Theory of
Occupational
Adaptation
Intellectual Heritage
The theory of occupational adaptation (OA)
describes the integration of two global
concepts in occupational therapy:
1.
Occupation
1.
2. Adaptation
The intellectual heritage of OA dates back to
the founders of OT and also contemporary
theorists in and outside the field
It is a Frame of reference.
First introduced as a frame of
reference 1992 by Schkade &
Schultz
Basic OT Theory
Most occupational therapy is driven by assumption that
as clients become more functional , they will be more
adaptive.
Guiding Assumptions of OA Theory
Practice based on OA assumes as clients become more
adaptive they become more functional.
Founders of OA proposed six guiding assumptions
about the relationship between occupational
performance and human adaptation. Each assumed to
be normative and applicable across lifespan
Six Guiding assumptions
1. Competence in occupation is a lifelong process of
adaptation to internal and external demands to
perform
2. Demands to perform occur naturally as a part of
person's occupational roles, and the context in which
they occur
[Link] occurs because persons ability to
perform has been challenged to the point at which
demands for performance are not met satisfactorily
4. the person's adaptive capacity can be overwhelmed
by impairment , physical or emotional disabilities, and
stressful life events
5. the greater the level of dysfunction , the greater the
demand for changes in person's adaptive process
6. Success in occupational performance is a direct
result of the person's ability to adapt with sufficient
mastery to satisfy the self and others
The press for mastery
The ongoing interaction of the person's desire for
mastery and the environment's demand for mastery
- yields the occupational challenge
Adaptive response
The person makes an internal adaptive response
and than produces an occupational response
known as an occupational outcome
Person: Internal Factors of
the OA Process
The left side of the model is devoted to
the internal factors: those that occur
within the person
The desire for mastery is a constant factor
in the OA process
The person is made up of the individual’s
unique sensorimotor, cognitive, and
psychosocial systems
Occupational Environment:
External Factors of the OA
Process
The right side of the model is devoted to
external factors that affect the person
The external process also begins with the
demand for mastery
The second external factor is the
occupational environment
Interaction of Internal and
External Factors: OA Process
The internal and external factors continuously
interact with each other through the modality
of occupation
The ongoing interaction of the person’s desire
for mastery and the occupational
environment’s demand for mastery creates a
third constant: the press for mastery
The press for mastery yields the occupational
challenge
Interaction of Internal and
External Factors (Continued)
The occupational role expectations of the
person and of the occupational environment
intersect in response to the unique
occupational challenge that the individual
experiences
The occupational response is the outcome—
the observable by-product of the adaptive
response
The occupational adaptation process begins
at the top of both the left and right sides of
the model at the same time
The OA Process: Adaptive
Response Subprocesses
Within the broad occupational adaptation
process, there are three subprocesses that
are internal to the person:
The generation subprocess is activated by
a mechanism that explains how an
adaptive response is created
The evaluation subprocess is activated
when the individual assesses the quality of
the occupational response
The integration subprocess communicates
negative results to the person
Introduction to Practice Based
on the Theory of Occupational
Adaptation
OA directs practice to be focused on the
therapeutic use of occupation to promote
clients’ adaptation
The primary intervention goal is to
maximize the client’s effectiveness in
using his or her own ability to be adaptive
The OA Clinical and Professional
Reasoning Process provides a systematic
progression of questions that practitioners
uses to frame overall thinking
Interruption in the OA
Process
When the normative OA process is seriously
disrupted, the person’s adaptive responses
are often inadequate
Impairments in person systems place
significant limits on the individual’s ability
to effectively use former or existing
adaptive responses
Cognitive issues often further limit the
ability to adapt
Strengths and Limitations
Strengths of OA include:
A theoretical orientation that is holistic
Assumptions adhere to the ideas of
occupation and adaptation that are
inherent in the profession’s history and
philosophy
Limitations include:
Practitioners who believe that
intervention based on meaning is not
practical in everyday practice
Lack of an OA assessment tool
Researc
h
There have been two main OA assumptions
and related outcomes under study:
First, OA-based interventions will have a
greater effect on functional independence
than therapy based on traditional ADLs,
tested by the Functional Independence
Measure (FIM)
Second, OA-based interventions will result
in greater generalization of skills learned in
therapy than traditional OT rehabilitation
methods
Thank you…
