Theoretical Models Flashcards
Minority stress model
A theoretical model with a foundation understanding that adverse experiences cause less than optimal health outcomes for individuals who are in the minority
Dynamic systems theory
Theoretical that includes an appreciation for a transactional relationship between person, environment, and occupational performance to support participation
Self-determination theory
Theoretical approach that includes tenets of:
- autonomy over selection of life roles and activities
- perceived success
- being connected with an effective social network to gain results in satisfaction
Cognitive orientation to occupational performance (CO-OP)
Problem solving intervention approach that involves:
- client-centered goal setting
- cognitive strategies
- guided discovery
Biomechanical model
Practice model used to improve:
- ROM
- postural alignment
- strength
- functional mobility
Transtheoretical model of change: maintenance stage
Stage of change in which the client is committed to maintaining behavior change and is working to prevent relapse
Transtheoretical model of change: action stage
Stage of change in which the client has made observable changes in behavior and is committed to continuing to acquire new behaviors for a more positive lifestyle
Task-oriented approach
Motor recovery intervention approach that includes:
- repetition of movement during meaningful, client-centered, daily activities
- activity analysis and consideration for the interaction between person, environments, and occupation
Transtheoretical model of change: determination stage
Stage of change in which the client has decided that changing behavior is beneficial for the future and is actively preparing to take steps toward making positive lifestyle changes
Also called preparation stage
Transtheoretical model of change: contemplation stage
Stage of change in which the client starts to weigh the pros and cons of change and considers making changes in the future
Transtheoretical model of change: precontemplation stage
Stage of change in which the client has not yet considered, or is resistant to, change
Transtheoretical model
Practice model that includes the tenet that behavior change occurs in the following sequential stages:
- precontemplative
- contemplative
- preparation
- action
- maintenance
Multicontext approach
Expectation that task modifications/cognitive strategies should be applicable and be practiced in multiple contexts where the client has performance demands
Precede-procede model
A multi-dimensional health promotion model structured for assessing health and QoL and to guide health promotion programming designed to meet these needs
Health belief model
Practice model includes tenet that an individual’s perception of health combined with their environment impact selection of behaviors that influence health
Dialectical behavior therapy (DBT)
Form of CBT based on tenet that emotional states are affected by cognitive processes, intervention may include:
- mindfulness
- distress tolerance
- emotional regulation
- interpersonal effectiveness
Cognitive behavioral therapy (CBT)
Intervention with basic tenet that a change in thinking or in assumptions will result in a change in behavior
Commonly used with clients who have anxiety, substance abuse, or mood disorder
Occupational Adaptation Model
Practice model that includes the 3 basic tenets of person, environment, and the interaction of the person and environment
Adaptation is achieved once there is experience with activity modifications followed by mastery of the occupation
Person-environment-occupation-performance model (PEOP)
Practice model that includes tenets regarding the importance of considering the person, environment, and occupation and how they relate to performance
Model of human occupation (MOHO)
Practice model that include the following tenet:
individuals are a product of their own volition, habituation, and performance with an appreciation for the effect of the environment
Complex trauma model
An interprofessional model that can be used to guide intervention for children who have had exposure to multiple adverse experiences during childhood
The model includes the following domains:
- self-concept
- emotional
- dissociation
- cognition
- body and brain
- behavior
- attachment and relationships
Behavior modification FOR
used as a therapeutic approach in institutions to reinforce desirable behaviors while using negative reinforcement to extinguish undesirable behaviors.
Recovery model
It involves the acceptance of an identity that includes the mental illness while not allowing that illness or its stigma to define the person.
Allen’s Cognitive Levels FOR
Help guide decisions on if the client can live independently and manage their own affairs.
Acquisitional FOR
This FOR uses the teaching-learning process and activities analysis, to achieve the goal which is the acquisition of specific skills or appropriate behaviors required for optimal performance within an environment.
Dynamic Interactional Model of Cognition
This Model targeted towards those with brain injury and select populations of mental health and developmental disabilities.
Lifestyle Performance Model
Provides a framework for knowing and understanding a person’s total activity repertoire within the context of his or her human and nonhuman world.
4 Domains:
- Domain of self-care and maintenance
- Domain of intrinsic gratification
- Domain of societal contribution
- Domain of interpersonal relatedness
Occupational adaptation model
Explains how a person adapts to
everyday life when they experience stress, a sudden change, injury, or
disability. These factors can cause a person to lose their ability to function
physically thus their also losing their ability to participate in meaningful
occupations
This theory discusses how and what factors occur to adapt to these life
changes and how that is healthy to developing and maintaining skills.
What is the Kawa Model?
Attempts to explain OT’s overall purpose, strategies for interpreting a client’s circumstances and clarify the rationale and application of OT within the client’s particular social and cultural context.
The inclusive nature of the model allows the client to be considered as a collective (can be used on individuals, families, groups, and organizations).
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)
What is the Motor Control/Motor Learning FOR?
Motor control examines how one directs & regulates movement; Motor learning theory describes how clients’ learn movements. This approach is based on dynamic system theory that many factors influence movement & must be considered in intervention
- Interaction among systems is essential to adaptive control of movement
- Motor performance results from an interaction between adaptable & flexible systems
- Dysfunction occurs when movement patterns lack sufficient adaptability to accommodate task demands and environmental constraints
- Motor learning occurs as clients’ repeat motor tasks that are intrinsically motivating, meaningful, and for which they can problem solve.
What is the Sensory Integration FOR?
Organization of sensory input to produce an adaptive response; theoretical process & intervention; addresses sensory info from the environment
- Sensory input can be used systematically to elicit an adaptive response
- Registration of sensory input needed before an adaptive response can be made
- Adaptive responses contribute to the dev. of sensory integration
- Better org. of adaptive responses enhances the client’s general behavioral org.
- More mature & complex patterns of behavior emerge from consolidation of simpler behaviors
- More inner-directed a client’s activities are, the greater the potential for the activities to improve the neural organization.
What is the Neurodevelopmental Treatment FOR?
Techniques developed by Karel & Berta Bobath to help kids with functional limitations resulting from neuropathology, primarily Cerebral Palsy. Goal of NDT is to help perform skilled movements more efficiently so they can carry out life skills. Knowledge of typical movement needed. Therapists use handling techniques and key points of control to facilitate normal postures so that kids “feel” typical movement patterns
What is the Cognitive Disability FOR?
Based on the premise that cognitive disorders in those with mental health disabilities are caused by neurobiological defects or deficits related to the biologic functioning of the brain. The theoretical base is derived from research in neuroscience, cognitive psychology, information processing, & biologic psychiatry.
Proposes change occurs because of the capacity of the client and the environment.
- Function-dysfunction continuum with this FOR
- Level 1 (Profound disability) to Level 6 (Normal Ability)
- 2 Tools: Allen Cognitive Level (ACL) and the Routine Task Inventory Test
Ecology of Human Performance Model
Based on premise of how human behavior and task performance are affected by the interaction between a person and the context (the ecology).
The OT intervention process is designed to improve the client’s performance by changing variables such as the person, the context, the task, or the transaction between them.
These variables (person, context, task performance) have an affect on, and are affected by, human performance.
Applied Behavioral FOR
The behavioral FOR is on a continuum. It spans from behavioral modification to cognitive behavioral therapies and ends with social cognitive theories of learning.
The behavioral FOR comes to us from psychology theories. Pavlov, Skinner, and Bandura are widely know for their contributions to behaviorism.
Common terms: shaping, chaining, scaffolding, prompting
It promotes the learning of skills of occupational performance without regard to sequence or developmental stage.
This FOR is useful for anyone wishing to form a new habit or to break a bad (maladaptive) one.
Prompting, scaffolding, and fading in Applied Behavioral FOR
While a client performs a sequence of steps, the occupational therapist may either visually or verbally prompt the client to remind him or her what needs to happen next.
Scaffolding is “a method of grading an activity by providing assistance to the client at times that he or she might struggle or be unable to successfully complete a step.”
Removing such assistance when it is no longer needed is called fading. Fading “occurs when prompts or cues that guide the performance of a complex behavior are gradually withdrawn”
Shaping and chaining in Applied Behavioral FOR
Shaping and chaining, an outgrowth of operant conditioning, can guide the learning of occupational skills.
Skinner demonstrated these principles by teaching a pigeon to turn around. Each time the bird turned in the desired direction, it was given a morsel of food (shaping). Eventually, the bird turned all the way around (chaining) and learned that repeating this behavior brought continued reinforcement.
Cognitive Behavioral FOR
Cognitive behaviorism incorporates complex systems and nonlinear science.
Occupational therapists should consider this FOR whenever psychological barriers to activity engagement are encountered.
This frame of reference has been identified as the one most often used in behavioral health settings because it is especially effective in dealing with issues of motivation and emotion.
Used with OCD
Functional individuals can control and manage their own thoughts, feelings, and behavior to cope with stress, manage time, and balance their life roles and occupations.
Social cognition and 3rd wave cognitive FOR
We define social cognitive theory as an FOR intended for OTs treating mental health populations. Its focus, however, is on thought processes, self-determination, and social participation (roles, relationships, identity, and support).
This approach is especially useful for occupational therapy individual and group interventions for populations with mental health issues.
Functional persons can exercise personal and proxy agency by self-directing their own life roles, choosing supportive relationships and environments, and seeking out the help and resources they need to pursue a meaningful and fulfilling life.
Toglia’s Dynamic Interactional Approach
This approach has been used with all types of acquired brain injury, including trauma and stroke, as well as some mental health and developmental disability populations.
The goal is to restore functional occupational performance for persons with cognitive dysfunction.
Domains of concern have previously been identified as orientation, attention, visual processing, motor planning, cognition, occupational behaviors, and effort.
The key features are self-awareness and the creation and use of cognitive strategies.
Cognitive functioning requires the ability to receive, elaborate, and monitor incoming information and the flexibility to use and apply one’s analysis of information across task boundaries.
Traditional occupational therapy interventions address attention, memory, and perception.
Ayers’ Sensory Integration FOR
SI affects all of the occupations people undertake and, to a large extent, determines the effectiveness of occupational performance.
Ayres used the term sensory integrative dysfunction to describe the focus of occupational therapy intervention.
Disorders of attention, hypersensitivity to sensory stimuli, poor postural control and balance, apraxia, tactile defensiveness, and inefficient cognitive processing are some of the many difficulties that have been addressed successfully using SI strategies.
Neuroscientists define SI as the brain’s ability to organize sensory information received from the body and environment and to produce an adaptive response.
Children are functioning when they are able to integrate sensations within the process of engaging in their age appropriate occupations, such as playing, learning (education), self-care, rest and sleep, and social participation.
The SIPT battery has been called the “gold standard” for evaluating SI and praxis.
Sensory motor and processing frames
Sensory modulation difficulties in adulthood often interfere with their ability to work, socialize, or participate in other occupations of daily life.
Sensory motor functioning must be adequate for a client’s occupational performance and participation goals. This includes the ability to modulate sensory input and to self-direct attention to relevant internal and environmental sensory dimensions of a specified occupation, activity, or task.
People with normal sensory processing and integration ability can perform their daily occupations without becoming distracted or side-tracked by extraneous sensory input; they can also seek and incorporate sensations that facilitate their occupational objectives.
Dysfunction occurs when sensory systems cannot be controlled internally or automatically.
The occupational therapist’s role in this frame of reference is to identify activities within the client’s social and occupational roles that involve the type and intensity of sensation clients need to normalize their sensory processing and produce adaptive responses.
Motor Control FOR
The focus of the NDT frame of reference is the restoration of skilled voluntary movement for both children and adults with either developmental or acquired neurological health conditions.
The focus of the NDT frame of reference is the restoration of skilled voluntary movement for both children and adults with either developmental or acquired neurological health conditions.
Most of the traditional motor control theories, including NDT (neurodevelopmental therapy), have their basis in reductionism.
Functional motor control refers to the capacity to perform voluntary skilled movements needed for everyday life.
The initial goals vary according to client condition, motivation, and occupational preferences.
Motor Learning and Task-Oriented Frames
General rehabilitative approach to all forms of movement abnormalities and disorders.
Motor learning theories currently provide guidelines for restoring functional movement with clients having a broad range of health conditions.
This frame of reference incorporates the concepts of nonlinear science and depends upon neuroplasticity and brain self-organization as targets of therapeutic change.
Motor learning is defined as “a set of processes associated with practice or experience Motor learning is defined as “a set of processes associated with practice or experience define motor control as “the ability to regulate or direct the mechanisms essential to movement”
Functioning is defined within the context of specific tasks. Acquisition of skills for doing a task may be separated into early (experimental) or late (refinement) stages of motor learning.
With specific task accomplishment as the goal, intervention would focus on assisting clients in developing the optimal motor and cognitive strategies for achieving functional goals.
Learning Theory
Procedural learning refers to learning tasks that can be performed without attention or conscious thought. Procedural learning develops slowly through many repetitions and eventually becomes habitual.
Declarative learning, in contrast, results in knowledge that can be consciously recalled and thus requires awareness, attention, and reflection. This type of motor learning allows individuals to mentally practice a movement sequence before performing it. For example, learning to ski requires the conscious application of strategies and techniques
Declarative learning, in contrast, results in knowledge that can be consciously recalled and thus requires awareness, attention, and reflection. This type of motor learning allows individuals to mentally practice a movement sequence before performing it. For example, learning to ski requires the conscious application of strategies and techniques
Habituation refers to a decrease in responsiveness (or desensitization) that results from repeated exposure to a nonpainful stimulus.
Sensitization is an increased responsiveness following threatening or noxious stimuli.
Psychoanalytic Frames
The psychoanalytic frame of reference offers both insight and effective strategies to guide occupational therapists in dealing with our clients’ emotional issues and barriers.
The focus of this frame of reference, in a broader scope of practice, may target the following life dimensions: social participation, emotional expression and motivation, self-awareness, defensive behaviors, and projective arts and activities.
Freud suggests three ways by which observation of unconscious content is possible: projections (drawings, music, drama, and creative writing), dreams (symbols and their meaning), and free association (spontaneous connections of objects, symbols, and emotions).
Psychoanalytic theory provides an explanation for many of the irrational, even bizarre behaviors we observe in persons with a variety of illnesses, such as suicide attempts and paranoia.
A balance exists in the functioning individual that allows the psychic energy to flow freely between the id, ego, and superego. A functioning adult is free from conflicts and fixations and is able to satisfy his or her needs and direct his or her drives in ways that fit in with the social environment and culture.
Psychodynamic-Ego Adaptive Frames
The psychodynamic frames of reference are some of the most relevant for occupational therapy because they focus on the person’s inner drive toward growth, development, and mastery and incorporate the role of doing, or occupation, in a person’s self and social identities.
This frame of reference for occupational therapy most often targets the following: self-identity, self-direction and motivation, self-awareness, self-management, and social identity and relationships.
A healthy ego is synonymous with a strong sense of self; body image, self-identity, and self-esteem are realistic and can serve as the basis of adaptive function. The ego is in control and defense mechanisms are not exaggerated so that the individual with a healthy ego can use most of his or her energy to grow and develop and interact effectively with others.
