FORs and Model

• Occupational Therapy use Frame of References as a theoretical basis for its treatment approach.
• Frame of References is the theoretical or conceptual ideas that have been developed outside the profession, but, with judicious

  use, are applicable within the occupational therapy practice.
• Psychodynamic FOR - It equally focused on the patient’s relationship with his/her external world.
• psychodynamic for - identifies symptom-producing unconscious content
• psychodynamic for - The goals of psychodynamic are client’s

  self-awareness & understanding of the influence of the past on the present behavior.
• psychodynamic for - It enables the client to examine unresolved

  conflicts & symptoms that arise from past dysfunctional relationships & manifest themselves in the need & desire to abuse substances.
• behavioral for - emphasizes on the use of behavioral modification to shape behaviors
• behavioral for - support to increase the tendency of adaptive behaviors or to decrease the probability of maladaptive learned behavior
• movement centered - directed toward and adolescent or adult population identifies as having cns dysfunction
• movement centered - typically having behavior and performance problems and often having psychiatric diagnoses
• movement centered - this population is believed to have problems with processing sensation into normal, fluid movement, which in turn relates to impoverished body image, confidence, and social behavior
• cognitive disability - a limitation in sensorimotor actions originating in the physical or chemical structures of the brain and producing observable and assessable limitations in routine task behavior
• lifespan development - approach will be assisting clients with transitional tasks.
• model of human occupation - conceptual framework that addresses how and why we engage in meaningful daily assessment
• occupational adaptation - the more adaptive the person is, the more functional they become
• ecology of human performance - occupation is determined by the person, environment and occupation
• kawa model - Group of japanese occupational therapists embarked on a project that aimed to develop an alternative approach that would transform their occupational therapy and bring it more in line with their client’s day-to-day realities and experiences of disablement.
• Spatiotemporal Adaptation - Each individual has a unique spatiotemporal orientation to environmental experiences.
• rehabilitative - Rehabilitation as the process of facilitating

  patients in fulfilling daily activities and social roles with competence.
• biomechanical - A remedial approach focusing on impairments that limit occupational performance
• biomechanical - Assumes clients are able to acquire the voluntary motor skills necessary to perform the desired human

  occupation, meaning that the underlying impairment is amenable to remediation.
• sensorimotor - views client who has sustained a cns insult to the upper motor neuron as having poorly regulated control of the lower motor neurons
• sensorimotor approach - use of sensory stimulation to evoke a motor response, either through facilitatory or inhibitory effect on muscle
• proprioceptive neuromuscular facilitation - Developmental sequencing of movement and the balanced interplay between

  agonist and antagonist in producing volitional movement.
• four theoretical assumptions of rehabilitative FOR:

  1. A person can regain independence through compensation
  2. Motivation is a basic requirement for independence, it cannot be separated from the volitional and habitual subsystems
  3. Motivation cannot be separated from environmental context
  4. A minimum of emotional and cognitive prerequisite skills are needed to make independence possible
• REHABILITATIVE FOR

  Clinical reasoning should take top-down approach → client-centered
• Kawa Model follows

  the more ‘primitive’

  ontological view of

  people and nature,

  drawing no clear

  distinctions or

  separations between

  selves and their

  context of reality.
• “Kawa” means river

  and this model uses it

  as a metaphor for life

  flow.
• River (kawa): fluid and

  integrative image to

  represent the

  complexity and

  harmony of the client’s

  occupational life flow.
• Water (Mizu):

  symbolizes their life

  journey, flowing

  through time and

  space.
• Rocks (Iwa):

  problematic life

  circumstances that are

  difficult to remove
• River side walls

  (Kawa no soku-heki)

  and bottom (kawa no

  zoko): environmental

  issues affective the

  flow of the river and

  determining

  boundaries, shape,

  and flow of river.
• Driftwood (Ryboku):

  personal assets such

  as material or

  immaterial resources

  (liabilities).
• Space between the

  obstruction in the

  river (Sukima):

  Occupation.
• ecology of human performance

  • Occupational Performance is the primary outcome of interest.
  • provide assessment and intervention that focus on ENVIRONMENT
• OA Process:

  • Highly interactive, complex and self-organizing process with the goal of achieving mastery.
  • Goal is not to achieve a determined balance or equilibrium.
  • Goal is a continuous process of order and disorder and reorganization.
• MOHO

  Composed of 3 interacting elements

  1. volition (personal causation, values, interest)
  2. habituation (habits, internalized roles)
  3. performance capacity