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Baum, C., Christiansen, C., & Bass, J. (2015). Person-Environment-Occupational Performance (PEOP) Model. In C. Christiansen, C. Baum, J. Bass, Occupational Therapy: Performance, Participation, Well-being. (4th ed.). Thorofare, NJ: Slack.
... The initial Adult Cooking Task [29,30] and the subsequently developed and adapted children's version, the CCT [25,26], were found to be highly sensitive to executive dysfunction. There is a great need to take these performancebased assessments a step forward to provide more accurate and sensitive assessment of everyday functional activities that consider the person's environment [31]. Performance-based assessments such as the CCT have the potential to detect EF difficulties because its tasks capture the complexity of real-life performance [32][33][34]. ...
Purpose:
To characterize and analyze the performance of adolescents with executive function deficits through the Children's Cooking Task (CCT) as a performance-based complex ecological assessment.
Methods:
Participants were 41 adolescents (aged 10-14 years) with normal intellectual function and executive function deficit profiles based on the Behavior Rating Inventory of Executive Function (BRIEF) parent reports and self-reports (BRIEF-SR) and the WebNeuro and 40 controls with typical development matched by age and gender. Participants in both groups performed the CCT, an ecological standardized complex task.
Results:
Significant group differences were found for all CCT outcome measures (total number of errors, task duration, and all qualitative rating variables). Significant correlations were found among children with executive function deficit profiles between the CCT performance duration and total number of errors and the BRIEF-SR subscale score. Two separate discriminant function analyses described primarily by the CCT correctly classified the study groups.
Conclusion:
The poor performance of adolescents with executive function deficit profiles exhibited through the standardized complex task, as well as the relationships with their executive functions, supplies better insight about their daily confrontations. Identifying how they perform may lead to development of focused interventions to improve these adolescents' daily performance, participation, and wellbeing.
Major health care problems such as patient dissatisfaction, inequity of access to care, and spiraling costs no longer seem amenable to traditional biomedical solutions. Concepts derived from anthropologic and cross-cultural research may provide an alternative framework for identifying issues that require resolution. A limited set of such concepts is described as illustrated, including a fundamental distinction between disease and illness, and the notion of the cultural construction of clinical reality. These social science concepts can be developed into clinical strategies with direct application in practice and teaching. One such strategy is outlined as an example of a clinical social science capable of translating concepts from cultural anthropology into clinical language for practical application. The implementation of this approach in medical teaching and practice requires more support, both curricular and financial.
This article argues that although occupational therapy and rehabilitation are often considered synonymous, the latter is but one aspect of the former. Early influences on occupational therapy are briefly reviewed, and some philosophical ideas about activity are described. The rationale for the use of occupations as treatment in the early part of this century, both in Canada and in the United States, is examined and contrasted with the development of physical medicine and rehabilitation after World War II. This discussion demonstrates that the origins of occupational therapy and rehabilitation in North America had little in common. As occupational therapy became incorporated into rehabilitation, the profession's core values eroded, and although current definitions of rehabilitation offer a more appropriate fit for occupational therapy, rehabilitation continues to see engagement in occupations as a separate and subsequent step. The article concludes by considering future directions and the tasks that lie ahead.
The authors summarize 35 years of empirical research on goal-setting theory. They describe the core findings of the theory, the mechanisms by which goals operate, moderators of goal effects, the relation of goals and satisfaction, and the role of goals as mediators of incentives. The external validity and practical significance of goal-setting theory are explained, and new directions in goal-setting research are discussed. The relationships of goal setting to other theories are described as are the theory's limitations.
In this chapter, more than a century of occupational therapy history has been reviewed, beginning with a description of important ideas and personalities prior to the 20th century that infl uenced the birth of the profession. For each of fi ve eras, a contextual backdrop was provided to describe the historical circumstances under which different events occurred, with the aim of emphasizing that professions, like individuals, are best understood in situational contexts. Occupational therapy began during a progressive era that was auspicious for bold ideas and new approaches.Although its fundamental principles were already being applied by professionals and nonprofessionals in different settings, it was not until an enthusiastic and ambitious consumer (George Barton) took the initiative to bring an interdisciplinary group of like-minded advocates together that the profession of occupational therapy was officially launched. Within weeks, a nation's preparations for caring for its wounded soldiers as it entered a great war provided a rare opportunity for the profession to organize around a patriotic cause and demonstrate its value. Because women were just emerging as a political force in the country and so few women held professional roles at the time, the recruits to occupational therapy were uncertain about how to manifest their opportunities. Occupational therapy had to compete with medical specialties, vocational educators, nurses, and others who believed that they were equally entitled to the use of curative occupations as part of their treatment regimens. For the entirety of their history, occupational therapists have been doers, often little interested in explaining or proving the theoretical ideas and practical benefi ts of their actions. This has placed the profession at a disadvantage to medicine and other disciplines, where sciencebased practice has become increasingly the norm. Yet, the inherent fl exibility of occupations as a therapeutic medium has continued to off er creative opportunities for benefi ting a wide range of patients and clients. Although once daunting health problems served by occupational therapists (e.g., tuberculosis [TB], HIV, and polio) have faded into the history books of biomedical success, occupational therapists have been able to mobilize in the service of emerging health problems and concerns deemed important by the public (such as dementia and autism spectrum disorders). Moreover, the cooperative nature of the therapeutic relationship has aff orded a bridge to connect the body and mind-providing occupational therapists with a rare, important, and enduring place in the lives of their patients-serving as healers as well as technologists, a role not easily appreciated by the casual observer. As occupational therapy moves ahead into the 21st century, one must ask if these themes will continue to shape the story of the profession. Will there continue to be role ambiguity and underappreciation for the importance of science and theory? Will therapists continue to reinvent new approaches for serving the emerging diseases of the 21st century, and will they capitalize on the unique position they have, but perhaps underuse, as technologists and custodians of meaning (Engelhardt, 1983)? Only the histories yet to be written will tell. © 2014 Lippincott Williams & Wilkins, a Wolters Kluwer business. All rights reserved.
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In recent years increasing need has been felt for a body of systematic theoretical constructs which will discuss the general relationships of the empirical world. This is the quest of General Systems Theory. It does not seek, of course, to establish a single, self-contained "general theory of practically everything" which will replace all the special theories of particular disciplines. Such a theory would be almost without content, for we always pay for generality by sacrificing content, and all we can say about practically everything is almost nothing. Somewhere however between the specific that has no meaning and the general that has no content there must be, for each purpose and at each level of abstraction, an optimum degree of generality. It is the contention of the General Systems Theorists that this optimum degree of generality in theory is not always reached by the particular sciences.
The derailment of occupational therapy, exemplified by the profession's symbiosis with the medical model, its alignment with the rehabilitation movement, and its devaluation of the arts and crafts is the central theme of this article. The occupational behavior paradigm, which represents a recommitment to the values and beliefs of the profession's founders, has emerged to arrest the derailment process and thereby reinstate the substantive goals of occupational therapy.
This paper is a historical account of occupational therapy during the past 60 years. The focus is on the bodies of knowledge, the identity of the field, and the shifts that have occurred in those elements. The analysis is based on a historical model of epistemological change and provides a basis for making predictions about the future of occupational therapy. For therapists who are concerned about the present problems of identity and theory in occupational therapy, this paper provides one way of looking at the problems and proposes some possible courses of action.
This paper presents a description of the transformation of science under General Systems Theory, and the relationship of this transformation to the field of occupational therapy. Changes in scientific methods of proof and in scientific laws that underlie theory are discussed. The paper presents a scale for recognizing complexity in phenomena and for analyzing the appropriateness of theories designed to explain the phenomena. It also presents the theory of open systems as an alternative to mechanistic explanations of human behavior.
( This reprinted article originally appeared in Science, 1977, Vol 196[4286], 129–236. The following abstract of the original article appeared in PA, Vol 59:1423. ) Although it seems that acceptance of the medical model by psychiatry would finally end confusion about its goals, methods, and outcomes, the present article argues that current crises in both psychiatry and medicine as a whole stem from their adherence to a model of disease that is no longer adequate for the work and responsibilities of either field. It is noted that psychiatrists have responded to their crisis by endorsing 2 apparently contradictory positions, one that would exclude psychiatry from the field of medicine and one that would strictly adhere to the medical model and limit the work of psychiatry to behavioral disorders of an organic nature. Characteristics of the dominant biomedical model of disease are identified, and historical origins and limitations of this reductionistic view are examined. A biopsychosocial model is proposed that would encompass all factors related to both illness and patienthood. Implications for teaching and health care delivery are considered.
As I join the roster of Eleanor Clarke Slagle lecturers, I am keenly aware of the privilege and responsibility of being so honored by my professional colleagues. Since my selection for the award was based on a recognition of a synthesis of skills in occupational therapy practice, education, and research, it seemed fitting for me to pursue a topic that would in some way enable me to reflect this synthesis. Thus, in developing the theme of clinical reasoning, I have taken a practice issue, studied it from an educational perspective, and formulated a conceptual framework for guiding the development of a clinical science of occupational therapy.
This paper, the first of four, presents the structure and content of a model of occupation. The model is proposed as the first step in the development of paradigm of occupation for the field of occupational therapy and is designed for application in practice and research. It draws upon the theory of open systems to build a structural framework. Concepts relevant to human occupation are integrated into this framework. Subsequent papers will add concepts to the model and demonstrate its application in clinical practice.
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