guiding theories, models, and frames

What are theories?

• A theory specifies how concepts or factors are related and gives a name to a set of elements that share something in common

• They are an effort to

  • Explain a particular phenomena or process

  • Organize information about that phenomena

Why are theories used in OT process?

• To help OTs clarify and evaluate assumptions and propositions

• Help us clarify and ground our assumptions into something bigger than ourselves

What is an assumption?

An idea we believe to be true

What is a proposition?

A statement about the nature of relationships among features of the world

Process of Theory Development

• As the body of knowledge around a problem or set of problems increases, it may be that the current explanations for intervention do not adequately explain the clinical problems anymore

• Sometimes we need to look at problems differently, or sometimes we have new problems entirely

Who authored the Model of Human Occupation?

Gary KielhofnerW

When was the Model of Human Occupation developed?

1980s

What is the Model of Human Occupation (MOHO)?

An occupation-focused model, and the most used in OT practice

• Return from medical focused to human centered

• Involves patients in a very specific way

What does the MOHO focus on?

• Focuses on determining what the client would like to do as their occupation and defining an assessment and treatment plan focused on that occupation

• Written as a response to the impairment-oriented approach, which focuses solely on fixing the impairment without a specific occupational goal

• Patterns of performance and skills are maintained and changed through engagement in occupation

What are the 3 interacting elements of MOHO?

• Volition

• Habituation

• Performance Capacity

MOHO: Volition

The process by which people are motivated to choose what activities they do

MOHO: Habituation

Process by which people organize their actions into patterns and routines

MOHO: Performance Capacity

A person’s underlying mental and physical capabilities and how they are used in occupational performance

OTs role in MOHO

OTs support client engagement in order to shape the client’s choices, routines, and skills

Ecological Models

• A group of models published in the 1990s

• Influenced by the civil rights movement

What do the ecological models emphasize?

• Environment as a barrier and facilitator of occupational performance

• Client-centered practice

Components of Ecological Models

• Person

• Environment

• Tasks

• Occupations

• Occupational Performance

EM: Person

• An individual

• Variables associated with a person are values, interests, skill, and abilities

EM: Environment

• Where occupational performance takes place

• Consists of physical, cultural, and social characteristics

EM: Tasks

• Objective representations of all possible activities available in the universe

• Purposeful activities

EM: Occupations

Self directed tasks that a person engages within their lives

EM: Occupational Performance

The outcome associated with the confluence of the person, environment, and occupation factors

Key Point of Ecological Models

Ecological Models are interrelated and focus on dynamic interaction of the Person, Environment, and the Occupation/Task

• Ex: If environment changes, person or occupation (or both) must change to keep center overlap intact

Who developed Theory of Occupational Adaptation?

Dr Janette Schkade, Dr Sally Schultz, and several faculty members at Texas Woman’s University in 1987

Key Concept of Theory of Occupational Adaptation

Development through a press for mastery

• Every person has an innate need and desire to master occupation - it’s the mechanism that drives participation, and people will continually adapt to achieve mastery

OA Components

• Person

• Occupational Environment

• Occupational Participation

• Press for Mastery

OA: Person

A being with a desire to master occupations

OA: Occupational Environment

Settings that influence occupational performance and present a demand for mastery

OA: Occupational Participation

Mechanism that leads to increased Occupational Adaptation

OA: Press for Mastery

All of the concepts manifest this

Who developed the Kawa Model

Dr. Michael Iwama in 2006

What did the Kawa model seek to do?

Create a culturally safe and relevant model of practice that was easily understood and used by OTs with diverse clientele

Why is the Kawa model important to OT history?

It’s one of the first models of OT made outside of the western English-speaking world, bringing cultural diversity into the profession

Components of the Kawa model

• Water

• Driftwood

• Rocks

• River walls

Kawa: Water

Represents life flow and health

Kawa: Driftwood

Represents personal factors (both assets and liabilities)K

Kawa: Rocks

Represent difficulties and challenges

Kawa: River Walls

Represents the environment

Who developed the Model of Occupational Wholeness?

Farzaneh Yazdani and Tore Bonsaksen in 2016

Where does the Model of Occupational Wholeness stem from

The interrelated concepts of being, becoming, and belonging

Model of Occupational Wholeness

Being + Belonging + Becoming = Doing

• DOING meaningful occupations allows individuals to feel a sense of becoming, belonging, and being

• the act of doing promotes being, belonging, and becoming, encouraging harmony

• These relationships are all interconnected through the Triangle of Human Wholeness

• Can be applied to all populations

Who developed the Recovery Model?

Patricia Deegan, who defined the term “recovery” in 1996

What does the term Recovery describe?

Describes the idea that people who experience illness, specifically mental illness, can still live rich and meaningful lives and engage in their occupations to create life purpose

What are the four dimensions from the Substance Abuse and Mental Health Services Administration (SAMHSA)?

• Health

• Home

• Purpose

• Communtiy

RM: Health

Overcoming or managing one’s diseases or symptoms

RM: Home

Having a stable and safe place to live

RM: Purpose

Having daily activities that bring meaning and purpose to one’s life

RM: Community

Being surrounded by supportive family and friends

Components of Recovery

• Hope

• Holistic

• Person-centered

• Empowerment

• Self-direction

• Non-linear

• Strengths-based

• Peer support

• Responsibility

• Respect