occupational performance process model

1: 1 Occupational Performance Process Model Source material for lecture: Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., Letts, L. (1996). The person-environment-occupation model: A transactive approach to occupational performance, Canadian J Occup Ther, 63 (1) p.9-23

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3: 3 Corollary of Move Toward Client Centered Practice Traditionally Clients had little say in how therapy was carried out Therapist established the priorities for tx Followed the traditionally paternalistic practices of medicine

4: 4 Client Centered Practice Clients are the experts in identifying the problems that face them in adapting to life and should decide whether or not they want assistance in understanding and addressing these problems Therapist forms an alliance with the client to use their combined skills and strengths to work towards client goals

5: 5 Theory Background Occupational performance is the product of a dynamic relationship between the person, their occupations and roles, and the environments in which they live, work and play. In a nutshell-individuals and problems don’t exist in a vacuum

6: 6 Our lives are very complex… Each day we deal with a variety of factors We play many different roles We operate in a variety of environments and contexts We bring to each role/activity a unique perspective which is a product of Upbringing Cultural roots Cultural values of community and family Place within our family Place within our community

7: 7 Our education Our place in society Our experiences All adaptation has a temporal component Roles change throughout the day Assume each for a period of time Viewpoints/perspectives change over time as result of experiences

8: 8 Our ability to engage successfully in occupations results from a combination of personal attributes and environmental attributes Our behavior (and that of our clients) is influenced and cannot be separated from contextual influences, temporal factors and physical and psychological characteristics

9: 9 Context continually changes requiring behavior to change to adapt Nothing is forever; change is the only constant

10: 10 OPPM

11: 11 Operating Definitions Activity The single unit-singular pursuit in which a person engages as part of his/her daily occupation Act of slicing cheese Task A set of purposeful activities Making a cheese sandwich Occupation Groups of self-directed functional tasks and activities that a person engages in over the lifespan Role of being the family cook A job as a chef

12: 12 Definitions continued… Occupations Clusters of activities completed over time Completed to meet intrinsic needs for self-maintenance, expression and fulfillment Carried out within the context of individual roles and multiple environments Temporal Time patterns incorporated into the activities Extended to their fullest-represent the life span of the person

13: 13 Major Components of OPPM Occupational performance is the outcome of the transaction between the person, environment, and occupation The dynamic experience of a person engaged in purposeful activities and tasks within an environment Key dimensions of occupational performance Person Environment Occupation

14: 14 Person Key component in the process of adaptation Unique being who assumes a variety of roles simultaneously Roles are dynamic Vary across time in duration Vary in significance Person has three dimensions: mind, body and spirit

15: 15 Person continued… Person brings a set of attributes (performance components) and life experiences to bear on occupational performance Self concept Cultural background Personality style Personal competencies Motor performance Sensory capability Cognitive capability Social skills General health

16: 16 Person continued… Some aspects of the person are changeable and some are not Person’s cultural roots cannot be altered But person’s cultural views can be altered By a move to another culture By self determination

17: 17 Environment Context in which the activity takes place Includes Personal Social Physical Cultural Economic Legal Political

18: 18 Environment continued… Influences person on several levels Home Neighborhood Community State Country

19: 19 Environment… Influences the behavior and in turn is influenced by the behavior of the person Not static Can have an enabling or constraining effect on occupational performance Problems with disability stem primarily from the association between the individual and the environment Environments can foster independence or dependence From a treatment perspective, environments are more amenable to change than persons

20: 20 Occupations Meet the person’s intrinsic needs for self maintenance, expression, and fulfillment within the context of his/her personal roles and environment Includes activities and tasks done to accomplish a purpose Can be simple or complex Brushing teeth to driving a car in rush hour traffic

21: 21 Assumptions Made by the Model Person is a dynamic motivated and ever developing being constantly interacting with the environment The qualities defining the person will influence the way in which the person interacts with the environment and carries out his/her occupational performance Some qualities are more amenable to change than others

22: 22 Occupational Performance A complex, dynamic process Has both spatial and temporal aspects Shaped by the transaction that occurs among the person, environment and the occupation in which the person engages Requires the ability to balance occupation and views of self and environment Sometimes conflict Person must encompass changing priorities Over a lifetime, individuals are constantly renegotiating their view of self and their roles

23: 23 Treatment Intervention Using the OPPM Goal is to achieve optimum person/environment fit Person, environment, occupation interact with one another across time and space Interaction may increase or diminish their congruence Closer person, environment, occupation overlap one another and fit-the better the occupational performance

24: 24 Treatment intervention…. Treatment intervention can be targeted at Environment Change environment to improve participation Person Change person to improve participation Occupation Change the requirements of the occupation to get a better person/occupation fit and improve performance OT clients are not just individuals but also may be groups/systems such as families, caregivers, businesses, organizations, communities and governments

25: 25 In Designing Tx Interventions… Person must be considered in multiple contexts As an individual As part of a family As a member of a community, As a member of a state As member of a region As member of a community

26: 26 Treatment cont…. Treatment must be client centered and client driven When problems occur, individuals usually draw on their own experiences and environmental supports to solve these problems satisfactorily When a person can’t solve the problem on their own, they start to lose momentum They seek the assistance of an outside expert (OT)

27: 27 Treatment cont… Role of the OT is to assist the client to problem solve so that lost momentum can be redirected to a continuing satisfactory experience Requires a complex combination of knowledge and skills to enable a client to move through the stages required to complete problem resolution First step is to assess the client, environment and occupation to determine how each can be modified to provide a better fit

28: 28 The 7-Stages of the Occupational Performance Process Model 1. Name, validate, and prioritize occupational performance problems/issues 2. Select Potential Intervention Models 3. Identify Occupational Performance Components and Environmental Conditions 4. Identify Strengths and Resources 5. Negotiate Targeted Outcomes and Develop Action Plans 6. Implement Plans through occupation 7. Evaluate Occupational performance Outcomes

29: 29 Treatment is successful when a maximal fit between person, environment and occupation is achieved