SAKLAY: A Guide to an Assistive Technology Service Delivery Process in the Philippines

@#Occupational Therapy (OT) can help enhance human performance and well-being through assistive technology (AT). This entails guiding clients through the AT selection and acquisition process down to helping them integrate these tools’ use as supports to their day-to-day living. Unfortunately, the AT prescription and acquisition process can be tedious, costly, complicated, and uncoordinated in some countries such as the Philippines. AT service delivery is an undeveloped area of practice among Filipino occupational therapists due to the lack of local evidence-based research, practice models, and practical knowledge of the process. Moreover, access to AT is affected by economic factors and by some Filipinos’ negative attitudes towards assistive devices as being a validation of one’s incapacitation. The SAKLAY is a service delivery framework that was created to offer a practical and systematic guide to Filipino occupational therapists who render AT services for persons with disabilities (PWD) that takes into account the client’s needs, resources, abilities, and contexts.

The Tele-Evaluation Facilitators Model

@#Telehealth has become an alternative service delivery of different healthcare professionals, including occupational therapists, upon the onset of the COVID-19 pandemic. Occupational therapists have adapted to this platform to deliver service in response to the global crisis. This conceptual framework explores the facilitators of occupational therapy evaluation provided via telehealth. It aims to provide insights to clinicians and clients in engaging tele-evaluation. It also aims to establish primary considerations to ensure a thorough evaluation process. The Tele-Evaluation Facilitators Model (TFM) describes the occupational therapy evaluation in the therapy setting. It outlines the OT evaluation process, adapting it to the telehealth setting. The process emphasizes the importance of client-caregiver interaction in creating and achieving occupational therapy goals. Moreover, surrounding the tele-evaluation process, the model highlights the facilitators of tele-evaluation, enabling a comprehensive evaluation process despite the challenges and barriers of this alternative service delivery. Across practice settings, the COVID-19 pandemic necessitated a shift in service delivery to telehealth, and occupational therapists adapted accordingly. Evaluation frameworks exist for telehealth services, but none are unique to occupational therapy evaluation. As a result, an occupational therapy framework that highlights the facilitators of telehealth evaluation will benefit occupational therapy. TFM consists of three domain areas: (1) Family Involvement, (2) Accessibility, (3) Professional Development. This framework promotes telehealth evaluation to clinicians and clients who have hesitations and difficulties in this service delivery model.

Building Occupational Alliance for Therapy (BOAT) Model

@#Occupational Therapy (OT) is a profession that is not easily understood, leading to limited appreciation and misunderstanding of its therapeutic scope and areas of concern. The BOAT Model was created to guide therapists in establishing a therapeutic alliance with clients for the purpose of eliciting mutual concern, perception, and understanding of the client’s unique occupational performance issues (OPI). The model also aims to help enhance the appreciation for OT services. Two specific steps were provided as a process in achieving the outcomes stated, namely Establish and Converse. The use of appropriate therapeutic interactive styles and modes outlined in the IRM were incorporated into the model. At the end of the process, the identified OPI using the COPM will be used to advise the creation of an occupation-based evaluation and intervention that is more relevant and meaningful for the client.

The Family Therapy Engagement Model (FTEM)

@#Among pediatric Occupational Therapists’ goals is to provide a holistic approach towards intervention planning which includes preparing the child’s social environment, especially in facilitating the carry-over of tasks in the child’s daily contexts. This model explores the factors contributing to the limited opportunities for family/caregiver participation during actual therapy sessions. It also discusses and integrates some of the best practice principles for family engagement that are based on the Phoenix Theory of Parent Attendance, Adlerian Play Therapy, and Discrimination model. This model was conceptualized in response to the growing need to increase family engagement during therapy in the Philippine setting, which could help them overcome barriers and strengthen their therapeutic skills and relationship with the child. Techniques and intervention processes that aim to engage the family during occupational therapy need to be further developed and studied. To fulfill this, this paper introduces a conceptual framework that maps out (1) five core elements, (2) five phases of family therapy engagement, and (3) a process checklist during the intervention process. The five core elements that affect family engagement are client, therapist, family, therapy-related, and environmental factors. This model explains how good collaboration between the family and therapists can be achieved if they undergo the preparation, consultation, planning, experiential activities, and re-education phase. The researchers suggest using this conceptual framework as a guide to understand and provide a systematic family engagement process during therapy sessions.