The Rise (and Suggested Demise) of Occupation-based Models of Practice
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The diagrammatic models used to represent occupation-based theories are common entities in occupational therapy, with at least six English versions in existence. Each one of these models seeks to represent and explain the same dynamic relationship between a person in an environment engaged in an occupation, drawing on many sources of knowledge to do so. Some of the important contributing knowledge sources to occupation-based models come from mathematics, physics, psychology and systems theory. General systems theory brought models into occupational therapy’s line of sight as early as the 1960s, with an explosion of specific model making in the late 1970s and 1980s. Since then occupation-based models seem to have taken on a hegemonic presence and act as an unquestioned reference point for practice. This thesis approaches the models from two angles, namely a historic and a semiotic perspective. The history of the development of two predominant occupation-based models, the ‘Canadian Model of Occupational Performance and Engagement’ and the ‘Model of Human Occupation’ is examined in relation to important contextual influences starting from the 1800s. The history of ideas methodology underpinning this examination reveals that people were increasingly categorised and practice became systematic and controlled. It is argued that the historical influences, the model making processes and how they are represented moved the profession into a scientific and abstract realm that neglected important elements of a person’s involvement in their every-day way of being with the world. The increased scientification and abstraction neglected the ontological perspective, the nature of being a human in the world. Semiotics, the study of signs and symbols is used to explain these two models and their production. The Model of Human Occupation is further considered in relation to systems theory, given its situatedness in this perspective. Semiotics explains what the model, as a standalone object, communicates and means, and takes a critical perspective on conceptual model building in occupational therapy. To illustrate how the occupation-based models fail to account for the richness that an ontological perspective could bring to practice, an example from the experiences of one man, after a stroke, is applied to each model. This thesis concludes by presenting a Heideggerian phenomenological interpretation of the story of the person in the case study. I mount an argument that the strength of the ontological perspective be restored to its central place in occupational therapy and that diagrammatic models that hold the profession to outdated modes of thinking need to be abandoned.