This worktext is the ideal resource for OT students and professionals to learn or improve the critical skill of documentation, it can also serve as an essential professional reference. SOAP notes as well as other forms of documentation—in a variety of clinical and school settings—are provided throughout to illustrate how to write clear and accurate client notes. The book also addresses the ethical, legal and language issues related to occupational therapy documentation.
• Presentation of the new Framework for Occupational Therapy Practice, Standards of Practice and Guidelines for Documentation (AOTAj).
• New chapter on writing job descriptions.
• More examples pertaining to practice in mental health.
Exercises in every chapter challenge readers to apply their knowledge to real-life situations.
• Sample reproducible forms support hands-on practice.
• An appendix on grammar and spelling points out common mistakes—serving as a resource to promote accurate and effective documentation.