Occupation Based Models Flashcards
Why occupation based models?
Occupation is the central focus of OT practice.
At the base of every model are concepts from Mary Reilly’s original theory on occupational behavior (1966).
In each model are philosophical tenets of humanism and holism, systems theory, and client/person centeredness.
These models complement a transactional, client-centered approach for evaluation and intervention to meet the needs of society today.
With increased demands for community-based practice and preventive medicine, occupation-based models serve as a natural fit and relevant choice to meet the current standards of care today.
Each of them provides a distinctive theoretical perspective to promoting occupational engagement and performance.
All models consider the interdependent relationship among person (population), occupation (task, activity), and environment (contexts)—the focus for intervention is distinctive (different).
Clinical decision making and professional reasoning should be based on theoretical concepts and evidence (not opinion)
What are the 5 American occupation based models?
Occupational Behavior (Reilly)
Model of Human Occupation (Kielhofner & Burke)
Person-Environment-Occupation-Performance Model (Christiansen & Baum)
Occupational Adaptation (Schkade & Schultz)
Ecology of Human Performance (Dunn & Brown)
What are the 3 international models?
Person-Environment-Occupation (Law)
Canadian Model of Occupational Performance
Kawa (Iwama)
When is OT month in America?
April
When is OT month in Canada?
October
What is the PEO model?
Person: mind body spiritual
- Culture and history can’t change, but an individual’s interpretation and practices can
Environment:
- Context within which occupation takes place
- Influences and is influenced by person’s behavior
- Cultural, socio-economic, institutional, physical, social, person, household, neighborhood, community
Occupation:
- Meets person’s intrinsic needs
What is the COPM?
Canadian Occupation Performance Measure
A semi-structures interview that enables an open dialogue between client and therapist.
1. Problem definition
2. Rating importance
3. Selecting problems for scoring
4. Scoring performance and satisfaction
5. Client reassessment
The core of this model is spirituality, which is defined broadly as anything that motivates or inspires a person.
other parts of the model are person, environment, and occupations.
This model emphasizes client-centered care
The COPM is a semi-structured interview based on this model. The COPM is an outcomes measurement tool.
Scores satisfaction and performance
Why does the COPM matter?
First edition was published in 1991, since then 5 editions have been released. Translated into 36 languages and used in over 40 countries. Over 500 articles have been published about it?
What is the PEOP model?
Good for organization, population
Focuses on engagement
Top-down approach, focus on the whole picture then down to the smallest part
States a person may be occupationally engaged, though not physically doing the occupation (making decisions)
Person (intrinsic factors)
- Physiological, psychological, cognitive, neurobehavioral
Environment (extrinsic factors)
- Climate, structure, social network
Occupation
- What people want or need to do
- Social: directly perform with others, or indirectly to establish identity like morning routine
Model integration
The 5 occupation-based models emphasize the significance of occupational engagement and participation in the promotion of health and well-being.
Each model has its own distinctive theoretical structure.
Each model’s intervention guidelines highlight the unique approaches to reach therapeutic outcomes for OT practice .
Why do we use occupation based models?
Clinicians must use clinical and professional reasoning in the selection of theories and interventions to best fit a population and setting for service delivery.
Where do you begin???
1. You MUST learn and comprehend (understand) each model with its own unique framework structure.
2. You compare and contrast each of the models; the ability to distinguish one model from the other will help you select the best theory for clinical practice outcomes.
The proof is in the APPLICATION of the principles. Each model provides a central focus in the framing of occupation-based behaviors and highlights relative strategies to achieve occupational performance outcomes.
What are Frames of Reference?
FORs are NOT occupation based
Most have been developed to address specific disability areas and are best used as GUIDELINES for addressing the impairments that create barriers to occupational performance.
The process for change in the client and principles for moving a client along a continuum from dysfunction to functions
Provide practitioners with specifics about how to treat specific clients
List FORs
Applied Behavioral Frames
Cognitive Behavioral Frames
Social Cognitive & Third Wave Cognitive Frames
Biomechanical & Rehabilitative Frames
Allen’s Cognitive Levels Frames
Toglia’s Dynamic Interactional Approach
Ayres’ Sensory Integration Frame
Sensory Motor & Processing Frames
Motor Control Frames
Motor Learning & Task-Oriented Frames
What are the 2 major structural components to theory?
Concepts: ideas (Concrete to complex) that are expressed through the use of symbols and language
- Example of concept – clothing is a category that can be divided into shoes, pants, dresses, shirts and so on
Principles: explains the relationship between 2 or more concepts
- Example of principle – once the concept of color is learned, then the principle of mixing primary colors produces other colors
Why do you need to know theories?
It is necessary to therapeutic reasoning and to develop effective intervention.
Theory provides the basis for practice
What is the Developmental FOR?
Identifies level of motor (gross, fine, oral), social, emotional, and cognitive skills & targets intervention to help the client advance
- Development occurs over time and across areas
- Typical developmental sequence skills interrupted as a result of illness, trauma, or birth condition
- Gaps in development can be affected by physical, social, emotional, or traumatic events
- Repetitive practice for mastery provides experience that promotes elasticity and learning
- Developmental FOR promotes practice of skills in a developmental sequence and at the level just above where the client is functioning (Llorens)
