Person-Environment-Occupation-Performance (PEOP) ●​ Social Support: Belonging, resources.

●​ Policy: Funding, advocacy.

Model
●​ Assistive Technology: Devices for functional capabilities.
Introduction
●​ Application: OT uses a systems-based, client-centered
●​ Origin: Developed by Charles Christiansen and Carolyn Baum, first
approach to match intrinsic/extrinsic factors for meaningful
published in 1991, with updates in 1997, 2005, and 2015 (Baum,
outcomes.
Christiansen, & Bass, 2015).
Function and Dysfunction
●​ Purpose: Highlights the complex interplay of person, environment,
●​ Function (Healthy Functioning):
occupation, and performance to support occupational therapy (OT)
●​ Occurs when a person’s desires and competencies align with
practice.
occupational demands, leading to participation, well-being, and role
●​ Core Belief: "Occupational performance (doing) enables participation
satisfaction.
(engagement) in everyday life that contributes to well-being (health and
●​ Indicators: Self-management, caring for others, work/play, community
quality of life)" (Baum et al., 2015, p. 54).
engagement, adaptability to challenges.
●​ Scope: Applies to individuals, populations, organizations, and communities
●​ Dysfunction:
across various health care settings (e.g., medical, rehabilitation,
●​ Limited/restricted occupational performance, resulting in lack of goal
community).
attainment and participation (Rogers, 1983).
Theoretical Foundations
●​ Causes: Person-based impairments, environmental barriers, lack of
●​ Influences:
resources, role conflict, or unclear cultural expectations.
●​ Occupational Therapy Theories: Reilly (1962), Kielhofner & Burke
●​ Application: Assess person, occupation, and environment to identify
(1980), Howe & Briggs (1982), Reed & Sanderson (1999), Law (1991).
constraints and enablers.
●​ Non-OT Theories: General systems theory, environmental theory,
Change and Motivation
neurobehavioral theories, occupational science, social/behavioral
●​ Motivation:
psychology, Maslow’s motivational learning.
●​ Rooted in human agency (Reilly, 1962): Innate desire to explore and
●​ Environment-Behavior Theories: Bronfenbrenner’s ecological
master the environment.
systems (1977), Lawton & Nahemow’s ecological theory of aging
●​ Driven by intrinsic factors (motivation, self-efficacy, self-esteem,
(1973), Csikszentmihalyi’s adaptation (1988).
identity) and perceived value of outcomes.
●​ Framework: An ecological-transactional systems model blending
●​ Application: Elicit client’s narrative to understand psychological
biomedical and sociocultural perspectives, aligned with WHO’s International
factors and align interventions with meaningful goals.
Classification of Functioning, Disability and Health (ICF) and
●​ Change Process:
biopsychosocial (BPS) model (Meyer, 1922).
●​ Top-down, client-centered, starting with the narrative phase to identify
Focus
client priorities.
●​ Target: Address disruptions in occupational performance, participation,
●​ Success depends on matching performance enablers (intrinsic factors)
and well-being caused by person, occupation, or environment factors.
with activity demands, fostering self-satisfaction and competency.
●​ Approach: Top-down, client-centered, evidence-based, emphasizing the
●​ Positive reinforcement (intrinsic satisfaction, extrinsic rewards)
client’s narrative (story) to guide intervention.
sustains engagement.
●​ Client Definition: Includes individuals, families, organizations,
●​ Goal Setting Tips (Locke & Latham, 2002):
communities, and professionals in consultation.
●​ Realistic, challenging goals enhance performance.
●​ Key Components (Figure 7-1):
●​ Goals focus attention and skill application.
●​ Narrative: Client’s subjective story (perceptions, goals, needs).
●​ Constructive feedback supports goal achievement.
●​ Person Factors: Intrinsic capabilities (physiological, psychological,
Evaluation and Intervention: PEOP Occupational Therapy Process
cognitive, neurobehavioral, spiritual).
●​ Overview: A four-phase, client-centered, evidence-based process to
●​ Occupational Factors: Activities, tasks, roles.
enhance occupational performance (Figure 7-2).
●​ Environmental Factors: Extrinsic influences (culture, social
●​ Phases:
determinants, support, policy, technology).
●​ Narrative Phase:
Key Terms
●​ Gather client’s subjective story (perceptions, goals, history) to
●​ Occupation: Activities, tasks, and roles a person wants/needs to do daily
assess occupational desires and determine OT relevance.
(Baum et al., 2015, p. 50).
●​ Similar to an occupational profile, emphasizes client’s
●​ Occupational Performance: Doing meaningful activities/tasks/roles via
perspective.
person-environment interactions.
●​ Assessment and Evaluation Phase:
●​ Occupational Participation: Active engagement in occupations
●​ Use evidence-based assessments to measure person,
contributing to well-being.
occupation, and environment factors.
●​ Narrative: Subjective data on client’s situation and goals, akin to an
●​ Assessments: COPM (Law et al., 2014), Activity Card Sort
occupational profile.
(Baum & Edwards, 2008), Interest Checklist (Matsutsuyu, 1969),
●​ Person Factors: Physiological (health, fitness), psychological
Role Checklist (Oakley et al., 1986), Occupational Performance
(self-concept, motivation), cognitive (memory, reasoning), neurobehavioral
History Interview II (Kielhofner et al., 1997).
(sensory, motor), spiritual (meaning, identity).
●​ Analyze strengths/enablers vs. constraints/barriers, summarized
●​ Environment: Extrinsic factors (culture, social support, physical/natural
on a continuum chart.
environment, assistive technology, policy).
●​ Intervention Phase:
●​ Human Agency: Innate desire to master the environment.
●​ Collaboratively design an action plan based on client priorities
●​ Transactional Relationship: Reciprocal interaction among person,
and evidence-based strategies (Table 7-1).
occupation, and environment.
●​ Objectives:
●​ Intrinsic Factors: Person-based capabilities (e.g., self-efficacy, cognition).
●​ Enhance restorative benefits of occupational performance
●​ Extrinsic Factors: Environmental influences (e.g., social support, barriers).
(e.g., improve sensorimotor skills, cognition, motivation).
Theoretical Base
●​ Address environmental impacts (e.g., use assistive
●​ Assumptions:
technology, adapt to cultural norms, foster social support).
●​ Health and Occupations: Health requires engagement in meaningful,
●​ Structure occupations for mastery and participation.
satisfying occupations; only the client knows their desired outcomes
●​ Teach compensatory techniques and temporal adaptation.
(AOTA, 2014).
●​ Enhance role functioning (skill development, role clarity).
●​ Application: Begin with client’s narrative, assess capabilities and
●​ Principles: Client-centered, evidence-based, culturally sensitive,
environmental factors, and collaboratively plan interventions.
ethical, with effective communication and therapeutic use of self.
●​ Occupational Performance: Supports participation and well-being via
●​ Outcomes Phase:
person-occupation-environment interactions.
●​ Inform clients about potential intervention outcomes to ensure
●​ Application: OT guides clients to engage in meaningful
informed choices.
tasks/roles, using evidence-based practice.
●​ Focus on improving performance, participation, well-being,
●​ Dynamic Process: Occupational performance results from reciprocal
quality of life, and prevention.
interactions among person, occupation, and environment.
●​ Use evidence-based outcome studies (e.g., randomized clinical
●​ Person Factors:
trials) to validate OT effectiveness and support policy/funding.
●​ Neurobehavioral: Sensory/motor systems for adaptation.
Research
●​ Physiological: Endurance, strength, flexibility.
●​ General Studies:
●​ Cognitive: Memory, reasoning, attention.
●​ Maclean et al. (2012): PEOP in acute physical care settings.
●​ Psychological: Self-esteem, motivation, identity.
●​ Strong et al. (1999): Case studies (older adult with hip fracture, child in
●​ Spiritual: Personal meaning, purpose.
school, young adult with mental health issues).
●​ Occupations: Goal-directed, socially recognized
●​ Outcome Studies:
activities/tasks/roles.
●​ Hartman-Maier et al. (2007): Stroke survivors’ community-based
●​ Environment:
rehabilitation.
●​ Built: Tools, assistive technology.
●​ Taylor et al. (2007), Payne (2008): Children with developmental
●​ Natural: Terrain, climate.
coordination disorder.
●​ Cultural: Beliefs, norms.
●​ Qualitative Study:
●​ Social Determinants: Health inequities, access.
●​ Social Capital: Community cooperation.
 ●​ Connor Schisler & Polatajko (2002): Ethnographic study of Burundian
refugees’ person-occupation-environment interplay.
●​ Descriptive Study:
●​ Pizus-Barnekov et al. (2017): African American fathers’ occupational
participation to improve family health outcomes.
●​ Foundational Studies:
●​ Cooper & Stewart (1997): Older persons and physical environment.
●​ Strong (1998): Mental health and work environment.
●​ Westmorland et al. (2000): Work reentry for persons with disabilities.
●​ Law et al. (1999): Children’s participation and environmental factors.
●​ Stewart et al. (2001): Transition to adulthood for youth with disabilities.
●​ McKye et al. (1998): Cultural sensitivity of PEOP.
●​ Peachy-Hill & Law (2000): Environmental sensitivity.
●​ Green & Cooper (2000): Occupation as a quality-of-life factor in
nursing homes.
Summary
●​ Significance: Holistic, systems-based, client-centered model
complementing biomedical and sociocultural care.
●​ Unique Features: Top-down approach prioritizing client narrative, flexible
for various settings, aligned with global health goals (well-being, prevention,
social inclusion).
●​ Comparison: Similar to Law’s Person-Environment-Occupation (PEO)
model but expanded to include populations/organizations.
●​ Impact: Enhances OT’s role in addressing performance, participation, and
well-being across diverse contexts.
Learning Activities
●​ Key Terms:
●​ Occupation, occupational participation, occupational performance,
person, environment, human agency, transactional relationship,
intrinsic/extrinsic factors, personal narrative, intervention approaches,
intervention principles, general outcomes.
●​ Venn Diagram:
●​ Depict how occupational performance/participation results from
person, occupation, and environment factors.
●​ Show how program outcomes involve narrative, evaluation, and
interventions.
●​ Theory Analysis Template (Table 7-2):
●​ Title: PEOP Model.
●​ Focus: Enhance occupational performance, participation, well-being.
●​ Theorists: Christiansen, Baum, Bass, Law, Kielhofner, Reilly.
●​ Function: Congruent person-environment fit for role satisfaction.
●​ Dysfunction: Limited performance due to impairments, barriers, or
role conflicts.
●​ Change: Client-centered, narrative-driven interventions matching
enablers to demands.
●​ Motivation: Intrinsic factors (self-efficacy, identity) and meaningful
outcomes.
●​ Assessment: COPM, Activity Card Sort, Interest/Role Checklists,
OPHI-II.
●​ Intervention: Restorative, environmental, role-enhancing strategies.
●​ Research: Studies across acute care, stroke, developmental
disorders, refugees, and more.