Ch 17 lecture

Overview of Theories, Models, and Frames of Reference in Occupational Therapy

Introduction to Terms and Concepts

  • Occupational therapy incorporates various terms: models, frames of reference, theories.
  • Each term has a distinct definition; however, they all guide treatment.
  • Importance of understanding these terms in practice to improve patient outcomes.

The MOHO Framework

  • Model of Human Occupation (MOHO): Developed by Gary Kielhofner
    • Focus on key systems within MOHO, particularly Volition.
    • Volition: Patient motivation is central in guiding therapy.
  • Understanding this model is critical for effective treatment planning.

Purpose of Theories in Occupational Therapy

  • Theories provide a framework for guiding treatment.
  • Using theories helps in addressing specific patient needs, such as sensory processing disorders.
Sensory Processing Disorders
  • Defined as difficulties in adjusting to sensory stimuli.
  • Examples of challenges include:
    • Sensitivity to light.
    • Tactile defensiveness: Discomfort from clothing or touch.
  • The importance of using a sensory integration model to address these issues in therapy.
Application of Theories in Practice
  • When treating patients:
    • Utilize relevant models based on their conditions (e.g., neuro rehab for stroke patients).
    • Therapists apply multiple theories, blending them to fit individual patient contexts.
    • Students will encounter questions about theories and models on board exams.

Categories of Theoretical Frameworks

1. Theory Definition
  • A theory is described as a set of assumptions that serves as a big umbrella encompassing various disciplines.
  • Relevant disciplines in occupational therapy include:
    • Biology,
    • Kinesiology,
    • Medicine,
    • Occupational Science,
    • Physics,
    • Psychology,
    • Sociology.
2. Practice Models
  • Practice models organize concepts derived from theories based on philosophical foundations that guide treatment.
  • Focus on improving health through engagement in occupations (tasks performed daily).
  • Models can be occupationally based or linked to specific frames of reference for evaluating and intervening.
3. Frames of Reference
  • Frames of reference express the avenues through which practical assessments are guided.
  • They provide detail about the populations (e.g., children with sensory processing disorders) and age-related considerations in therapy.
  • Definitions of function and dysfunction are essential components:
    • Functioning well is aligned with strength and the ability to perform daily tasks.
    • Limitations signify dysfunction in a given model (e.g., biomechanical).

Common Theoretical Models in Occupational Therapy

1. Developmental Frame of Reference
  • Focus on milestone achievements; one skill must be mastered before another can occur (e.g., crawling before walking).
  • Developmental theory applied in both child and adult contexts, referring to stages of growth.
2. Biomechanical Frame of Reference
  • Application: Treatment involves enhancing range of motion, strength, and endurance.
  • Typical Neural Condition: Clients often have an intact central nervous system (CNS).
  • Interventions: Therapeutic exercises (e.g., post-rotator cuff repair therapy).
    • Functional tie-ins to occupations through strength development.
3. Neurodevelopmental Treatment (NDT)
  • Hands-on techniques focus on encouraging normal postural control and movement patterns.
  • Applications: Commonly used for stroke patients and cerebral palsy.
  • Importance of therapist-guided handling to facilitate learning of normal movement.
  • Efficacy: Limited literature supporting effectiveness but widely practiced.
4. Proprioceptive Neuromuscular Facilitation (PNF)
  • This addresses coordination of movements through diagonal patterns incorporating flexors and extensors.
  • Example: Reaching tasks that replicate daily grooming activities.
  • Goal: Enhance functional movements through mass movement patterns.
5. Model of Human Occupation (MOHO) Revisited
  • Key elements include volition, habituation, and performance capacity across the lifespan.
    • Example: Tailoring therapy sessions around interests (e.g., using a patient's interest in cats to motivate handwriting practice).
6. KAWA Model
  • Conceptualizes life flow using river as a metaphor; analyzes obstacles (rocks), context (riverbanks), and opportunities (spaces) for intervention.
  • Effective in both individual and group therapy settings.

Cognitive Behavioral Frame of Reference

  • Utilized primarily in mental health for reframing negative thoughts into positive ones.
  • Applications include treatment for anxiety and depression.

Conclusion and Study Guide Structure

  • Importance of learning various theories and models for practical application in occupational therapy.
  • Each model and frame of reference must be clearly understood to justify intervention choices during fieldwork and exams.
  • Encouragement to fill in gaps in knowledge through collaborative study and additional reading from provided textbooks and materials.