Occupation-specific Community Development Model for Family Mental Health

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. In cases of abuse, marital conflict, family violence, children and adolescence experience social isolation through inadequately learned occupational role behavior. The goal of this stage is to enable individuals to link together in the systems of mutual support. Mutual support is support groups (family, peers, and community networks) with mutual interest to address role inadequacies. By being part of the system and building greater cohesion, individuals are empowered with more control with their lives. Coalitions of mutual interest are coalitions of people with aligned interest (e.g., book clubs, art groups) and use their combined occupational roles to bring social change. Pro-active community participation is the consolidation of occupational roles, which facilitates coping with inequities of social and economic power, to understand the process of coping and how individuals generalize control into other areas of life. Clients are encouraged to participate and gain control in local organizations to combat the perception that children and adolescents are too inexperienced/irresponsible to run their own club. It is the means to achieve control of their club. Families start to make decisions about their child’s future, to combat with the perceived view that they are too dysfunctional to make decisions for their child. It is the way to generalize into other important parts of the family’s lives. The last stage, social movements, is the demonstration of role development through commitment to social change, which is the union of community development and health. Clients begin to see social commitment to social change as important, e.g., joining the School Boards of Trustees or volunteering in camps for socially disadvantaged children. With the feeling of increased control of their lives by taking parts in events that influences their life roles, this ultimately improves their sense of wellbeing and self-confidence. At this stage, community development and health coincide. Occupational therapists are frequently involved at the developmental casework stage and start to relinquish power to the group from the second stage. At the third stage (i.e., coalitions of mutual interest), therapists also have the role in listening carefully, using knowledge of local systems, and determining which issues have sufficient support to bring about the change.