The CRAFT Model - Dynamic Variations of a Holistic Model - Part 2

Balance and the Ability Pillars of the CRAFT Model


People need to participate in life roles; enabling people to do things that are meaningful to them is a central goal of Functional Therapy. In our last segment we delved deeper into the 'things we do' as functions in our lives. We looked at what might happen when the categories of function are out of balance with the depiction of the adage 'All work and no play makes Jack a dull boy!' Now we will look more at the pillars of ability and problems that may arise from impairments and disabilities.

The ability pillars support the balanced platform of the 'things we do' or functions, these are sometimes called occupations by OTs. The balance of this platform depends on the integrity of the 4 pillars; a significant impairment in any of the Physical, Mental, Social or Motivational pillars can prevent a person from performing functions and participating in life roles. Lets consider the model as we depict a failing pillar.

In this simplified case, only one pillar has been affected; this may be how an imbalance starts. Over a period of time, if the imbalance should persist, it is probable that other pillars may falter. It is important that a Functional Therapist work to restore the balance of personhood in order to start the process of recovery.

The motivational pillar contains the abilities that get us up in the morning, in many ways these are central to choosing to do things. In the following depiction, the motivational pillar has collapsed and this has unbalanced the platform of functions. During a depression the motivational pillar can be significantly impaired; in this case the first thing to falter is the self care function. In this unbalanced system the stresses on the rest of the system will cause other areas to falter.

Imagine replacing this broken pillar with any of the other pillars, deficits in physical abilities can have a profound impact on being able to do things, mental deficits can prevent a person from organizing and performing functions, and deficits in social abilities can limit all functions which involve interactions with others. These can be very limiting to the performance of life roles and a balance of functions.

At this level Functional Therapists can focus on remediation or working to restore the ability. While it is possible to perform exercises and tasks to improve physical skills one of the more effective ways of restoring the motivational pillar is to return to functional tasks. The central tenent of Functional Therapy is "The more you do, the more you can do!" By supporting the motivational deficit while supporting and encouraging function we help people return to balance.

In the next section we'll look at the CRAFT model and the context level.


Ed Kaine

President of the League of Functional Therapists
"Functional Therapy... the Next Generation of Occupational Therapy."


P.S. Please submit your comments or contact us at RFT@FunctionalTherapist.org.