What is it about?

Assessment is a crucial part of occupational therapy practice, as therapeutic measures build on such assessment. However, assessment practices may have effects that goes beyond their immediate impact on subsequent individual treatment planning. This article discusses the way using a specific assessment - the Assessment of Communication and Interaction Skills (ACIS) - can impact on those using the assessment, in addition to the broader multidisciplinary treatment team.

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Why is it important?

The study is important because it explores experiences of students and therapists who have used the ACIS. As such, the study is concerned with one aspect of the instruments' feasibility.

Perspectives

The first theme, "observations", indicates that activities to be used in the assessment should be chosen based on their ability to yield the relevant and required information. Not every activity requires the person to perform all possible forms of interaction skills. Therapists who have reason to assess clients with a view to their specific skills performance need to carefully choose the activity used in the assessment. Moreover, they need to consider their own role during the assessment - to what degree should the therapist actively take part in the activities going on? The issue is commonly referred to as participatory observation. This mode of observation may yield valuable insights, but may again preclude the therapist from making other observations from a more distanced perspective. The second theme, "scoring", denoted that (in particular) the students were unfamiliar with assessing clients using numerical scores. They were also very concerned about their personal feelings when scoring a client's performance: Giving low scores sometimes made the student feel guilty or bad about themselves, because this was viewed as treating the client in a non-considerate way. To me, it appears that the resource focus in the profession (by all means, a good focus) should not be emphasized to the extent that noticing problematic behaviors in clients leads students into despair, alternatively into looking the other way. Problems are there to be dealt with, they do not disappear by our looking away. The third theme, "clinical utility", emphasized that the ACIS might be useful in direct feedback to clients as well as in the context of multiprofessional collaboration. Direct feedback should be given when and where appropriate for the given client. In multiprofessional collaboration, on the other hand, using the ACIS assessment as a means to structure clinical observation and reporting was found to improve collaboration with other team members. As a side effect, using structured and reliable assessment tools that clearly makes a positive impact in practice may also contribute to an improved view of occupational therapy as a profession.

Professor Tore Bonsaksen
Inland Norway University of Applied Sciences

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This page is a summary of: Experiences of Occupational Therapists and Occupational Therapy Students in Using the Assessment of Communication and Interaction Skills in Mental Health Settings in Norway, British Journal of Occupational Therapy, July 2011, SAGE Publications, DOI: 10.4276/030802211x13099513661117.
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