Figures
Causal and temporal aspects of the tripartite structure of treatment theory. The causal chain runs from left to right: clinician-provided ingredients, through a mechanism of action, bring about changes in a desired target. In clinical reasoning, the sequence is reversed, with the clinician determining an aspect of the patient's functioning that needs changing, deciding on a mechanism of action that might bring about the change, and then selecting the ingredients that are expected to engage that mechanism. Often, the “mechanism of action” step is not explicit in the latter process. Reprinted, with permission from Elsevier, from: Hart T, Tsaousides T, Zanca JM, et al. Toward a theory-driven classification of rehabilitation treatments. Arch Phys Med Rehabil. 2014;95(1 suppl 1):S33–S44.
The focus of the proposed taxonomic scheme: individual treatments and how they fit into the larger rehabilitation program. The focus of the proposed conceptual scheme is on treatments (Rx 1, 2, and 3) and their respective targets (Tgt 1, 2, and 3)—those measureable aspects of functioning that are changed directly by treatment. Changes in those targets, in turn, may contribute to downstream changes in outcomes referred to as “aims.” Selection and ongoing modification of nature, strength, and dosage of treatments is directed by formal and informal assessments of the patient in a feedback loop. Reprinted, with permission from Elsevier, from: Dijkers MP. Rehabilitation treatment taxonomy: establishing common ground. Arch Phys Med Rehabil. 2014;95(1 suppl 1):S1–S5.
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