Chapter 38 Ecological Models in Occupational Therapy Catana

Learning Objectives After reading this chapter, you will be able to: 1. Explain how

Three Ecological Models • Emphasize the importance of considering the environment in occupational therapy

Intellectual Heritage • The ecological models were: – built on social science theory, earlier

Definitions Person • EHP, PEO, and PEOP have similar definitions of the person: a

Definitions (Continued) Environment • The environment is also described similarly across the three models.

Definitions (Continued) Occupation/Task • The biggest difference in the three models is found in

Definitions (Continued) Occupation/Task • EHP uses the term task because a primary purpose of

Definitions (Continued) Occupational Performance • The outcome that is associated with the confluence of

Person Environment Occupation Model Copyright © 2014 Wolters Kluwer Health | Lippincott Williams &

Person Environment Occupation Performance Model Copyright © 2014 Wolters Kluwer Health | Lippincott Williams

Ecology of Human Performance Model Copyright © 2014 Wolters Kluwer Health | Lippincott Williams

Assumptions of the Ecological Models • The relationships between people, environments, and occupations are

Assumptions of the Ecological Model (Continued) • Occupational performance is determined by the confluence

Application to Practice • The ecological models provide a framework for thinking about OT

Evidence Supporting the Ecological Models • Studies indicating a relationship between environment and occupational

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Learning Objectives After reading this chapter, you will be able to: 1. Explain how an understanding of the environment is essential to understanding occupational performance. 2. Describe the ecological models and their concepts. 3. Describe and distinguish the five intervention strategies: (1) establish/restore, (2) adapt/modify, (3) alter, (4) prevent, and (5) create. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Three Ecological Models • Emphasize the importance of considering the environment in occupational therapy practice: – The Ecology of Human Performance model (EHP); – The Person Environment Occupational Performance model (PEOP); and – The Person Environment Occupation model (PEO) Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Intellectual Heritage • The ecological models were: – built on social science theory, earlier occupational therapy models, and the disability movement; – based on the idea of goodness of fit; and – influenced by civil rights movements that arose from disability groups Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Definitions Person • EHP, PEO, and PEOP have similar definitions of the person: a unique and holistic view of the person that acknowledges the mind, body, and spirit. • Variables associated with the person include: – Values and interests; – Skills and abilities; and – Life experience Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Definitions (Continued) Environment • The environment is also described similarly across the three models. • The environment is where occupational performance takes place and consists of: – Physical components – Cultural components – Social components Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Definitions (Continued) Occupation/Task • The biggest difference in the three models is found in the concepts related to occupations or tasks. • PEO and PEOP use the term occupation, and describe a series of nested concepts that make up occupations. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Definitions (Continued) Occupation/Task • EHP uses the term task because a primary purpose of the model is to facilitate interdisciplinary collaboration. – The EHP model also describes five intervention strategies: Establish/Restore, Adapt/Modify, Alter, Prevent, Create Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Definitions (Continued) Occupational Performance • The outcome that is associated with the confluence of the person, environment, and occupation factors. • The degree to which occupational performance is possible depends on the goodness of fit of these factors. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Assumptions of the Ecological Models • The relationships between people, environments, and occupations are dynamic and unique • The environment is a major factor in the prediction of successful and satisfying occupational performance • Rather than exclusively using interventions that change the person, it is often more efficient and effective to change the environment or find a person-environment match Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Assumptions of the Ecological Model (Continued) • Occupational performance is determined by the confluence of person, environment, and occupation factors • OTs practice begins by identifying what occupations the person wants or needs to perform • OT practice involves promoting self-determination and the inclusion of people with disabilities in all environments Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Application to Practice • The ecological models provide a framework for thinking about OT practice but do not delineate specific assessments or techniques. • Using an ecological model requires OTs to consider the environment as extensively as they consider the person. • The process begins by identifying what the person wants or needs to do in his or her life. – The client and OT collaborate throughout the OT process. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

Evidence Supporting the Ecological Models • Studies indicating a relationship between environment and occupational performance provide support for the ecological models. – This growing body of research describes the impact of the environment on occupational performance. • Research has also supported the efficacy of OT intervention using a ecological approach. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins