Adzima, Fidel and Moxi are the representatives who developed this treatment model. This model is a theoretical professional guidance. It regards individuals, media and activities as interrelated, and such objects all have spiritual energy. They believe that the satisfaction of personal needs depends on the interaction of these objects. When basic needs are met, individuals can gain energy and help themselves achieve the goal of self-expression and balance. The purpose of activities or homework is to promote interpersonal communication, help healthy emotions and help us.
The object relationship therapy model is developed from the communication process orientation in psychoanalysis and occupational therapy. Moses further perfected it and advocated the adoption of "eclectic orientation", which combined Jung's and Freud's existential theories.
1. Basic components and theory
(2) Mutual energy system
(3) the choice and relationship of objects
(4) the process of self-improvement
(5) Psychological failure and obstacles
2. The role of occupational therapists
(1) Equal interaction and cooperation with patients.
(2) Use activities to increase patients' and therapists' understanding of behavior.
(3) Be a participant and an observer.
3. Function of homework or activity
(1) Assist in venting and feeling.
(2) Group interaction and curative effect produced by the activity process.
(3) Re-establish the feeling of self-control
(4) improve (self) defense ability
(5) Provide opportunities for choice.
(6) Re-examine yourself/have confidence in your new role.
4. The role of activities in the object relationship model in occupational therapy.
(1) Provide suitable space.
(2) provide opportunities to improve "self-defense ability"
(3) Provide methods to establish or rebuild the sense of self-control.
(4) Provide a place to learn new skills, improve skills or increase confidence in existing skills.
(5) Provide opportunities to try new roles or have confidence in existing roles.
(6) provide channels to understand their relationship with others.
(7) Provide a way to accept yourself.
(8) Assisting growth and making yourself more flexible in facing things in life.
(B) Behavior therapy model
This treatment model is based on clinical research and theoretical principles such as cognitive sociality and restricted learning. In the field of therapy, these principles are systematically applied to the establishment of behavioral skills and functional techniques to change behavior procedures, so that individuals can successfully live in their environment.
The purpose of treatment is to identify and eliminate the functional skills necessary for the development of problem behavior, without paying attention to the past sensory history or self-development. Generally speaking, the problem of human adaptation is considered to be a behavioral technology and procedural problem caused by poor learning. It uses behavior-oriented experience to teach behavioral therapists and patients to shape and improve the skills they need to develop, and actively participate in a learning process to cope with daily life, work and leisure activities. These techniques include explicit behavior, which therapists can use to help patients.
1. Basic components and theory
(1) Classification of typical inhibitory stimuli and classification of learning.
(2) Operational restriction discriminates stimulus discriminates behavior (behavior reduction)
(3) Behavior reinforcement, positive and negative reinforcement and media reinforcement (reward)
(4) Punishment
(5) shaping behavior chain and establishing regression behavior chain.
(6) Imitate the object
(7) Symbolic reward system
(8) the system sensitivity is reduced.
(9) Physiological feedback training and stress management
2. The role of occupational therapists
(1) Encourage and strengthen the system.
(2) Teachers revise their learning skills.
(3) Imitate the behavior of the object, rehearse the role, and learn how to solve the problem through role-playing.
(4) Life consultant
3. Function of homework or activity
(1) Building skills
(2) Learning special skills
(3) Composition of active ingredients
(4) producing finished products
(5) Activity as a reinforcing agent
4. Evaluation method Behavior evaluation, through objective and measurable behavior observation and statistics, achieves the following purposes.
(1) Determine the problem and the purpose, behavior and learning skills to be achieved.
(2) Help to formulate feasible treatment methods.
(3) As the basic line to evaluate the treatment progress.
(C) the way of human operation
This occupational therapy model evolved from MaryReilly's "professional behavior theory". It is a highly eclectic treatment model, referring to the "professional theory" and "universal system" theory of occupational therapy, and integrating existential biology and social psychology. It emphasizes the humanity of work: the role of system and environment, and how to promote and provide the scope of human work. The representative of this treatment reference standard model is GaryKielhofner.
1. Basic components and theory
(1) The individual is an open system, which interacts with the outside world through a circular process: injection process, harvest (achievement) and reaction (feedback).
1) Indoctrination: Individuals actively seek and ingest information in this open system, including the material and atmosphere of people in the environment or the internal pressure of personal needs.
2) Information evolves in the process: it is the individual's interest goals and beliefs that catalyze this evolution, and the stimulus is systematically evaluated. Finally, individuals use this injection as a response to their personal skills and habits.
3) New skills are generated with evolution: therefore, new information and behaviors are generated.
4) The result is returned to the system to form feedback or new injection.
(2) Homework behavior: including homework games and self-care.
(3) The hierarchical system has three hierarchical subsystems in an open individual: the will system, the habit system and the behavior system. The interaction of these subsystems can determine the function of the whole open system in the environment.
1) components of the will system: values, personal control, beliefs and interests.
2) Habit system components: including habits and life roles.
3) Behavior system components: including work behavior skills.
(4) Judgment of function and dysfunction: In the case of illness and disability, the individual open system will strive to maintain the balance of work and maintain a good system. According to their work performance, individuals should use their information (such as knowledge, skills and habits) to adapt to social requirements, safeguard their dignity, participate in social and cultural activities and contribute to the adaptability of social people. When there is dysfunction or obstacle, the individual fails to successfully cope with the requirements of daily life, such as lack of leisure time, dissatisfaction with self-expression or loss of self-expression.
2. The role of occupational therapists
Occupational therapists are mainly responsible for evaluating patients' work performance and planning treatment plans, providing individuals with opportunities to survive successfully in the environment, enhancing their required skills, promoting the feeling of self-control and restoring the balance among various work elements.
3. Function of homework or activity
Activities are mainly used to produce results or achieve performance goals. The activity process can provide countermeasures to improve the quality of homework. The performance of homework activities includes: daily life, gymnastics, time management, social skills training, creative expression, media process projects, etc.
estimate
The purpose of the evaluation is to understand the functions of personal work more completely, including self-care and leisure time.
The selection of evaluation tools depends on the following factors: (1) Time available for evaluation.
(2) required information
(3) the existence of evaluation tools
(4) Evaluate the scientificity and accuracy of the instrument.
The commonly used evaluation methods in the world are: bayareaffictional performance education; Occupation analysis interview and training scale (OCAIRS); History of professional roles; List of interests; Occupy a seat, perform Hisyoryinterview, etc. , but it has not been implemented in China.
(D) Cognitive behavioral therapy model
This treatment model is different from the behavior-oriented model. Behavior mode is mainly to strengthen methods and change behaviors, while cognitive behavior mode is mainly to determine the thinking that leads to or changes behaviors and develop a knowledge base for solving problems. This treatment model thinks that individual's cognitive function can influence or guide individual's mood and behavior, provides an evaluation method to evaluate individual's cognitive function and emotional state, and puts forward treatment methods, including: changing patients' thinking, speech and behavioral skills, so as to drive behavior change or functional improvement to operate in this model. Occupational therapists will adopt hierarchical activities as a guiding method, provide gradual challenges and successful experiences, and ultimately help patients develop their cognitive function, expand their knowledge and skills, increase their control over their living environment, and enhance their ability to know themselves and solve problems, so as to meet the challenges of life.
Occupational therapists apply the basic elements of cognitive behavioral therapy model to psychiatric treatment, which is called psychological education model. It combines the basic elements of cognitive behavioral model theory, social learning theory, cognitive theory and behavioral theory.
1. Basic components and theory
(1) Man is a cognitive, social and psychological individual, and his life will only develop and change constantly. Knowledge is stored, extracted and reorganized in a structured form, resulting in self-concept, thoughts on others, and behavior rules and skills for getting along with others.
(2) The slow development or interference of knowledge is the cause of problem behavior, while cognitive or thinking problems are the basic factors of mental illness. This dysfunction is due to lack of knowledge, or lack of flexibility and biased knowledge.
(3) Cognitive dysfunction (obstacle) can be observed from individual behavior, such as indifference to the environment, lack of self-identification mechanism for failure in exploration, wrong evaluation of the real environment, and lack of ability to actively deal with problems.
(4) Sense of security: In a safe and encouraging environment, children learn to control the environment, dare to explore and grow, so as to establish practical basic knowledge, so as to shape their own world and self-concept, guide future learning and knowledge growth, and establish a problem-solving orientation. However, negative growth experiences or lack of opportunities to explore may lead to individual fear of the environment, wrong understanding, and more likely to lead to rigid defensive attitudes and lack of problem-solving skills.
(5) Competency and incompetence: when an individual's cognitive function cannot meet the requirements of growth and development, there will be a feeling of incompetence. Individuals will feel that they cannot be independent, lack self-concept or feel that everything is limited.
(6) Irrational explanation: Due to the existence of biased knowledge, individuals tend to use some irrational thinking or unrealistic ideas to guide behavior or explain reasons, leading to obstacles or disorders in event behavior.
2. The role of occupational therapists
(1) Teaching facilitator: design learning courses, determine patients' learning needs, provide therapeutic content that can be practiced at home, and therapists should design learning experience and environment suitable for patients.
(2) Set an example: learn to imitate objects with a scientific and rational attitude.
(3) Point out and challenge patients' biased ideas and self-concepts.
(4) Participatory observer: from the process of activities with patients, deeply understand patients' cognitive ability and learning attitude, and recognize different learning experiences.
3. Function of homework or activity
(1) Assess the level of knowledge and skills.
(2) Improving knowledge and ability ① Learning unit content ② Family practice activities.
4. Evaluation method
(1) active thinking mode
(2) thought interpretation program
(3) The role of thinking modes, such as memory and perception, in the field of logical knowledge.
(4) personal outlook on life
(5) Assessing the conformity between personal ability and environment; (6) Evaluation tools, such as Hewitt`staskchecklist Baker Dipson inventory.
(5) the mode of occupational performance therapy
This treatment mode is the basic theory of occupational therapy, not only a single concept, but also an operating guide and guide for the whole occupational therapy profession.
The model of occupational performance therapy confirms the influence of "life time and space" on occupational activities. This kind of "time and space" includes cultural background, human nature and inhuman environment, including social material and cultural environment, and it is a place where professional ability and activity ability can be expressed and have an impact on professional activities.
1. Basic components and theory
(1) The field or category of homework performance: daily self-care games, education, productivity, leisure time, etc. Are within the scope of operation.
(2) Job performance components: These components are the elements of individual functions and directly affect the operation of individual activities or the ability of performance skills. These factors will also affect the importance and intensity of personal work experience. These components can be further classified, including: psychology-values, interests, self-concept; Sociality-the role expresses the interpersonal relationship of social operation; Self-rationality-coping skills, time management and self-control.
(3) Occupational therapists focus on "practice" life, but before understanding "practice", they must understand individuals and explore their thoughts and feelings.
2. The role of occupational therapists
Apart from traditional therapeutic roles, there is no obvious role classification.
3. Characteristics of operation mode
This treatment mode does not limit the therapist to adopt other operation modes and evaluation orientations.
The advantage of this model is that it will not restrict therapists from using other models or theoretical orientations, and requires therapists to consider the overall state and living conditions of patients before focusing on their work fields.
4. The most commonly used assessment is "Canadian Professional Performance Assessment (COPM)". The evaluation uses semi-planned questions as interview guidance and measures patients' self-perception concept of homework/activity manipulation. It can be measured at any time during the treatment, usually in different treatment periods, to understand the changes of patients before and after treatment.