Four Basic Constructs:The four main constructs of the EHP model are person, task, context, and performance.
The four main constructs of the EHP model are person, task, context, and performance. Each person brings a unique and complex array of skills, abilities, interests, patterns of doing, and social roles. Tasks are defined as objective sets of behaviors, such as playing a game, writing a check, or driving a car. Tasks are the building blocks of occupations, and the way each person organizes tasks leads to the occupational performance and enactment of social/ occupational roles. Contexts, the interdependent conditions that constitute a person’s surroundings, must be carefully evaluated within EHP. Two aspects are specifically defined: temporal and environmental. Temporal contexts refer to the client’s age and life stage including life experiences, as well as the timing of task availability and difficulty. For example, children lose the opportunity to go to public school after a certain age, and for adults vocational or career training involves certain time commitments with many steps along the way. The second aspect of context includes physical, social, and cultural environments that define, shape, and expand or limit the range of task availability (Dunn, 2007). Performance is the person-context-task transaction that “determines what behaviors and level of participation will be possible” (Dunn, 2007, p. 129). The range of occupational performance includes all possible interactions of person and context variables. Because both people and contexts are constantly changing, often the resulting performance is difficult to predict.
Five Basic Assumptions
Some of the initial applications of EHP were applied to occupational therapy practice with children (Dunn, Youngstrom, & Brown, 2003). However, these assumptions can also be applied across the lifespan. The following have been adapted from Brown (2014).
1. There is a dynamic relationship between persons and their contexts. In order to design relevant occupational therapy interventions, practitioners must first understand the client’s circumstances, background, abilities, and expectations within his or her specific contexts and demands for performance. In the broader view of the person in context, participation rather than disability becomes the focus of intervention.
2. The environment is a major factor in promoting or inhibiting occupational performance. As such, all aspects of the environment (physical, social, cultural, and temporal) should be evaluated when addressing performance of a desired occupation. For example, it is important to analyze the relatively unpredictable attributes of the child’s natural settings in order to enable his or her best performance in those settings.
3. Occupational therapy practice promotes selfdetermination and full inclusion. This assumption takes a top-down, client-centered approach, focusing intervention upon what the person wants or needs to do. Inclusion involves building supports in the person’s environment and advocating for the client’s rights to full participation. Occupational therapists work with families, schools, communities, and other natural settings to overcome contextual barriers.
4. Occupational performance within a constantly changing environment will require ongoing evaluation, adaptation and a rebalancing of client goals, skills, and abilities with environmental factors to determine the best match between person, environment, and occupa
5. Independence occurs when wants and needs are satisfied. Devices and technology may be necessary tools to promote self-direction and participation in natural settings. Contextual and task adaptations in natural settings should be tried first, so that the person’s need for personal adaptation and training can be determined. Dunn (2007) gives the example of changing the seating arrangement in a classroom so that the child can interact with others. From observing the child’s performance with this adaptation, his or her need to participate in a social skills training group can best be determined.