1. Occupational Adaptation (Schkade & Schultz, 1992)

2. Occupational Adaptation (OA)
Developmental Origins
Developed by scholars at Texas Women’s University in 1989 for application to research. Framework for OT curriculum at TWU.
Introduced as a frame of reference in 1992, proposed as an overarching theory for research and practice in 2003

3. Occupational Adaptation
A way to understand the normative process of how individuals
Initiate,
Evaluate,
Integrate,
responses to their desire to meet a demand from their occupational environment

4. What does the model address?
Provides understanding about the integration of two global concepts: occupation and adaptation
Holistic model for OT practice.
Generic perspective across conditions, dysfunction, and practice settings.

5. Interdisciplinary Base
Occupational therapy theory - Gilfoyle, Reed, Kielhofner and Burke, Nelson
Occupational therapists historically from Dr. Adolph Meyer and William Dunton to present day theorists.

6. Theoretical Assumptions About Organization and …
Competence in occupation is a lifelong adaption to internal and external demands.
Demands to perform emerge from our roles and contexts
Success in occupational performance results from our ability to perform with mastery satisfactory to ourselves and others.
The greater the adaptive transitional needs, the greater the importance of the occupation adaptive process, and the greater the likelihood that the process will be disrupted.

7. Adaptive capacities can be overwhelmed by impairment, life events, and physical/emotional challenges.
The greater the level of dysfunction, the greater the demand for changes from the person.
Success in performance is a result of the person’s ability to adapt with sufficient and satisfying mastery.

9. The Person Desire for mastery
Person: includes the unique sensorimotor, cognitive, and psychosocial systems

10. The Occupational Environment
Demand for mastery
Occupational environment: context in which occupations occur; physical, social, and cultural.
Work, play/leisure, and self care

11. OCCUPATIONAL RESPONSE!
Interaction
Press for mastery
Occupational challenge
Occupational role expectations
OCCUPATIONAL RESPONSE!

12. Internal adaptation process
Stimulated by an occupational challenge
Responses must be
Generated
Evaluated
Integrated
Success=relative mastery
Efficiency
Effectiveness
Satisfaction (self and society)

13. Adaptation processes Energy Mode
Primary-active thinking and concentration
Secondary- subliminal
Mode
Existing- use ways you always have
Modified- make some changes, alterations
New- entirely different approach

14. Adaptive Response Behaviors
Primitive: Hyperstable
No movement or adaptation. Frozen
Transitional: Hypermobile
High activity, random, variable
Mature: Blended mobility & stability
Goal directed, modulated

15. Response cycles Relative mastery Negative or aversive experience
Result satisfying to person & occupational environment
strengthens state of occupational adaptation
Negative or aversive experience
Learn need for different approach, eventually gain relative mastery
No learning-repetition of dysfunctional behavior, reinforces occupational dysadaptation

16. Therapeutic Intervention - Focus
Maximize client’s effectiveness in his or her own ability to be adaptive.
Occupations are the means to achieve the goal.
Increased adaptation leads to increased participation in life’s activities.

17. Intervention principles
Way of thinking about intervention in internal adaptation process
Intervention guided by occupational role requirements in context
Personally relevant intervention likely to be more efficient/effective than general skill development

18. Intervention principles
Focus: To facilitate person’s internal adaptation processes
Methods
Client selects occupational role to perform
Occupational readiness
Address deficits affecting performance (i.e., sensorimotor, cognitive, psychosocial)
Occupational activity
active participation
meaningful
result in tangible or intangible product

19. Intervention principles
Client evaluates progress to relative mastery
time, energy, resources
goal achievement
satisfaction (self/others)
Therapist assesses progress with standard tools and observation
spontaneous generalization
initiation of new approaches-novel situation
increase relative mastery

20. Technology for Application
OT is an agent of the occupational environment.
OT applies principles of therapeutic use of self.
OT uses occupation to promote adaptation.
Client is the agent of change.

21. How do we know if mastery is improving?
Self-initiation
Generalization of skills
Satisfaction with performance?

22. Empirical Security
Studies with persons experiencing CVA and hip fractures
Several studies researching differing constructions from the theory: quasi-experimental designs
Focus of OT doctoral program at TWU with ongoing student and faculty research