Vocational intervention based on the Model of Human Occupation: a review of evidence

Abstract

Work is a growing concern in disability and rehabilitation fields. Specific evidence related to occupational therapy in the area of vocational rehabilitation is somewhat limited. With increased demands for occupation-focused, evidence-based, and theory-informed practice, this review aims to use clinically relevant questions to organize and synthesize evidence regarding work-related interventions specifically related to an occupation-focused theory, the Model of Human Occupation. A total of 45 published works related to both the MOHO and vocational issues were identified and included in the review. The review demonstrates that there is a range of evidence that supports the use of the MOHO and its tools as a basis for work-based clinical interventions. Evidence supports the conclusion that MOHO-based work assessments have good psychometric properties and are useful in evaluating vocational potential and needs. MOHO-based work programs have been shown to have a positive impact in improving vocational outcomes to a range of clients.

Occupational therapy and return to work: a systematic literature review

“…In order to do so, both uniform terminology and specific, detailed descriptions of the therapeutic content of the OTIs would be needed. This supports the statement of Lee and Kielhofner [2], as they point out the lack of well-described definitions in the field of OT research. Research efforts indicate that performing or simulating patients' "work activity" during rehabilitation can be very valuable in assisting them to restore their labour-participation [26-28].…”

“…In literature, occupational therapists report many challenges in adopting and implementing evidence-based principles to practice. According to Lee and Kielhofner, research indicates that current OT practice is still not strongly grounded in theory, occupation and evidence [2]. They state that, although occupational therapists provide a range of work-related interventions, specific evidence related to OT in the area of vocational rehabilitation remains somewhat limited [2].…”

“…Nevertheless, Lee and Kielhofner also state that experiences (of some authors of projects in which occupational therapists are involved) indicate that simultaneous consideration of theory and evidence is advantageous to achieve occupation-focuses best practice [2]. …”

“…Gibson and Strong [35] stated that occupational therapists can play a major role in work rehabilitation for RTW by assessing and rehabilitating workers with a disability injury. Kinébanian & Le Granze indicate that Lee and Kielhofner [2] described and synthesised evidence about work-related OTIs the Model of Human Occupation (MOHO) [36]. MOHO-based work programs have been shown to have positive impact in improving vocational outcomes for a broad range of clients, including persons with chronic illness [2,7,9,12,13,37,37-40].…”

“…Assisting patients to return to their job is clearly an important part of the therapeutic effort of occupational therapists [2], the OT process is based on initial and repeated assessments in individual patients. Assessment includes the use of standardized procedures, interviews, observations in a variety of settings and consultation with significant people in the person's life.…”