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’. All the three elements are considered protagonists; each communicates and transfers something to the other, creating a dynamic transference (unconscious links with other relationships in the patient’s or therapist’s past or present lives). This model uniquely includes theorization of the presence of the therapist and emphasizes the dynamic of the therapeutic change. The seven interconnected components of MOVI are, with emotions in the relationship as the central concept:
- Evaluation: attentive observation to offer respect and create an atmosphere of containment, an emotional climate that allows therapists to identify two areas of functioning: patient’s external, visual lives and internal lives linked to fantasies, dreams and desires. The use of activities like human figure with clay, free painting, structured tasks is included in the process,
- The interactive process: it contributes to growth of mental function,
- The space and time settings: stability and a space of trust, fixed time schedule,
- Choice and play: by client’s choice, self-initiated, original and creative,
- Materials and transformations: transformation of materials by cutting, pounding, cooking, playing, etc.,
- Sensory experience and thought: “doing” as a means to gain access to the mind,
- Nonhuman environment: materials, objects, landscapes, etc.
The MOVI is based on psychoanalytic thinking and it helps occupational therapists in examining the meaning of ‘doing’, therapeutic relationship, and unconscious elements during the interactions.
- Macey Cho
- Frame of reference
Domain of occupation
It contributes to facilitation of therapists’ understanding in meaning of unconscious and unspoken elements during therapeutic relationship.
Nicholls, L., Cunningham-Piergrossi, J., de Sena-Gibertoni, C., & Daniel, M. (2013). Psychoanalytic thinking in occupational therapy: Symbolic, relational, and transformative. Chichester, West Sussex: Wiley-Blackwell.
- Lindsey Nicholls
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