Is the use of life history and narrative in clinical practice reimbursable? Is it occupational therapy?

N arrative and life history methods in occupational therapy offer practitioners an OppOrtuniry to undemand what might otherwise remain an unspoken and informal part of therapeutic imeraction. In contrast to the formal information about a patient's medical and psychosocial condition, therapists often gain insight into the patient's inner life (e.g., family background, favorite music, holiday and birthday traditions) through the spontaneous conversations that arise during treatment. This informal information is importam to occupational therapists because it fills in the details about the patients they are working with and how the illness experience is affecting, and will ultimately affect, the patients' lives. Informally collected data invariably find their way into treatment interventions, informing the selection of treatment goals, activities, and outcomes. The use of factors such as age, roles, values, culture, and interests to guide therapy has been a consistent theme in occupational therapy theories and frames of references (Miller & Walker, 1993) and has been demonstrated as a strategy therapists use to form ideas during the treatment process (Clark, 1993; Crepeau, 1991; Mattingly & Fleming, 1994; Peloquin, 1990). The use of case stories in the occupational therapy literature illustrate the central role of patients' stories in therapists' clinical reasoning (Clark, 1993; Crepeau, 1991; Mattingly & Fleming, 1994). The following is a description of such reasoning: