EHP Flashcards
what is not used in EHP?
occupation!
what does EHP highlight?
context and interdisciplinary model
what does EHP include?
inclusion of intervention options
has EHP evolved since?
nope
How does EHP developed?
Several influences from social sciences Environmental psychology Czikszentmihalyi’s Flow Transactional Contextualism Environmental Competence
Development of EHP was by
Lela Llorens Mary Reilly Gary Kielhofner Florence Clark David Nelson Charles Christiansen
Focus of EHP
Persons of varying ages & needs across the age span
Emphasizes a preventive and health promotional attitude, as well as rehabilitative
“Task performance”
Dynamic in nature
Transaction between the person and context
4 main constructs Person Task Context Person–Context–Task Interaction
4 main constructs of EHP
Person
Task
Context
Person–Context–Task Interaction
PERSON
An individual with his own configuration
Unique & complex
Personal meaning
EHP Definitions – Person
Includes Past experiences Personal values/ interests Sensorimotor skills Cognitive skills Psychosocial skills
Person brings these things to the tasks
Influences what tasks are chosen
Person is embedded within the context (toostie roll center of a tootsie pop)
EHP – The Person
Past experiences Personal values/ interests Sensorimotor skills Cognitive skills Psychosocial skills
Context
Conditions in which the person exists and performs
- Temporal context
- Physical context
- Social context
- Cultural context
Supports or hinders the person
Interacts with the person and serves as a lens resulting in performance
CONTEXT – 2 aspects
Temporal Aspect chronological age life cycle disability status developmental stage or phase period or measurable span of time during which a task exists or continues
Environmental Aspects
Physical
nonhuman aspects
Social
norms, role expectations, and social routines that are
organizations, institutions, political and economic systems, etc.
significant relationships
Cultural context
Cultural context
includes customs, beliefs, activity patterns, behavioral standards
shared by the person’s associated group
politics, laws, opportunities for education, services, employment, financial assistance, etc.
Context continued…
Considers availability of: Materials People Resources Expectations and norms of performance
TASK
Objective sets of behaviors combined to allow for engagement in performance
Behaviors are determined by the demand of the task
Combinations of tasks represent responsibilities of roles
Defined differently and have different meaning by different people
EHP – The Tasks
Interaction between the person and the context
Interactions serves as lens which dictates the performance range
Tasks within the performance range are available to the person
Person–Context–Task Confluence
Major variable in task performance
Ecology
Task performance
This interaction leads to human performance
Performance Range
Dictated by the person–context match
Includes all the tasks available to a person
Tasks inside the range are able to be performed
Tasks outside the range are not available to the person
Function vs. Dysfunction
Function
Determined by the range of task being performed
Dysfunction
Occurs when there is a mismatch between the person and the contexts and tasks
Intervention Strategies
Establish / Restore
Remediation, done to person
Alter
Change to a different context
Adapt
Modify the context or the task
Prevent
Work with person, context and/or task to prevent negative outcomes
Create
Generating circumstances through contexts or tasks
Interventions in Practice
Establish / Restore – Through education, the therapist can establish or restore skill/knowledge by developing or refreshing the therapists’ knowledge of driving as an IADL and how to address it
Adapt – The context can be made more supporting through adaptation by establishing Medicare reimbursement, changing the medical reporting guidelines in the state, educating the physicians in the role of OT in driving leading to a more cooperative team approach
Create – One can create a more supportive context by establishing a referral pathway, changing the assessment form to include inquiry about driving or developing a reporting protocol
Prevent – The lack of attention to driving can be prevented through education and establishment of contextual supports
EHP Assumptions
It is impossible to understand the person without also understanding the person’s context
Persons influence contexts and contexts influence persons
A person’s performance range is determined by the transaction between the person and the context
It is through engagement in tasks that person and contexts transact
EHP Perspective on Contexts
When compared to natural environments, contrived contexts may either facilitate or inhibit performance
Assessments and intervention best approximate the person’s true performance when enacted in natural environments
EHP Client – Centered Perspective
The OT process begins when the person / family served identifies what the person wants or needs
OT practice includes making changes in systems so that persons with disabilities receive the full rights and privileges they are due
EHP Perspective on Independence
The use of assistive devices or other person does not mean a person is dependent
Intervention strategies that adapt or alter the environment are not reserved for use only when restorative interventions have failed
Application to Practice
The ecological models provide a framework for thinking about OT practice but do not delineate specific assessments or techniques.
Using an ecological model requires OTs to consider the environment as extensively as they consider the person.
The process begins by identifying what the person wants or needs to do in his or her life.
The client and OT collaborate throughout the OT process.
