Occupational therapy is a science-based, holistic health care profession that uses evidence-based interventions to help people overcome challenges and lead meaningful lives.
Here, we'll explore key concepts to understand the theories and practices that make occupational therapy so unique.
Occupational Therapy Theory
Occupational therapy (OT) is a science-based and client-centered health care profession that enables people of all ages to participate in meaningful daily activities (occupations).
Intervention focuses on any meaningful activity that a person wants or needs to accomplish in any area of life, from self-care, home and family, school, work, and recreation.
Based on theory, occupational therapy models are the lens through which occupational therapists view human performance.
The primary models that occupational therapists use to inform evaluations and interventions are:
Model of Human Occupation (MOHO)
The Model of Human Occupation (MOHO) explains how occupation (meaningful activity) is motivated, patterned, and performed. It views humans as composed of three interrelated components: volition, habituation, and performance capacity.
MOHO is applicable across the lifespan and can be used with any person experiencing difficulty participating in meaningful activities.
- Volition is what motivates us to participate in occupations or meaningful activities.
- Habituation is the process through which occupations are organized into patterns or routines.
- Performance capacity includes the physical and mental capabilities needed for skilled occupational performance.
Suppose an OT evaluates a patient and creates a treatment plan using MOHO.
In that case, the OT needs to understand what activity is motivating that individual (volition), how the activity will be carried out (habituation), and what physical and mental capabilities are needed to perform the activity (performance capacity).
Person-Environment-Occupation-Performance Model (PEO)
The PEO model is based on the concept that the person, environment, and occupations are interconnected and ultimately affect occupational performance.
We constantly interact with our environments (surroundings), impacting how we do what we need and want to do daily.
An OT providing services for a middle school child with autism spectrum disorder who is distracted by noise and the activities of others may recommend environmental modifications to support the student's school performance.
For example, the student may benefit from being seated closer to the front of the classroom and being allowed to wear headphones during work and study times.
Allen's Cognitive Disabilities Model (CDM)
Occupational therapists have used the Cognitive Disabilities Model for over 40 years with individuals whose functional performance (participation in meaningful activity) appears to be impacted by possible cognitive impairments.
CDM focuses on understanding how functional cognition (information processing capacity and the performance of a skill) affects an individual, and it is measured by consistently observing how the individual performs the skill.
From there, the environment and activity may be adapted to enable the individual to perform the activity safely and effectively.
For example, if an OT is evaluating a person with memory loss who needs to make the bed every day and who was observed to occasionally forget the steps, environmental modifications could include a three-step picture board placed on the wall (1. Pull up the sheets, 2. Pull up the comforter, 3. Place the pillows at the top) and clutter could be reduced on the bed to reduce distraction.
Canadian Model of Occupational Performance and Engagement (CMOP-E)
The CMPO-E is a newer adaptation of the previous Canadian Model of Occupational Performance (CMOP). The modern addition recognizes the component of "engagement," meaning that people can find meaning and satisfaction in occupations that they can't physically perform.
Under the CMPO-E model, people are viewed as having cognitive, affective, and physical components, all of which are influenced by spirituality. This model considers how less tangible aspects of a person's identity affect occupational participation.
An individual is viewed as interacting with their environments (physical, institutional, cultural, and social) through occupation (meaningful activities), including self-care, work, and leisure.
Using the CMOP-E model, an OT will appreciate cultural diversity and consider how an individual's cultural background may impact functional performance at home and work.
Key Interventions in Occupational Therapy
Occupational therapy interventions vary by practice area and setting. At their core, however, interventions support participation in meaningful activities. They are client-centered and meant to address the individual's needs.
Common interventions found in occupational therapy practice include:
- Task analysis and activity modification: Determine the physical and mental capabilities needed to complete a task and modify the activity to meet the individual's skill level.
- Functional activities (occupations) as therapy: The client participates in activities to improve skills and promote healing. For example, a person healing from a broken wrist may gently fold laundry as exercise.
- Play-based interventions: A child's primary occupation is play, and play-based interventions promote the development of skills in a motivating and meaningful way for children.
- Environmental modifications: home, work, and school environments may be adapted for safety and to promote participation.
- Adaptive equipment and assistive technology: OTs provide recommendations and education for adaptive equipment, such as wheelchairs, and assistive technology, such as talk-to-text devices and software.
Why Do Theory and Intervention Matter
Occupational therapy theory and intervention set the profession apart as uniquely focused on the "person" first and as using "occupation" as the primary form of intervention.
The foundation of all occupational therapy models is to consider the interaction between the person and their environment and how that interaction impacts performance and participation in meaningful activities.
Occupational therapy intervention includes functional activities (rather than repetitive rote exercise, for example) to promote health and healing, build skills, and support individuals and their families in doing the things they want and need to do each day across the lifespan.
Occupational Therapy Theory and Intervention
Occupational therapy is a client-centered and impactful profession grounded in research and theory that uses meaningful, functional activities as interventions.
Occupational therapy is a profoundly impactful profession grounded in research, shaped by theory, and brought to life through practical, client-centered interventions. Its holistic, flexible approach makes OT effective across diverse settings, from hospitals and schools to community programs and telehealth platforms.
Whether supporting a child with developmental needs or helping an older adult recover independence after an injury, OTs use science and empathy to support their clients' goals. As the profession evolves, the foundational models and strategies will remain essential to the profession's success.
