults with ID have transitioned from living and working in institutional settings to community-based settings (Dean et al, 2015). However, provision of community-based services, including occupational therapy, do not meet current demand (Friedman & VanPuymbrouck, 2018).…”

“…They have endured a history of isolation in state-operated facilities with limited supports and services and have confronted policies and professional practices that have, at times, reproduced their marginalization by perpetuating custodial care (Johnson & Bagatell, 2017). Although access to community-based services has increased since the passing of the ADA and the Olmstead Decision (Dean, Dunn, & Tomchek, 2015), barriers that restrict the spectrum of opportunities for occupational participation continue to put adults with ID at significant risk for occupational alienation and a decreased sense of occupational competence (Mahoney, Roberts, Bryze, & Kent-Parker, 2016). This has resulted in disparities in health care, community housing, transportation, secondary education, gainful employment, and social inclusion, to name a few.…”

The Distinct Value of Occupational Therapy in Supported Employment of Adults with Intellectual Disabilities

“…The literature demonstrates that occupational therapists can improve work performance by identifying the strengths and challenges of supported employees, assessing job responsibilities and work environment, and adapting the work environment and/or job responsibilities to ensure success of the supported employee in the worker role (Arikawa, Goto, & Mineno, 2013;Dean, Dunn, & Tomcheck, 2015). The use of self-determination principles to facilitate improved work performance by collaborating with the supported employees to solve problems and adapt the work environment is another way occupational therapists can add value to the supported employment team (Dean et al, 2015). Occupational therapists have a strong understanding of habits, routines, and roles to facilitate success in aspects of employment, such as job interviews, arriving to work on time, and dressing appropriately for work, which can facilitate improved work performance (Delahunt, Lowery, & Rudkoski, 2015).…”