This document provides an overview of occupational therapy theory. It defines what a theory is and discusses the purpose of theory in occupational therapy. Some key points made include: - Theories are conceptual tools that help explain or predict phenomena central to occupational therapy like occupation, the person, and environment. - The purpose of theory is to understand humans and their occupations and to predict changes in human functioning and occupational performance. - Theory guides occupational therapy practice and research advances theory through a circular process. - Occupational therapy draws on theories from other disciplines as well as its own occupational theories related to concepts like occupation, the person, and environment.

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OT 321
Occupation: Theory and Analysis
Theory and Practice in Occupational
Therapy
W & S CH 42
Overview
• Introduction to Theory
• Purpose
• Types
• Compare Basic & OT Theory
• Core Constructs
• Person/Client
• Environment/Context
• Occupation

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What Is A Theory?
Definitions
• ..theories are conceptual tools that help explain or predict a
central construct or that promotes understanding of a central
phenomena. (McColl, Law, & Stewart,1993 in Theoretical Basis
of OT, 1st edition)
• Theory is a set of ideas or concepts that people use to guide
their actions. (Morse, 1997 in Completing a qualitative project:
Details and dialogue)
• Theory is a “creative and rigorous structuring of ideas that
projects a tentative, purposeful, and systematic view of
phenomena.” p. 83 (Chinn & Kramer, 1991 in Theory and
ndursing: A systematic approach)

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Purpose of Theory in OT
• To understand humans and their occupations
• To predict change in human functioning and occupational
performance
Why Is Theory Important?
• It’s part of the profession’s knowledge base—provides credibility
• For new practitioners theory gives you a way to think about
practice—guides observation and problem solving
• It helps you reflect and articulate

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Theories Help Therapists:
• Understand phenomena
• See relationships
• Organize information and observations
• Make decisions about actions
• Interpret and explain what you see
• Summarize existing knowledge
• Point out directions for research
Current Practitioners Use Theory
To Guide Their Practice, But May Not
Explicitly Identify Theories
• Theoretical thinking may become embedded in reasoning
• Some ideas and constructs cut across multiple theories
• Several theories may be used simultaneously
• Theory continues to develop

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Theory, Research & Practice
• Theory guides practice
• Practice advances theory
Relationship Between Theory And
Research
A circular process
1. Research applies
theory
to verify. Relationships
may
not be supported
(deduction)
2. Research studies show
Relationships (induction)
1.Theory may need
to be modified
2. Theory may be
developed
Theory outlines
relationships

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There Are Many Types Of Theories In Our Tool
Box!!
• Conceptual Models
• Practice Models
• Occupational Theory
• Basic Theory
CONCEPTUAL MODELS
• Tools to help us understand
• Ways to think
• Statements about relationships of concepts or ideas
• Two types of conceptual theories
• Those about occupation—from our profession
• Those about humans & their environments—from other disciplines

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PRACTICE MODELS
(Frames of Reference)
•Tools to help us know what actions to take
•Two types of Practice Models
• Ways to therapeutically change performance of
occupations—from our profession
• Ways to therapeutically change humans & their
environments—from other disciplines
•Include assessments and interventions
approaches
Occupational Theory
• Conceptual
• Ways of thinking about occupation
• Practice
• Ways of acting to change occupation/occupational performance

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Basic Theory
• Conceptual
• Ways of thinking about humans/environments
• Practice
• Ways of acting to change humans/environments
Occupational Theory Tool box
Occupational
Conceptual
Occupational
Practice
Basic
Conceptual
Basic Practice

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Where Did OT Theories Come From?
• Our theories sprang from our philosophical values and beliefs
• Our theories drew upon science from related disciplines
Exploring The Philosophical Roots Of
Our Theories

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Occupation 1900-1974
• “… a freer conception of work, including recreation and any form of
helpful enjoyment.” Adolf Meyer, 1922
• “…Man, through the use of his hands, as they are energized by his
mind and will can influence the state of his own health” Mary Reilly,
1962
Occupation 1980’s
• What is our domain?
• Performance components vs Occupation
• Use of activity as the medium for human interaction
• Defining occupational form and performance

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Occupation 1990’s
• Academic discipline underlying practice
• Connection between theory and application
• Engagement in occupation therapeutic medium
• Occupation—form/maintain identity
Occupation 2000’s
• Occupational Therapy Practice Framework
• Domain & Process
• Focus on strengths—International Classification of Functioning

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Difference Between Theory and OT Practice
Framework
• OT Practice Framework describes the domain
• Theories describe how various aspects of the domain are related
Core Constructs
in OT Theories

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Core Constructs
•What is a construct?
•Levels of abstraction about
phenomena
-Highest level of abstraction
•Constructs are core ideas that
are woven throughout theories
Core Constructs
Across OT Theories
• Performance in Areas of Occupation
• Person/Client Factors
• Environment/Contextual Factors

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Areas Of OCCUPATION
•Activities of Daily Living (ADL)
•Instrumental Activities of Daily Living (IADL)
•Rest & Sleep
•Education
•Work
•Play
•Leisure
•Social Participation
OCCUPATIONS
• Beliefs about occupation have evolved over time
• Occupation is both an end & a means
• End: Desired outcome => to engage in occupations
• Means: Occupation as a therapeutic approach to health & well-being

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Different theories use different
terminology to identify similar or
related constructs
Terms
•Occupational performance
•Occupations
•Meaningful, purposeful activities
•Activities
•Tasks

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Many definitions of the term
“occupation”
“Occupation is intentional human performance
organized in number and kind to meet the
demand of self-maintenance & identity in family
and community.” Crabtree (1998)
Occupations involve choice and goal direction
Humans make meaning through occupations

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“Occupations may be organized into a view
of the human as a multileveled, open system
acting upon and responding to the
environment over a developmental trajectory,
from birth to death.”
Yerxa (1998)
People & occupations are dynamic &
complex—can’t be reduced to simple recipes!
Occupation Construct:
Analysis of Theory
•Does the theory include occupation?
•Are other terms used instead of occupation to
indicate a similar construct?
•How is the term occupation or related terms
defined/understood?
•Are categories of occupations or activities
described?
•What features or aspects of occupations are
discussed or emphasized?

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Construct
Person/Client
Client Factors
• Factors within the client
• Can affect occupational performance
• Include body function/structure

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Person Construct
•How do we view clients?
• Active
• Changing, evolving
• Intrinsically motivated
• Holistically—physical, psychological, social, emotional
• Individuals are unique
• Individuals have right to dignity
•This construct can be used to describe
characteristics of an individual, group, or
population.
Person Construct (cont.)
• Does the person have required body functions/body structures?
• Mental functions
• Sensory functions & pain
• Movement
• Cardiovasular, respiratory, immune system
• Voice & Speech
• Urinary/reproductive functions
• Skin

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Person Construct (cont.)
• How is the person’s performance skills?
• Motor skills
• Processing skills
• Communication skills
Person Construct (cont.)
• What are the performance patterns of the person?
• Habits
• Routines
• Roles

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Person Construct:
Analysis of Theory
•Does the theory include person/client factors or
related terms?
•How is the person defined/understood in a
particular theory?
•Does their theory identify categories to describe
person factors?
•What features or aspects of the person are
discussed or emphasized in the model or
framework?
Construct
Context/Environment

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Context
•Variety of interrelated conditions within and
surrounding the client
• Cultural
• Physical
• Social
• Personal
• Spiritual
• Temporal
• Virtual
Context/Environment Construct
• What we know so far…
• Context influences occupation
• Occupation influences context
• Context/environments can support or hinder engagement in occupations

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Context/Environment
Construct: Analysis Of Theory
• What terms are used to refer to this concept?
• How are terms defined?
• What types of context are addressed?
• What characteristics or qualities of context are emphasized
Occupation And Health
•How are they related?
•How do they influence each
other?

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What Is Health?
•Narrow view—body or mental functioning
•Broad view—a positive, dynamic state of well
being
• Personal fulfillment—satisfaction with own activities, good quality of life
• Adaptability—able to meet challenges of life and integrate functions to
realize goals
Broader View Of Health Values The
Person’s Perception
• Well being—perception of your overall physical and mental condition.
Can you have a positive sense of well being when you have a disability?
• Quality of life—appraisal of satisfaction, self concept (efficacy), health
functioning & socio-economic factors

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Global Health Perspective: International
Classification of Functioning, Disability &
Health
• Health can be affected by
• inability to carry out activities and participate in life situations
• problems that exist with body structures and functions
(WHO, 2001)
How does this view of health fit with
occupational therapy’s thinking about health
and wellness?

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Potential Consequences Of Loss Of
Occupations
• Decreased health
• Increased stress
• Resultant physiological changes
• Decreased self-efficacy
• Poorer quality of life
Potential Benefits Of Engaging In Occupations
• Positively influences health by supporting well being and life
satisfaction
• Among persons with spinal cord injury--life satisfaction related to work,
community mobility and social support NOT impairment or disability
• Among persons with dementia who remained active in occupations
demonstrated fewer disturbing behaviors

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Potential Reasons Why Engaging In
Occupations Affects Health & Well-
being?
• Choice
• Control
• Maintains social connections—roles
• Achievement of goals
• Development of capacities
• Provides stimulation and learning
How might these ideas affect your thinking
about designing and providing
interventions?

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Ways In Which Engaging In
Occupations Are Therapeutic
• Supports survival—take action to resolve stressor
• Provides diversion—”release” activity to allow time to recoup. Offers
balance
• Provide mastery—control/competence
• Provide the structure of habits—relieve the nervous system
Ways In Which Engaging In Occupations Are
Therapeutic
• Provides opportunities to give and receive support
• Grounds us in our identity—provides continuity, integrity
• Provides a spiritual connection by connecting us to purpose and
meaning

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OT Theories Offer
•Different
•Focus, Emphasis, Terminology
•Similar
•Core Constructs
Theories Can Emphasize Different
Determinants of Occupation
• Physical
• Psychological-Emotional
• Cognitive-Neurological
• Socio-Cultural
• Environmental

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Theories describe how
elements interrelate within our
domain—occupational therapy
Key Points
• Theories can guide thinking and/or actions about the performance of
occupations
• Occupation is both a desired end result and a means to supporting
health and well-being

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Key Points
• Core constructs are the main ideas of a theory that can be used to
understand and guide OT practice
• When selecting a particular theory or framework to guide your
practice, consider what constructs are addressed in that perspective.
BasicConceptualModel
BasicConceptualModel
BasicConceptualModel
OTConceptualModel
OTConceptualModel
OTConceptualModel
OTConceptualModel
Occupational Therapy Practice Framework
OT Practice ModelBasic Practice Model