Occupational Therapy Report: CMOP-E Model Application and Analysis

This report delves into the application of the Canadian Model of Occupational Performance and Engagement (CMOP-E) in occupational therapy, focusing on a case study of Mr. Jozef, a 51-year-old mechanic suffering from rheumatoid arthritis. The report examines how the CMOP-E model, with its emphasis on person, occupation, and environment, can be utilized to assess Jozef's condition, addressing his physical limitations, psychological well-being, and environmental factors. It explores the model's strengths in promoting client-centered care and engagement while acknowledging its limitations, such as potential cultural criticisms and the impact of environmental challenges. The report also discusses standardized assessment methods and proposes a care plan that incorporates exercises and balance training. Furthermore, an alternate model is chosen with justification for the chosen model, alongside its appropriateness to the case scenario and limitations. The report concludes with a comprehensive overview of the patient's condition and the effectiveness of the CMOP-E model in providing support and care.

Running head: OCCUPATIONAL THERAPY
Occupational therapy
Name of the student
University name
Author’s note

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Table of Contents
Section 1.......................................................................................................................................2
Introduction..................................................................................................................................2
Discussion of the model...............................................................................................................2
Assessment of patient condition through chosen model..............................................................3
Standardised methods used for assessment of Jozef........................................................................5
Advantages and disadvantages of the chosen model.......................................................................6
Justification of the chosen model.................................................................................................7
Section 2.......................................................................................................................................8
Alternate model chosen................................................................................................................8
Appropriateness to the case scenario...........................................................................................9
Limitations of the model..............................................................................................................9
Justification of the model...........................................................................................................10
Conclusion.................................................................................................................................10
References..................................................................................................................................11

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Section 1
Introduction
The current assignment focuses on the concept of occupational therapy and the
application of models for catering to the requirements of the patients. The present assignment
focuses on the case study of Mr. Jozef who is a 51 year old mechanic by trade and had moved to
England with his wife Teresa 25 years ago. The man had been adversely affected with
rheumatoid arthritis which limits his day to day activities along with his ability to work
channelizing him towards depression and disability. In the current scenario the Canadian Model
of Occupational Performance and Engagement (CMOP-E) have been taken into consideration for
analysing the patient condition and providing him proper support care.
Discussion of the model
The CMOP-E model puts the patient, i.e. Jozef at the centre of the care services which
helps in providing sufficient amount of autonomy to the health care service users. As outlined by
Delany et al. (2013), the occupation is the prime concern domain. The application of the model
enhances the optimal functioning of the therapist within a team of multidisciplinary nature. The
introduction of the parameter of engagement into the scenario broadens the professional scope of
practise. The model embodies justice, well being and health as the sole criterions. For concerns
represented by the case of Jozef, there are three elements of COMP-E that needs to be discussed,
person, occupation and environment. The model helps in putting the patient at the centre of the
care processes but also evaluates the social determinants such as the surrounding environment
and its effect on the mental health of Jozef.
The main emphasis of the model is on occupational performance which is achieved due
to the interplay between a number of factors such as the person, occupation and environment
(Bilics et al. 2011). The model is based upon a number of theoretical underpinnings such as the
humanistic theories. As commented by Pohlman et al. (2010), such theories help in emphasising
upon important variables such as client centeredness. Additionally, the development and learning
theories are also promulgated to enable the occupational therapist acquire skills that will be able
to decipher the issues associated with Jozef and be able to interpret those issues.

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Function-dysfunction continuum
The components of the CMOP-E model are interrelated in that a change in one
component has a drastic effect on the other components. As commented by Bilics et al.(2011),
such function-dysfunction continuum can bring about occupational dysfunction. The function
continuum is established by a harmonious interdependent relationship between person,
occupation and the environment. Therefore, it can be stated that applying this theoretical model
can help in enabling both Jozef and his therapists to gain a better understanding of current
situation and the issues that Jozef is struggling with. However, as argued by Baum and Bass-
Haugen (2014), there are a number of limitations of the model where a slight change in one of
the variables can bring about a huge paradigm in the other parameter. Moreover, large scale
restrictions are faced from the external environment for the implementation of the models within
the healthcare. Some of the challenges faced in this aspect are lack of appropriate levels of
knowledge regarding the benefits of the integration of a particular model. In case of Jozef, the
limitations that restricted successful implementation of the theoretical framework are the
restricted amount of information available about him and his reluctance to share more
information with the therapist; along with that it has to be mentioned in this context that if the
therapist ailed to have a clear and comprehensible understanding of the condition represented by
the patient, he will not be able to arrive at the most suitable suggestive strategies to implemented
(Pohlman et al. 2010).
Assessment of patient condition through chosen model
The CMOP-E model could be applied here for the assessment of the patient condition by
a strict evaluation of each of the three parameters such as the person, occupation and the
environment. In the present context, the patient Mr. Jozef had multiple concerns and have been
suffering from chronic rheumatoid arthritis. He had been living in the countryside alone with his
wife. Although, he misses his sons and his family sheltered at the Slovakia region, who he
cannot go and meet. This could be attributed to his severe disability which has made life

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miserable for him. The inability to perform the daily set of activities might have made him more
prone to depression.
Person
In the CMOP-E model, the spirituality of the care user is placed at the centre of the model
and is represented by a triangle. The three main performance indicators based upon which the
evaluation is done are –cognitive, affective and physical. The cognitive factors here refer to the
decision making skills possessed by the patient which are the major determinants of the person
centred approach. Therefore, the application of the model provides sufficient opportunity to
Jozef to participate in the care planning and decision making approach. Therefore, the model
helps in the establishment of a client centred approach. As commented by Zbogar et al. (2017),
the affective factor covers the social determinants which happen to produce a serious impact
upon the level of mental well being of the person.
As commented by Kumar et al.(2014), the CMOP-E places spirituality within the
occupational practices and is positioned at the core of the patient centred practices. The
spirituality would help in the establishment of an essence of self within Jozef. It has been
reported that Mr. Jozef had been feeling futile about himself due to the inability of contributing
towards the well being of his family. Additionally, the physical aspect of the CMOP-E model
would help in addressing the physical disabilities faced by Mr. Jozef. The daily life activities of
Mr. Josef had been challenged owing to his chronic arthritis condition. However spirituality may
be confusing as occupation should be at the centre, being the core value for occupational
therapist, although it can be neglected that the spirituality of an individual is instrumental in the
overall wellbeing of the patient. In this context, one of the major desires with Jozef had been
after he left Slovakia had been to retain his spirituality. When he shifted to the village side, the
absence of any catholic church might have had a significant impact on his psychological
wellbeing and in turn could have influenced his physical wellbeing and performance.
Environment

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The outer circle of the model represents the environment within which the occupations
are functional and the individuals exist. The environment has an adverse effect on the individuals
and the existent occupations. The components could be further broken down into – physical,
cultural, institutional and social (Abaoğlu et al. 2017). With regards to Mr. Jozef the social
factors plays a curial role over here. Due to the increasing sickness level and separation from his
children and family Mr. Jozef had been increasingly prone to depression. It can be stated the
growing distance from his family may have contributed to his depression; the model used may
help Jozef understand how his environment may both currently negatively impact on him, but
how in future it could also support him.
Occupation
The occupation aspect could be further divided into three major components such as –self
care, leisure and productivity. The inner circle of the CMOP-E model represents occupation and
is of prime importance over here. It is through occupation that the person interacts with the
environment. Therefore, the occupation can serve as link between the occupational therapists and
the person. As Jozef currently is not engaged in many occupations it is facilitating a sense of
disconnection between his inner spirituality and his environment, and especially if he could
visualise this in the diagram it might help him understand his current situation further.
Limitations of the CMOP-E model
In this respect, Mr. Jozef was undergoing depression which could have limited his
responses to the support services. The cultural criticisms also possess a major hindrance to the
application of the model (Niemiec et al. 2016). Additionally, failure in including the family
members of Mr. Jozef in the support care and decision making process could result in a situation
of conflict between the therapist and the respective client.
Standardised methods used for assessment of Jozef
The clinical condition of Jozef had made him unable to perform his daily set of activities.
It has been represented in the case study that Jozef had been suffering greatly with rheumatoid
arthritis which crippled him with recurring acute joint pain rendering him unable to stand on his
own. The mentioned medical constrain coupled with the extreme fatigue restricted Jozef’s ability

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to move around freely. According to the COMP-E model, it is very important to explore the
impact of the environment and the patient’s own feelings in order to decipher the contributing
factor behind the manifestation of the symptoms in the patient (Niemiec et al. 2016). Jozef had
been subjected to increased melancholy and feelings of depression due to the mobility restriction
and not being able to connect to his personal and professional identity, for which the doctor had
prescribed him sentranile.
Jozef had been disconnected from his professional sphere due to his medical
complication and it affected his cognitive health significantly. Hence it can be considered an
essential cause behind the depression and societal withdrawal that Jozef had been under.
However, the COMP- E model also takes into consideration the effect of the surrounding
environment on the cognitive health and wellbeing of the patient (Niemiec et al. 2016).
according to the case study, Jozef had no leisurely activities, could not participate in gardening
which had been a regular regime for him all throughout his life and due to his deteriorating
arthritis he could not get out of the house to socialize as well. Furthermore, after he relocated to
the countryside with his wife, the absence of any catholic church also facilitated to the complete
detachment and de-motivation he faced in his new environment. The impact of environment is a
key stakeholder in the concept of psychological wellbeing of a human being and hence this
detachment contributed to facilitate guilt, worry and social isolation further complicating his
cognitive health (Procknow and Leung, 2015).
Additionally, the surrounding environment also offers greater levels of challenges for the
optimal expression and the exercising of the model. In this respect, the lack of awareness about
the health concerns and lack of sufficient amount of support from the family members of the
Jozef can challenge the rate of success of the model (Procknow and Leung, 2015). In this
respect, Jozef’s wife had been away for a while due to the ill health of her mother. Jozef’s
depression also reduced the amount of conversation he had previously with his family. As
asserted by Ghitza (2014), lack of a supportive environment is both detrimental for the
concerned person and the occupational therapists. The therapists are dependent on sufficient
collaboration and participation from the person and their respective families. This could affect
the person centred approach promulgated by the model thereby affecting the objective of growth
and success outcomes.

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The assessment method emphasises upon implementation of supportive systems and
frameworks for management of the health conditions and deteriorating symptoms expressed by
Mr. Jozef. For assessment and redressal of the physical limitations possessed by Jozef a care plan
needs to be designed putting light exercises and balance training at the centre of the model. As
commented by Schiavi et al.(2017), use of new and improved technologies such as provision of
friendly and virtual mobile interface could help patients like Jozef connect directly with the
healthcare executives. This can help in providing direct access and help to the Jozefs’. Moreover,
the model being result focussed helps in bringing about positive health outcomes in the patient.
Standardized tool for assessment
For the assessment of the present condition of Jozef a standardized assessment tool had
been used over here such as the Canadian Model of Occupational performance (COPM). The
model analyses the different personal and professional engagements of a person and the manner
in which it affects the well being of the person. Thus, over here five key occupational areas are
considered and given a score between 1-10 based upon the performance and satisfaction levels of
the client. In the present context, Jozef was a 51 year old man who had been living in England
with his wife and is affected with rheumatoid arthritis. This affects his daily set of activities and
life in general. The five key performance areas have been identified by Jozef as follows such as
unable to manage his daily set of activities alone. In this context, being affected with rheumatoid
arthritis Jozef takes consecutively longer duration of time in managing his daily set of activities.
The present health condition of Jozef has also made him unable to continue in his professional
life. This further compromises his economic independence and makes him more dependent on
others.
The ill health of Jozef also does not allow him to accompany his wife occasionally for the
long drives. He also misses being with his children who are settled far away from him. Jozef had
always been spiritually inclined and likes visiting churches. However, the present condition of
Jozef does not allow him to travel or walk long distances up to the country church. Jozef had
been interested in some of the activities such as gardening as a hobby. However, the present
conditions of Jozef doesnot provide him sufficient time to vest in activities which could make
him happy or reduce his depression. The performance has been rated between 1 to 10; where 1
means ‘extremely important’, whereas 10 means ‘not important at all’. In terms of satisfaction

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vice versa scores have been observed where 1 means ‘not at all satisfied’ and 10 means
‘extremely satisfied’
Activities Performance (score between
1-10)
Satisfaction(score between 1-
10)
Unable to manage daily set of
activities
1 1
Unable to continue job 2 1
Unable to spend time with
loved ones or meet them
1 1
Spiritual inclinations 3 2
Hobbies/interests 4 2
Total score =11 =7
Average score =11/ 5=2.2 =7/ 5=1.4
Table 1: performance and satisfaction measure using COPM
(Source: Author)
Analysis:
Therefore, from the reassessment of the scores based on the rating given by Jozef we can
say that Jozef is extremely depressed about his present physical dilemma and superimposed
restrictions. He also thinks his performance is extremely poor in each individual areas of interest
and is not satisfied with it. Therefore, the assessment helps in understanding the current situation
of Jozef and the also the measures which could be implemented for providing him with
additional support care.
Advantages and disadvantages of the chosen model
There are a number of advantages and disadvantages of the CMOP-E model which could
be evaluated further in the context of care delivery to patients like Mr. Jozef. The main benefits
provided by the implementation of the model are that the model places the patients at the centre
of the care delivery process. This helps in providing more autonomy to patients such as Jozef,
where they are made a part of the decision making process. Therefore, involvements of patients

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like Mr. Jozef in the care planning would help in infusing more positivity within him and help
him is regaining control over his life. The person centred approach also places emphasis upon
inculcating the hobbies and the interests of the people within the care delivery process (Larsson-
Lund and Nyman, 2017). This could help in reducing the depression faced by people like Jozef
and making him an integrated part of the care plan.
There are a number of disadvantages of the process pertaining to the other two abstracts
of the CMOP-E model such as the occupation and environment. The model places the spirituality
at the centre of the care delivery process. As mentioned by Eklund et al. (2017), lacking
sufficient amount of skills can disregard most of the benefits received from the model.
Additionally, placing occupation at the centre results in greater level of scrutiny and speculations
from patients like Jozef and their respective families.
Section 2
Alternate model chosen
The vona du toit model of creative ability or the VdtMoCA is an occupational therapy
model which could be used for provision of care and support services to patients like Mr. Jozef.
The VdtMoCA model is different from the CMOP-E model in that four different perspectives
had been taken into consideration. As mentioned by Abaoğlu (2017), analysing the neuro
behavioural aspects of patients like MR. Jozef helps in providing additional level of support.
Therefore, the model rests upon the different intrinsic factor which shapes the perceptive
knowledge of a person. As commented by Casteleijn (2014), thus expanding upon the model can
provide more autonomy to the users by inculcating the policies of informed decision making.
The VdtMoCA model further emphasises upon occupation and performance as two overlapping
features (Abaoğlu et al. 2017). Thus, the model considers performance as one of the variables
which will be able to address how and why lack of productivity caused significant challenges in
this scenrio. However, performance enhancement is further subject to appropriate levels of
individual or group participation. This allows the patient to become an integrated part of the care
delivery process and reduces the chances of gaps in the services and the loopholes. The model

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emphasises that a human being passes through developmental cycles of behaviour and skill
development (Abaoğlu et al. 2017). The progressions through the various stages of life are
further governed by motivations and actions. As commented by Joubert (2013), the lack of
motivation can generate a feeling of depression and futility within an individual. The motivation
level can be rated from 1- 9 , with the highest action achieved at number 9. Thus, implementation
of the model helps to identify and develop existing abilities within the patient. As lack of
occupational productivity and performance questioned sense of self worth and value in Jozef,
using this model will be appropriate for Jozef.
Appropriateness to the case scenario
The VdtMoCA model could be applied in the case study of Mr. Jozef as the
implementation of the model could be beneficial in generating motivation in the patient. Here,
the patient had been suffering from a number of physical and psychosocial issues. The health
condition of the concerned patient demanded that he be provided with constant support services.
However, owing to the ill health of his mother in law his wife would be away at times. The
physical condition of the patient would also not allow him to travel long distance and meet his
sons or drive up to his mother-in-law’s house with his wife.
Therefore, application of the models such as CMOP-E by occupational therapists would
have helped in relieving the adverse conditions faced by Jozef. However, the application of the
VdtMoCA model also takes into consideration the overlapping parameters between occupation
and performance. However, as asserted by Wilcox (2016), the model helps in reaching the
different levels of motivation which helps in the inculcation of self-managerial skills within the
Jozef.
Limitations of the model
The model places relative emphasis upon the development of creative levels for reaching
the utmost patient satisfaction. However, limitations such as lack of time for achieving each and
every level of behaviour and motivation development, lack of sufficient amount of support from
the patient and the their respective families can act as hindrances. One of the objectives specified
by the model is achieving sufficient amount of participation from the society for reaching the

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highest stage of motivation and positive action development. As argued by Niemiec, , Halle, and
Sarkisian (2016), the availability of sufficient amount of participation is often subjected to
collaboration between a vast number of health care channels. However, due to residing in the
countryside the family may not have sufficient amount of availability to healthcare services.
Justification of the model
VdtMoCA model is best suited to apply within the context of Mr. Jozef due to the
multidisciplinary approach of the model. The model takes into consideration all the intrinsic and
extrinsic factors which further govern the mental and overall well being in a person(Delany,
2010). The intrinsic and extrinsic factors help in establishment of a person centred approach
Since Mr. Jozef was suffering from depression the inculcation of the VdtMoCA model can help
in generating motivation in the service user. This helps in catering to the grievances of the
patient.
The model helps in providing sufficient space and freedom to patients like Mr, Jozef in
realizing their ambitions and wishes. The model helps in providing sufficient opportunity to
patients like Mr. Jozef for expanding upon their spirituality aspects. The model also emphasizes
the ideals of informed decision making, which puts the family members patients like Jozef in a
more comfortable or dominating position.
Conclusion
The assignment focuses upon the implementation of two such models which helps in
evaluation of the care concerns of the patients suffering from multiple issues. The models which
have been evaluated and compared through the assignment are the CPOM-E model and the
VdtMoCA model. The assignment further focuses upon standardising and assessment of the
patient condition through the implementation of occupational therapy models. However, the
limitations need to be taken into consideration which further helps in establishment of the care
goals. Thus, person centred approach; optimal occupational services can play a huge role in the
improvement of the care services.