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Research Article  |   April 1995
Reasoning and the Art of Therapy for Spinal Cord Injury
Author Affiliations
  • Cynthia Creighton, MA, OTR, is Assistant Director, Occupational Therapy Department, Rehabilitation Institute of Michigan, 261 Mack Boulevard, Detroit, Michigan 48201
  • Marcel Dijkers, PhD, is Director, Research Department, Rehabilitation Institute of Michigan, Detroit, Michigan
  • Normajean Bennett, MA, OTR, is Assistant Professor, Occupational Therapy Program, Eastern Michigan University, Ypsilanti, Michigan
  • Karmen Brown, MPH, OTR, is Assistant Professor, Occupational Therapy Department, Wayne State University, Detroit, Michigan
Article Information
Neurologic Conditions / Spinal Cord Injury / Research
Research Article   |   April 1995
Reasoning and the Art of Therapy for Spinal Cord Injury
American Journal of Occupational Therapy, April 1995, Vol. 49, 311-317. doi:10.5014/ajot.49.4.311
American Journal of Occupational Therapy, April 1995, Vol. 49, 311-317. doi:10.5014/ajot.49.4.311
Abstract

In this pilot study, qualitative methodology was used to examine the clinical reasoning of four experienced occupational therapists as they presented and modified therapeutic activities to treat patients with spinal cord injuries. The therapists demonstrated the multi-layered thinking discovered in previous research, but hierarchical structuring of knowledge emerged as an unexpectedly dominant theme in their reasoning. Examples of hierarchical thinking about therapeutic activity included creating mental files of therapy tasks and materials sequenced from elementary to advanced and determining the level of difficulty at which to present an activity in order to build the patient’s skills in a stepwise manner The therapists reported that they learned to make decisions about the use of activities in treatment by observing skilled clinicians and by treating patients.