CANADIAN MODEL OF OCCUPATIONAL PERFORMANCE / CANADIAN MODEL OF OCCUPATION PERFORMANCE - ENGAGEMENT

                              CANADIAN MODEL OF OCCUPATIONAL PERFORMANCE

1.      HISTORY:

·         This model previously known as Canadian guidelines for client centered practice was originally devised in 1982 by a task force supported by Canadian association of occupational therapist and the department of national health and welfare and following revision in 1983 and later in 1997 was renamed the Canadian model of occupational performance. 

·         The model is essentially base on a client –centred philosophy  viewing the client value and belief as the core ,giving meaning to activity recognizing the human skills that contribute to performance and the range of performance area all of which are surrounded and influenced by the impact of the environment.

·         Occupational performance is the result of a dynamic relationship between persons ,enviorment and occupation over a lifespan.

2.      ASSUMPTIONS:

·         The model is based on the assumption and core beliefs of the profession. it is also informed by the principles of client centeredness .

·         Another assumption that informs the model is that occupation are contextually and developmentally influenced.

·         It is based on the assumption that occupation the domain of concern for occupational therapists is the bridge that connects person and environment .

3.      ELEMENTS OF OCCUPATIONAL PPERFORMANCE:

·         Components of performance

Ø  Physical

Ø  Cognitive

Ø  Affecttive

Ø  spiritually

·         Components of occupation

Ø  Self-care

Ø  Productivity

Ø  leisure

·         The environment influences

Ø  Physical

Ø  Cultural

Ø  Social

Ø  Institutional

           3.1. The performance is carried out through the three following component:

·         Doing –physical components which comprise motor ,sensory and sensorimotor skills

·         Thinking-cognitive  components of intellect ,perception, comprehension, concentration, judgment, and reasoning   

·         Feeling-affective components related to emotional and social areas in personal and interpersonal relationships

           3.2. Occupation

·         CAOT {The Canadian Association of Occupational Therapist} defines self-care as occupations for looking after the self. which includes all the activities necessary for self-care and self -management  

·         Productivity is defined as occupations that make a social or economic contribution or that provide for economic sustenance. This includes those activities  that enable individuals to consider themselves productive whether or not there is any end product or financial reward involved  

·         Leisure is defined as occupations for enjoyment

          3.3. Environment

·          The cultural environment fluctuates and is different for each individual. Many issues that have an impact on a therapeutic intervention are culturally determined, including beliefs, values, customs, patterns of authority, how decisions are made and individual roles.

·         The physical environment can be seen as both a barrier and a support for individuals' participation in their community. Physical range composed of natural surrroundings –buildings ,equipment, roads, trees, weather ,nature, climate and technology 

·         The social environment is composed of social groups such as family, coworkers and friends and their roles, as well as occupational forms such as playing cards or jogging. Social environment including social priorities with in the community ,social groups , common interests ,attitude ,beliefs and relationships.

·         The institutional environment includes legal elements that often overlap with the economic one as control of funds and who makes financial decisions often become legal matters, which determines policies ,procedures and practices and includes  such as legal, political and economic elements.

4.      APPLICATION IN OCCUPATIONAL THRRAPY:

·         The application of the model of occupational performance is best seen in the practical use of the Canadian occupational performance measure {COPM}- assessment that acts as a clinical measure of client s self –perception of occupational performance.

·         The COPM is a client – centred semi –structured interview and self- rating  assessment.

·         The strength of this model is its client –centered approach and clearly articulated focus on occupation and occupational performance.

5.      THE APPLICATION OF THE MODEL IN PRACTICE:

·         Stage-1 : Name , validate and prioritise occupational performance issuses with the client in areas of self-care ,productivity and leisure

·         Stage -2: Select theoretical approach or approaches with the client to address the issues identified

·         Stage -3 : Identify occupational performance components and environmental conditions that are contributing to the performance issue

·         Stage -4 : Identify the clients personal strengths and environmental resources  and the therapist s experience ,expertise and resources  

·         Stage -5: Negotiate targeted outcome and develop an action plan .this specifics  what the client and occupational therapist will do to resolve  or minimize limitations to occupational performance in order to achieve the targeted outcomes

·         Stage -6: Implement plans through occupation

·         Stage -7: Evaluate occupational performance outcomes .this may result in completion of the intervention if the targets are achieved  review of the activities or the targets have not been achieved or continuation if this is still beneficial to the client

6.      FUNCTION –DYSFUNCTION:

·         Function is denoted by harmonious interdependent relationship between the person ,occupation and environment

·          A change in one component results in a change all the dimension due to the interdependent relationship between them therefore a disruption in one component can in occupational dysfunction

                   CANADIAN MODEL OF OCCUPATION PERFORMANCE - ENGAGEMENT

1.      BACKGROUND:

·         Development from the Canadian model of occupational performance {CMOP}.

·         Captures the occupational perspective of human occupation.

·         Positions profession beyond the medical model.

·         Envisions health ,well-being and justice as attainable through occupation .

·         Introduces engagement as an important construct in understanding human occupation.

2.      THERORY REGARDING ORDER –DISORDER:

2.1.Order

·         Occupational order hass six perspectives –physical rehabilitative , psychological emotional, socio-adaptive, neurointegrative, developmental or environmental- in relation to the arbitrary performance area of self care ,leisure and productivity.

·         Quality of function is assessed in term of both performance and satisfaction.

2.2.Disorder

·         The dimension of person ,occupation or environment or when the momentrum of experience is lost due to unresolved issues.

3.      ASSUMPTIONS:

·         Based on shared assumptions the profession

·         Client –centredness is key

4.      THEORIES THAT INFORM CMOP-E:

·         Humanistic theories –client centered principles

·         Development theories – adaptation and development of occupation roles

·         Environmental theories- the influence of environment  on occupation and the person

5.      FOCUS OF MODEL:

·         Occupational performance.

·         Occupational engagement.

·         Both are a result of a dynamic interaction between components of the model.

·         Presents a transverse view of the model that situates occupation as the core focus of the profession.

6.      AIMS:

·         To improve transactions between person ,occupation ,environment, through the process of enablement rather than treatment.

·         Enablement involves working with clients to facilitate autonomy and does not focus primarily on performance components.

7.      ENGAGEMENT:

·         Refers to all that people do to become occupied.

·         Speaks to occupying self or others.

·         Presents a broader view of human occupation.

·         Relates to having occupations and not only performing them.

8.      COMPONENTS OF CMOP-E:

8.1.Person

·         With spirituality as the core of the person

·         Components of performance

Ø  Physical

Ø  Cognitive

Ø  Affective

8.2.Occupation

·         Link between the person and the environment

·         Components of occupation

Ø  Self-care

Ø  Productivity

Ø  leisure

8.3.Environment

·         Present occupational opportunities

·         The environment influences

Ø  Physical

Ø  Cultural

Ø  Social

Ø  Institutional

9.      FUNCTION –DYSFUNCTION:

·         Limitations with in the person – decreased performance.

·         Limited occupational opportunities – limited occupational engagement.

·         Harmonious relationship between component – optimal performance and engagement.

·         An unsupportive environment –decreased performance and engagement.

·          Change in one component – change in another component.

10.  IMPLICATIONS FOR PRACTICE:

·         Allows for use with other frameworks

·         Can be used across age groups

·         Can be applied to various diagnoses

·         Promotes client –centredness

·         Can be used in multicultural settings

·         Directs focus of practice on creating environments that are occupationally supportive

·         Means t hrough which health and well-being may be attained