Canadian Model of Occupational Performance and Engagement

Canadian Model of Occupational Performance and Engagement

Nota:

• CAOT - Canadian Association of Occupational Therapists

1. PERSON
   1. SPIRITUALITY at the core
   2. Performance components
      1. COGNITIVE (thinking) --- the domain that comprises all mental functions both cognitive & intellectual, & includes, among other things, perception, concentration, memory, comprehension, judgement & reasoning
      2. AFFECTIVE (feeling) --- the domain that comprises all social & emotional functions & includes both interpersonal & intrapersonal factors
      3. PHYSICAL (doing) --- the domain that comprises all sensory, motor & sensorimotor functions
2. ENVIRONMENT (affords occupational opportunities)
   1. CULTURAL --- Ethnic, racial, ceremonial & routine practices, based on ethos & value system of particular groups
   2. PHYSICAL --- Natural & built surroundings that consist of buildings, roads, gardens, vehicles for transportation, technology, weather & other materials
   3. SOCIAL --- social priorities about all elements of the environment, patterns of relationships of people living in an organised community, social groupings based on common interests, values, attitudes & beliefs
   4. INSTITUTIONAL --- societal institutions & practices including policies, decision-making processes, procedures, accessibility & other organisational practices. Includes economic components, legal components & political components
3. OCCUPATION
   1. bridge that connects person and environment - i.e. individuals act on environment through occupation
   2. Domain of concern for Occupational Therapy
   3. groups of activities and tasks in everyday life, named, organised, and given value and meaning by individuals and culture
      1. SELF-CARE --- looking after oneself
      2. PRODUCTIVITY --- contributing to social & economic fabric of community
      3. LEISURE --- enjoying life
4. BASIC ASSUMPTIONS
   1. Humans are occupational beings
   2. Occupation has therapeutic potential
   3. Occupation affects health & well-being
   4. Occupation organises time& brings structure to living
   5. Occupation brings meaning to life through the combination of cultural and individual influences on the creation of meaning
   6. Occupations are idiosyncratic - the specific occupations that a person might engage in will vary from person to person
5. OCCUPATIONAL PEFORMANCE & ENGAGMENT
   1. OCCUPATIONAL PERFORMANCE - the dynamic interaction of person, occupation & environment (more limited concept than occupational engagement)
   2. OCCUPATIONAL ENGAGEMENT - Individuals can engage in occupation without necessarily performing it
6. ENABLEMENT & CLIENT-CENTRED PRACTICE
   1. CLIENT-CENTRED PRACTICE
      1. focussing on client goals and projected outcomes
      2. six categories of clients
         1. Individuals
         2. Families
         3. Groups
         4. Communities
         5. Organisations (e.g. agencies, clubs, associations, government, corporate or non-governmental populations
         6. Populations
   2. ENABLEMENT
      1. Occupational therapy is the art & science of enabling engagement in everyday living, through occupation; of enabling people to perform the occupations that foster health and well-being; and of enabling a just and inclusive society so that all people may participate to their potential in the daily occupations of life (Enabling II , p.89)
      2. ENABLE - giving power, strengthening, providing with ability or means to do something & with means to do or be something & making something possible
      3. Three type of undertaking that are enabled: 1) people's engagement in everyday life, 2) their performance of occupation, 3) the development of a just society in which people can participate (for an OT to enable all 3 of these outcomes, their practice would need to be aimed at both personal & societal levels)
      4. ENABLEMENT through occupation is the current core of occupational therapy
   3. Enabling is the basis of occupational therapy's client-centred practice and a foundation for client empowerment & justice (Enabling II, p.99)
   4. The assumption at the core of both enablement &client-centred practice is that occupational therapy involves "collaborating with people rather than doing things for them" (Enabling II, p.98)
   5. Mutual relationship between client-centredness & enablement "In occupational therapy, client-centred practice delimits the definition of enablement; conversely enablement delimits the definition of client-centred pratice" (Enabling II, p. 99)
   6. The processes through which occupational therapists facilitate occupational performance and engagement
   7. Challenges to client-centred practice & enablement - e.g. client's culture & level of education, therapist's capacity to share power & recognise client expertise, management philosophies & resource distribution of the broader systems
   8. CANADIAN MODEL OF CLIENT-CENTRED ENABLEMENT (CMCE)
      1. CMOP-E does not specify the process of enablement
      2. focuses on the encounter between OT and client (therapeutic relationship) and aims to make explicit the process of enabling occupation in a client-centred way
7. NB. The three practice models / frameworks are designed to be used in combination. CMOP-E provides the overall structure for conceptualising occupational performance & engagement and the work of OTs. CPPF provides details about the generic process used by OTs when working with clients,. CMCE provides an action framework within which to conceptualise how OTs work with their clients