A Prevention Model for Occupational Therapy

Abstract

The role of occupational therapy in prevention has received much discussion but relatively little empirical testing and model building. Because of the evidence linking stress and illness, the life stress process has become a popular area of investigation. More importantly, a role strain model can provide a theoretical guide to occupational therapy practice due to the central importance of adaptive behavior and social competence. To illustrate, the maternal stress study is presented as an example of prevention research that examines the relationship between maternal stress and child psychopathology. Risk factors are identified as the first step in reliable case finding and the design of preventive interventions. Such model building can help occupational therapists develop prevention services for vulnerable populations.

A survey of mothers' relationships with their preschoolers

“…The quality of mothers' relationships with their children is an important fac tor in the optimal development of both mothers and children (Crowell & Feldman, 1988). A number of authors have emphasised the need for preven tion models in occupational therapy (for example, Gilfoyle, 1988;Grossman, 1991). However, the beneficial effects of early intervention and parent involvement in early intervention are difficult to measure unequivocally (Esdaile, 1994), and agencies providing health services remain sceptical about the cost-effectiveness of this approach to enhancing productive living (White, Taylor & Moss, 1992).…”

“…Problems related to the mental health of mothers (Goodnow, 1988) and abused children (Wright, 1994) continue to be issues of serious concern in the community. The development of prevention pro grammes which are designed effectively to meet the needs of these mothers and children are crucial for society (Dunn, 1991;Grossman, 1991). There fore, it is necessary to have a means of clarifying and identifying these needs precisely.…”

“…Cruzcosa, 1989). Mothers most at risk of abusing their children are those who, as well as having expectations beyond the capacities of the child's developmental stage, tend to lack social supports (Kugler & Hansson, 1988;Grossman, 1991) and exhibit marked physiological symptoms of fear and anxiety when confronted with difficult (non-responsive or non-compliant) children. The temperamental variables of the child may make it especially stressful to negotiate this stage of development from the perspective of both mother and child (Lancaster et al, 1989).…”

“…To be effective, occupational therapy intervention and parent education programmes must ensure that par ticipants' confidence is enhanced, not undermined. Programmes that are lim ited to parent training often fail to provide lasting results, because they fail to meet the fundamental developmental needs of the mothers as well as the chil dren involved (Allan & Schultz, 1987;Grossman, 1991). Parents are a child's first teachers, or therapists, and play a critical role in fostering the child's development, education, achievement motivation and behavioural adjust ment (Hess & Holloway, 1983).…”

“…The role of parents as educators of their chil dren is particularly important for the child with developmental problems (Hinojosa &. Anderson, 1991), but equally important for the child who is socially deprived or at risk of abuse (Slaughter, 1984;Grossman, 1991).…”