Theoretical Perspectives: Occupation Based Models

Week 11 - Occupation Based Models

Introduction
  • Presented by: Dr. Wesam Darawsheh, OTR/L, BScOT, MScOT, PhD

  • Recognition: 2018-2019 Fulbright Post-Doctoral Research Grantee; 2020 Cordelia Myers Best Article Recipient

Objectives of the Session
  • Identify and discuss various examples of ecological models, such as:

    • Ecology of Human Performance

    • PEOP (Person-Environment-Occupation-Performance)

    • PEO (Person-Environment-Occupation)

  • Differentiate between EHP, PEOP, and PEO.

  • Apply ecological models and the occupational adaptation model to various case studies.

  • Discuss occupational adaptation as a model and a construct.

Ecology of Human Performance

Overview
  • Originator: Winnie Dunn

  • Influence: Inspired by the disability civil rights movement.

  • Accessibility: Language is suitable for several disciplines.

  • Key Elements:

    • Integration of person, context, and task in relation to human performance.

    • Occupational performance is viewed within the scope of the natural environment.

    • Performance is influenced by past experiences and context.

    • Addresses various elements of an environment:

    • Physical

    • Social

    • Temporal

    • Cultural

Evaluation Methods
  • Utilizes specific checklists and the sensory profile for assessments.

Intervention Strategies
  • Establish: Create new routines or practices.

  • Alter: Modify the environment or tasks, e.g., using adaptive tools for fall prevention.

  • Adapt/Modify: Provide structured instructions for clients with conditions such as schizophrenia.

  • Prevent: Implement strategies to avert dysfunction.

  • Create: Enhance and develop more enriching and complex performance opportunities.

Person-Environment-Occupation Model (PEO)

The Model
  • Three Circles Model: Represents the interaction and overlap between person, environment, and occupation.

  • Outcome Perspective: Occupational performance is a result of the transactional relationship among the three circles.

  • Life Span Influence: Performance can change throughout a person’s lifespan.

  • Assessment Tools: While specific evaluations are not outlined, various tools from MOHO (Model of Human Occupation) can be applied to PEO.

  • Intervention Basis: Focused on occupation-based approaches.

Occupational Adaptation

Key Principles
  • Approach: A top-down perspective focusing on internal adaptive processes.

  • Therapeutic Climate: Defines the roles of both therapist and client in the therapeutic process.

  • Occupational Demands: Occupational demands arise naturally from the client’s roles and contexts.

  • Occupational Competence: A continuous process adjusting to both internal and external demands to enhance functionality.

Components of Occupational Adaptation
  1. Person: Comprises sensorimotor, cognitive, and psychosocial aspects reflecting the desire for mastery.

  2. Occupation Environment: Encompasses social, physical, and cultural systems which dictate the demand for mastery.

  3. Occupational Response: Results from the interaction of person and environment, characterized by self-initiation, generalization, and perceived mastery.

Assumptions of Occupational Adaptation
  • Occupation serves as the medium for adaptation.

  • The desire to participate acts as the catalyst for adaptation.

  • A heightened need for adaptation correlates with increased importance of adaptation and the presence of significant challenges or disruptions.

Function and Dysfunction in Occupational Adaptation

Definitions
Function
  • The individual is able to engage in and perform occupations with a sense of mastery that satisfies both societal and personal standards.

Dysfunction
  • The demands placed on the individual exceed their capacity for adaptation.

Adaptive Subprocesses
  1. Generation: The creation of strategies and responses to adaptation.

  2. Evaluation: Assessing the effectiveness of the adaptation strategies employed.

  3. Integration: Incorporating successful adaptive strategies into routine practices and behaviors.

Conclusion
  • Understanding these models and processes allows for a holistic approach to occupational therapy aimed at enhancing client participation and performance in daily life activities.