Three-phase framework

  • The three-phase framework helps to view the life resuming process of people who suffer from long-term disabilities such as stroke, traumatic brain injury, and whiplash, and to provide the right intervention at the right time. In this framework, the reestablishment of previous role(s) of the clients and/or the development of a new role are the most important. The role achievement is believed to be the primary goal of therapy intervention for people with long-term disabilities. The three phases are included as named for this framework. In phase 1 (focus on “getting better”), the clients may found that their impairments will never be resolved fully even though they have known and accepted their situation. The therapists will utilize the clients’ determination to maximize their recovery and give them “hope”. In phase 2 (coming to terms with loss), the clients may experience a plateau in their recovery process. To continue a satisfying life, the therapists can help to examine their current strengths and limitations and make adjustment in the intervention. The therapists will also develop self-care strategies for the clients to prevent he development of secondary complications such as postural malalignment and joint contractures, and evaluate the training implemented in phase 1. In phase 3 (reestablishing social roles), there may be some roles that are not compatible with the reconstructions of the clients or they perceive incapability to achieve to the normal status. The therapists can facilitate the task performance and role achievement after evaluating the current levels of abilities, and collaborate with the clients and the family members to identify needs and determine achievable goals. Throughout the therapeutic process, the therapists assist the clients in developing long-term skills for the task based on their strengths and developing new solutions to future tasks. By using this three-phase framework, the clients can receive the most suitable intervention at the different stage of recovery, and the intervention process provided by the therapists will be helpful to their life.

Summarized by

  • Davie Tsang

Type

  • Framework

Population

  • Adolescent
  • Adult
  • Elderly

Disability

  • Neurological disorder

Domain of occupation

  • Unspecified

Application Note

  • The use of this framework must be continued during the whole process of the recovery.

Key Reference

  • Sabari, J. S. (1998). Occupational therapy after stroke: Are we providing the right services at the right time? American Journal of Occupational Therapy, 52, 299-302.

Year Published

  • 1998

Primary Developer

  • Joyce Sabari

Primary Developer Email

  • jsabari@netmail.hscbklyn.edu

Related Models

Functional Model of Cognitive Rehabilitation (FMCR)

  • The Functional Model of Cognitive Rehabilitation (FMCR) applies general concepts from the Canadian Model of Occupational Performance (CMOP). It aims to complement to the CMOP for choosing, organizing, and performing useful and perceived meaningful occupations in order to addresses the cognitive performance component. In the CMOP, the cognitive performance components include perception, concentration, memory, comprehension, and judgement. The FMCR recognizes the dynamic interaction between clients and their environments (physical, cultural, and social).

Clinical reasoning process underlying teaching transfer skills: An integrative framework

  • This integrative framework mainly consists of two elements: (1) the factors influencing clinical reasoning (CR), and (2) the evolving CR process underlying the choice of teaching strategies. First, both internal factors (relate to occupational therapists, such as knowledge and experience, personal habits) and external factors (relate to client, environment, task, and interaction of them, such as emotional/cognitive/physical availability, previous knowledge) influence CR of therapists.

Meaning Perspectives Transformation Model

  • 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.

Expanded Awareness Model

  • This model is based on the concepts of metacognition and awareness to view the relationship between the metacognition and awareness as a dynamic process. This model differentiates between one’s self knowledge and awareness that are pre-existing or stored within long-term memory (or called metacognitive knowledge) and the knowledge and awareness that is activated during a task (or called on-line awareness).

Model Type

Population

Disability

Domain of Occupation

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