Top 5 Occupational Therapy Models To Know

Occupational therapy models, theories, frameworks, frames of reference — all of these different terms can be enough to make your head spin! Content that we learn in OT school is often heavily focused on these areas, and for good reason.

We need to understand the basis behind all of the work we are doing as occupational therapists. Otherwise, we are just aimlessly recommending activities without really knowing what the outcome will be.

Models are some of the most practical of all those terms we just mentioned because they are easier to understand and are often visual in nature. Let it be known that there are quite a few OT models, but it’s important to get the gist of the main ones that will most often be used to inform treatment and guide your understanding of the field.

Conceptual models are the more common type, since they are abstract and better learned as part of OT classes. Practice-based models can more readily be implemented but they are not taught as often, or in as much depth, during your academic career.

Some examples of popular conceptual models (that we will be covering here) include:

• Allen’s Cognitive Disabilities Model (CDM)
• Canadian Model of Occupational Performance and Engagement (CMOP-E)
• Dunn’s Model of Sensory Processing
• Model of Human Occupations (MOHO)
• Person-Environment-Occupation-Performance Model (PEOP Model)

Allen’s Cognitive Disabilities Model (CDM)

We typically learn about the Allen’s Cognitive Disabilities Model (CDM) and its use with individuals who have dementia, but the CDM is actually designed to assist pediatric through elderly populations with any mental disability. This model focuses on describing an individual’s functioning by looking at six cognitive levels:

• Automatic actions
• Postural actions
• Manual actions
• Goal-directed actions
• Exploratory actions
• Planned actions

Task analysis is a big part of using the Cognitive Disabilities Model with your patients. This involves breaking down activities, which allows therapists to clearly identify deficits and categorize each patients’ cognitive abilities according to the levels above. From here, therapists can modify tasks to meet the needs of each patient. This process is done continually, since patients may display varying needs from day to day depending on the status of their condition.

This model also helps with treatment planning and setting goals. Therapists can structure a plan of care in a way that facilitates a patient’s engagement and progress toward the next cognitive level, if this is appropriate and realistic.

Canadian Model of Occupational Performance and Engagement (CMOP-E)

The Canadian Model of Occupational Performance and Engagement (CMOP-E Model) is very versatile in that it is appropriate for use in nearly any OT practice setting and with any age range from children to older adults. The CMOP-E is just one of many models that focus on the interaction between occupation, performance, and the person.

Across these similar models, each component is often ascribed a slightly different meaning that changes the intention and delivery of the model in practice. In the CMOP-E, each component is broken down as follows:

• The Person represents the intrinsic workings of a human with the innermost center being their spirituality. Other aspects include their physical, mental, and emotional abilities.
• Occupation is any activity that a person takes part in. This is further described using the categories of self-care, productivity, and leisure.
• Last is the environment, which covers a person’s physical, cultural, and social environments.

Clinically, this OT model helps therapists develop personalized goals and activities. This is an ideal tool because it goes beyond simply assessing how someone performs functionally and extends to their engagement as well. Engagement allows the therapist to access areas that personally motivate patients, so they are empowered to choose their own meaningful occupations and get better at them over time. This can transform the way therapists view client-centered care!

Dunn’s Model of Sensory Processing

Another common model, Dunn’s Model of Sensory Processing, is authored by Winnie Dunn, who has played an integral role in sensory processing research over the years. The Model of Sensory Processing is ideal for any setting and any age range. This model posits there are four basic responses that result from someone’s threshold (or tolerance) for sensory input. They are:

• Sensation seeking: Those who crave sensory input and actively seek it to meet their threshold
• Sensory avoiding: Those who can’t tolerate much sensory input and actively avoid it to keep themselves safely below their threshold
• Sensory sensitivity: Those who can’t tolerate much sensory input but may more passively react to this dislike by screaming, crying, or tantruming
• Low registration: Those who want sensory input but their bodies have trouble processing it so they may respond as if they haven’t had input at all

You may already know that the world (and therapy sessions, even) are full of various types of sensory input. Therapy practitioners can use these categories to help identify their patients’ needs, make recommendations that help them become more regulated, and function within their daily lives.

Model of Human Occupation (MOHO)

The Model of Human Occupation (MOHO) is one model that you simply can’t forget. Not only does it have an abbreviation that sometimes makes you chuckle, but it really represents the crux of what we do as occupational therapists. The MOHO can be used with patients of all ages and abilities in any setting. MOHO likens a person’s way of interacting with their world as a dynamic cycle made up of three parts: volition, performance, and habituation.

• Volition consists of a person’s confidence along with their ability to seek out interests for their own pleasure and set goals based on the occupations they value.
• Habituation states that someone’s internalized roles guide them through life. Additionally, habits are formed when they repeat activities without conscious thinking.
• Performance is the skilled action that results from volition and habituation.

The intention of the MOHO is to be a living reflection of the dynamics at play in someone’s life. As such, this is a great way for therapists to keep up with the constant shifts in perception and needs of their patients.

Person-Environment-Occupation-Performance Model (PEOP Model)

The Person-Environment-Occupation-Performance (PEOP) Model’s goal is to assess occupational performance by analyzing the interaction between these three main areas. The PEOP model rather obviously states the three areas of focus, but there are actually many more subcomponents that are important to note.

• The person is broken down into their characteristics, including sensory, cognitive, spiritual, physical, psychological, and physiological.
• The environment spans areas such as social support, cultural considerations, demographics, finances, technology, and more.
• Lastly are the traits of the activity (or role) in question. There are outcomes from each activity and these results are highly dependent on the characteristics of the person and their environment.

As a result, the PEOP Model identifies factors (both positive and negative) in any category that may impact performance. It is then a therapist’s goal to help adapt, switch, or otherwise adjust the task and characteristics as needed to help promote success.

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As we mentioned, these are just a few of the many important models that occupational therapists and occupational therapy assistants can use to guide their treatment. Most of these are a great fit for any practice setting, population, and diagnosis, so you can start thinking of all the ways that these models can help patients. This will give you a jump start in knowing which ones you’ll use once you enter the field!

Thirsty for more occupational therapy models? Take a look at some other great ones that we didn’t cover:

• Fidler’s Lifestyle Performance Model
• Experiential Model of Occupational Balance
• Kawa Model

Which one is your favorite model? What other occupational therapy models would you add to this list? Let us know your thoughts in the comments!

This post was originally published on June 23, 2021 and last updated on May 27, 2023.