Wednesday, January 5, 2011

Old ideas come back better than ever

When I first graduated from OT school, I thought I knew it all. I started work at a mental health institution, and worked closely with OTs who had been there a long time.

At that time, the approach of my OT schooling was to work on the specific tasks that a person would need to perform in order to live independently. We were taught to choose tasks as close as possible to what the person would need to perform in the community, so that the person would not have to generalize the skills.

This was at odds with the approach being taken by the more experienced OTs. Many were using what I considered an "outdated" approach, where they chose activities (not related to independent living) to work on specific deficit areas they saw in a client (e.g. memory or concentration).

I realize now, that what I was doing was mostly cognitive adaptation (adapting a task around cognitive deficits). A "new" ideas has come along, which is cognitive remediation (practicing cognitive processes to improve them). The interesting thing is that the evidence so far on cognitive remediation programs is promising, and seems to show that the improvement in abilities can generalize to other tasks. It seems the approach of the more experienced OTs isn't outdated after all - it could be considered ahead of its time.

There's a dose of humility. I think it is situations like this that allow us to grow wiser as we get older. I still love new ideas and change, but I am learning that new ideas are not always better than the old ones - there's something to be learned from both of them.

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