CHAPTER - 1
 Introduction
to Occupation therapy.
 Conceptual
foundation for practice.
 Process
of Occupation therapy
OBJECTIVES
 Describe
occupational functional model.
 Use
the language of Occupational Functional
Model,the American Occupational Therapy
Association’sOccupational Therapy practice and
world health organization’s International
Classification of Functioning interchangeably.
 Organize
assessment and treatment planning
according to the occupational functioning model.
BASIC TERMINOLOGY
Activity : The occupational therapy practice
framework (AOTA) defines activity as a class
of human actions that are goal directed.
Activity analysis : A process used to identify the
properties inherent in a given occupation or
activity as well as abilities to complete it.
Adaptive therapy : Therapy that promotes a
balance among a person’s goals, capabilities
and environmental demands by use of assistive
technology.
Impairment : Any significant deviation or loss of
body structures or physiological or psychological
function.
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Occupation : Everyday life activity.
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Occupational dysfunction : Inability to maintain
one’s self , to advance oneself through work,
learning and financial management.
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Occupational functioning model : A conceptual
model that guides occupational therapy
evaluation & treatment of persons with physical
dysfunction
Propositions of the model
 To
engage satisfactorily in a life role.
 Tasks are composed of activities, which
are units of behaviour.
 To be able to do a given activity.
 Abilities are developed from capabilities
that person gains from learning.
 Developed capacities depend on first
level capacities that derive from person’s
genetic endowment.
Occupational functioning
model
 OFM
guides evaluation and treatment of
persons with physical dysfunction leading
to competence in occupational
performance.
 It is derived from clinical practice.The
primary belief is that people who are
competent in their life roles experience a
sense of self-efficacy,self esteem and life
satisfaction.
 Competence in occupational
performance contributes to development
of a person’s identity.
THE OCCUPATIONAL
FUNCTIONING MODEL
 The
goal of treatment , following the
OFM,is to enable satisfactory
engagement in valued roles whether by
restored self performane or by directing
others.
 Another assumption of the OFM is that the
ability to carry out one’s roles and
activities of life depends on basic abilities
and capacities e.g. strength, perception.
THE OCCUPATIONAL
FUNCTIONING MODEL
 Many
capacities contribute to the
development of one ability and many
abilities are needed to engage
successfully in an activity.
 When one capacity or ability is impaired,
occupational dysfunction does not
automatically occur.
 A person may adaptively use other
capacities and abilities to allow
accomplishment of the activity.
THE OCCUPATIONAL FUNCTIONING
MODEL
 Research
is modify to clarify the
multivariate relationships among lower
level abilities and capacities and higher
level activities, tasks and roles.
 Researchers must verify whether
remediation of impaired capacities and
abilities results in more complete and
versatile participation in the activities and
tasks of importance to people’s lives than
would learning specific routines of
activities in an adapted way.
THE OCCUPATIONAL
FUNCTIONING MODEL
 Another
assumption of OFM is that
satisfactory occupational functioning
occurs only within enabling environments
and contexts particular to the individual.
 True occupational functioning does not
occur in vaccum or in a controlled
situation such as clinic, it is successful with
interaction of person with objects,
situations & surroundings of their family or
community.
Sense of self efficacy and self
esteem
 Goal
of occupational therapy is the
development of competence in activities
and tasks of one’s role which promotes a
sense of self efficacy and self esteem.
 Competence
refers to effective
interaction with physical and social
environments.
Sense of self efficacy and self
esteem
 To
be competent means to have the skills
that are sufficient or adequate to meet
demands of a situation or task. It does not
equate to excellence or ability to do
everything.
 Competence reflects people’s belief in
their own control rather than being
controlled by social or physical
environment.
Sense of self efficacy and
self esteem
 OT
help people achieve competence
through graded engagement in
occupation, vicarious engagement in
occupation, developmental and
instrumental learning with immediate
feedback.
 Self esteem is that aspect of self concept
that attributes a negative or positive
value to the self.
Sense of self efficacy and
self esteem
 Self
esteem is created by individual’s
analyses of their competency in socially
relevant areas.
 People’s level of self esteem depend on
their confidence based on their
experience, that they can make desired
things happen and others will
appreciatively recognize this
competence.
Self maintenance roles
 Self
maintenance roles are associated
with maintenance of the self and care of
the family and home. This equates to the
OTPF areas of occupation of ADL and
IADL.
Paradigm of OFM
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
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•
Organic substrate
first level capacities
developed capacities
abilities and skills
activities and habbits
competence in tasks of life roles
satisfaction with life roles
Self maintanence
Self advancement
Self enhancement
Sense of efficacy and self esteem
Self advancement : roles are those that draw the
person into productive activities that add to the
person’s skills, possessions or other betterment.
Ability : is a general trait such as muscle strength or
memory that individuals bring with them to a new
task.
Self advancement roles
 This
domain corresponds to the OTPF
areas of occupation of work and
education but extends to include the
instrumental roles that enable work.
 Self advancement roles correspond to the
participation category of the ICF.
Self –Enhancement roles
 Self
enhancement roles contribute to the
person’s sense of accomplishment and
enjoyment. This corresponds to the OTPF
areas of occupation of play,leisure and
social participation and fits within the the
ICF category of participation.
ACTIVITIES AND HABITS
Activities
 Activities
are smaller units of goal-directed
behavior that comprise tasks. Activities
bring together abilities and skills within a
functional context. For example, one task
of the gardener is pest control. Activities
that make up this task include hanging
lures, spreading granular insect killer,
mixing and spraying liquids and picking
insects off plants.
Activities
 Each
of these activities consists of even
smaller units of behavior, such as opening
the package and pouring the granular
insect killer into a garden spreader.
Habits
 Habits
are chains of action sequences
that are so well learned that person does
not have to pay attention to do them
under ordinary circumstances and in
familiar contexts.
 Physical dysfunction disrupts habits,
requiring attention to be paid to the
simplest of activities of daily living.
Process of occupational
therapy
•
The process of occupational therapy follows the
universal plan for problem solving, identifying
the problem, intervene and evaluate the result.
•
The occupational therapist focuses on problems
related to the person’s occupation life.
•
The therapist can then use various occupational
, adaptive and adjunctive therapies to
intervene.
THE PROCESS
OF
OCCUPATIONAL THERAPY
1. Goal of therapy
OFM

Satisfactorily engage
in self identified,
important life roles
through which
person gains a sense
of self efficacy and
self esteem.
OTPA (AOTA)
 Engagement
in
occupation to
support
participation.
2. Evaluation to identify the
problems
OTPA (AOTA)
OFM
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Identify roles, tasks and
activities the person
wants to do .
Observe & analyze the
person’s performance.
Identify impaired
abilities or capacities
that causes impairment.
Identify environmental
or contextual
hindrances.
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Do an profile to
understand the client’s
occupational history,
patterns of living, needs
& performance.
Do an analysis of occ.
Performance by identify
client’s problems.
Identify targeted
outcomes.
3. Plan intervention
OFM
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Plan in collaboration
with the person or
family.
Establish short term
goals that directly relate
to the long term goal.
Select interventions that
have evidence for
effectiveness for the
immediate goal.
OTPF(AOTA 2002)
 Develop
plan with
the client to guide
action.
 Base therapy on
theories, frames of
reference and
evidence.
4.Implement the intervention
OFM



Utilize therapeutic
mechanisms.
Utilize adjunctive
therapies to facilitate
performance.
Modify contexts and
environments to
facilitate programs
OTPF(AOTA 2002)

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Act to influence and
support improved
client performance of
targeted outcomes.
Monitor and document
client’s response.
Review the progress
toward targeted
outcomes &
intervention plan.
5. Evaluate the result
OTPF (AOTA 2002)
OFM

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Determine whether the
targeted outcomes
were achieved.
Determine whether the
person was satisfied
with his or her
achievement.
Plan for future therapy
or referral.

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
Determine success in
achieving targeted
outcomes.
Plan future action
with client.
Evaluate the
program.