Transcript LWW PPT Slide Template Master

Chapter 38
Ecological Models in
Occupational Therapy
Catana E. Brown
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
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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
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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
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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.
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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
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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.
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Person Environment Occupation Model
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Person Environment Occupation
Performance Model
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Ecology of Human Performance Model
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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
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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
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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.
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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.
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