V E L E Z C O L L E G E
DEPARTMENT of OCCUPATIONAL THERAPY
CONTENTS
1 Intro to Philosophical Base of OT
1-2 Theories, Models, FORs
2-5 Model of Human Occupation
INTRODUCTION TO THE PHILOSOPHICAL BASE OF
OCCUPATIONAL THERAPY
Philosophy and its relationship to OT
- The foundation upholding all that practitioners
and researchers do
- Develop a clear and coherent professional
identity as an occupational therapist
- Hone a practice that is and looks unique among
health care providers
- Explain the hidden and often underestimated
complexity of the profession both to
themselves and others
Elements of the OT Profession
1. Ontology/metaphysics – study of being and
existence
2. Epistemology – how is knowledge acquired and
used
3. Axiology – values, beliefs
4. Theory Base
5. Knowledge Base
Philosophy, Theory & Knowledge, and OT Practice
Theories, Models, and Frames of Reference
Theory
- An explanation or system of anything: an
exposition of the abstract principles of a
science or art
- Used broadly to discuss theoretical
understandings of the profession
- Identify developments in understanding
particular to OT
- (Keilhoffner) Theory should be viewed as a
network of explanations that label and describe
phenomena and propositions that specify
relationships between concepts
- Dr. A. Jean Ayres’s theory of sensory
integration is one of the commonly used
theories in OT
Development of Theory
- Develop from a variety of principles which
include the research and knowledge available
at that time; The values, attitudes and ethical
bases of individuals and their practical
experience of phenomenon under question
- OT existing predominantly within the help and
social fields of society has been observably
influenced by environmental influence within
these settings and prevailing pressures on
professional groups within these fields
- Environmental Influences: Professions do not
exist in isolation and are therefore open to
influence from the pressures and prevailing
norms of other professional groups and the
environment in which they exist
- Historical viewpoint: when history is read, it
becomes interesting; it facilitates
understanding of contemporary roles and
OT 201 – Foundations for OT – Theories,
Models, FORs, and Approaches
relationships. It illustrates that early OT
interventions held a humanistic concern for
individuals’ well-being and consistently
accompanied by the efforts to build a
theoretical understanding about the various
process in the work.
- Further to the external environmental
influences that have directly shaped
occupational theory and practice, it is also
important to note the influence of
philosophical perceptions of ‘reality’ and their
impact on the development of occupational
theory and practice
- A basic understanding of the philosophical
principles relating to truth is important for OTs
to attain as it is from these that the
foundational concepts for future theoretical
develops and OT has been shaped by wide
variety of philosophies throughout the course
of its history to the present days. And these
theories form the foundation of the
profession’s current theoretical developments
- Philosophy is the pursuit of wisdom or
knowledge, the principles underlying any
sphere of knowledge
Model
- A symbolic representation of concepts or
variables and interrelationships among them
- A guiding theory used to understand the
complexity of certain individual situations
- Shared knowledge among different disciplines,
particularly psychology and medicine and can
also be a foundation in evidence
- In OT, models can be further divided into 2
types:
Conceptual models – Occupation-focused theoretical
constructs and propositions that have been developed
specifically to explain the process and practice of OT
Practice models – Used during the intervention
Frames of Reference (FOR)
- Provides a systematic way to uphold the core
principles of the profession while thinking
about and explaining the prioritization of goal
areas for intervention, as well as a means to
structure different aspects of intervention
- Theoretical or conceptual idea that have been
developed outside the profession but which
judicious use are applicable in OT practice
- Components of FOR – used as organizational
scheme for all FOR
Theoretical base (TB)
- Understand the future result the client may
notice after intervention
- Provides foundation of the entire FOR
- May draw from one or more theories
- Assumptions, concepts, definition, postulates,
and relationship b/n them
Function-Dysfunction Continua
- “concern/problem area”
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DEPARTMENT of OCCUPATIONAL THERAPY Models, FORs, and Approaches

- After TB, OT should be able to identify the

specific areas of performance important to the
indiv. skills and abilities
- Fxnal End: OT expects client to be able to do
(abilities)
- Dysfxnal End: represent disabilities
- A single FOR consist several FDC
Guide for evaluation
- Eval. makes a baseline to the intervention
- Should be related to the FDC
- Specific assessment tool/scale or specified
protocols may be applied during evals
- OT uses tools either: standardized or
nonstandardized that will provide an
appropriate baseline of performance and assist
in developing a meaningful plan
Postulates regarding change
- Provides more concrete structure to the OT
FOR
- Cause-effect phenomenon
- Guides OT about the change seen after
applying action
- Transform abstract material stated theoretical
base in practical action that need to be take by
OT to facilitate change in the client
Postulates regarding intervention
- Guided by the postulates of change
- After assessment, OT can plan out the media
and modalities according to the FOR
- Helps OT to set client-centered goals
- Guide how to use the specific techniques and
modalities according to the theory

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DEPARTMENT of OCCUPATIONAL THERAPY Models, FORs, and Approaches

act is determined by internal images that a

OCCUPATION-BASED MODELS person holds as a participant in the external
Model of Human Occupation (MOHO) world
Theoretical Base • Personal causation (indv’s personal
- Human occupation is defined as inborn, knowledge of self who creates
spontaneous tendency of the human system to observable change in the environment
explore and master the environment and considered as self convictions that
- Dr. Gary Keilhofner influence personal choices
- Focus on systemic, holistic approach for o belief in skill – person’s
individual’s varying needs and shows the conviction the he/she has a
importance of mind and body connection of range of important abilities
how motivation (internal) and performance of o Belief in efficacy of skill – useful
occupations (external) are interconnected and relevant to one’s life
- Identifies three levels to examine what a situation
person does o expectancy of success and
failure – one’s anticipation of
Occupational participation – refers to engaging in future endeavors and wether
work, play, or adls that are part of one’s sociocultural the outcomes are successful or
context and that are desired and necessary to one’s not
well-being o internal and external control –
belief of their own control and
Occupational Performance – doing a task related to skills
participation in major life areas; require the ability to • Values – images of understanding of
balance occupations, self-perception, and changing what is moral, important, worthy,
priorities due to conflict in environment upright; combination of principles of
biological influence that guides human
Performance Skills – motor, process, and behavior; maintain and organize
communication interactions; actions that make up behavior through routines and
occupational performance patterns; provides a sense of obligation
to participate in certain occupations;
Occupational behavior – behavior motivated by an helps person experience a sense of
intrinsic conscious need to be effectove in the connection to social group
environment in order to perform a variety of o temporal orientation – is the
individually interpreted roles; roles that are shaped by way in which an individual
cultural tradition and learned through the process of interprets or views his own
socialization. placement of time. It includes
• Intrinsic motivation – the person grows and the degree of orientation or
changes bc a need to explore and be active concern with past, present,
• Extrinsic motivation – demand for growth and future, and the beliefs one
change by external forces or for external holds about how the time
rewards would be used
o meaningfulness of activity - it is
General systems theory – model conceptualizes the the individual’s predisposition
individual as an open system that evolves and to find importance, security,
undergoes different forms of growth and development sense of worth and purpose
and change through an undergoing interaction with the certain forms of occupations
external environment o occupational goals – plans
action that maintains behavior;
Human systems theory – cyclical process of interaction are objectives for personal
involving the 4 phases; An individual give output to the accomplishments or future
environment and receives feedback from it by input. occupation activities or roles
From the feedback, the individual experience o personal standards – are
throughput, which is the process of change and commitments to performing in
adaptation moral, excellent, efficient or
other socially sanctioned ways
Input – interpretation of energy or information in the • Interest – pleasure to find occupation
system pleasurable; produced from experience
of pleasure and satisfaction of
Throughput – transformation of the system to occupation; generate the action of the
accommodate the incoming energy or information system and influences an indv’s choice
a. Volition - highest subsystem and connotes of occupation
“willing or choosing”; responsible for choosing o Discrimination – indv develop
participation in occupations; perform behavior preference of more or less
by creating motivation and the motivation to enjoyable; it is the degree to

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DEPARTMENT of OCCUPATIONAL THERAPY
which one differentiates a
liking or expectation/pleasure
in certain occupations and
objects
o Pattern – outline of
occupations that one is willing
to enjoy; is the configuration of
occupations toward which a
person expresses interest
o Potency – degree of which
interest are based on past
experiences and influence
present action
a. Habituation – collection of images which trigger
and guide the performance of routine patterns
of behavior; engagement of interest hat
acknowledges work and time as necessity in
duty; explains how human system maintains
everyday patterns of behavior without ongoing
conscious choices
• Roles - part played by persons that
holds their positions in social groups;
behavior expected depends on their
statuses; guide our daily routines and
our style, manner, and content with
others
o Perceived incumbency –
awareness of self-duty; variety
of acquired role that
determines behavior; it is the
belief that one has status,
rights, and obligations of a role
and that others perceive him to
be in that role. It also includes
the image one holds of him
when (f.e. during the day,
week) he is in a given role
o Internalized expectations –
self-imposed rules, obligations
on what to do in an expected
role; are the images one holds
of what other expect him to do
by virtue of being in a role (f.e.
the perceived obligations of a
given role)
o Role balance – equalize
different roles acquired; is the
degree of health integration of
roles into one’s daily life
• Habits – images that guide routine in
ways in which person performs task;
regulate routine, actions, behavior
within a role
o Degree of organization –
organize behavior that balance
time or work of an activity;
promotes productivity; the
degree to which one has and
can report a typical use of time
o Social appropriateness – to be
able to know the expected
behavior in harmony with the
social environment; the degree
to which one’s typical behavior
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OT 201 – Foundations for OT – Theories,
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are those expected and valued
by the environments in which
he performs
o Flexibility and rigidity – degree
to which a person is able to
change routines of behavior to
accommodate interrupted
incidents ; refers to the
continuum representing the
degree a person changes
routines of behavior to
accommodate unusual
contingencies
b. Performance – using mental and physical
capabilities organized into skills to perform
purposeful behavior or activity; includes
muscoskeletal, neurological, cardiopulmonary
and cognitive images
• Skill – abilities the person has for the
performance for various forms of
purposeful activities
o Perceptual motor skills –
nervous system takes sensory
info translate images perceived
o Process skills – involves
planning, problem solving
o Communication and
interaction skills – abilities for
sharing and receiving
information and for
coordinating one’s behavior
with that of other to
accomplish mutual activities
and goals
Output – external action or occupational behavior in
result to the feedback
Feedback – return of information tot the system about
the process and consequences of the action
a) Internal feedback – experience enjoyment in
the activity; feel competent; see their own
progress towards the goal; used to monitor the
performance
b) External feedback – represents others’
evaluations of one’s occupational behavior and
its processes and consequences
Function-dysfunction continuum
- Identities, perception, and motor abilities
created through behavior; therefor engaging in
new behavior forms or occupational identities
- Consistent practice enables one to progress to
the level of mastery and develop occupational
competence
- Reconstructing and improving occupational
identity and occupational competence result in
becoming occupationally adapt. By
participating in therapeutic occupations,
individuals become adaptive and healthier.
- Adaptive cycles result in a state of occupational
function; on the other hand maladaptive cycles
result in a state of occupational dysfunction
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DEPARTMENT of OCCUPATIONAL THERAPY
- Functional indv are occupationally functional
when they meet both society’s expectations for
productive participation and their own need for
exploration and mastery; dysfunctional if both
not met
Levels of occupational function – represets state of
optimal arousal and accomplishment with the
environment
1. Exploration – lowest level and involve curious
investigation of one’s potential for action in
combination for properties of the environment;
results of innovation and development of skills
2. Competence – striving to be adequate to the
demands of a situation by improving and
reshaping one’s self to the environmental task
and expectations; results in development of
new skills and organization of skills into habits
3. Achievement – an indv striving to maintain and
enhance performance in occupations with the
standards of performance and excellence;
manifests in role performance of various types
Levels of occupational dysfunction – represents stress
and lack of involvement with the environment
1. Inefficacy – least dysfunctional level; indicates
reduction of motivation; defines as interference
of performance accompanied by
dissatisfaction; reduction of personal causation
that has negative impact on interest, values,
and habits
2. Incompetence – inability to routinely and
adequately perform task of daily living;
characterized by major loss, limitation of skills,
failure, disruption of self confidence and
satisfaction
3. Helplessness – characterized by a total
disruption of occupational performance
together with extreme feelings in
ineffectiveness, anxiety, and depression
Behaviors Indicate function and dysfuntion
1. Functional individuals – a function of order is a
status of health and competent performance of
daily living, work, and play. Client shows
functions in ability to choose, organize, and
perform occupations that are personally
meaningful and demonstrates a sense of
competence and role fulfillment. Process
whereby a person continually learns how to
balance own expectations with those of the
society.
2. Dysfunctional individuals – disorder is the
inability to perform occupations, an
interruption in role performance, and an
inability to meet role responsibilities. A person
with dysfunctional behavior patterns does not
experience a basic quality of life nor can he
meet personal and societal expectations.
Assessment tools
1. Occupational case analysis interview and rating
scale (OCAIRS)
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2. The occupational performance history
interview – designed to gather info of indv’s
work, play and self-care performance history
3. Role change assessment – examines the past
and current role participation, changes in role
participation and value or importance of roles
in older adults
4. Occupational role history – screening tool to
identify critical info in patterns, skills,
achievement or patterns of dysfunction in past
and current occupational role; degree of
balance or imbalance between leisure activities
and activities associated with occupational role
5. Adolescent role assessment – give both
narrative and quantitative data about worker
role development
6. Inventory of occupational choice skills -
inventory to work cooperatively with client in
choosing a job they desire
7. Time reference inventory – self-administered
pencil and paper test providing an indication
and orientation to time and significance of past,
present, and future events
8. ADL checklist – tool to help clients determine
which ADLS and IADLs require assistance and
how much assistance is needed
9. Bay area functional performance evaluation –
assess general components of functioning
needed to perform ADLs
Population and Settings
- MOHO in populations is intended for use with
any person experiencing problems in their
occupational life and is designed to a=be
applicable across the life span and been applied
with such diverse groups such as
o Adults with chronic pain, children with
ADHD, persons with traumatic brain
injury, older persons with dementia,
persons living with AIDS, adolescents
with mental illness
o Children and adults who are homeless,
battle-fatigued soldiers, victims of war
and social injustice
- MOHO in settings is applied in hospitals,
outpatients clinics, residential facilities, nursing
homes, rehab programs, work programs,
prisons and correctional settings, and
community based orgs
Postulates regarding change and motivation
- As clients experiments with their behaviors and
repeats them overtime, they become
automatic and habitual. Clients’ occupation
must be relevant to them to be effective;
create a sense of occupational competence
when they are capable of engaging in
productive and meaningful actions; sufficient
repetition and environmental feedback is
required to assimilate the performance
patterns. In getting the client in moving
towards the regular performance of the desired
occupational behaviors
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DEPARTMENT of OCCUPATIONAL THERAPY
- Therapists should let the client make choices
with their advice and therapists should also
identify, and restore meaningful roles in the
society; this will lead to a change when the
environment allows for the expression for the
individual’s innate urge for exploration,
competency, and achievement through
enactment of these innate urge in facilitating
environment.
- After a source of occupational dysfunction has
been identified a change in the system must be
initiated within the volitional subsystem
o Exploration is aimed at generating skills
o Competency presents greater demands
for performance and develops habits
o Achievement prepares the person for
occupational roles
- OTs remediate occupational dysfunction by
o Directly providing an occupation in
which the person engages as therapy
o Counseling and problem solving with
the person to identify and alter a
maladaptive occupational lifestyle
o Facilitating engagement in occupation
by improving the fit between the
person and their environment
- OTs in group application plays both roles as an
advisor and collaborator. They are responsible
for evaluating client’s occupational
performance and in supporting them in making
those changes they desire. Hey also advise
patients in various aspects of occupational
functioning. Also, they encourage the client to
actively participate in activities and reinforce
patients’s sense of control and personal
efficacy
- Roles of Activities
o Exploratory level – the therapists would
incorporate simple activities to help the
most severely disorganized patients to
develop basic process skills, perceptual
motor skills, communication or
interaction skills. OTs should select
activities to develop specific skills (ex.
Skill building sessions)
o Competence level – OTs assume that
the patients have basic skills but need
to integrate them in habit patterns;
choices are encouraged so patients can
apply their skills and organize them into
habit patterns (ex. Time management)
o Achievement level – help integrate skills
into daily life roles and also give
training and awareness. Focus on life
roles (ex. Work support, leisure
planning)
Duncan, willard, bruce
Occupational Adaptation
Theory Base
- developed by a group in Texas Woman's
University occupational therapy faculty headed
by Dr. Grace Gilkeson to develop a Ph.D.
program in occupational therapy focusing on
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OT 201 – Foundations for OT – Theories,
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two global concepts occupation and adaptation
that have long been present in occupational
therapy thinking.
- Sally Schultz and Janeth Schkade who
developed the group's conceptualization of
occupational adaptation. The model was fully
established in the year 1994. Its intellectual
heritage writings were inspired by William
Dunton and Adolph Meyer
- Occupational Therapy has the assumption that
as clients become more functional, they will be
more adaptive. On the other hand,
Occupational adaptation is opposite to that
assumption, that if clients become more
adaptive they will become more adaptive, they
will become more functional.
- There are 6 proposed guiding assumptions
about the relationship between occupational
performance and adaptation. These
assumptions will guide occupational therapists
with a way of viewing the client and the
problems that are presented in the therapy.
These assumptions form the core of
occupational adaptation. Another concept that
is held by this model is Mastery. Based on this
model, the individual Desires for Mastery, the
environment Demands for it and the
interaction of the two Presses for it. The
combination of the three gives an impetus for
humans to face occupational challenges and
make adaptive response. There are three
elements presented in the model of
occupational adaptation; the person, the
occupational environment and their
interaction.
o Competence in occupation is a
lifelong process of adaptation to
internal and external demands
to perform.
o Demands to perform occur
naturally as part of person's
occupational roles and the
context (environment
interactions).
o Dysfunction occurs because the
person's ability to adapt has
been challenged to the point at
which the demands of
performance are not met
satisfactorily.
o The person's adaptive capacity
can be overwhelmed by
impairment, physical or
emotional disabilities, and
stressful life events.
o The greater level of dysfunction,
the greater demand for changes
in the person's adaptive
processes.
o Success in occupational
performance is a direct result of
the person's ability to adapt
with sufficient mastery to
satisfy the self and others.
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DEPARTMENT of OCCUPATIONAL THERAPY
3 Elements of Occupational Adaptation
Person
- The person is the internal factor of the OA
process. The person as a constant is believed to
seek adaptation and mastery in the
environment and is considered to be an innate
human condition. An individual is made up of
unique Sensorimotor, Cognitive, and
Psychosocial systems and that are affected by
Biological, Genetic and Phenomenological
influences.
Occupational environment
- These are referred to as the external factors
that affect or influence the person. This
external factor also at some degree has
demand for mastery. The occupational
environment is highly significant because it has
an expectation from the person and also has an
impact on the person. According to Schultz,
Occupational environment is, "the overall
context within which the person engages in the
particular occupation and occupational role.”
- There are three types of occupational
environment: Work, Play/Leisure, and Self-care.
Each of these types is affected by the physical,
social and cultural influences that are part of
the individual's experiential context. Physical
influences are the actual settings where
occupation occurs. Social influences are
referred to as the participants within the
occupational environment. Cultural influences
are the habits, mores, traditions, and rituals
that are present in the occupational
environment. Understanding the specific
demands that the occupational environment is
asking on each individual will guide
occupational therapists to design and devise
interventions that are appropriate for each
occupational need of clients.
The interaction of internal and external factors
- The process of interaction between internal
(person) factors and external (occupational
environment) factors is continuous all
throughout the OA process.
- The demands for mastery by the internal and
external factors will produce another constant
which is the Press for Mastery. This press for
mastery gives way to occupational challenges
and in turn occupational challenges suggests or
demands occupational role expectations. The
intersection of the person's and of the
occupational environment's occupational role
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expectations in response to occupational
challenge demands for adaptation.
- The person makes an Internal Adaptive
Response to the situation and then produces an
Occupational Response. Occupational response
is the end-product or the outcome, the
observable by-product of the adaptive
response. Occupational response is the
behavior or action that the individual carries
out in response to an occupational challenge.
Adaptive Response Subprocesses
- This is the process where individuals make
adaptive responses.
Adaptive response generation subprocess
- This is the anticipatory portion of the
subprocess. It is where a person generates a
response to the occupational challenge being
presented and to the following occupational
role expectations.
- There are stages in which responses are being
generated, first is through adaptive response
mechanism and second by adaptation gestalt.
- Adaptive response mechanism is composed of
Adaptive energy (Primary and Secondary) these
are being used when an individual is attempting
to generate a response, Adaptive response
modes (Existing, Modified and New) are
patterns or strategies that the individual has
learned through life experiences and Adaptive
response behaviors (Hyperstabilized – stuck at
one solution, Hypermobile – moving from one
solution to another and Transitional – blending
of hyperstable and hypermobile that produces
a more positive outcome.) these are behaviors
that exists within the person’s stock of
experiences.
- After all the three mechanisms are being
successfully engaged the individual then
activates his adaptation gestalt.
- Adaptation gestalt is comprised of the
sensorimotor, cognitive and psychosocial
systems of the person. This part is where the
person configures his person systems to carry
out the plan being generated.
Adaptive response evaluation subprocess
- This is where the person evaluates his
generated responses for its quality. Because
the occupational response is a consequence of
the desire, demand and press for mastery, the
criterion for used to assess the quality of the
occupational response is called Relative
Mastery.
- Relative mastery is a personal assessment of
the individual by how well they feel their
occupational response met the occupational
challenge. It is relative to the individual.
Efficiency (use of time, energy, resources),
Effectiveness (the extent to which the desired
goal was achieved), Satisfaction to Self and
Satisfaction to Society.
Adaptive response integration subprocess
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DEPARTMENT of OCCUPATIONAL THERAPY
- It is the final subprocess in which leads to the
integration of the person’s actions towards the
occupational challenge. If the person’s overall
evaluation of his actions or response is positive
then there is less need for further adaptation. If
the result is negative, the integration
subprocess communicates this to the person.
This will lead to generating a modified or new
response.
A Sample Case Study
“Raven is a 37-year-old woman who was hospitalized
with brain aneurysm, which affected her speech, right-
sided movement, and cognitive abilities. Raven is
unable to remain standing for long periods of time, and
she needs frequent breaks during seated activities.
Raven experiences difficulty with memory and poor
concentration.
Raven works as an assistant manager at a grocery store.
She takes care of her family and is involved in the
church. She enjoys socializing with others. Currently,
she is unable to engage in these occupations, due to
right-sided weakness, slurred speech, and fatigue.”
Occupational Adaptation Intervention:
- The OT practitioner changes the demands of
the occupation of socializing by allowing Raven
to sit in a chair and visit family members for
short periods of time.
- The OT practitioner provides Raven with short
projects in which she can participate with her
grandchildren when they visit. This helps Raven
continue her nurturing occupations, while
helping her gain function.
Function-Dysfunction Continua
- The determinants of function-dysfunction in an
individual may exist during which an individual
is capable/incapable of generating a response,
evaluating a response, and integrating a
response to the occupational challenge.
- In occupational adaptation model an individual
is considered to be functional if the individual is
able to adapt to life’s challenges and changes.
- When demand for performance exceeds
person’s ability to adapt, dysfunction may
occur. Constant inability to generate an
appropriate occupational response to an
occupational challenge could result in
dysfunction.
- The more adaptive the person, the more
functional he/she is in daily activities. An
imbalance between the desire and demand for
mastery could lead to inability to adapt to an
occupational challenge, therefore dysfunction
may occur.
Behaviors Indicative Of Function-Dysfunction
- In the OA-driven practice, the OTs focus must
be on increasing the client’s ability to adapt.
Since there is no specific assessment tool used
in occupational adaptation, the OA Clinical and
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Professional Reasoning Process provided a
systematic progression of questions that an OT
can use to frame his/her overall thinking and
therapeutic program, which is the use of OA:
Therapeutic Reasoning Process and also the
OA: Guide to Assessment and Intervention.
- OA: Therapeutic Reasoning Process (adapted
from Willard & Spackman’s Occupational
Therapy 11th ed. p.469)
Data Gathering and Evaluation
- What are the client’s occupational
environments and occupational roles?
o Which role is of primary concern of the
client and family?
o What occupational performance is
expected in the primary OE/OR?
- What are the physical, social, cultural features
of the primary OE/OR?
- What is the client’s sensorimotor, cognitive and
psychosocial status?
- What is the client’s level of relative mastery in
the primary OE/OR?
- What is facilitating or limiting relative mastery
in the primary OE/OR?
Planning and Intervention
- What combination of occupational readiness
and occupational activity is needed to promote
the client’s occupational and adaptation
process?
- What help will the client need to assess his or
her occupational responses and use the results
to increase his or her adaptive-ness?
- What is the best method to engage the patient
in the intervention process?
Evaluating Intervention Outcomes
- How well is the program affecting the client’s
occupational adaptation process?
o Which adaptation energy level is used
most often (primary or secondary)?
o What changes are occurring in the
adaptive response mode (existing,
modified, or new)?
o What is the most common adaptive
response behavior (hyperstable,
hypermobile, or transitional)?
- What outcomes does the client show that
reflect positive change in overall adaptiveness?
o Self-initiated adaptations?
o Enhanced relative mastery?
o Generalization to novel activities?
- What changes are needed in the program to
help the client maximize his/ her adaptiveness?
Other Assessment Tools
Occupational Self Assessment
- Authors: Kathi Baron, Gary Kielhofner, Anita
Iyenger, Victoria Goldhammer, and Julie
Wolenski
- This assessment tool is used for reflecting the
uniqueness of each client's values and needs,
the OSA is a tool that facilitates client-centered
therapy. The OSA self report and planning
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forms assist the client in establishing priorities
for change and identifying goals for
occupational therapy. The wide range of
everyday activities, including handling
responsibilities, managing finances, and
relaxing, provides a client with the opportunity
to identify and address their participation in
important and meaningful occupations.
- The OSA is designed to capture clients’
perceptions of their own occupational
competence on their occupational adaptation.
Clients are provided with a list of everyday
occupations, and assess their level of ability
when participating in the occupation and their
value for that occupation.
Allen Cognitive Level Screen – 5 (ACLS-5)
- Author: C. K. Allen, S. L. Austin, S. K. David, C. A.
Earheart, D. B. McCraith and L. Riska-Williams.
- This is an assessment tool for all ages that
provides a quick measure of learning potential,
global cognitive processing and performance
abilities. The areas being assessed are mostly
problem solving and decision-making.
Coping Inventory
- Author: S. Zeitlin
- This assessment tool is for child’s aging 3 –
16yrs. with the use of an observation form and
self-rating for ages 15 and above. This tool is
used to assess adaptive and maladaptive coping
habits, skills and behaviours and also to see
how a person is able to cope with self, with the
environment and the use of personal resources
and also in initiating an activity.
- Behaviors assessed:
o Difficulty in generating responses,
evaluating responses and integrating
responses.
o Repetition of ineffective techniques
o Diminished Adaptive Capacity
o Depression
o Poor Frustration Tolerance
o Low Coping Skills
o Poor relation to the environmental
context
o Poor adaptation to changes and
challenges
Postulates Regarding Change And Motivation
- Occupational adaptation focuses on the
therapeutic use of occupation to promote
adaptation. Occupational therapists improved
client’s adaptive-ness through engagement in
occupation. The primary goal of the
intervention is to maximize the client’s
effectiveness in using his or her own ability to
adapt. The goal of occupational therapists is
not the help the client adapt but to help the
client become adaptive. Clients are more
inclined to discover their own ability to adapt
when they are challenged within the
occupational activities, most especially if
activities that are meaningful to them and that
has a beginning and an end, that is process
oriented, and have an end-product. The goal is
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to keep the individual as adaptive as possible;
the more individual is unable to manage his or
her personal systems the more the therapist
has to manage the occupational environment
to facilitate the person’s potential to
experience the highest possible level of relative
mastery. The more the therapists directs,
solves, and teaches, the more the client
becomes less adaptive.
Role of OT in group applications
- Interview the client
- Facilitator
- An agent of Occupational Environment
- Advisor
- Guide
- Assess what areas of occupation he/she has a
problem
- Help client create a goal
- Create an intervention plan and implement
- Encourage client during the activity
- Change agent
- Communicator
- Collaborator
- Expert in enabling occupation
- Consultant
- Practice Manager
- Educator
Facilitative Leadership
- allows clients to make choices while showing
care and concern.
- decisions are made by clients with the
facilitators guidance
- a resource person, provides clients with need
info, equipment, structure and supplies.
- useful in motivating clients and getting them
involved.
Advisory Leadership
- Passive leadership style.
- Limited to highly functioning clients that are
working on goals like problem solving or
attitude change.
- For clients who seek assistance with specific
problems may need advice on issues such as
coping with stress, conserving energy, or
eliminating physical and social barriers.
Role of Activities
- The roles of activity will engage client's
interests, will uphold client's values and beliefs
and will aid in formation of concepts in order
for the client to adapt. Activities enable their
performance of occupation in simulation to
their occupational functioning. Activities are
comprehensive process that brings about
adaptations in clients in different settings.
Activities and interventions in OT Adaptation
1. Occupational Readiness
o It addresses the deficits in motors,
process, and communication/
interaction performance skills to
prepare clients for occupational
activity. Occupational readiness may
include splinting to support hand,
exercise to strengthen muscles,
trainings in social skills and etc.
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2. Occupational Activity
o It engages client’s in tasks that are part
of the occupational role selected by the
client. Any activity that is important
and meaningful to the client.
SAMPLE Warm Up Activity
1. Title: Lend me your hands, I will be your eyes.
Model/FOR: Occupational Adaptation
2. Objectives: To prepare and participate for
adaptations in occupational environment.
3. Materials: Puzzles, blindfolds
Time: 10 minutes to 15 minutes
Procedure:
o Pair up people by 2.
o One gets to be blindfolded and the
other one gets to tie his hands.
o Blindfolded one can use his hands
according to the instruction of the
other one.
o Finish the puzzle.
Precautions/Contraindications: Avoid any sharp
objects around.
4. Therapeutic goals
o To understand the activity/occupation
and adaptations in relation to obstacles
o To achieve interactive process between
the activity/occupation and adaptation
to accomplish the goal
o To fulfil the desire for mastery at the
end of the activity
Person-Environement- Occupational performance
(PEOP) by Baum and Bass
- designed to facilitate the development of a
COLLABORATIVE intervention plan with the
client and with other professionals. This
encourages the client in the whole process of
intervention planning, implementation, and
outcomes measurement
- A core assumption is that people cannot truly
be well if they cannot participate fully in their
lives. This is not just talking about the usual
occupations that they do, that they have to be
fully there. It also signifies the importance of
participation in how a person wants to set
goals, and what he wants to achieve and how
he wants to do the activities and how he wants
to achieve those goals. THE PERSON SHOULD
BE IN THE CENTER OF THE COLLABORATION
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ALONG WITH OTHER PROFESSIONALS AND
ALSO THE FAMILY.
- Occupational performance is the complex
interactions between the person and the
environments in which they carry out activities,
tasks and roles that are meaningful or required
of them. Its is determined not only by the
nature of the activity, task or role to be
performed, but also by the characteristics of
the person or client and the environment.
- (E.g.) I have my coffee mug right beside my
laptop right now, when I hold it
- and bring it to my mouth I'm drinking coffee,
thus I'm interacting with my mug by holding it
and bringing it to my mouth. The occupation
there is to drink my coffee, that's the activity.
The task would be bringing my hand to my
mouth. The relationship between all of that,
thats how you perform your occupation
(Occupational performance)
- It centers around occupational performance
and participation which is influenced by these
factors around them.
- Basically what we want to see is how well a
person does, or how satisfied he is doing. There
we have occupational performance and
participation in the beige circle. Around that is
the Occupation and Performance (how you do
it)
- Quality of life is the satisfaction of what you’re
doing in your life*
- Three factors:
o Intrinsic Factors (person): what the
person has
o Activities, Tasks, Roles (occupations of
importance): anything that the person
does, either usually or occasionally for
Occupation of importance
o Extrinsic Factors (Context,
Environment): affect the occupation
and how the person interacts with the
environment.
- All these things affect each other, we have to
identify which things hinder the person from
doing what he wants to do or which aspects
support and encourage the person to be able to
perform these occupations.
- All of this the person, the environment and the
occupation interact with each other, however
the main point of the PEOP model is that the
client should be active in the collaboration of
goals setting and intervention implementation.
Therefore he has to know what he wants to
achieve. Us OT’s are only helping him to make
steps for him to reach the goal he wants to
achieve.
Person (intrinsic factors)
Physiological
- strength, endurance, flexibility, inactivity,
stress, sleep, nutrition and health
- what happens in the body physically
- Not everything is good like Inactivity and stress,
that's not because we want to see the good
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DEPARTMENT of OCCUPATIONAL THERAPY
side only of the person, we also want to see
what his limits are so that we can enhance
those things and overcome those weaknesses
Cognitive
- organization, reasoning, attention, awareness,
executive function and memory, all necessary
for task performance
- (E.g.) When you're writing your notes, you have
to organize which one comes first, we have to
be attentive to know what i'm saying in this
lecture, you have to be aware of what's going
on around you
Neurobehavioral
- somatosensory, olfactory, gustatory, visual,
auditory, proprioceptive and tactile, as well as
motor control, motor planning (praxis) and
postural control
- what happens inside the brain that's translated
to the whole body. Neuro means brain and
behavior is how you react.
- we have to be able to function with these
senses for us to function and react with the
environment
Psychological and emotional
- emotional state (affect), self-concept, self-
esteem and sense of identity, self-efficacy and
theory of mind (social awareness)
- We want to know how a person feels with his
condition, we want to know how he feels if he
could still go back to work and do the things he
wanted to do
Spiritual
- that which brings meaning
- Why does the person do what he is doing. Why
am I drinking coffee, why are you listening to
me rn (wtf), why are you writing down your
notes.
Environment (extrinsic factors)
Social support
- practical support: when someone helps you
physically, when someone carries your bag, or
when someone cooks for you
- instrumental support: Indirect help, if you need
hospital services someone calls the hospital and
an ambulance comes to get you
- informational support: when someone tells you
about the coronavirus updates
Societal
- interpersonal relationships (groups), social and
economic systems and their receptivity (policies
and practices) to supporting participation, laws
- We have laws that we are aware of, and these
things that we have to follow or else there will
be consequences. These laws only don't
threaten us with consequences, it also
encourages that ppl will follow these
regulations so that there will be harmony in
society.
Cultural – values, beliefs, customs, use of time
Physical environment
- physical properties, tools, assistive technology,
design
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- Whatever you see, whatever material or item
your holding on, sitting on thats part of the
physical environment
Natural environment – geography, terrain, climate and
air
Application to practice
1. Situational analysis
- Seeks information from the client by interview
and by employing assessments that give the
practitioner a clear understanding of
constraints and/or barriers that may limit the
person’s activity and participation
- Occupational history: what the person has done
previously and how culture impacts on their
everyday life
- Client’s perception of current situation: what
the client thinks has happened, how the
situation is appraised, and what the client
knows about a likely course of intervention.
What the client knows about a likely course of
intervention. They also have to be aware of
how they can help themselves, before we let
them know what to do they must also know
what they think we can do.
- Client’s immediate and long-term goals:
formulate goals that not only will be achievable
but also will be meaningful. We have to know
what the client wants to do right now, and
what he wants to do in 6 months. This also
means that we know what to prioritize.
- Match between client goals and OT: NO MATCH
means the OT should make referrals to another
professional; MATCH means determine
capabilities, enablers, barriers and constraints.
There's only so much we can do as OT’s,
although there's a lot we can do there's a limit
to that. If our clients goals and our services
don't match then. Maybe we should make
referrals to other professionals, either others or
who can help him specifically sports, or hand
rehab. If there is a match we have to determine
the capabilities of the enabler or support in the
environment, the barriers and the constraints.
2. Selection of measures/assessments
- understand the person’s intrinsic and extrinsic
factors
- there are standardized and non-standardized
assessments used for OT wherein we can
identify specific client factors, skills and
performance patterns that are problematic and
that support occupation. We have to
understand person’s intrinsic and extrinsic
factors
3. Client-centered intervention plan
- review and share available interventions with
client so that they know what their options are
4. Intervention implementation
- promote health, prevent complications,
compensation of lost skills, education,
modification, adaptation
- Educate about condition about the progress,
about how long its gonna take and education to
the other environmental aspects.
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- Educate employer/family of changes of our
clients performance
5. Outcome of the plan
- measure outcomes to know effectiveness of
intervention also to identify if there is progress
in the client to know if they have plateaued,
maybe no more improvements, so we can
change our plan again.
- We can tweak some intervention plans if the
client is not ready for discharge, to fit their
changing needs.
Person-Environment-Occupation (PEO)
Ecology of Human Performance by Winnie Dunn
Ecology
- occupational performance as the outcome of
the relationship of the persons with their
occupations in the environments.
- It’s almost the same as the PEOP , it's just that
the PEOP emphasizes the importance of
collaborating with the client, not only with the
client but the client and all the other
professionals involved. Although for PEO that's
also essential so that all members of the multi
disciplinary team are aware of what each of
you are doing
- The positioning of the circles show you how
content and satisfied a person is with what he
or she is doing.
- Occupational performance is the interaction
between all these three, when a person
interacts with the environment and does his
occupation well enough it's not only how well
he does it physically but also the satisfaction
and the sense of achievement that the person
gets when he is able to perform something or
anything.
- The one in the middle is what we call the fit and
how much each of the elements fit into each
other.
o Person: the things that comprise the
performance skills, performance
patterns, subjective information and
we also have the client factors.
o Environment: physical, natural social
and context.
o Occupation: Anything that you want to
do, anything that you like to do.
Anything that has meaning.
- The difference of 2 Venn diagrams is the size of
what is in the middle. How big the intersection
in the middle. It translates to how much of a fit
there is in the occupational performance of the
individual. How much satisfaction there is, how
much happiness there is that a person can do
her job.
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- Big space in the middle = good fit + good
harmony between all elements
- PEO is generic and is easily explainable to
clients and their families and to other related
professionals as well because you're going to
use those three circles and illustrate the
importance of each
- Reasonable Accommodation is when we give
modifications or accommodations to the
worker with disability or with a physical or
mental condition wherein we adjust not the
person but. the occupation or environment.
Anything that doesn't require too much
spending on the part of the employer is a
reasonable accommodation.
- the interaction between person and
environment
- The previous frameworks or models also focus
on these things, but for EHP the CONTEXT is the
main issue
- CONTEXT is a lens from which a person see the
world, this is as you learned in you
- previous concepts we have the virtual context,
temporal context. It is how a person
experiences those things around him. Although
we have similar experiences, similar
environments how we see those experiences
ARE DIFFERENT FROM ONE ANOTHER.
- (E.G.) When you’re talking to a baby, it’s very
different compared to when you're talking to
an adult. Because you're basing your behaviour
on the context, you're basing your behaviour
on the situation.
- (E.G.) How you dress when you go to the mall.
When you are going grocery shopping, it’s very
different when youre going to the wet market.
Do you dress the same in the mall grocery or
wet market??
- Our behaviour is affected by how we
experience our environment, and we then act
accordingly and our occupations are still the
same however there are changes in the task.
- This is one of the illustrations of the EHP, it
consists of the person, the context (the circle
with oblong in the middle) and the task (which
are the small circles outside) and the
performance.
- A person is surrounded by the context, which
will be used like a lens like eyes for this
framework and that is how we can relate the
person’s behaviour towards the task and the
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performance in that task or activity or
occupation.
- If we base this illustration on the previous one
you will remember that the man in the picture
is the person, the circle with oblong is the
context and the circles with small T is the task.
- The dark blue beam in the diagram signifies the
skills that a person uses for him to be able to do
the tasks. So if you pass light through a
magnifying glass, the light gets more
concentrated and gets diverted in another
form. This is very similar to using a magnifying
glass, the light that goes in are a person’s
SKILLS and the light that goes out are HOW YOU
PERFORM ON THE TASKS.
- Context is like the lens of the eyes or the
magnifying glass that will depend on the skills
you will use to perform the task
- (E.g.) if you see the red light, the red light is the
context or environment. What you do is you
stop, the task there is to stop and the skills you
need to do is to be aware and stop walking, and
look at surroundings.
- What that means is the context interacts with
the skills to enable persons to perform tasks.
Similarly we simply need to identify our roles as
individuals to guide us and let us know what
our tasks should be in the role.
- (E.g.) if the person is me, I'm a daughter and
the task include taking care of my parents, and
doing dishes and making sure my family is
healthy and another role of mine is a teacher,
that includes educating my students,
interacting and socializing with my students
and colleagues and other thing is a volunteer.
As a volunteer, I'm also supposed to do
different tasks.
- The tasks that are related in the illustration,
each role may share different tasks but they
may be differently seen by the individual, they
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may be differently experienced by the
individual.
- This is similar to the first illustration, with the
dark blue beam. However this one signifies
limited skills, and the same context. Compare
this to the other one, the earlier one had a
bigger darker blue beam. The blue beam
signifies THE SKILL.
- The person has the same context, is in the
same context, but he doesn't have enough skill
he might not be able to perform the tasks at
hand.
- (E.g.) If it is your first time skiing, you go in the
mountain with ice, however you don't know
how to ski the limitation in your skill even if the
context is there, the skiing shoes and jacket and
goggles and everything is there for the context.
Your performance will still be limited according
to how you perform the task
- “WITH LIMITED SKILL AND THE SAME CONTEXT,
THE PERFORMANCE WILL ALSO BE LIMITED”
- This is the opposite, SAME SKILL BUT LIMITED
CONTEXT SO PERFORMANCE WILL ALSO BE
LIMITED
- (E.g) you’re a chef you cook well, you taste
well, but the kitchen you go into cooking only
has charcoal, no stove, you have very limited
ingredients. If your context is limited, your
performance will also be limited according to
what's available. You're gonna see the
experience differently and react according to
how you experience the situation .
IF you compare the three:
- A: There is a supportive context, and you also
have enough skill which means your
performance in doing those tasks is also
efficient
- B: There is enough skill, but less context so the
task you will be able to do are fewer, probably
not fewer but less efficient, less effective. This
may even have less meaning for you.
- C: There is enough environment, but there is
little skill that would also affect the
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performance, also there is a limit to what you
can do.
- You're basing your skills and your context on
how you perform your occupations and your
task, and your activities.
- (E.g.) If you're working in a home for the aged,
by giving stimulating activities such as bingo or
field trips you're creating opportunities for the
old people to interact with each other, and
reminisce their previous memories.

Applications for approaches

Establish/Restore Diagram for approaches of OT
- it’s improving client skills and abilities, or re
establishing the client’s role.
- (E.g) a client has muscle weakness, for him to
be able to do the things that he needs to do,
you have to strengthen, so you’re going to
restore skills he previously can do so that he
can perform his occupations again.
Alter
- You place the client in an entirely different
setting.
- (E.g.) A worker gets an injury and he isn’t able
to do the same job anymore. After evaluation
you realize that it is better to place him in 1. Establish and restore - target is the person, change
another area of work where in they don't have skills of person.
to change anything, rather than put him back in 2. Alter - change the whole context even if they have
the previous job where there are so many to do the same job
things that have to be modified. Placing client 3. Adapt - We can change elements of the context and
in a totally different setting, in a different the task for the person to find the task easier to
context. perform
Adapt 4. Prevent - you can either make interventions for the
- This is designing a more supportive context, person for the context or for the task
your putting the person back in the previous 5. Create - we’re making interventions for tasks and
job, but there are modifications in the job. for contexts.
- (E.g.) You're moving the furniture away so his
wheelchair can pass through, or put ramps, or Kawa Model by Micheal Iwama
talk to the supervisor to lessen work schedule. - Each person has his own personal river (life
Changing tasks or environment. journey, flowing through time and space)
Prevent - The river’s spaces represent opportunities to
- Preventing occurrence of maladaptive problem-solve and to focus intervention on
performance. We change the course of events positive opportunities, which may have little
to enable functional performance. direct relation to the person’s medically
- (E.g.) when you started on velez you were defined condition
under orientation by the guidance. So that is
better than not having orientation, but when Elements of the River
you do something wrong you're gonna be Water (mizu): the individual's life energy or life flow
punished. It’s like preventing the occurrence of River side-wall (kawa no seku-heki) and River bottom
being punished by giving you an orientation. (kawa no zoko): the client’s environment
- (E.g.) If you’re running, it's better to stretch Rocks (iwa): discrete circumstances that are considered
before to prevent injury rather than run right to be impediments to one’s life flow
away and fix an injury after ward. Preventing Driftwood (ryuboku): the subjects personal attributes
occurrence of something wrong that's gonna and resources
happen Gaps between obstructions (sukima): the points
Create through which the client’s life energy (water) evidently
- Our role here is to enrich contextual and tactic flows, and these spaces represent ‘occupation’
experiences by providing opportunities, so
these circumstances we don't presume
disability we don’t prevent disability it's more
like creating opportunities for people to be
better even if they don't have disabilities.
- (E.g.) Working in a community and there are
children in the community, you make programs
such as enhance learning or skill building so
that you are going to help in the development
of the children. Enhancing what they already
have.

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Theory, Models, FORs, MOHO short quiz
1. These are part played by persons that hold their
positions in social groups but also the behavior
expected depends on their statuses. Roles
2. This is responsible for consciously choosing
participation in occupations. Volition
3. It is an individual’s personal knowledge of self as a
cause who creates observable change in
environment. Personal Causation
4. This is the persons ability to be aware of time.
Temporal orientation
5. The degree to which a person is able to change
routines of behavior to accommodate interrupted
incidents. Flexibility and Rigidity
6. It is the lowest level of occupational function that
involves curious investigation of oneself and one’s
potential for action in combination with the
properties of the environment. Exploration
7. The following are levels of occupational
dysfunction, except: Incumbency
8. It serves as a guiding theory that can be used to
understand the complexities of a certain individuals
situation. Models
9. Kielhofner stated that this should be viewed as a
network of explanations that label and describe
phenomena and propositions that specify
relationships between concepts. Theory
10. Theoretical or conceptual ideas that have been
developed outside the profession but which, with
judicious use, are applicable within occupational
therapy practice. FORs
11. The functional end of continuum represents, what
the therapist expects a client to be able to do,
whereas the dysfunctional end of the continuum
represents disabilities. True
12. The assessment tool used to assess for the
occupational functioning for MOHO role change
assessment. False
13. An individual give output to the environment and
receives feedback from it by input. From the
feedback, the individual experience throughput,
which is the process of change and adaptation.
True
14. A person with dysfunctional behavior patterns
experience a basic quality of life and meet personal
and societal expectation. False
15. Postulates regarding change guides therapist about
changes seen after applying the action. True
Theory, Models, FORs, MOHO long exam
1. MOHO focuses on systemic, holistic approach for
invidivual’s varying needs and shows the
importance of mind and body connection of how
motivation and performance of occupations are not
connected. False
2. Adaptive cycles result in a state of occupational
function; on the other hand maladaptive cycles
result in a state of occupational dysfunction. True
3. According to Kielhofner, theories should be viewed
as a network of explanations that label and
describe phenomena and propositions that specify
relationships between concepts. True
4. Disorder is the inability to perform occupations, an
interruption in role performance. False
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5. In getting the client in moving toward the regular
performance of desired occupational behaviors,
therapist should let the client make choices with
your advice. False
6. Practice models are occupation-focused that
theoretically constructs and propositions that have
been developed specifically to explain the process
and practice of occupational therapy. True
7. Individuals that are dysfunctional are
occupationally dysfunctional when societal
demands for productive and playful participation
are not met or the individual’s behavior does not
fulfill the urge to explore and master. True
8. Every frame of reference consist of one function-
dysfunction continua each. False
9. MOHO provides specific occupationally focused
outcomes measures to measure occupational
participation True
10. Occupational therapy's development has been
shaped by the influence of a variety of external
philosophical influences. True
11. Our interests, values and personal causation affect
what everyday activity we are motivated to do,
what activities we choose to engage in and how we
experience doing them. True
12. Professions exist in isolation and are therefore
open to influence from the pressures and prevailing
norms of other professional groups and the
environment in which they do not exist. False
13. MOHO emphasizes that volition is also central to
occupational therapy since the therapy process
requires clients to make choices to do things. True
14. Learning a new role involves internalizing an
identity, an outlook, and an expected way of
behaving. True
15. The environment includes the particular physical,
social, cultural, economic, and political features
within a person’s context that influence the
motivation, organization, and performance of
occupation. True
16. This refers to the demand of growth and change by
external forces or for external rewards. Extrinsic
Motivation
17. This is affected by the status of one’s
musculoskeletal,neurological, cardiopulmonary,
and other bodily systems. Performance capacity
18. It is the highest subsystem in MOHO. Volition
19. The MOHO asserts the following, except:
• Persons and their environments are inextricably
linked in a constantly unfolding dynamic
• What a person does in daily life results from
the interplay of the persons inner
characteristics
• A persons inner capacities, motives, abilities
and routine ways of doing things are shaped,
maintained through engaging in occupations
• NOTA
20. It is defined as a symbolic representation of
concepts or variables and interrelationships among
them. Models
21. This serves as the baseline of the intervention.
Evaluation
22. The concepts of MOHO are the following except:
• The motivation for occupation
 V E L E Z C O L L E G E
DEPARTMENT of OCCUPATIONAL THERAPY
• The routine patterning of occupational
performance
• The influence of environment on occupation
• NOTA
23. The worker who has a stroke and subsequently
loses his job, the mother whose mental illness
interferes with parenting her child, the child whose
learning disability makes it difficult to do as well in
school as he thinks he should, and the elderly
person whose fear of falling are all examples of
persons who are unable to enact their. Interest
24. If one has a broken arm and one's dominant hand is
in a cast, simple things like turning on the shower,
brushing one's teeth or putting on clothes take a lot
more thinking and effort or may be impossible,
what part might be disrupted? Habits
25. This refers to the process by which people organize
their occupational performance into the recurrent
patterns of behaviour. Habituation
26. Persons with depression may find that they no
longer enjoy doing what was previously
pleasurable. What is affected? Interest
27. Ecology of human occupation, MOHO and CMOP-E
are examples of. Models
28. Engagement in work, play, or activities of daily
living that are part of one’s sociocultural context
and that are desired and/or necessary to one’s
well-being. Occupational participation
29. Clients’ doing, thinking, and feeling under certain
environmental conditions in the midst of or as a
planned consequence of therapy. Occupational
engagement
30. Constructing a positive occupational identity and
achieving occupational competence over time in
the context of one’s environment. Occupational
adaptation
Occupational Adaptation Long Exam
1. One of the guiding assumptions about the
relationship between occupational performance
and adaptation is the greater level of dysfunction,
the lesser demand for changes in the person’s
adaptive processes. False
2. In occupational adaptation model an individual is
considered to be functional if the individual is able
to adapt to life’s challenges and changes. When
demand for performance exceeds person’s ability
to adapt, dysfunction may occur. True
3. A balance between the desire and demand for
mastery could lead to inability to adapt to an
occupational challenge, therefore dysfunction may
occur. False
4. The goal of occupational therapists is not the help
the client adapt but to help the client become
adaptive. True
5. Occupational response is the behavior or action
that the individual carries out in response to an
occupational challenge. True
6. A person functions well because the person's ability
to adapt has been challenged to the point at which
the demands of performance are not met
satisfactorily. False
7. Clients are more inclined to discover their own
ability to adapt when they are challenged within
the occupational activities, most especially if
16
OT 201 – Foundations for OT – Theories,
Models, FORs, and Approaches
activities that are meaningful to them and that has
a beginning and an end, that is process oriented,
and have an end-product. True
8. Occupational Therapy has the assumption that as
clients become more functional, they will be more
adaptive. On the other hand, Occupational
adaptation is opposite to that assumption, that if
clients become more adaptive they will become
more adaptive, they will become more
dysfunctional. False
9. In evaluating intervention outcomes, OT’s must be
aware of how well the program is affecting the
client’s occupational adaptation response. True
10. It is the overall context within which the person
engages in the particular occupation and
occupational role. Occupational Environment
11. It is one of the type of occupational environment
that is referred to as the participants within the
occupational environment. Social Influences
12. These are patterns or strategies that the individual
has learned through life experiences. Adaptive
response modes
13. The following are the roles of OT in group
application for occupational adaptation, except:
a. Participant
b. Guide
c. Communicator
14. It is where a person generates a response to the
occupational challenge being presented and to the
following occupational role expectations. Adaptive
response generation subprocess
15. Ms. Anna, an occupational therapist, is conducting
a group intervention in a Psychiatric facility. During
their session, the OT allowed the clients to choose
their activity with her guidance. What is the OT’s
role in the intervention? Facilitator
16. It is a personal assessment of the individual by how
well they feel their occupational response met the
occupational change. Relative mastery
17. This gives way to occupational challenges and in
turn occupational challenges suggests or demands
occupational role expectations. Press for mastery
18. It is the final subprocess in which leads to the
integration of the person’s actions towards the
occupational challenge. Adaptive response
integration subprocess
19. The following are the assessment tools that can be
used under occupational adaptation, except:
a. Coping inventory
b. Role Checklist
c. Occupational self-assessment
20. It is believed to seek adaptation and mastery in the
environment and is considered to be an innate
human condition. Person