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Canadian Model of Occupational Performance & Engagement (CMOP-E)
Reference: Townsend, E., & Polatajko, H. (2013). Enabling Occupation II: Advancing an Occupational Therapy vision for health, well-being, & justice through occupation (2nd ed.). Ottawa, ON: CAOT Publications ACE.
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Background of the CMOP-E
- The Canadian Model of Occupational Performance and Engagement (CMOP-E) is an expansion of the Canadian Model of Occupational Performance (CMOP).
Background
- The expanded model reflects a broader scope of practice - creating occupationally supportive environments, advancing a vision of health, well-being, and justice through occupation.
Description
The CMOP-E model is a system model that graphically demonstrates the dynamic relationship between person, environment and occupation and its influence on occupational engagement and experience.
Basic assumptions
Occupation affects health and
well-being
Occupation organises time and brings structure to living
Occupation brings meaning to life
Occupations are idiosyncratic
The CMOP-E emphasises the
idea that occupations occur in a
range of environments and
therapists need to focus on creating
environments that are occupationally supportive
Conceptual components
Understanding that occupation has potential therapeutic value; therapists should understand the individuals
interests, intrinsic motivation
and values
Reflect
Reflect on the basic assumptions of the CMOP-E. How do these 4 assumptions fit within the practice of Occupational Therapy?
Reflect on a time where you could have better utilised an individual's interests, intrinsic motivation and values to enhance therapeutic outcomes.
The components of the CMOP-E
Components
Function occurs when all three components work in harmony. Dysfunction occurs when there is a disruption to any one of the components
Physical: Related to all sensory, motor and sensorimotor functions eg. proprioception, mobility
Affective: Comprises of all social and emotional functions as well as the individual's feelings
Person
Cognitive: Related to cognitive and intellectual functions eg. problem solving, memory
Spirituality: The core of the person. Therapist's need to understand personal meaning and uniqueness which in turn helps us to explore occupations
with our clients.
Self-care: Occupations related to looking after or maintaining one’s health and well-being (eg. toileting, brushing your hair)
Occupation
Productivity: Occupations that make a social or economic contribution or provide sustenance (eg. work - paid or unpaid, volunteering).
Leisure: Occupations for enjoyment and personal fulfillment (eg. reading, sports)
Institutional: Formal and
informal structures that promote social order and govern society eg. rules, policies, legal elements
Physical: The natural and built environment around the individual. Also includes objects that are constructed eg. products, technology, tools equipment
Environment
Social: Pertains to occupational roles and social interactions eg. people you encounter in everyday life/relationships
Cultural: Based on the values of the individual's culture. Can be impacted by beliefs, customs, ethnicity, race, age, gender.
Reflect
Think of a patient/client who was experiencing difficulties in one or more of the three components (person, environment and occupation). How did this impact on the other components?
Within the person factors, spirituality is the core of the person. How do you currently explore this in practice?
The nature of the model
allows for use among all age groups and with different
diagnoses and multicultural settings.
Applicability
The CMOP-E also has utility at a
population level. It has a focus on advancing a vision of health,
well-being and justice, and
encourages therapists to actively
consider institutional and
cultural factors.
5 Essential elements of Occupation-Based Practice
These five elements identify skills an Occupational Therapist must understand or possess to promote occupational health, well-being and justice.
1. Presence of an occupational challenge
Occupational Therapist's need to identify the presence of activity limitations or engagement restrictions which interferes with the ability of occupations to bring meaning to life.
One
2. Solutions that enable
There needs to be a collaborative approach to find a solution that enables occupational engagement by changing or adjusting elements of therapy. These solutions should draw on the individual's strengths and available resources.
Two
3. Client-centred enablement
Three
Enabling occupational engagement will stem from client-centred solutions and not something that is prescribed to a range of individuals. Therapists should focus on the client's goals and be led by their desires.
4. Multidisciplinary knowledge base
Four
To fully understand occupational complexity of an individual, we must understand that human occupation is impacted by a variety of elements, practices and people. Remember the individual does not only face physical occupational changes but also psychological and social challenges too.
5. Reasoning Process That Can Deal with Complexity
Five
As Occupational Therapists we must have an in-depth understanding of all aspects of the person, environment and occupations to develop a reasoning process that considers all complexities. Overall, our goal is to enable occupations with high level clinical reasoning.
Reflect
Do you feel like the CMOP-E could easily be incorporated/utilised within your practice with your specific population group?
Reflect on whether you consider any or all of the 5 essential elements of occupation-based practice when you are practicing.
COPM & CPPF
The Canadian Model of Occupational Performance and Engagement has informed the development and under pinning values of the Canadian Occupational Performance Measure (COPM) and the Canadian Practice Process Framework (CPPF)
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The Canadian Occupational Performance Measure (COPM) is designed to identify problems with occupational performance across self-care, productivity and leisure both as a tool to identify goals and as an outcome measure.
This measure is useful for identifying gaps between desired and actual occupational participation
COPM
Title
CPPF
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The Canadian Practice Process Framework (CPPF) outlines eight key action points that guide the therapeutic process in occupational therapy practice.
The eight action points may not always be linear, and it is important for therapists to be flexible and adaptable.
Title
Reflect
Reflect on whether the Canadian Practice Process Framework (CPPF) is similar or different to your current therapeutic process.
Reflect on a time where you have or could have used the Canadian Occupational Performance Measure (COPM) in practice and how this strengthened your occupation-based practice approach.
Explore the strengths and weaknesses of the CMOP-E
- Can be used across multiple settings and with a variety of populations
- Emphasises occupational engagement with less importance on performance
- Considers the interwoven relationship between the person, environment and occupation
Strengths
- Has specific assessments and frameworks associated with the model
- Considers the International Classification of Functioning, Disability and Health (ICF)
- Promotes client-centred practice
- The model has its own specific assessments and frameworks so fits best within these
Weaknesses
- A western conceptual model
Based on the strengths and weaknesses, reflect on when you think this model would be more practical to implement over another OT theoretical model.