Occupational therapy is a very hands-on, practical, person-focused profession, so why is there so much emphasis on learning theory? This is a question that’s often asked by new students trying to understand where they should be focusing their efforts as they undertake their training. It can be confusing to begin with, but as you begin to find your feet, you’ll realize how much you need it.
The theories and models used in this profession give you the conceptual understanding or frame of reference that you need to get to grips with different issues you are likely to encounter. There are numerous occupational therapy theories and models out there, and sometimes you will find that you need to study a new one in order to help a particular patient. This article will help you get started by outlining five of those that are most commonly used.
Core values
Before you begin to explore occupational therapy models, it’s useful to reflect on the core values of the profession: altruism, equality, freedom, justice, dignity, truth and prudence. Every occupational therapy theory is founded on these, so if you can’t see how they apply to it, then you probably haven’t understood it properly. Whenever you prepare to use a model, think through how you will be engaging with these values, and you will be able to support your patients more effectively.
Key models used in occupational therapy
Model of Human Occupation
This is a great model to start with because it’s highly adaptable and you can use it with practically any patient. The Model of Human Occupation provides a way of thinking about how people interact with the world around them. It breaks this down into three parts: volition, habituation and performance. Volition concerns the ability to articulate desires, set goals and build up the will and confidence to try to achieve them. Habituation concerns the things we do without conscious thought, and how they relate to our internalized ideas about our roles in life. Performance identifies the skills that emerge from a combination of volition and habituation.
PEOP
The Person-Environment-Occupation-Performance (PEOP) model also focuses on three aspects of interaction, but does so rather differently. Here, we have the person, who can be understood in terms of characteristics such as the physical, psychological and cognitive, plus the environment, which takes into account things such as culture and class and support networks, plus the occupation – that is, the specific task that the person hopes to accomplish at any point in time. By identifying positive and negative factors in each of these areas, the therapist can pin down the areas where help is needed and go on to identify specific interventions that may be of use.
Allen’s Cognitive Disabilities Model
Used when treating patients who are mentally impaired or very young, this model assesses six types of action: automatic, postural, manual, goal-directed, exploratory and planned. This is done in regard to specific tasks so that the therapist can work out which aspects of a task (if any) the patient is struggling with, and design interventions accordingly. Performance in some tasks can help with building predictive models where others are concerned. Where the patient has the capacity for improvement, the therapist can then plan care so as to help the patient engage with tasks more successfully and make cognitive leaps in the process.
Kawa Model
This model – named after the Japanese word for river – visualizes life as a process of flow, shaped by external factors as a river is shaped by its banks. Here, impairments and modes of dysfunction are compared to rocks that inhibit the river’s smooth passage, while assets and liabilities function like driftwood, either helping to support the flow or obstructing it. It’s useful because most people can relate to it regardless of their age or cultural background. Therefore, it can be a useful way to engage directly with patients and prompt them to think about their needs and priorities, while identifying ways that they might be able to work around difficulties, either with or without support.
Dunn’s Model of Sensory Processing
Designed to help patients of all ages and backgrounds who have difficulty regulating their sensory threshold, this model divides them into four types: those who actively seek sensation; those who actively avoid it; those who are highly sensitive to it but, unable to actively avoid it, become overwhelmed; and those who have trouble processing sensory input. By observing how well a patient fits into one or another of these categories, a therapist can establish where difficulties lie and offer interventions or make suggestions aimed at helping the patient achieve a more satisfactory level of regulation.
Choosing the right model
With all of these models to choose from, how do you select the right one for any given situation? The reality is that most occupational therapists simply find two or three that they find work best and use those in the majority of situations. They then bring in others as needed to deal with patients who have specific needs that are different from those that they usually deal with.
It can be useful, however, to push yourself out of your comfort zone from time to time and make the effort to get to grips with different models, because this will enable you to expand your own abilities. If you study an occupational therapy doctorate online at American International College, for example, you’ll get an in-depth look at multiple models used in clinical practice during your two-year course. The combination of academic and practical expertise that AIC makes available to its students will broaden your horizons and make it much easier for you to assist patients with complex needs.
Conclusion
As with other aspects of this challenging yet deeply rewarding profession, the understanding you acquire in studying theory will not only prove beneficial in your professional life, but will also enrich your relationship with the world around you. As you help your patients to get more out of life, you will also be identifying barriers in your own life and figuring out how to overcome them.
