MODELS OF PRACTICE

• Conceptual Models: Occupation-focused theoretical constructs and propositions that have been
developed specifically to explain the process and practice of occupational therapy

• Frame of Reference: Theoretical or conceptual ideas that (may) have been developed outside
the profession but which, with judicious use, are applicable within occupational therapy
practice.

Conceptual Models

• Ecological Model - emphasized on the importance of considering the environment in practice

- indicate that occupational performance is determine by the person ,
environment (context) and occupation (task)

1. Ecology of Human Performance Model

- Persons who show healthy function have a high performance range of tasks. This means that
they can participate in numerous occupations and roles that suit their person variables and
match their natural contexts. Persons show various abilities and interests; can integrate the
expectations, supports, and manage the barriers of the context; and can fulfill the task
requirements that are part of their life roles.
 2. Person-Environment-Occupational-Performance Model

- A level of competency in his ability to perform and master occupations.

- Balance of personal and environmental demands
- Adaptation in his occupational performance as challenges naturally evolve in his life.
- Establish healthy role patterns that fulfill personal and societal expectations

3. Person-Environment-Occupation Model

- Behavior is influenced by and cannot be separated from contextual influences

- Occupational performance is the outcome of the transaction of the person, environment, and
occupation
- To be able to move towards meaningful roles in the social environments

• Occupation Based Model - focuses on occupation as an outcome and means for intervention

1. Model of Human Occupation (MOHO)

- Person's inner characteristics and external environment are linked together into a dynamic
whole
- Asserts that inner capacities, motives, and patterns of performance are maintained and
changed through engagement in occupations.
- Composed of three interacting elements: volition, habituation, and performance capacity

2. Occupational Adaptation (OA)

- Adaptive capacity can be overwhelmed by disability, impairment and stress

- Characterized by constant desire, demand and press for mastery within an occupational
environment
- Main objective is to achieve mastery over environment

3. Canadian Model of Occupational Performance (CMOP)

- Client centered model in which occupations are contextually and developmentally determined
and influenced within a multidisciplinary team
- Envision health, well being and justice through occupation

4. Occupational Therapy Practice Framework (OTPF)

- Use of transactional relationship among the person, engagement in valuable occupations, and
the context to design occupation-based intervention plans that facilitate change or growth in
client factors .

- Goal: participation through adaptations and modifications to the environment or objects

within the environment when needed.
 • Emerging Theories

- contemporary theoretical approaches which reflect movement away from reductionist

framework to a contextual and population-based approach

1. Complexity Theory

- To understand phenomena , as well as interconnectedness of individuals and contexts , social

processes and structural arrangements

- Examine how human influences and structural arrangements relate to occupational choices,
occupational production and individual interaction within a given system.

2. Transactionalism

- Exploration of occupation in a larger context that extends beyond the singular person and view
the individual and context as an integrated whole.

3. Occupational Systems Approach

- Focus occupations within context of social collectiveness (groups, communities, and

population)

4. KAWA Model

- find opportunities for intervention within the spaces

- not to control the nature and circumstances but to find ways to increase the flow within them
- use the power of the water to facilitate

FRAMES OF REFERENCE

1. Client Centered
- Client is the focal point of this model which emphasizes that it is the therapist's responsibility to
develop a positive relationship with client.
- Therapist must work to understand the client’s situation and enduring personal characteristics

2. Cognitive Disability FOR

- Describes the nature of cognitive processing impairments that compromise the ability for normal
function and identifies adaptations that will optimize the ability of cognitively disabled persons to
function in their everyday world.

3. Cognitive-Behavioral
- assumes that a person’s cognitive function and beliefs mediate or influence his or her affect and
behavior.

4. Behavioral FOR
 - Behavior responds to environmental inputs.
- Learning occurs when reinforcement is present, which can be positive(support) or negative
(punishment).
5. Psychodynamic
- Psychological constructs are believed to account for one’s occupational and social behavior.
- Fears and anxieties cause people to form maladaptive behaviors.
- Balance between id, ego, superego

6. Sensory Integration
- proper organization of sensory information in the brain to make an adaptive response.

7. Biomechanical
- Concerned with stability of the many body structures, with prevention, restoration, and
compensation such as ROM, strength, endurance

8. Motor Relearning
- Views the individual as an active participant whose major goal in rehabilitation is to relearn
effective strategies for performing functional movement.
- To be able to performing motor skills in accordance to the norm of average persons.

9. Rehabilitation FOR
- Aims at making the person as independent as possible in spite of residual disability.

Importance of Theories in Practice

- shapes Profession's Practices
- it is part the knowledge base of the field and an important aspect of each practitioner's
professional paradigm (Argyris & Schön, 1974)
- it is part of the data practitioners bring to the therapeutic encounter (Rogers, 1983, 1986)
- it helps practitioners to “name and frame” the problems they encounter (Parham, 1987, Schön,
1983, 1987).
- use of Theories Varies with Experience
- need to be routinely and systematically check their professional paradigms against emerging
theory and research (practitioners' ethical responsibility)
- Personal or Formal theories

CMAG OT1 1617