Models of Practice & Frames of Reference

Model of Human Occupation (MOHO)

• Occupation is context dependent

• Volition

• Habituation (roles + patterns of behavior)

• Performance capacity (physical + mental skills)

• Environment (physical + social)

Person - Environment - Occupation Model (PEO)

• Occupation is dynamic

• P + E + O = occupational performance

Lifestyle Performance Model

• match environment & individual needs

• 4 hypotheses

  • competence in socially significant activities inc social efficacy

  • Activities have reality and symbolic meanings that effect motivation/experience

  • mastery/competence more easily achieved in activities that match a persons neurobiological and psychological structure and are more easily seen in the end product/outcome of an activity

• Performance made of

  • self care and maintenance

  • intrinsic gratification

  • social contribution

  • reciprocal relationships

Ecology of Human Performance Model (EHP)

• Context (cultural, physical, and social env.) impact task performance

• Ecology = interaction between person + env

• person - context - task interactions

Occupational Adaptation

• Person occupation environment + interaction btwn the two

• Desire to participate in occupation in driving force behind adaptation

Role Acquisition Frame of Reference

• Use tasks and social skills to meet demands of personally desired roles

Cognitive Disability Frame of Reference

• Cognitive ability determined by biological factors

• Cognitive Performance Levels

  • Level 1: Automatic Actions

    • automatic motor responses and changes in autonomic nervous system

    • conscious response to external environment is minimal

  • Level 2: Postural Actions

    • movements associated with comfort

    • some awareness of large objects, may assist caregiver with simple tasks

  • Level 3: Manual Actions

    • beginning to use hands to manipulate objects

    • can perform limited # tasks with long term repetitive training

  • Level 4: Goal Directed Actions

    • perform simple tasks to completion

    • reliant on visual cues, cannot cope with unexpected events

  • Level 5: Exploratory Actions

    • overt trial and error problem solving

    • New learning occurs

  • Level 6: Planned Actions

    • absence of disability, can do mental trial and error problem solving when thinking of actions

Cognitive Behavioral Therapy (CBT)

• Works to alter negative thought patterns by correcting misinterpretations of life events (cognitive restructuring)

• Development of insight is necessary for growth and change (changing the way a person thinks can reduce symptoms and thinking can be self regulated)