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Canadian Model of Occupational Performance

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Katie Schaeffer

on 4 November 2014

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Transcript of Canadian Model of Occupational Performance

Canadian Model of Occupational Performance and Engagement (CMOP-E)
Bre Lengel and Katie Schaeffer
Author and Timeframe
CMOP-E Schematic
“This material reproduced/replicated for fair use for educational purposes in OCTH 611.101, Fall 2014, Towson University and should not be copied without permission of copyright holder.”
Philosophical Assumptions
Application of the Model
Helene Polatajko
Elizabeth Townsend
Janet Craik
Members of the Canadian Association of Occupational Therapists (CAOT)
Wanted to enable occupation

1. There is a dynamic interplay between the person, environment and occupation.

2. Spirituality is the core of the person, environment and occupation interactions.

3. Occupation is the bridge that connects the person and the environment.
Concepts and Constructs

3 performance components
Cultural, institutional, physical, and social
Occupation - core domain
3 areas
self care

Randomized Controlled Pilot Study of an Occupational Time-Use Intervention for People with Serious Mental Illness
By Megan Edgelow and Terry Krupa
10 community dwelling people with serious mental illness receiving assertive community treatment services
Methods: randomized controlled design
Action Over Inertia increased occupational balance (shifted away from sleep towards increased general activity in tx group)
No differences in occupational engagement
Action Over Inertia shows efficacy and clinical utility (all participants would recommend tx to others with SMI)
CMOP-E: Interventions
Spirituality in bedlam: Exploring professional conversations on acute psychiatric units
By Melinda J. Suto and Sharon Smith
8 mental health professionals in acute settings representing variety of disciplines
Methods: community-based participatory research design using focus groups, individual interviews, appreciative inquiry, and interpretive description
Results (participants described):
Challenges in setting boundaries related to spirituality conversations and discerning spiritual experience from psychosis
Emphasized importance in providing empathetic presence while also engaging in spiritual networking
CMOP-E: Spirituality

Evaluation of Functional Goal Outcomes Using the Canadian Occupational Performance Measure (COPM) following Deep Brain Stimulation (DBS) in Childhood Dystonia
By Hortensia Gimeno, Kylee Tustin, Daniel Lumsden, Keyoumars Ashkan, Richard Selway, and Jean-Pierre Lin
30 children with dystonia 1 year post DBS
Methods: a prospective case series using COPM and Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) as outcome measures
All groups demonstrated significant improvement in goal attainment
Secondary dystonias (another condition present)- improved performance and satisfaction scores
BFMDRS scores did not show significant improvement (due to insensitivity of impairment scales for dystonia)
CMOP-E: use of COPM
Perceptions of Spirituality and Spiritual Care in Occupational Therapy Practice
By Douglas N. Morris
310 occupational therapists who were members of AOTA listservs
Literature Review: importance of holistic treatment by including spirituality and its impact on occupational engagement
Method: randomized online survey
Significant positive relationship between education on OT spiritual care and influences on attitudes towards OT spiritual care
~70% of OTs felt education did not emphasize use of spirituality in practice
~7% of OTs felt spiritual care was a form of "proselytizying" (converting)
CMOP-E: spirituality and engagement
Strengths of the Model
Focuses beyond occupational performance on engagement
Incorporates spirituality
Occupation as the core domain
Provides COPM as an assessment/evaluation tool
Ease of application and use in the clinical setting
Limitations of the Model
Limited research
Defines occupation in just 3 areas
Defines person in only 3 performance components
Occupation based application
Ideas for Future Refinement
The Person
Motivated by food
Easily distracted
Limited concentration
Good memory
Slow learner
Limited fine motor skills
Limited body awareness
Good spatial awareness
Good gross movements (with orthotics)
The Environment
Maori culture (Australian)
Culturally diverse school
Positive attitude
Friends at school
Older sister
Maori culture (upholding traditional values)
School rules
Human Rights Act
Privacy Act
OT code of ethics
Independent with toileting, eating, sleeping, dressing
Difficulty eating independently
Decreased hygiene/grooming
Participates in class
Attends horse riding sessions 1x week (for coordination, balance, planning)
Uses adaptive technology to communicate effectively
Socializing with staff and classmates
Occupational Imbalance
Unaware of danger/too friendly
Soft spoken- gets hurt by other kids and unable to be assertive
Fear prevents him from participating in different occupations
Decreased concentration
Difficulty with fine motor tasks
Noisy environment
Limited access to communication devices in class
Limited equipment in class
This material reproduced/replicated for fair use for educational purposes OCTH 611 Fall 2014, Towson University and should not be copied without permission of the copyright holder.
Material adapted from http://prezi.com/q4u22zladiks/case-study/
CMOP-E Interventions
Approaches: educational, acquisitional, modeling, manual guidance, positive reinforcements, verbal prompts
Using music to encourage, working with Atticus' mood, incorporating spirituality
Ensuring all interventions are meaningful to Atticus to promote engagement
Atticus, a 12 year old boy
-Characteristics: fun, spiritual, musical, rhythmic, friendly, easily scared
-Dx: ID, microcephaly, single palmar crease, self injurous behavior, LE contractures

Helene Polatajko
Retrieved from: http://www.ot.utoronto.ca/faculty/faculty_directory/polatajko_h.asp
Elizabeth Townsend
Retrieved from: http://www.ot.utoronto.ca/news/current_events/leaders.asp
Janet Craik
Retrieved from: http://www.caot.ca/default.asp?pageid=2426
History and Evolution of the CMOP-E
Occupational Performance Model: 1991
Development of Canadian Occupational Performance Measure (COPM)
Canadian Model of Occupational Performance (CMOP): 1997
Canadian Model of Occupational Performance and Engagement (CMOP-E): 2007
Includes and extends beyond occupational performance
Advancement of CMOP to include engagement
Incorporates ideas from PEO model
Highlights the importance of the interdependence and interactions of the person, environment and occupation
Spirituality-focused model
Advances a vision on health, well-being, and justice through occupation
Derived from interdisciplinary theories:
Humanistic theory - client-centered approach
Environmental theories - ability to adapt and acquire skills
Broader understanding of human occupation
History and Evolution of CMOP-E
CMOP-E Assumptions
1. Spirituality resides in persons, is shaped by the environment, and gives meaning to occupations.

2. Engagement in occupations bring meaning to life.

Occupational Therapy is...
“Occupational therapy is the art and science of enabling engagement in everyday living, through occupation; of enabling people to perform the occupations that foster health and well-being;  and of enabling a just and inclusive society so that all people may participate to their potential in the daily occupations of life” (Townsend & Polatajko, 2007, p. 27).
Future research on clinical application of CMOP-E
Include OTPF terminology in definitions of occupation
More than 3 areas of occupation
Include OTPF terminology in definitions of person
More than 3 performance components
Cultural - Personal and community attitudes and beliefs
Institutional - Policies, laws, and enforcement of laws
Physical- Physical barriers in home and community
Social- Support from family, friends and involvement in community
Self-Care - ADLs: Bathing, toileting, dressing, grooming, feeding, Functional mobility: stairs, bed transfers, car transfers
Productivity - IADLs: meal prep, cleaning, laundry, shopping, paid or volunteer work, schoolwork, play skills
Leisure- Quiet recreation, active recreation (sports, travel, outings), socialization
shaped and expressed through occupations
does not refer to religion, but the essence of self, the place where determination and meaning are drawn
STM, judgment, problem solving, reasoning, comprehension
Mental health, emotional acceptance and readiness, motivation, initiation
assessment of current needs with future changes considered
Retrieved from: http://en.wikipedia.org/wiki/Nick_Vujicic
Edgelow, M., & Krupa, T. (2011). Randomized controlled pilot study of an occupational time-use intervention for people with serious mental illness. American Journal of Occupational Therapy, 65, 267–276. doi: 10.5014/ajot.2011.001313
Esau, Z. Case Study. Retrieved from http://prezi.com/q4u22zladiks/case-study/
Gimeno, H., Tustin, K., Lumsden, D., Ashkan, K., Selway, R., & Lin, J. P. (2014). Evaluation of functional goal outcomes using the Canadian Occupational Performance Measure (COPM) following Deep Brain Stimulation (DBS) in childhood dystonia. European Journal of Paediatric Neurology, 18, 308-316. doi: 10.1016/j.ejpn.2013.12.010
Morris, D. N. (2013). Perceptions of spirituality and spiritual care in occupational therapy practice. Occupational Therapy in Mental Health, 29, 60-77. doi: 10.1080/0164212X.2013.761109
Ramafikeng, M. (2010). The canadian model of occupational performance and engagement (CMOP-E). Retrieved from https://vula.uct.ac.za/access/content/group/9c29ba04-b1ee-49b9-8c85-9a468b556ce2/Framework_2/pdf/The%20Canadian%20Model%20of%20Occupational%20Performance%20and%20Engagement.pdf
Polatajko, H.J., Townsend, E.A. & Craik, J. (2007).
Enabling occupation II: Advancing an occupational therapy vision of health, well-being, & justice through occupation
. Ottawa, ON: CAOT Publications ACE.
Suto, M. J. & Smith, S. (2014). Spirituality in bedlam: Exploring professional conversations on acute psychiatric units. Canadian Journal of Occupational Therapy, 81, 18-28. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24783485
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