OT 301 A & B OT 603 & 604 Foundations of Practice Model of Human Occupation

Model of Human Occupation (MOHO) Kielhofner, Burke, & Heard, 1980,2002, 2009

Interdisciplinary theoretical Base Psychology Anthropology Sociology Philosophy Environmental psychology Systems theories – general and dynamic

What is MOHO about? “Individuals participation and adaptation in life occupations” (Kielhofner, 2009, p. 149)

What does the model address? The motivation for occupation – Reilly, 1960s – “occupation is a central aspect of the human experience” (Kielhofner & Burke, 1980, p. 573) Patterns of occupation Subjective elements of occupational performance How the environment (context) influences occupation

Theoretical Concepts About Organization Human beings and human behavior are composed of three subsystems: Volition Habituation Performance capacity

Theoretical Concepts About Organization Volition – all humans have a need and desire for action. Life experience shapes our thoughts and feelings. Habituation – how actions are organized into patterns and routines Performance capacity – the resource for occupational performance, our underlying mental and physical capacities

Volition Personal causation – the thoughts and feelings about an individual’s effectiveness or efficacy about occupations. Will I be successful? Interests – occupations chosen because an individual finds them interesting or pleasurable Values – commitments and convictions guiding right and wrong, what is important

The volitional process is unique to each individual.

Habituation allows us to perform routine behavior efficiently. Organizes occupational behavior into patterns and roles. Habits are automatic. Our habits influence our daily and weekly routines Roles - identity Habituation allows us to perform routine behavior efficiently.

Performance Capacity Underlying physical and mental abilities – How does this relate to the “Framework” concepts? Subjective experiences - how do people experience impairment?

Theoretical Concepts About Organization – the environment The environment interacts with the person during occupational performance. Environment includes objects, space, people and events influenced by cultural, political, and economic factors Occupational forms (Nelson, 1988) – a “rule-bound” convention for doing provide information about motivation Occupational settings – influence occupations

Occupational Performance Occupational participation Occupational forms Skills: motor, process, communication

Theoretical Concepts About Organization Over our lifetime, we create our occupational identity through competency and a process of ongoing adaptation. Occupational identity – who you are and wish to be as an occupational being Occupational competency – successfully engaging in occupations to reflect your identity

Theoretical Concepts About Problems “Life happens” and our occupational narrative changes! Enter occupational therapy

Postulates (relationships) An individual’s characteristics and the environment are linked together Occupation reflects the influence of both the person and the environment An individual’s inner characteristics are maintained and changed through occupational performance

Therapeutic Intervention Change is driven by a client’s occupational engagement Skills practice Learning new habits Trying a new role Experience success and mastery Feeling competent

How? (intervention) Therapy should be the “doing” of meaningful, relevant occupation not contrived – occupation based activities are necessary The OT continuously identifies and seeks to understand the lack of occupational adaptation and work to influence change Your clinical reasoning

Technology for Application 19 assessment tools – observational, self-report, interview, mixed method formats Remotivation Process Enabling Self-Determination (ESD) Program

Empirical security* Basic aspects of the model – content validity, correlative, comparative, prospective, and qualitative Applications of MOHO *More than 400 publications and 100 studies

MOHO Clearinghouse http://www.moho.uic.edu/ Products Resources Information about Model development Evidence-based practice