The Occupational Therapy Practice Framework: the evolution of our professional language.

607 Mary Jane Youngstrom Over the years occupational therapy has adapted to historical, cultural, and technological change—while always staying focused on helping people to participate in their daily life occupations. As knowledge has developed and adaptations have occurred, the language that the profession’s practitioners use to describe what they do and how they do it has also evolved. The Occupational Therapy Practice Framework: Domain and Process (Framework) is an example of the natural evolution in terminology and language that occurs in a viable and dynamic profession. The Framework was adopted at the May 2002 meeting of the Representative Assembly and will replace the Uniform Terminology for Occupational Therapy—Third Edition (UT-III) (American Occupational Therapy Association [AOTA], 1994). In early 1999, the Commission on Practice (COP) began the process of reviewing UT-III and seeking feedback from practitioners, leaders, and scholars on whether it should be rescinded or revised. After review of the extensive feedback, the Commission decided that there was still a need for a document that outlined the constructs in the profession’s domain. However, many changes had occurred in the practice environment and profession’s knowledge base since UT-III’s adoption in 1994. Practice patterns in traditional health care settings were changing due to shifting reimbursement parameters. Practitioners had to rethink their practices. Occupational therapists and occupational therapy assistants were seeking support for applying occupational therapy in new practice arenas. The increased interest in the study of “occupation” was stimulating discussion about “occupation-based” practice in all areas and placing increased attention on the construct of occupation. A common theme in all of these shifts was the need to reaffirm and clarify what occupational therapy practice is all about. With these changes forming the backdrop for discussion, the Commission began to rethink what the purposes and format of a new document should be. The Commission concluded that the new document needed to be a different kind of document—one that could be helpful to practitioners adapting to these changes and assist them in clarifying the profession’s domain and process for internal and external audiences. In reviewing the feedback and discussing the profession’s current status, the Commission identified several issues that needed to be addressed in the new document: • The outline of the domain needed to be clearly tied to the idea of occupation and should reflect recent thinking and new constructs. • The document needed to explain how the construct of occupation was integrated throughout the occupational therapy process and how the domain and process were related. The process description needed to be general enough to be applicable across specialties and in newly developing arenas. At the same time, it needed to illustrate how all practice was linked by its focus on helping people engage in meaningful everyday life activities. • The language and terminology used in the new document needed to be updated to reflect current knowledge and revised to include terminology more familiar to other disciplines as well as the terminology outlined in the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF) (WHO, 2001). Use of more familiar language would help external audiences to more clearly understand the profession’s interests and contributions to health care. • The new document needed to more explicitly describe occupational therapy’s outcomes and contribution to health. Occupational therapists needed to understand their role within a larger societal and health context in order to position themselves in changing traditional areas and to take advantage of opportunities in emerging arenas. Clients needed to be recognized not only as individuals but as FROM THE GUEST EDITOR The Occupational Therapy Practice Framework: The Evolution of Our Professional Language