Female occupational therapist wearing a face mask helping senior client in kitchen reading materials on a tablet
Practice

Domain & process

The domain and process of occupational therapy are described in the fourth edition of the Occupational Therapy Practice Framework: Domain & Process (OTPF–4). 

Access the Framework
practice

Occupational therapy domain and process

Figure 1 provides a visual representation of all aspects of the domain and process and the overarching goal of the profession of “achieving health, well-being, and participation in life through engagement in occupation.” This statement reflects the profession’s belief that active engagement in occupation promotes, facilitates, supports, and maintains health and participation.

Smiling female healthcare working in blue scrubs talking with male colleague
practice

Domain

A profession defines a domain to help practitioners, clients, payers, regulators, and other stakeholders understand the distinct focus of the profession. A domain describes what the professional group is "in charge of" and what they will make decisions about. The domain is based on the profession's established body of knowledge and expertise.

The domain of occupational therapy includes:

  • Occupations (e.g., activities of daily living, rest and sleep, work, and education)
  • Contexts (i.e., environmental and personal factors)
  • Performance patterns (i.e., habits, routines, roles, and rituals)
  • Performance skills (i.e., motor skills, process skills, and social interaction skills)
  • Client factors (i.e., values, beliefs, spirituality, body functions and body structures).
Female occupational therapist alongside senior woman holding a pencil working on handwriting skills
practice

Process

Process describes the actions a professional group takes when providing services. The occupational therapy process is client centered, focused on engagement in occupations, and used to provide intervention and services to persons, groups and populations. The occupational therapy process has three parts: Evaluation, Intervention, Outcomes.

Important features of the process include:

  • Service delivery approaches
  • Practice within various settings
  • Therapeutic use of self
  • Clinical and professional reasoning
  • Occupational and activity analysis.

Occupational therapy practitioners use the occupational therapy process with clients.

In the OTPF–4, a client is defined as a person, group, or population.

  • Person: An individual (e.g., client, family member, caregiver, teacher, employee)
  • Group: Two or more persons that share a common purpose or have similar characteristics or occupational challenges (e.g., family members, workers, students)
  • Population: A large number of people that share common context-related characteristics, health concerns or risks, or occupational challenges (e.g., all persons with heart disease, all individuals who are incarcerated, all individuals who experience housing insecurity).

    Reference

    American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001