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(Schell, Gillen &Scaffa, 2013)
• Foresee a negative outcome and attempt to avoid it
• Can use any of the other intervention strategies before problem develops
• Person is the target
• “Aimed at developing and
improving skills and abilities so
person can perform tasks
(occupations) in context” (p. 497)
• E.g., ROM
(Schell, Gillen &Scaffa, 2013)
(Schell, Gillen &Scaffa, 2013, p. 497)
• Target context or task
• Important to consider social and
cultural environment, not just
physical
(Schell, Gillen &Scaffa, 2013)
(Law et al., 1999 as cited in Schell, Gillen &Scaffa, 2013)
(Lund & Nygard, 2004 as cited in Schell, Gillen & Scaffa, 2013)
(Hargreaves et al., 2002)
(Paul-Ward, Kielhofner, Braveman, & Levin, 2005)
(Chamberlin, 1990; Deegan, 1993 as cited in Schell, Gillen &Scaffa, 2013)
(Stav, 2010)
(Brown, Rempfer, & Hamera, 2002)
(Schell, Gillen & Scaffa, 2013)
(Gillespie, Robertson, Gillespie, Lamb, Gates,
Cumming & Rowe, 2008)
• Improve fit
(Pendleton & Schultz-Krohn, 2013); (Schell, Gillen &Scaffa, 2013)
(Schell, Gillen &Scaffa, 2013)
• 1990’s ==> Creation of three models
emphasizing the environment
• Ecology of Human Performance Model (EHP)
• Person-Environment-Occupational-
Performance Model (PEOP)
• Person-Environment-Occupation Model (PEO)
(Schell, Gillen &Scaffa, 2013)
All three models:
• Are dynamic
• Are primarily concerned with occupational
performance
• Consider person, environment (context) and
occupation (task) as determinants of OP
• Are based on goodness of fit
Based on:
• Social science theory
• Earlier models of occupational therapy
• Disability Movement
(Schell, Gillen &Scaffa, 2013)
(Dunn et al., 1994, p. 605)
According to all three models:
(Schell, Gillen &Scaffa, 2013)
"Establish/Restore: The therapist decides to work on functional range of motion for reaching and stepping using facilitation techniques."
"Alter: The therapist and Ms. T discuss her need to socialize and Ms. T expresses concern over her usual socializing in the quilting club, which expects a certain level of performance, The therapist suggests Sunday school as a place to socialize that doesn't require the fine motor control."
"Adapt: The therapist brings clamps to help her with her stitching so that she could still do some stitching, The therapist brings her a stocking darner and Velcro to attach to key items in the bathroom when she expressed desire to dress and complete personal hygiene."
"Prevent: The therapist helps Ms. T to establish a daily routine to prevent joint, muscle, and skin breakdowns."
"Create: The therapist helps her plan regular times to play with her grandchildren as part of the family routine."
(Schell, Gillen &Scaffa, 2013, p. 498)
(Dunn, Brown, & McGuigan 1994)
Crepeau, E. B., Cohn, E. S., & Schell, B. A. (2013). Willard & Spackman's Occupational Therapy (12th ed.). Baltimore, MD: Lippincott, William & Wilkins.
Dunn, W., Brown, C., & McGuigan, A. (1994). The ecology of human performance:
A framework for considering the effect of context. The American Journal of Occupational Therapy, 48(7), 595-607.
Gitlin, L. N., Winter, L., Corcoran, M., Dennis, M. P., Schinfeld, S., & Hauck, W. W. (2003). Effects of the home environmental skill-building program on the caregiver–care recipient dyad: 6-month outcomes from the Philadelphia REACH initiative. The Gerontologist, 43(4), 532-546.
Hargreaves, M., Schlundt, D., & Buchowski, M. (2002). Contextual factors influencing the eating behaviours of African American women: a focus group investigation. Ethnicity & Health, 7(3), 133-147.
Lund, M. L., & Nygård, L. (2004). Occupational life in the home environment: the experiences of people with disabilities. Canadian journal of occupational therapy. Revue canadienne d'ergothérapie, 71(4), 243.
Paul-Ward, A., Kielhofner, G., Braveman, B., & Levin, M. (2005). Resident and staff perceptions of barriers to independence and employment in supportive living settings for persons with AIDS. American Journal Of Occupational Therapy, 59(5), 540-545
Schell, B., Gillen, G., & Scaffa, M.(Eds.) Willard & Spackman’s Occupational Therapy, 12th edition (pp 364-381). Baltimore, MD: Lippincott Williams & Wilkins.
Stav, W. (2010). CarFit: an evaluation of behaviour change and impact. The British Journal of Occupational Therapy, 73(12), 589-597.
Schultz-Krohn, W., & McHugh Pendleton, H. (2012). Pedretti’s occupational therapy: Practice skills for physical dysfunction. Elsevier.
Teel C. Dunn W. Jackson ST. Duncan P. (1997). The role of the environment in fostering independence: conceptual and methodological issues in developing an instrument. Topics in Stroke Rehabilitation, 4(1):28-40, 1997.
(Schell, Gillen &Scaffa, 2013, p. 496)
What does the EHP do?
Focus:
Values:
Goal:
All three models:
(Schell, Gillen &Scaffa, 2013)
(Dunn et al., 1994, p. 605)
(Schell, Gillen &Scaffa, 2013)
(Dunn, Brown, & McGuigan 1994)
(Schell, Gillen &Scaffa, 2013)