Rehabilitative frame of reference (FOR) considers rehabilitation as the process of facilitating patients in fulfilling daily activities and social roles with competence. This FOR is used with clients whose underlying impairments are unlikely to remediate and be considerable permanent, or the clients who lack motivation to participate in remediation. The theoretical basis of this FOR is that the client must focus on the remaining abilities, despite of any disabilities, to attain his/her highest level of functioning in the desired occupational performance. This FOR includes concepts of adaptation, compensation, and environmental modifications. It uses the method of teaching clients compensatory or functional methods, and makes use of assistive equipment and environmental modifications to restore function. Occupational therapists must consider the client’s potential to learn, motivation to learn, and his/her optimal learning style in using the teaching approach under this FOR. Assessments that are commonly used in this approach include standardized objective tests of occupational performance, evaluations to determine client's strengths, and evaluations of environmental and social contexts to determine supports and limitations. Some common interventions include energy conservation, work simplification, and home modifications. The ultimate goal of this FOR is to maximize independence despite the presence of persistent impairments.
Frame of reference
Domain of occupation
It is used to facilitate clients to acquire or regain independency that leads to increased satisfaction with performance of domains of concern.
Gillen, G. (2014). Occupational therapy interventions for individuals. In B. A. B. Schell, G. Gillen, M. E. Scaffa, & E. S. Cohn (Eds.), Willard and Spackman's occupational therapy (12th ed., pp. 322-341). Philadelphia: Lippincott Williams & Wilkins.
The compensatory frame of reference (FOR) aims to increase occupational performance and facilitate independence by utilizing compensatory techniques. It is used to compensate dysfunction in desired occupations, e.g., using assistive device or equipment such as Ergonon/Reflex knife during meal preparation, to compensate difficulty with using traditional knife. This FOR also includes environmental change, e.g., altering layout of living environment or using splints.
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).
Kawa model is a model that uses the metaphor of a river with different contextual elements to represent human life. The key features of Kawa model include water, river sidewall and bottom, rocks, driftwood, and space between obstructions. Water represents a client’s life flow or life energy. River sidewall and bottom reflects a client’s physical and social contexts which are inseparable with the water flow. Rocks represent the problems or difficult situations that hinder smooth water flow and they are usually difficult to remove.
This model aims to contextualize challenges that youth with persistent concussion symptoms face during recovery by considering the person, occupation, and environment factors that influences occupational performance. The model suggests that the relationship between the amount of allostatic load and occupational performance is represented as a normally disturbed curve.
This model comprises of four components including Assistive Computer Technology (ACT) service delivery (evaluation and training), the provision of ACT devices, education, and coordination and collaboration. ACT service delivery includes evaluation, training, and coordination of technology services. A service delivery team includes an occupational therapist, computer specialist, education specialist, and augmentative communication specialist. The team is responsible for conducting assessment and providing training for students who are in needs.