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. In the trigger phase, the experience of being ill or injured presents three types of interacting triggers (recognition of the symptoms and functional limitations, challenges of the health care authority, and the diagnosis itself). For example, the diagnosis, as an external trigger, and the client’s critical reflection on the impact is the internal trigger that brings emotions and awareness. Then the changing phase is the client’s critical self-reflection of bio-psycho-social and spiritual issues encountered when living with the functional limitation. Distortions, and a psycho-cognitive logic, may react and result in distressed sense of self and false expectations, which are expressed in words. These distortions can be used to harness energy for transformative change. Therapeutic activities or other appropriate modality of treatment in occupational therapy interventions serves as a platform for this phase. For example, when practicing of one-handed techniques, clients concretely confront their limitations and learn to cope and manage with residual function. They can express their difficulties with their beliefs, values, feelings, and knowledge, while therapists listen carefully to the reflective self explorations on various concepts, such as occupation, environment, and their contextual significance attached with the meaning perspective. Transformation of meaning perspectives and the time when the client moves into a readiness for change in occupational performance indicates the end of this phase. The outcome phase involves making choices to obtain a new occupational balance based on guidelines created in the changing phase. Therapists observe if there is reconstruction of a new identity, in which the client regains a sense of coherent at present, and foresees a positive, important future.
Domain of occupation
This model provides a tool for occupational therapists to increase awareness to clients, listen closely to identify the weakening and emerging meaning perspectives.
Dubouloz, C. J. (2014). Transformative occupational therapy: We are wired to be transformers. Canadian Journal of Occupational Therapy, 81(4), 204-212.
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.
The Framework of Occupational Justice (FOJ) offers an occupational perspective of justice or injustice on everyday occupations. This framework emphasizes on the inclusion of every individual in an occupationally just word (i.e., the environment, such as community and government, in which the individuals can do what they decide to be the most meaningful and useful to themselves, family, communities and nations). It illustrates how the inter-relationships of structural factors and contextual factors support or restrict occupational outcomes and occupational rights.
This model presents a hierarchy of family-therapist involvement in occupational therapy services, with associated attitudes, specific knowledge, and skills that enable therapists to operate at each level.
The first level, no family involvement, outlines the traditional medical model of intervention. This level focuses on technical skills which are expected of entry-level therapists, with no awareness of the role of the family and client’s social context. It provides the basis for alternative types of family involvement.
The theory of occupational reconstructions emphasizes the mind-body engagement to deal with an inherently transformational injustice or problematic situation. This theory views occupations as pragmatic with meaning of inquiry. In other words, occupations are experiments for searching the truth. Occupations are creative, and engagement in occupations are intrinsically motivated (the hallmark of occupational therapy). This theory consists of seven principles, 1) Occupational reconstructions respond to a problematic situation (i.e.
The psychoanalytic frame of reference (FOR) emphasizes on the unconscious aspect of what is done and said, and it is embedded in an occupational therapy relationship model of practice - the Vivaio model (MOVI). The central element of the MOVI is the recognition of constant emotions that exist in the interdependent relationship between the three elements of patient, therapist and ‘doing’.