ICIDH‐PR: A potential model for occupational therapy

Abstract

Occupational therapists frequently work with clients who are challenged by chronic disabilities that may often lead to handicaps. Consequently, chronicity and possible resulting handicaps are matters of concern for occupational therapists in all domains, including: practice, research and education. In 1980 the World Health Organization put forth a classification scheme to capture the long‐term consequences of disease: the International Classification of Impairments, Disabilities, and Handicaps (ICIDH). Its use within occupational therapy was advocated. They showed that the constructs of this classification system mirrored those of occupational therapy's occupational performance model. More recently, a proposal for the revision of the ICIDH (ICIDH‐PR) has been advanced. This proposal is consistent with the enablement and occupational competence models. Within this proposed model, occupational therapy is concerned with enabling clients to interact optimally within their chosen environments. This paper presents a brief review of a selected portion of the international literature on the ICIDH and introduces the proposed revision of the ICIDH for occupational therapy. The structure of this proposed classification is compared with the occupational therapy models. The implications that the use of the ICIDH‐PR will have for occupational therapy are also addressed.

Client-Centred Care Means that I am a Valued Human Being

“…Corring & Cook ment of past and present mental health practices and their ideas for change are confirmed and supported by literature describing the loss of caring about the human being in health care (Montgomery, 1993), the medicalization of mental health care (Speechley, 1992;Stewart et al, 1995) , health care's history of focusing on disease and impairment while not fully understanding the full impact of disability and handicap (Anthony, Cohen, & Farkas, 1990;Dain, 1994;Martini, Polatajko, & Wilcox, 1995;World Health Organization, 1978 and the stigmatization of clients by service providers (Capponi, 1992;Deegan, 1988;Dubin & Fink, 1992;Elliot, Hanzlik, & Gliner, 1992;Leete, 1989;Lyons & Ziviani, 1995;Townsend, 1990). Health care clients, health care providers, and scholars in the social sciences field are joining them in the pursuit of a health care service system that will improve clients' quality of life , enable and empower them to achieve their life goals (Martini et al, 1995;Polatajko, 1992), provide a sense of hope and recovery from illness ( Anthony et al, 1990;Anthony, 1993;Deegan, 1988Deegan, ,1993Neuhaus, 1997;Woodside et al, 1994) and a return to caring in health care (Montgomery, 1993).…”

An Interactional Model of Mental Disability (IMMD) Based on the International Classification of Functioning and Disability (ICIDH-2)

“…There is considerable disagreement concerning the terminology of the model, particularly words like handicaps and disabilities, which are thought to have negative connotations. In the last decade, some studies (Polatajko, 1992;Martini et al, 1995;Fougeyrollas, 1993; Japanese Association of Psychiatric Rehabilitation (JAPR), 1996; 1997) have concentrated on improvement on the ICIDH-1980 or a better fit for the occupational therapy and the psychiatric domain. Yamane (1996,1997) has described some structural models for psychiatric diseases and disabilities in which personal factors, such as individual abilities, environmental factors, and details of mental disability, are reflected.…”

“…Let us first analyze the characteristics and limitations of the principal models based on the ICIDH. The Canadian model (ICIDH-PR model) (Martini et al, 1995;Fougeyrollas, 1993) is an explanatory model of the consequences of disease and trauma. The Canadian model highlights the nature of handicaps as the situational result of an interactive process between the characteristics of a person's impairments, disabilities and the social and environmental obstacles in a given situation (Fougeyrollas, 1994).…”