After treatment what?

Until very recently, occupational therapy services have been provided in institutional settings and have followed the medical model. The escalating costs of hospital care have been the primary incentives for moving patients out of acute settings and thus increasing the need for occupational therapy services in the community. Yet, relatively few therapists have moved from the medical model even though the need exists and legislation encourages that service be provided in the least restrictive alternative. Further, occupational therapists have been slow to adopt distinct strategies for planning with patients for their roles and needs after treatment even though the heart of the occupational therapy philosophy centers on adaptation to life roles. This paper explores the current trends away from institution-based health care and towards a continuum of health and social services, and the roles for occupational therapists in community settings. Occupational therapists are urged to act as facilitators in assisting patients to move successfully from active treatment to independence in whatever settings they find themselves.