1st Edition
Matthews Model of Clinical Reasoning A Systematic Guide to Occupation-Based Evaluation and Intervention Planning
The Matthews Model of Clinical Reasoning (MMCR) provides occupational therapy practitioners with a systematic approach to develop their clinical reasoning skills during the evaluation and intervention process when collaborating with persons served across multiple practice locations.
The three core constructs of person, environment, and occupation lay the foundation for practitioners to compartmentalize information from selected evaluations, determine relevant intervention priorities, implement occupation-based intervention plans, and interpret successful outcomes. This book, influenced by these constructs, the practice framework, and accreditation standards for academic preparedness, provides the reader with the foundational information on how to apply the core constructs using a MMCR systematic approach for evaluation and intervention. Within the chapters are a variety of instructional methods, interviews with practitioners of various levels of experience, and case study examples. Clinical reasoning guidesheets are presented to assist the reader to follow the MMCR clinical reasoning process in terms of evaluation findings, application of frame of reference (FOR)/practice models, intervention strategies, and documentation.
Occupational therapy students and practitioners will be provided with the foundational skills to systematically think about and apply the steps of the clinical reasoning process, starting with a person’s evaluation through the completion of the intervention plan.
SECTION 1 Clinical Reasoning and Evaluation
1 Exploring the Literature Related to Clinical Reasoning
ASHLEY N. FUENTES, ERIK M. HORN, SUSAN E. KUSHNER, DARYLL ADRIAN A. HENSON, JESSICA L. ORTIZ, LYNNE RICHARD, AND LAURIE KNIS-MATTHEWS
2 The MMCR Approach to Evaluation Guided by the Profession’s Domain of Concern
LAURIE KNIS-MATTHEWS AND NANCY R. DOOLEY
3 Compartmentalizing Evaluation Information and Understanding the Person Served
LAURIE KNIS-MATTHEWS AND LYNNE RICHARD
4 Compartmentalizing Evaluation Information and Understanding the Six Facets of the Environment
LAURIE KNIS-MATTHEWS AND NANCY R. DOOLEY
5 Compartmentalizing Evaluation Information to Understand How Activities and Occupations Relate to a Person’s Story
LAURIE KNIS-MATTHEWS AND MARGARET SWARBRICK
6 Putting It All Together to Identify Occupational Performance Issue(s)
LAURIE KNIS-MATTHEWS AND MARGARET SWARBRICK
SECTION 2 Intervention
7 MMCR Five-Step Guide to Infusing the Frame of Reference/Practice Model Into a Person’s Story
LAURIE KNIS-MATTHEWS AND LYNNE RICHARD
8 Overview to Intervention Planning: Spiraling Within the Top-Middle- Bottom Occupational Performance Issues
LAURIE KNIS-MATTHEWS AND LYNNE RICHARD
9 Overview to Intervention Planning: Spiraling the Top-Middle-Bottom Occupational Performance Issues Across the Intervention Plan
LAURIE KNIS-MATTHEWS
10 Overview to Intervention Planning: Spiraling the Top-Middle-Bottom Occupational Performance Issues Across the Intervention Plan Continued
LAURIE KNIS-MATTHEWS AND MARGARET SWARBRICK
11 Strategizing the Beginning-Middle-Ending of the Specific Intervention Plan
LAURIE KNIS-MATTHEWS AND MARGARET SWARBRICK
12 Strategizing How to Create Change During the Intervention Plan
LAURIE KNIS-MATTHEWS AND MARGARET SWARBRICK
SECTION 3 Documentation
13 Documentation Overview and the Evaluation Summary
LAURIE KNIS-MATTHEWS AND ASHLEY N. FUENTES
14 Documentation Continued: Goal Creation, Progress Notes, and Discharge Summaries
LAURIE KNIS-MATTHEWS AND ASHLEY N. FUENTES
SECTION 4 Case Examples
15 Case Example: Using the MMCR in an Outpatient Hand Therapy Clinic Over 8 Weeks of Intervention
PAIGE GARRAMONE, PAULINE GASPARRO, AND SHANIQUA BRADLEY
16 Case Example: Using the MMCR to Guide a Seven-Day Intervention Plan in an Inpatient Acute Rehab Hospital
CHRISTINE BODZIOCH, MARLEE MURPHY, SHANIQUA BRADLEY, AND ASHLEY N. FUENTES
17 Case Example: Using the MMCR to Guide a Six-Month Intervention Plan for an Adult With an Intellectual and Developmental Disability
MAUREEN GRAINGER, THAIS K. PETROCELLI, SHANIQUA BRADLEY, AND ASHLEY N. FUENTES
18 Case Example: Using the MMCR to Guide a Three-Month Intervention Plan in a Homecare Setting
VALERIE HENGEMUHLE, GERALDINE PAGAOA-CRUZ, SHANIQUA BRADLEY, AND ALLISON INSERRA
MMCR Glossary of Terms
Appendix 1A MMCR Guide to Understanding a Person’s Story (Triangle)
Appendix 1B Explanation of MMCR Guide to Understanding a Person’s Story (Triangle)
Appendix 2A MMCR Five-Step Guide to Infusing a Frame of Reference/Practice Model Into a Person’s Evaluation Selection and Intervention Plan
Appendix 2B MMCR Five-Step Guide to Infusing a Frame of Reference and/or Practice Model Into a Person’s Evaluation Selection and Intervention Plan (Explanation)
Appendix 3A MMCR Overview Guide to Intervention Planning
Appendix 3B MMCR Overview Guide to Intervention Planning (Explanation)
Appendix 4A MMCR Planning Guide to Address Specific Sections of the Overall Intervention Plan
Appendix 4B MMCR Planning Guide to Address Specific Sections of the Overall Intervention Plan (Explanation)
Appendix 5A MMCR Guide to Evaluation Summaries
Appendix 5B MMCR Guide to Evaluation Summaries (Explanation)
Appendix 6A MMCR Guidelines to Formulate a Short-Term Goal
Appendix 6B MMCR Guidelines to Formulate a Short-Term Goal (Explanation)
Biography
Laurie Knis-Matthews, PhD, OT, has been an occupational therapist for over thirty years, primarily focused on mental health practice. Laurie has been conceptualizing the MMCR since she began teaching full-time in academia over twenty-five years ago.
"The Matthews Model of Clinical Reasoning: A Systematic Guide to Occupation-Based Evaluation and Intervention Planning is a book both for occupational therapy students and seasoned practitioners. It offers a new model for understanding our clients and developing client—centered evaluations and intervention plans. It provides not only a theoretical base from which to build depth but also detailed information in a step-by step approach to assessment and treatment. Students will find this approach instructive while seasoned practitioners will find a new model method to add to their repertoire of client-centered care."
Victoria P. Schindler, PhD, OTR, BCMH, FAOTA, co-editor, Occupational Therapy in Mental Health, Professor Emeritus, Stockton University
"The Matthews Model of Clinical Reasoning presents a refreshing approach to the field of occupational therapy. It differs from the antiquated ways of past thinking by emphasizing a person’s life story rather than diagnosis. As an occupational therapist who switched practice areas after an extended absence from the profession, this model presented in a user-friendly format, was a great resource that taught me how to be more client-centered and occupation-based throughout the evaluation and intervention process for the people I serve. Dr. Knis-Matthews is an innovative changemaker whose book takes us on an exciting person-centered journey, creating a ripple effect from educator to student to future practitioner."
Mary-Jo Zinnie, licensed occupational therapist with 25 years of experience
"As a student in the midst of level II fieldwork, the MMCR model has provided me with a blueprint to strategize a person’s evaluation and intervention process. While I learned foundational information in my occupational therapy courses, this book presents, in a visual and friendly manner, how to apply this knowledge into practice. By examining the MMCR model case study chapters, I am able to generalize my clinical reasoning skills across various practice settings, evaluation findings, a person’s worldviews, and multiple occupational performance issues. I recommend this book to any student wanting to learn more about applying clinical reasoning and ways to approach occupation-based intervention in a clinical setting."
Jessica Onorati, OTS, occupational therapy student currently in level 2 fieldwork
