OA

OT Dude Academy’s Free NBCOT® Exam Prep Course Theories & Models OA

The Occupational Adaptation Model

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1 Theory
2 Evaluation and Assessment
3 Intervention

Theory

  • Person: has an innate desire for mastery of occupation.
  • Occupational Environment: where occupation occurs; social, physical, cultural
  • Interaction (of the two): produces mastery.
  • Person consists of their sensorimotor, cognitive, psychosocial, intervention targets, limitations, and potential.
  • Occupational adaptation is seen as a normative process during the transition in therapy.1 
  • Occupational adaptation is both a process and outcome.2 
  • Occupational adaptation is the highest level or form of occupational therapy.
  • Occupational adaptation is holistic.3 

Evaluation and Assessment

In OA, therapists evaluate and analyze the client’s level of occupational performance to:

  1. Understand the client.
  2. Understand their environment.
  3. Identify their desired outcomes.
  4. Prioritize and measure outcomes in intervention.4 
Sally Schultz, Janette K. Schkade; Occupational Adaptation: Toward a Holistic Approach for Contemporary Practice, Part 2. Am J Occup Ther October 1992, Vol. 46(10), 917–925. doi: https://doi.org/10.5014/ajot.46.10.917

Assessment Examples:

  • COPM: helps to identify performance in occupations in relationship to roles.
  • Coping Inventory: helps to identify coping and adaptive behaviors.

Intervention

  • Focus on the use of occupations to elicit adaptive responses.
  • Use preparatory techniques to support the occupational adaptation process.3 
  • Assess for and measure Occupational Readiness (improvement in client’s performance skills).
  • Engage the client in Occupational Activities (activities that address the client’s core features for the desired occupations).4 
  • Clinical reasoning questions for OA practice (refer to measurement relevant mastery figure above):
    • What occupations can elicit an adaptive response?
    • What resources from the environment can facilitate this?
    • What are the client’s important roles?
    • What occupations is the client good at? Want to master?
    • What are the client’s perceptions and insights of their competence and mastery?
    • What is the client’s level of satisfaction in relation to their roles and participation?
    • How do the contexts facilitate or hinder occupational performance?
    • What from the environment can empower occupational adaptation?
    • What are the role expectations demanded by the environment?
    • What are the occupational challenges faced by the client according to their roles?
    • What responses does the client make when perceiving a challenge?
    • Are these responses adaptive or dys-adaptive?
    • What shows that the client may be stuck using dys-adaptive responses when faced with occupational challenges?
    • How does the client become unstuck?
    • What can support the client to empower their occupational adaptation process?3 
  1. Janette K. Schkade, Sally Schultz; Occupational Adaptation: Toward a Holistic Approach for Contemporary Practice, Part 1. Am J Occup Ther September 1992, Vol. 46(9), 829–837. doi: https://doi.org/10.5014/ajot.46.9.829[↩]
  2. Grajo, L., Boisselle, A., & DaLomba, E. (2018). Occupational adaptation as a construct: A scoping review of literature. The Open Journal of Occupational Therapy, 6(1), 2.[↩]
  3. Grajo, L. (2017). Occupational adaptation. Perspectives on human occupation: Theories underlying practice, 287-311.[↩][↩][↩]
  4. Dunbar, S. B. (2007). Occupational therapy models for intervention with children and families. Thorofare, NJ: Slack.[↩][↩]
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