Barbara Acheson Cooper

The Person-Environment-Occupation Model: A Transactive Approach to Occupational Performance.

Occupational therapy theory, practice and research has increasingly emphasized the transactional relationship between person, environment and occupation. Occupational performance results from the dynamic relationship between people, their occupations and roles, and the environments in which they live, work and play. There have, however, been few models of practice in the occupational therapy literature which discuss the theoretical and clinical applications of person-environment interaction. This paper proposes a Person-Environment-Occupation Model of occupational performance which builds on concepts from the Occupational Therapy Guidelines for Client Centered Practice and from environment-behaviour theories. The model describes interactions between person, occupation and environment, outlines major concepts and assumptions, and is applied to a practice situation.

Application of the Person-Environment-Occupation Model: A practical Tool

Occupational therapy focuses on complex dynamic relationships between people, occupations and environments. Therapists must clearly communicate their practices and how their practice influences outcomes. This paper explores applications of the Person-Environment-Occupation Model (Law et al., 1996) in occupational therapy practice, and delineates how this particular model helps therapists to conceptualize, plan, communicate and evaluate occupational performance interventions. Three case studies illustrate how the model can be used by occupational therapists to systematically approach analysis of occupational performance issues while considering the complexities of human functioning and experience. The ways in which the model facilitates communication within and outside occupational therapy are explained. The Person-Environment-Occupation Model is offered as a tool for therapists to use in client(s)-therapist alliances to enable clients to successfully engage in meaningful occupations in chosen environments.

Post-occupancy evaluation: an environment-behaviour technique for assessing the built environment.

This paper reviews the development, structure and process of post-occupancy evaluation (POE) as an environment-behaviour approach to assessing built environments of all sizes and types. It illustrates the use of POEs with three examples from the Health Care sector: The Canadian Hospital Evaluation Program, the Weiss Institute, and 18 independent-living apartment units. A comparison is made between POEs and the approach currently used by occupational therapy (OT) for environmental assessments. Recommendations suggest that OTs approach could be extended and strengthened through 1) incorporating POE methods and existing data from environment-behaviour studies; 2) the use of standard assessment procedures and well-validated measures; and 3) the development of a data bank on OT environmental assessments.

Person-Environment Relations

The interaction that occurs between individuals and their environment is central to all work and rehabilitation practice. In the past, rehabilitation has focused more on facilitating personal adaptation and less on understanding the influence of the environment on behavior. Eight person-environment models, developed by other disciplines but of relevance to rehabilitation, are presented and discussed. The way in which each of these models views the person, the environment, the person-environment relationship, and adaptation is compared and contrasted to views inherent in rehabilitation practice. The literature suggests that rehabilitation is gradually moving from an interactive perspective of person-environment fit toward a transaction view that more accurately acknowledges the complexity and the entwined nature of these issues.

The P-4 Deck (Portable Patient Problem Pack): Educational Tool of the Future?

This paper describes the structure and use of the Portable Patient Problem Pack (P-4 Deck) as a clinical simulation and educational tool. Originally designed by Dr. Howard Barrows of McMaster University to present medical diagnostic problems, the deck has been adapted by the author for occupational therapy. This tool is described and its current use in this context and future trends are outlined.

Selecting Person— Environment Assessments

Rehabilitation practice is broadening not only to meet individual client needs but also to address group and community requirements. It now recognizes and emphasizes the influence of the environment on client function and treatment outcomes. This redirection in practice requires the use of trustworthy instruments of measure that address these person-environment relationships. The chapter presents a process that can be used to select and evaluate instruments for potential use in clinical practice and research. It also provides information on 41 assessments identified through a literature review and consultation with experts. Each assessment tool was rated according to construction, level of measurement, clinical utility, standardization, reliability and validity on 3-point scales. The instruments are listed by usefulness with social units of individual, family, and community and their usefulness identified based on four evaluation dimensions. Issues related to the clinical utility of these instruments in rehabilitation and research suggestions for future steps are also discussed.