PEO/MOHO

PEO Model is based on

• MOHO

• Ecological Systems Model

  • person is constantly interacting with environment and impacts how they develop and what they do

• Humanists Carl Rogers & Abraham Maslow

  • for a person to be self-actualized, need to have support of environment

  • every person has inherent want to grow

• Client-Centered Modek

• Lawton’s Environmental Press Theory (1973)

  • environment places demands on a person, person tries to meet demands of environment

  • experience stress to help them adapt

• Flow Theories of Occupational Engagement

  • person feels flow when they are completely engaged in an activity (lose track of time, experience is rewarding)

In PEO model, a good fit…

large overlap between person, activity, and environment indicating a good occupational performance

In PEO model, what is meant by it being temporal?

Occupational fit changes over time

Components of PEO

• person

• environment

• occupations

Person

• dynamic with multiple roles and unique skills/attributes (physical, cognitive, affective)

Environment

• physical

• social

• cultural

• socioeconomic

• institutional context

Occupations

• purposeful and meaningful to fulfill needs and are broken down into activities and tasks

• Activities: parts of tasks

• Tasks: components of occupations

What is the output in PEO?

Occupational Performance

• when we have good overlap, have a good occupational performance

Occupational performance is measured through

• competence

• satisfaction

Competence

ability to do something that his observed to be well or doing it well

Satisfaction

internal construct and how the person feels about their performance

Dysfunction

when any part of model is incongruent

Intervention Principles of PEO

• Occupational challenge: based on meaningful occupation

• Occupational enablement: focus on activity to enable occupational engagement

• Client-Centered: goals and solutions that are specific to unique situation

How are interventions made in regards to PEO?

• by examining complex interaction between all 3 components

• need to be flexible as fit changes over time

MOHO is

• evidence-based

• client-centered

• holistic

MOHO is based on Dynamic Systems theory which says

• to understand client and situation, you need to understand the many systems that influence the complex situation

MOHO helps us to understand individual’s

• occupational participation

• impact of disease, illness, and disability

• how OT can facilitate individuals, participation, their identity, and their competence

4 Pillars (Components)

• Volition

• Habituation

• Performance Capacity

• Environment

Volition

• patterns of thoughts and feelings about oneself as an actor in the world which help us to anticipate, choose, experience, and interpret what one does

  • personal causation

  • values

  • interests

Personal causation

• idea that we can influence the environment around us

  • allows us to feel successful, and have good self-efficacy

Values

• what is meaningful to us, desirable, important based on our culture, based on our sense of obligation

Interests

• activities that bring enjoyment and satisfaction to

  • bring us happiness

T or F? Past experiences influence volition

T

T or F? Volition helps us to determine what we choose to do now and in the future

T

Habituation

• idea of consistency in our behaviors through our habits and our routines and the roles we fill

  • habits and routines

  • roles

Habits and Routines

• time use, schedule in the morning, getting dressed

• habits of style: personal characteristics (ex. procrastinator)

Roles

• socially constructed and define who we are

Performance Capacity

• objective

• subjective

Objective

• measure underlying physical, mental, and emotional abilities influencing a person’s ability to do a skill or perform an occupation

Subjective

• person’s lived experience

  • how they think they are doing with the task

  • if they feel like they can → increases self efficacy and impacts volition

Environment

• physical, social, occupational, economical, political, cultural

• can’t separate human from environment

• can hinder or support

3 Underlying Principles

1. Actions, Thoughts, Emotions Result from Interaction

2. Perturbation in Constructs lead to Change

3. Person=specific Constructs influenced by Doing

Actions, Thoughts, Emotions Result from Interaction

• interaction of 4 components leads to a process of change

• as a result, people develop new thoughts, emotions, and activities and leads to a occupational shift

• Occupational shift → change in occupational performance/participation

Perturbation in Constructs Lead to Change

• can be internal or external

• ex. if environment changes, other constructs can change

Person-specific Construct Influenced by Doing

• we maintain the 4 constructs through doing and reflecting on doing

• as long as our thoughts, feelings, and actions are consistent with a supportive environment, we can maintain occupational engagement

As a person’s volition, habituation, and performance capacity interact with the environment, an occupational _____ occurs

shift

In response to the occupational shift, person seeks occupational identity and occupational competence which in turn, results in

adaptation

Levels of Doing: how people engage in activiites

• Occupational Skills

• Occupational Performance

• Occupational Participation

Occupational Skills

• observable and gold directed and are the direct result of person performance capacity

• are the motor, process, and communication skills

Occupational performance

• series of steps or discrete activities that are based on individuals volition and habituation

Occupational participation

• result of a contextually bound occupation in alignment with someone’s roles

Ex. of role of mother

• Participation - role as mother

• Performance - getting kids ready for school

• Skills - driving them to school

Outcome of MOHO

• person has occupational identity and occupational competence

Occupational identity

• influenced by how individuals view themselves within social contexts

Occupational competence

• evaluation of individuals performance in meaningful occupations

Occupational adaptation

• meeting personal needs and desires (identity)

• meeting reasonable expectations (competence)

Occupational adaptation is an

• internal process that is always changing

• doesn’t reach a peak

Order

• able to engage in occupations that are meaningful and fulfill identity AND also meet demands of sociocultural environment

Disorder

• unable to engage in occupations

How does change occur?

• can be negative or positive

• is inevitable

  • past experiences

  • disruption in equilibrium

  • therapeutic relationship

  • perturbation from environment

Exploration

• experiment to discover about self

  • in a safe environment

Competence

• looking to meet demands, learning process for self

  • help meet demands and provide support and increase expectations

Achievement of identity and competence

• gain greater competence and apply to everyday life