Introduction to MOHO

A National Board for Certification in Occupational Therapy (NBCOT) study of U.S. entry level practitioners asked respondents to indicate their top three frames of reference. The Model of Human Occupation was identified by 11 percent of practitioners. According to the NBCOT report, it was the occupation-based model most frequently used by practitioners and its use is comparable to that of other major occupational therapy models [e.g., biomechanical (17%), neurodevelopmental (14%) sensory integration (13%)]. For the full report see: National Board for Certification in Occupational Therapy (2004). A practice analysis of entry-level occupational therapist registered and certified occupational therapy assistant practice. OTJR: Occupation, Participation, and Health, 24 (supplement 1), S1-S31.

How did MOHO begin?

First published in 1980, the model of human occupation (MOHO) grew out of Dr. Gary Kielhofner's master's thesis and practice in the mid 1970s. While Dr Kielhofner has remained the primary person working on MOHO, it has always been the result of collaborative efforts. Today, this model reflects the ideas, research, and practice efforts of a large number of people throughout the world. Because so many people are involved in developing MOHO, it has become one of the leading theories in occupational therapy practice worldwide. The contributions so many people have made to MOHO are represented in the substantial resources which can be found and obtained through this website and the MOHO e-store. It is hoped that this website enables individuals to become part of a worldwide community of occupational therapists who use and contribute to the development of MOHO.

What is a model?

A model is a body of theory that explains some aspect of human behavior addressed in occupational therapy practice and that provides tools to apply that theory in practice. Another essential component of a model is the research that tests and improves the theory and practical tools.

What does MOHO theory address?

MOHO seeks to explain how occupation is motivated, patterned, and performed. By offering explanations of such diverse phenomena, MOHO offers a broad and integrative view of human occupation. Within MOHO, humans are conceptualized as being made up of three interrelated components: volition, habituation, and performance capacity. Volition refers to the motivation for occupation, habituation refers to the process by which occupation is organized into patterns or routines, and performance capacity refers to the physical and mental abilities that underlie skilled occupational performance. MOHO also emphasizes that to understand human occupation, we must understand the physical and social environments in which it takes place. Therefore, this model aims to understand occupation and problems of occupation that occur in terms of its primary concepts of volition, habituation, performance capacity, and environmental context.

These concepts have been consistent throughout the nearly three decades of development of this model. Theoretical refinement has taken place over the years to achieve a clearer and more accurate explanation of how these four factors interact to influence what people do in their everyday, occupational lives and to explain why problems can arise in the face of chronic illness and impairments and when environmental factors interrupt occupation.

For whom and where is MOHO applied in practice?

MOHO is intended for use with any person experiencing problems in their occupational life and is designed to be applicable across the life span. For example, MOHO has been applied with such diverse groups as adults with chronic pain, children with attention deficit hyperactivity disorder, persons with traumatic brain injury, older persons with dementia, persons living with AIDS, and adolescents with mental illness. It has also been applied in situations dealing with children and adults who are homeless, with battle-fatigued soldiers, and with victims of war and social injustice.

MOHO is also used in a variety of contexts. For example, it has been applied in hospitals, outpatient clinics, residential facilities, nursing homes, rehabilitation programs, work programs, prisons and correctional settings, and community based organizations.

Are there resources to apply this model in practice?

A major emphasis of MOHO is developing resources for its application in practice. The resources (e.g., case examples, manuals, articles, documented programs) for applying this model are extensive. More than 20 assessments have been developed for use with this model. Its application in practice is widely documented in articles, manuals, and book chapters. This website is designed to provide the practitioner with ease of access to materials and information that support practice. An active list serv features constant dialogue about the use of the model in practice.

Practitioner Perspectives