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Domain

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Area of human experience in which practitioners of the profession offer assistance to others.

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Process

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Evaluating the client's occupational needs, problems, and concerns.

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Purpose of the OT Practice Framework

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(a) to describe the domain that centers and grounds the profession's focus and actions and (b) to outline the process of occupational therapy evaluation and intervention that is dynamic and linked to the profession's focus on and use of occupation.

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Context, Activity Demands, and Client Factors

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Areas that influence performance skills and patterns

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Performance skills and performance patterns

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Describes the observed performance that the individual carries out when engaging in a range of occupations

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Occupation

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Something you do to spend time and energy that is meaningful to you

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Therapy

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Process that happens with 2 people to make a change, Treatment of an illness or disability

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Goal

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Desired outcome, The result or achievement toward which effort is directed.

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Activity

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Occupies time, physical-mental, Human actions that are goal directed.

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Independence

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Little guidance, doing something on your own / Having adequate resources to accomplish everyday tasks / The profession views independence as the ability to self-determine activity performance, regardless of who actually performs the activity.

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Function

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How well they can complete a task or activity

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Holistic Perspective

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1. Physical 2. Mental/cognitive 3. Psychosocial

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Domain of OT - Context

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Cultural, Physical, Social, Personal, Spiritual, Temporal, Virtual

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Domain of OT - Activity Demands

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Objects Used and Their Properties, Space Demands, Social Demands, Sequencing and Timing, Required Actions, Required Body Functions, Required Body Structures

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Domain of OT - Client Factors

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Body Functions, Body Structures

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Domain of OT - Performance Skills

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Motor skills, Process Skills, Communication/Interaction Skills / Features of what one does, not what one has, related to observable elements of action that have implicit functional purpose.

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Domain of OT - Performance Patterns

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Habits, Routines, Roles / Patterns of behavior related to daily life activities that are habitual or routine that are adopted by an individual as he or she carries out occupations or activities that provide structure for daily life.

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Domain of OT - Performance in Areas of Occupation

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Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Education, Work, Play, Leisure, Social Participation

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Skills

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Small units of performance that are observable elements of action that have implicit functional purpose

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Motor Skills

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Performance skill / Observed as the client moves and interacts with task objects and environments. Aspects include - posture, mobility, coordination, strength and effort, and energy.

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Process Skills

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Observed as the client manages and modifies actions while completing a task. Aspects include energy, knowledge, temporal organization, organizing space and objects, and adaptation.

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Communication/Interaction Skills

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Observed as the client conveys his or her intentions and needs and coordinates social behavior to act together with people. Aspects include physicality, information exchange, and relations.

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Habits

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Performance pattern / Specific, automatic behaviors that are integrated into more complex patterns that enable people to function on a day-to-day basis / Can support or interfere with performance in areas of occupation.

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Routines

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Performance pattern / Established sequences of occupations or activities that provide a structure for daily life.

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Roles

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Set of behaviors that have some socially agreed upon function and for which there is an accepted code of norms.

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Context

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Variety of interrelated conditions within and surrounding the client that influence performance.

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Activity Demands

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Objects, place, social demands, sequencing or timing, required actions and required underlying body functions and body structure to carry out the activity, The demands of the activity in which a person engages will affect skill and eventual success of performance.

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Client Factors

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Cognitive, Visual/Perceptual, Psychological, Sensory, Neuromuscular/Motor - Factors that reside within the client and that may affect performance in areas of occupation. Includes body functions and body structures.

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Body Functions

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Physiological function of body systems, A client factor - physical, cognitive, psychosocial aspects.

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Body Structures

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Anatomical parts of the body such as organs, limbs, and their components, A client factor

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Occupational Therapy Process

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Evaluation, Intervention, and Outcome

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Evaluation

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Understanding the client as an occupational human being for whom access and participation in meaningful and productive activities is central to health and well-being. Accessing the occupational needs, problems, and concerns via an occupational profile and analysis of occupational performance.

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Intervention

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Directed efforts toward fostering improved engagement in occupations via an intervention plan, intervention implementation, and intervention review.

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Occupational Profile

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The initial step in the evaluation process that provides an understanding of the client's occupational history and experiences, patterns of daily living, interests, values, and needs. The client's problems and concerns about performing occupations and daily life activities are identified, and the client's priorities are determined.

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Analysis of occupational performance

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Type of outcome / The step in the evaluation process during which the client's assets, problems, or potential problems are more specifically identifies. Actual performance is often observed in context to identify what supports performance and what hinders performance. Performance skills, performance patterns, context or contexts, activity demands, and client factors are all considered, but only select aspects may be specifically assessed. Target outcomes are identified.

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Intervention Plan

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A plan that will guide actions taken and that is developed in collaboration with the client. It is based on selected theories, frames of reference, and evidence. Outcomes to be targeted are confirmed.

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Intervention Implementation

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Ongoing actions taken to influence and support improved client performance. Interventions are directed at identified outcomes. Client's response is monitored and documented.

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Intervention Review

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A continuous review of the implementation plan and process as well as its progress toward targeted outcomes.

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Outcomes

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Determination of success in reaching desired targeted outcomes. Outcome assessment information is used to plan future actions with the client and to evaluate the service program.

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Framework Process Model

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Is dynamic and interactive. Always starts with the occupational profile. Context is a overarching, underlying, embedded influence on the process of service delivery.

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External Context

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Physical setting, social and virtual contexts

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Internal Context

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Personal and spiritual contexts

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Cultural Context

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Exists outside of the person but is internalized by the person

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Client

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Entity that receives occupational therapy services, May be served as individuals, groups, or populations

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Client-Centered Approach

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All interventions must be focused on client priorities, The client must be an active participant in the process.

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Unique Resources OT's and OTA's bring to the Framework Process

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How engagement in occupation affects health and performance, Knowledge about desease and disability coupled with information with their clinical reasoning and theoretical perspectives to critically observe, analyze, describe, and interpret human performance.

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What Client brings to to the Framework Process

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Knowledge about their life experiences and their hopes and dreams for the future.

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Engagement in Occupation

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Overarching outcome of the occupational therapy process, Supports participation as the end objectives of the process, Health and well-being are holistic and are developed and maintained through active engagement in occupation.

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Participation

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Involvement in a life situation.

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Areas of Occupation

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Various kinds of life activities in which people engage, including ADL, IADL, education, work, play, leisure, and social participation.

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Intervention Approaches

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Specific strategies selected to direct the process of intervention that are based on the client's desired outcome, evaluation data, and evidence. • Create/promote (health promotion) • Establish/restore (remediation/restoration) • Maintain • Modify (compensation/adaptation) • Prevent (disability prevention)

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Therapeutic Use of Self

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A practitioner's planned use of his or her personality, insights, perceptions, and judgements as part of the therapeutic process.

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Therapeutic Use of Occupations and Activities

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Occupations and activities selected for specific clients that meet therapeutic goals. To use occupations/activities therapeutically, context(s), activity demands, and client factors all should be considered in relation to the client's therapeutic goals.

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Consultation Process

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A type of intervention in which practitioners use their knowledge and expertise to collaborate with the client. The collaborative process involved identifying the problem, creating possible solutions, trying solutions, and altering them as necessary for greater effectiveness. The practitioner is not directly responsible for the outcome of the intervention.

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Education Process

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An intervention process that involves the imparting of knowledge and information about occupation and activity and that does not result in the actual performance of the the occupation/activity.

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Activities of Daily Living (ADL)

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Area of occupation / Activities that are oriented toward taking care of one's own body, Also referred to as basic activities of daily living (BADL) and personal activities of daily living (PADL).

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Adaptation

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Type of outcome / A change a person make in his or her response approach when that person encounters an occupational challenge.

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Adaptation

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Type of performance skill / Relates to the ability to anticipate, correct for, and benefit by learning from consequences of errors that arise in the course of task performance.

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Assessment

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Used to refer to specific tools or instruments that are used during the evaluation process.

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Client Satisfaction

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Type of outcome / The client's affective response to his or her perceptions of the process and benefits of receiving occupational therapy services.

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Communication/Interaction Skills

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A performance skill, Refer to conveying intentions and needs as well as coordinating social behavior to act together with people.

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Culutral

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Context / Customs, beliefs, activity patterns, behavior standards, and expectations accepted by the society of which the individual is a member / Includes political aspects, such as laws that affect access to resources and affirm personal rights / Also includes opportunities for education, employment, and economic support.

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Dynamic Assessment

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Describes a process used during intervention implementation for testing the hypotheses generated through the evaluation process. Allows for evaluation of change and intervention effectiveness during intervention. Assesses the interactions among the person, environment, and activity to understand how the client learns and approaches activities. May lead to adjustments in intervention plan.

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Education

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Area of occupation, Includes activities needed for being a student and participating in a learning environment. • Formal educational participation • Informal personal educational needs or interests exploration (beyond formal education) • Informal personal education participation

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Health

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Type of Outcome / A complete state of physical, mental, and social well-being and not just the absence of disease or inﬁrmity

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Health Status

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A condition in which one successfully and satisfactorily performs occupations.

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Identity

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A composite deﬁnition of the self and includes an interpersonal aspect (e.g., our roles and relationships, such as mother, wives, occupational therapists), an aspect of possibility or potential (who we might become), and a values aspect (that suggests importance and provides a stable basis for choices and decisions) / Identity can be viewed as the superordinate view of ourselves that includes both self esteem and self-concept, but also importantly reﬂects and is inﬂuenced by the larger social world in which we ﬁnd ourselves.

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Instrumental Activities of Daily Living (IADL)

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Area of occupation / Activities that are oriented toward interacting with the environment and that are often complex. IADL are generally optional in nature, that is, may be delegated to another • Care of others (including selecting and supervising caregivers) • Care of pets • Child rearing • Communication device use • Community mobility • Financial management • Health management and maintenance • Home establishment and management • Meal preparation and cleanup • Safety procedures and emergency responses • Shopping

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Interests

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Disposition to ﬁnd pleasure and satisfaction in occupations and the self-knowledge of our enjoyment of occupations.

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Interventions

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• Therapeutic use of self • Therapeutic use of occupations/activities • Consultation process • Education process

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Leisure

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Area of occupation / A nonobligatory activity that is intrinsically motivated and engaged in during discretionary time, that is, time not committed to obligatory occupations such as work, self-care, or sleep • Leisure exploration • Leisure participation

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Personal

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Context / Age, gender, socioeconomic status, and educations status / Features of the individual that are not part of a health condition or health status.

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Physical

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Context / Nonhuman aspects of contexts. Includes the accessibility to and performance within environments having natural terrain, plants, animals, buildings, furniture, objects, tools, or devices.

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Play

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Area of occupation / Any spontaneous or organized activity that provides enjoyment, entertainment, amusement, or diversion • Play exploration • Play participation

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Prevention

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Type of outcome / Promoting a healthy lifestyle at the individual, group, organizational, community (societal), governmental/policy level.

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Occupation-based activity

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Purpose: Allows clients to engage in actual occupations that are part of their own context and that match their goals. Examples: • Play on playground equipment during recess. • Purchase own groceries and prepare a meal. • Adapt the assembly line to achieve greater safety. • Put on clothes without assistance.

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Purposeful activity

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Purpose: Allows the client to engage in goal-directed behaviors or activities within a therapeutically designed context that lead to an occupation or occupations. Examples: • Practice vegetable slicing. • Practice drawing a straight line. • Practice safe ways to get in and out of a bathtub equipped with grab bars. • Role play to learn ways to manage anger

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Preparatory Methods

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Purpose: Prepares the client for occupational performance. Used in preparation for purposeful and occupation-based activities. Examples: • Sensory input to promote optimum response • Physical agent modalities • Orthotics/splinting (design, fabrication, application) • Exercise

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Quality of life

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Type of Outcome / A person's dynamic appraisal of his or her life satisfactions (perceptions of progress toward one's goals), self-concept (the composite of beliefs and feelings about oneself), health and functioning (including health status, self-care capabilities, and role competence), and socioeconomic factors (e.g., vocation, education, income).

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Reevaluation

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A reassessment of the client's performance and goals to determine the type and amount of change.

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Role competence

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The ability to effectively meet the demand of roles in which the client engages.

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Self-efficacy

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People's beliefs in their capabilities to organize and execute the courses of action required to deal with prospective situations.

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Social

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Context / Availability and expectations of signiﬁcant individuals, such as spouse, friends, and caregivers. Also includes larger social groups which are inﬂuential in establishing norms,role expectations, and social routines.

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Social Participation

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Area of occupation / Organized patterns of behavior that are characteristic and expected of an individual in a given position within a social system • Community • Family • Peer, friend

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Spiritual

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Context / The fundamental orientation of a person's life; that which inspires and motivates that individual.

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Temporal

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Context / Location of occupational performance in time

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Values

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A coherent set of convictions that assigns signiﬁcance or standards to occupations, creating a strong disposition to perform accordingly.

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Virtual

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Context / Environment in which communication occurs by means of airways or computers and an absence of physical contact.

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Wellness

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Type of outcome / The condition of being in good health, including the appreciation and the enjoyment of health. Wellness is more than a lack of disease symptoms; it is a state of mental and physical balance and fitness.

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Work

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Area of occupation / Includes activities needed for engaging in remunerative employment or volunteer activities • Employment interests and pursuits • Employment seeking and acquisition • Job performance • Retirement preparation and adjustment • Volunteer exploration • Volunteer participation

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