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Occupational Therapist (OT)
Psychosocial Approaches
Psychoanalytic and Psychodynamic Theory

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Psychoanalytic and Psychodynamic Theory

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Psychoanalytic and Psychodynamic Theory

Psychic-analyzing and Psychic-dynamite
Psychoanalytic and psychodynamic theories are commonly used to address psychological disorders. These theories are based on the psychodynamic frame of reference (FOR) and psychodynamic-object relations approaches, which emphasize the role of unconscious thoughts and feelings in shaping behavior and relationships. The Vivaio Model (MOVI) is a related concept that highlights the importance of the relationship between the OT and their client. Two main approaches used in therapy are the explorative approach, which encourages clients to explore their thoughts and feelings, and the supportive approach, which provides emotional support and guidance. Assessments commonly used in occupational therapy include observation, activity analysis, and standardized tools such as the Azima Battery and Barbara Hemphill Battery. The Lerner and Ross Magazine Picture Collage is a projective assessment tool that explores clients' unconscious thoughts and feelings.
Psychological Disorders
Psychological-brain Disordered

A psychological disorder is an ongoing dysfunctional pattern of thought, emotion, and behavior that causes significant distress and that is considered a reaction that is not culturally expected. It is a psychological dysfunction in an individual that is associated with distress or impairment in important areas of functioning.

Psychodynamic Frame of Reference (FOR)
Psychic-dynamite Frame

Psychodynamic Frame of Reference (FOR) draws on the work of Freud, Jung, Rodgers, and Maslow. Even though occupational therapists are not trained to the same extent as psychologists, the foundation of this frame of reference is to provide a framework the therapist can use to understand behaviors in order to meet goals. The therapy process uses self-awareness, emotional expression, social relationships, and defense mechanisms to help patients direct their actions to complete tasks.

Psychodynamic-Object Relations Approaches
Psyhic-dynamite with Object Relatives

Mosey outlines major principles with this frame of reference (FOR) and emphasizes the importance of the client’s mental state, the unconscious utility of symbols, and creative expression to promote insight into the self. Mosey stresses the importance of the client-therapist relationship and conscious use of self to facilitate rapport and promote a therapeutic environment conducive for the intervention.

Based on the Vivaio Model (MOVI)

The MOVI is based on psychoanalytic thinking and helps occupational therapists examine the meaning of 'doing' therapeutic relationships and unconscious elements during the interactions. The central element of the MOVI is the recognition of constant emotions that exist in the interdependent relationship between the three elements of patient, therapist, and 'doing.'

Relationship Between the OT and their Client
Relationship Between OT and Client

Based on Mosey’s ideas, empathy, compassion, unconditional positive regard, and humility are the foundations for the positive development of a therapist-client relationship in order to develop a collaborative partnership to better support goal achievement. It is imperative to provide a safe and structured environment where a client is capable of understanding self. The relationship between the OT and their client should consist of mutual respect, significance, and structured activities that provide functional performance, self-control, and personal safety.

Explorative Approach
Explorer Approaching-conflict

The explorative approach seeks to bring the conflicts in the unconscious mind to the conscious level to find potential ways to resolve the conflicts and express feelings. Explorative interventions include journaling and creative expression.

Supportive Approach
Supports Approaching-defenses

This approach emphasizes keeping conflicts hidden in the unconscious while strengthening the ego defense mechanics. The goal is to enhance the therapist-client relationship through empathy, trust, education in substituting unhealthy thought patterns with alternative and positive thoughts, provide defense mechanics and techniques, and provide feedback to aid the client.


In these approaches, therapists observe and analyze clients' behavior, communication, and interactions to gain insight into their unconscious thoughts and feelings. The therapist may also observe how the client interacts with the environment, how they approach tasks, and how they respond to different stimuli. This information is used to develop a better understanding of the client's underlying psychological processes and to inform therapeutic interventions. Observation is a critical tool in these theories, as it allows the therapist to gain valuable insight into the client's behavior and to identify patterns that may be related to their psychological issues.

Activity Analysis
Active-runner Analyzing

Activity analysis is a foundational process used in occupational therapy to break down and examine the components and demands of a specific task or activity. It involves a detailed analysis of the skills, abilities, and resources required to complete an activity, as well as the environmental and contextual factors that impact the activity's performance. Activity analysis helps occupational therapists identify areas of difficulty for a client and design appropriate interventions to improve their performance and participation in daily activities.

Azima Battery
A-Zoom Battery

The Azima Battery is an occupational therapy assessment that uses expressive media such as drawing a person, finger painting, and free drawing with a pencil or clay task. The therapist is able to examine the client's perception of the world, level of maturity, primary thinking, symbolic proximity, the concept of gratification on basic needs, reality contact, mood, and level of functioning.

Barbara Hemphill (BH) Battery
Barbed Hemp-hill Battery

A projective test that evaluates the psychological area of human function. The media used are mosaic tiling and finger painting. It is used to assess a client's self-esteem, abstract thinking, following directions, problem-solving, frustration tolerance, decision-making, organization, and body concept.

Lerner and Ross Magazine Picture Collage
Learner and Ross Magazine Picture Collage

Lerner and Ross Magazine Picture Collage is an expressive assessment that must be used in conjunction with an objective assessment. The client is provided with a variety of magazines, colored construction paper, scissors, glue, and pens. The client is given 30 minutes to choose one or more pictures, cut them out, and glue them on choice paper. The purpose of the learner-ross magazine collage is to assess cognitive-perceptual function, quality of defenses, affect, organization, object relations, and sense of self.


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