Psychodynamic Frame of Reference (psychodynamic FOR) is based on Dr. Sigmund Freud’s idea that human has the initiative to invest emotions and psychic energy to achieve basic needs and maintain relationship. When an individual fails to maintain healthy relationships due to the conflicts or insufficient ego defense mechanism, dysfunction will occur. Occupational therapists can base this psychodynamic FOR to help treat the dysfunction using two main approaches including explorative and supportive approach. Explorative approach is to bring the conflicts in the unconscious mind to the conscious level, and so potential ways can be found to resolve the conflicts and the feelings can be expressed. On the other hand, supportive approach is to keep the conflicts hidden. It tries to resolve the conflict by strengthening the ego defense mechanism of the clients to prevent the conflicts from going up to the conscious level. Both the explorative and supportive approaches under this psychodynamic FOR aim to help clients satisfy the needs and to enhance healthy and normal psychosocial development. It should be noted that there may not be a clear division between the assessment and intervention by using the two approaches. Therapists can implement the assessment and treatment by selecting activities that provide appropriate level of social interaction, and by using activity analysis to analyze the activities before the implementation. Individual- and group-based activities can be used. However, individual-based activities may be easier to create the client’s active engagement, whereas supportive group-based activities can be further used to provide chances for mutual support, exchanging information, and figuring out the ways to solve the problems together.
Frame of reference
Domain of occupation
This FOR may be more difficult to be applied in severely handicapped clients, and group size at eight to ten people is optimal.
Creek, J. (2014). Approaches to practice. In W. Bryant, J. Fieldhouse, & K. Bannigan (Eds.), Creek's occupational therapy and mental health (5th ed., pp. 50-71). Edinburgh: Churchill Livingstone.
This model consists of a continuum with five steps, each facilitating change for subsequent stages of mental health in families that are socially isolated. The five steps are (1) developmental casework, (2) mutual support, (3) coalitions of mutual interest, (4) pro-active community participation, and (5) social movements. Development casework is an individual therapy focusing on occupational behavior and role acquisition through participating in daily activities.
Psychospiritual integration frame of reference (FOR) emphasizes the nature of spirituality, the expression of spirituality in every occupation behavior, the nature of spiritual occupation, and the influence of spirituality and spiritual occupations on health and well-being. This FOR defines that spirituality is constructed of an integral harmony of six qualitatively distinct dimensions and each dimension is considered as an ever-expanding continuum with increasing depth and vastness. The six dimensions are:
This model of practice is based on the theoretical concepts relating to the child, environment, task, and the interaction among these key factors and the child’s participation in different occupations. A goodness-of-fit of those factors is necessary for successful participation in occupations.
The Meaning Perspectives Transformation Model is characterised by three phases: the trigger phase, the changing phase, and the outcome phase. These three phases move the process of meaning perspective transformation in the physical, emotional, cognitive, or spiritual dimensions. Critical self-reflection acts as a catalyst and represents as a moment of “readiness of change”. This allows clients to identify their assumptions, question meaning, and develop alternative ways of performing.
Cancer-related fatigues (CRF) is multifactorial and all potential contributing factors are needed to be assessed to understand the unique presentation on the individual’s life. This framework proposes a number of factors associated with CRF. Of these factors, the medical status of fatigue, which is predetermined and cannot be modified by therapists, includes disease-related factors (e.g., type of disease), treatment-related factors (e.g., treatment required), comorbidities, and underlying biomedical factors.