Occupational Therapy Models, Cognitive Approaches, and Mental Health Recovery

Comprehensive vocabulary flashcards covering the KAWA model, Model of Human Occupation (MOHO), cognitive models (Remedial, Functional, Multicontextual, Allen Cognitive Disabilities, Cog-Fun, CO-OP), and Mental Health Recovery frameworks.

KAWA Model

A culturally sensitive, holistic occupational therapy model developed by Dr. Michael Iwama, PhD, OTC, in Japan outside the Western/English-speaking framework that uses the metaphor of a river to explore client contexts and guide collaborative intervention.

Culture (KAWA Model)

A dynamic, continuous process of shared experiences and common spheres of meaning situated at the intersection of person, occupation, and environment.

Mizu (Water)

The component of the KAWA model representing the flow of life, life course, and overall well-being, flowing from birth to the end of life (depicted as release into the ocean).

Kawa no soku-heki / Kawa no zoko (Riverbanks)

The structural component of the KAWA model representing the environment and natural context (social, physical, and economic factors) that bound and guide the river's flow.

Iwa (Rocks)

Discrete functional barriers and difficult life circumstances impeding flow in the KAWA model (e.g., acute/chronic illness, injury, disability, congenital conditions, trauma) that can be moved, transformed, or eroded over time.

Ryu-boku (Driftwood)

Personal assets and resources supporting resilience (e.g., strengths, practical skills, training, personal values, material/financial resources) that exert dual effects by either clearing obstacles to aid flow or wedging against rocks to hinder it.

Sukima (Spaces Between Rocks)

Critical channels for growth, therapeutic change, and alternative pathways to occupational goals targeted during KAWA-based interventions.

Turbulence (KAWA Model)

Metaphorical river dynamic representing life crises, conflict, and acute disruptions to smooth life flow.

Model of Human Occupation (MOHO)

An occupation-based open system model founded by Dr. Gary Kielhofner asserting that impairment reduction alone does not restore occupational engagement, and that daily routines, physical/social environmental factors, and personal meaning are equally critical.

Volition

The person-level subsystem in MOHO representing motivation for occupation, comprising personal causation, values, and interests.

Personal Causation

A component of MOHO's volition subsystem defined as an awareness of personal capacity, self-efficacy, and perceived effectiveness (confidence vs. anxiety).

Values (MOHO)

A volitional component encompassing core personal convictions, standards, and priorities that determine what an individual finds meaningful.

Interests (MOHO)

A volitional component consisting of pleasurable, satisfying, and engaging activities.

Habituation

The person-level subsystem in MOHO responsible for structuring patterns and routines through habits and roles.

Habits (MOHO)

Automatic, repeated behavioral tendencies triggered by familiar environmental cues.

Roles (MOHO)

Socially or personally defined statuses accompanied by obligations, behavioral expectations, and identities (e.g., student, parent, worker).

Performance Capacity

The underlying mental and physical capacities (neurological, musculoskeletal, cardiopulmonary) in MOHO, encompassing both objective physiological capability and subjective lived bodily experience.

Occupational Participation

The broadest dimension of doing in MOHO, defined as engaging in major life areas within a sociocultural context (e.g., being a university student, homemaker, athlete).

Occupational Performance

The intermediate dimension of doing in MOHO, defined as executing specific discrete tasks or task clusters (e.g., studying for an exam, cooking a meal, driving a car).

Occupational Skill

The most granular dimension of doing in MOHO, defined as observable, goal-directed units of motor, process, or communication/interaction actions.

Occupational Adaptation

The product of constructing an Occupational Identity (internal sense of occupational self) reinforced by Occupational Competence (sustained execution of that identity over time).

Functional Cognition

The dynamic interaction among task demands, contextual environment, cognitive capacities, and actual performance, serving as a primary boundary separating OT from language-focused SLP.

Remedial Approach

A cognitive intervention approach that seeks biological recovery or reorganization of impaired cognitive-perceptual skills via neuroplasticity through routine, structured deficit practice.

Functional (Compensatory / Neurofunctional) Approach

A cognitive intervention approach that reduces activity limitations and participation restrictions by capitalizing on existing assets and residual skills without requiring neurological recovery.

Task-Specific / Errorless Learning

A compensatory cognitive strategy that trains an exact sequential routine without permitting error encoding (e.g., operating a specific coffee maker, executing a 5Bs transfer routine).

Multicontextual Approach

A metacognitive strategy training approach grounded in Joan Toglia's Dynamic Interactional Model (DIM) that uses internal and external strategies across a horizontal transfer continuum.

Dynamic Interactional Model (DIM)

Joan Toglia's theoretical model viewing cognitive performance as an ongoing, dynamic interaction between personal factors, environmental context, and activity demands.

Horizontal Transfer Continuum (Gradient of Generalization)

A metacognitive framework that systematically varies task similarity (Very Similar, Somewhat Similar, Different, Very Different) while keeping underlying cognitive strategies invariant.

Cognitive Disabilities Model

Claudia Allen's practice model premised on the concept that functional limitations stem directly from biological brain impairment caused by disease, trauma, illness, severe stress, or fatigue.

Global Cognition

In Claudia Allen's model, the integrated functioning of all brain processes that dictates overall behavior and occupational performance.

Level I: Automatic Actions

Allen Cognitive Level characterized by reflexive, automatic, or subconscious motor actions and basic protective reflexes, requiring 24-hour skilled nursing care.

Level II: Postural Actions

Allen Cognitive Level characterized by gross motor posturing in response to internal proprioceptive cues, spatial disorientation, and active resistance to care, requiring 24-hour supervision.

Level III: Manual Actions

Allen Cognitive Level characterized by repetitive motor actions elicited through tactile contact with tangible objects, requiring tactile/verbal cues and 24-hour supervision to manage safety.

Level IV: Goal-Directed Actions

Allen Cognitive Level characterized by purposeful actions guided by visible cues and physical samples, where individuals recognize overt errors but cannot anticipate hazards or generalize.

Level V: Exploratory Actions

Allen Cognitive Level characterized by overt trial-and-error problem-solving and fine motor adjustments, where basic ADLs are intact but IADL planning and future error anticipation are impaired.

Cognitive-Functional (Cog-Fun) Model

An intervention model originally formulated for pediatric ADHD that improves occupational participation by reconciling internal executive strategies with external environmental resources across four core principles.

Cognitive Orientation to Daily Occupational Performance (CO-OP)

A performance-based intervention model originally developed for children with Developmental Coordination Disorder (DCD) that uses cognition as an active mediator bridging underlying ability and motor performance.

Global Problem-Solving Framework (CO-OP)

The overarching cognitive strategy in CO-OP represented by the sequence $\text{GOAL} \rightarrow \text{PLAN} \rightarrow \text{DO} \rightarrow \text{CHECK} \rightarrow \text{REPEAT}$.

Guided Discovery

A core feature of the CO-OP model wherein the therapist coaches, hints, and questions instead of directly providing answers to allow client-driven problem solving.

Dynamic Performance Analysis (DPA)

A key assessment feature of CO-OP involving direct observation to pinpoint performance breakdowns across the person, task, and environment.

Personal Recovery

A highly individualistic, self-defined personal life journey focusing on living a hopeful, satisfying, and contributing life, even with ongoing limitations from mental illness.

Clinical (Medical) Recovery

Mental health recovery defined by symptom reduction, remission, or cure, judged by healthcare providers as an endpoint or baseline.

SAMHSA's 4 Dimensions of Recovery

The four major support dimensions of recovery comprising Health (managing symptoms), Home (stable living), Purpose (meaningful daily activities), and Community (relationships and social networks).

Slade Task Model

A recovery framework outlining four core tasks: developing a positive identity, framing the mental illness, self-managing the illness, and developing valued social roles.

Six-Stage Model of Recovery

A developmental framework formulated by the Recovery Advisory Group encompassing Anguish, Awakening, Insight, Action planning, Determined commitment to become well, and Well-being and empowerment.