arrival of the infant. An occupational therapist has the unique skills and education to facilitate assessment and intervention strategies that integrate all of the potential benefits relative to occupational intervention.
APPLYING A BIOPSYCHOSOCIAL MODEL
As articulated in the prior section covering Endometriosis & Chronic Pelvic Pain, the occupational therapist has a unique educational background in facilitating both physical modalities of intervention as well as psychosocial aspects of intervention; they are uniquely situated to deliver patient-centered care from a biopsychosocial model. This model allows the therapist to consider the diverse factors of biological, psychological, and sociological influences when creating an intervention plan (Gentry, Snyder, Barstow, & Hamson-Utley, 2018). Each of these dimensions of care has been shown to have a direct impact on the intermediate and final rehabilitation outcomes (Gentry, Snyder, Barstow, & Hamson-Utley, 2018). Gentry and colleagues’ (2018) adapted the Biopsychosocial Model for use in the OT practice addresses the needs of client across the continuum of care, incorporating seven key elements:
Characteristics of the condition (previously termed injury characteristics)
Sociodemographic variables that impact
Psychological variables, and
Social-contextual variables (which reciprocally interact with each other), to impact
The following presentations depict Case Vignette 2 - Nadine, which provides a client-specific scenario utilized to provide context to the completion of the biopsychosocial chart (as outlined in the previous section covering Endometriosis & Chronic Pelvic Pain, Figure 1), elaborated within the secondary presentation on Applying the Biopsychosocial Model as adapted for occupational therapy.
Case Vignette 2 - Nadine
Applying the Adapted Biopsychosocial Model for OT
CONSIDERING OTHER MODELS IN ACTION
As stated in the previous section on Endometriosis and Chronic Pelvic Pain, the Adapted Biopsychosocial Model for OT is only one example of an applicable model of care to address the client presenting with PPD. As this model represents a bridge between the top-down and bottom-up approach, which is largely controversial in the current transition of the occupational therapy paradigm, it was selected to illustrate the interconnectedness of the various components as outlined within the model's flowchart. Many occupationally focused models of care can be applied to the intervention process and may serve to be beneficial when considered in parallel to the existing representation of the Adapted Biopsychosocial Model’s application.
Other options for appropriate models of occupation that can be utilized in the creation of individualized clinical care plans include (Turpin & Iwama, 2011):
Occupational Performance Model (AUSTRALIA) (OPMA)
Occupational Adaptation (OA)
Person—Environment—Occupation—Performance (PEOP) Model
Person—Environment—Occupation (PEO) Model of Occupational Performance
Ecology of Human Performance
Canadian Model of Occupational Performance and Engagement (CMOP-E) as a component of the larger text entitled Enabling Occupation II (EO-II)
Model of Human Occupation (MOHO)
* The included PDF offers an expanded articulation of the use of each model as outlined in previous sections.
Regardless of the model of intervention that is selected by the evaluating therapist to initiate the assessment and intervention process, the most crucial element of the therapist's decision making should be focused upon occupation. In this, that the means by which intervention is delivered is focused upon occupation as an actionable task of daily doing, and that it is meaningful and purposeful to the lived experience and need for desired outcomes within the individual.
COMPLEMENTARY INTERVENTIONS AS ACTIONABLE PURSUITS
The universally recommended standard practice for treating PPD is through a first line intervention of antidepressants and psychotherapy (APA, 2019). However, there is a growing trend within the postpartum population toward an increased preference for integrative or c