Conceptual Framework for Therapeutic Occupation (CFTO)

  • The concept of occupation is described in this framework, and occupation is characterized by the following seven key concepts: 

     

    1. Occupational form: everything that surrounds the person, consisting of a physical and sociocultural dimension.

    2. Developmental structure: this includes one’s sensorimotor, cognitive, and psychosocial abilities and characteristics, developed from a long-term process influenced by maturation (genetics) and occupational adaptations (personal experience), while other influencing factors include maturation, disease, and medical interventions.

    3. Meaning: interpretive experience by the person, involving perceptual interpretation, symbolic interpretation, and affect.

    4. Purpose: the feeling of motive.

    5. Occupational performance: the active, voluntary doing of the person, after interpreting the occupational form and having a purpose.

    6. Impact: the effect of occupational performance on the person’s and others occupational forms.

    7. Dynamic relationship: occupation also has a dynamic effect on the person’s own developmental structure, which is represented by an adaptation or maladaptation.

     

    The quality of occupational performance and impact is determined by: 1) judgement by the individual and 2) in correspondence with the sociocultural norms. A therapeutic occupational synthesis and the design of a therapeutic occupational form require occupational therapists to analyze the physical and sociocultural aspects of the occupational form in terms of the client’s developmental structure. Occupational assessment involves the therapist’s observation of the client’s occupational performances and impacts in the context of synthesized occupational forms, as well as the therapist’s inferences on the client’s developmental structure and/or occupational structure. Intervention includes occupational adaptation and compensation in this conceptual framework. Occupational adaptation involves synthesis of a matching occupational form to the client’s developmental structure in order to elicit positive change in the developmental structure. Occupational compensation involves synthesis of atypical occupational form to substitute occupational performance and comparable impact. 

Summarized by

  • Macey Cho

Type

  • Framework

Population

  • Child
  • Adolescent
  • Adult
  • Elderly

Disability

  • All

Domain of occupation

  • Unspecified

Application Note

  • A therapeutic occupational synthesis involves clinical reasoning as guided by occupational therapy model of practice and generated in collaboration with the client.

Key Reference

  • Nelson, D. L., & Jepson-Thomas, J. (2003). Occupational form, occupational performance, and a conceptual framework for therapeutic occupation. Perspectives in human occupation: Participation in life, 87-155.

Year Published

  • 2003

Primary Developer

  • David Nelson

Related Models

Synthesis of Child, Occupational, Performance, and Environmental-In Time model (SCOPE-IT)

  • The Synthesis of Child, Occupational, Performance, and Environmental-In Time (SCOPE-IT) model aims to enhance children’s occupations and occupational performance. It considers children’s growth and maturity in occupational engagement by the course of development. Through participating in daily activities, children develop their occupations and enhance their performance. The type and time devoted in an occupation differs in one’s life course. As a result, the SCOPE-IT model has six assumptions,

Accountability-Well-Being-Ethics (AWE) framework

  • The Accountability-Well-being-Ethics (AWE) framework incorporates the humanist and contextualist perspectives to create a balanced foundation of client-centered profession. The conceptual cores include sociocultural, well-being, social/occupational justice, promoting capabilities, accountability, qualitative stories, contingency, hope, solidarity, person directed, coach/partner, and facilitating empowerment, in contrast to different concepts of biomedical health care. This framework is structured for use in education, research, and clinical practice for occupational therapy globally.

A Model of Children’s Play

  • This model aims to conceptualize children’s underlying skills and behavioral elements characteristic of play, as well as the influences that both individual and environmental factors. Embedded in the play environment and cultural and familial milieu, this model includes developmental play capacities (cognitive, physical and social play skills) and individual play style (internal control, freedom to suspend reality and intrinsic motivation) that make up the child’s contribution to the play transaction. Play reflects the child’s cognitive, motor, language and social skills.

Framework of Doing-Being-Becoming

  • The Framework of Doing-Being-Becoming describes the theme of “doing”, “being”, and “becoming” in occupational therapy practice. In this framework, “Doing” refers to occupation and occupational performance of an individual, which is essential for the individual to interact with others and develop own identity, and to create and shape the society. “Being” refers to being true to self, that people are required to spend time thinking and reflecting themselves. This helps an individual describes and sustains the own roles.

Spirituality Framework

  • This framework places spirituality as the core of the person. It regards an individual’s spirit as one’s being, unharmed by injury or illness, rather than as a component. In this framework, spirituality is depicted as two concentric circles surrounding the center. The first circle depicts human center and the second circle depicts personal worldview. The center is defined as the core, the heart, or what is means to be human.

Model Type

Population

Disability

Domain of Occupation

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