Occupational Adaptation Model (Schkade and Schultz): Concepts, Assessment and Examples
The Occupational Adaptation model: occupational challenge, press for mastery, adaptive response, relative mastery, assessment, a case example and a quiz.
Therapy can’t prepare someone for every situation they’ll face. A person recovering from a hip replacement might learn to put on socks with a sock aid, but what about getting into a friend’s low car, or travelling? The Occupational Adaptation frame of reference focuses on building a person’s own ability to adapt, so they can solve new challenges long after therapy ends.
See our frames of reference guide and OT models.
Background
Occupational Adaptation (OA) was introduced by Janette Schkade and Sally Schultz at Texas Woman’s University in a two-part article in the American Journal of Occupational Therapy in 1992. It sees adaptation as a normal process that happens throughout life, and that can be disrupted by illness, injury, disability or major life changes.
Key assumptions
- Occupation provides the means through which people adapt to changing needs.
- The desire for mastery is innate in all people.
- Adaptation is an internal process within the person.
- When people adapt more effectively, they function better in their occupations.
- Therapy should strengthen the person’s adaptive process, not just teach specific skills.
Key concepts
| Concept | Meaning |
|---|---|
| Person | Sensorimotor, cognitive and psychosocial systems, influenced by genetics, environment and experience |
| Occupational environment | Work, play and leisure, and self-maintenance, each with physical, social and cultural subsystems |
| Press for mastery | The person's desire for mastery meets the environment's demand for mastery |
| Occupational challenge | A situation that calls for an adaptive response |
| Occupational role expectations | What the person and society expect them to do in a role |
| Adaptive response | How the person plans and carries out a response to the challenge |
| Relative mastery | The person's evaluation of the response: efficiency, effectiveness and satisfaction to self and society |
The occupational adaptation process
Occupational challenge
Press for mastery
Generate a response
Plan an adaptive response
Evaluate
Relative mastery
Integrate
Learning shapes the next response
Adaptive response generation
The person draws on:
- Adaptation energy: primary energy (focused, high-level attention) and secondary energy (problem-solving that continues in the background)
- Adaptive response modes: existing (a response they already use), modified (a changed version), or new
- Adaptive response behaviours: hyperstable (rigid, repeating the same response), hypermobile (constantly changing, disorganised), or a blend (the most adaptive)
Relative mastery
| Element | Question the person asks | Example |
|---|---|---|
| Efficiency | Did it take a reasonable amount of time, energy and resources? | Dressing took 15 minutes, down from 40 |
| Effectiveness | Did I achieve what I wanted? | I'm fully dressed and ready for the bus |
| Satisfaction to self | Am I happy with how it went? | I feel proud I did it myself |
| Satisfaction to society | Would others see it as successful? | My clothes look right for work |
Assessment
- Occupational profile and interviews about roles, environments and expectations
- Relative Mastery Measurement Scale, which asks the person to rate their own efficiency, effectiveness and satisfaction
- Observation of how the person responds to real occupational challenges
- Identifying the person’s usual adaptive response pattern (hyperstable, hypermobile or blended)
Intervention
-
Choose occupations
Meaningful to the person's roles.
-
Occupational readiness
Prepare: skills, strength, strategies.
-
Occupational activity
Engage in the real occupation with a real challenge.
-
Self-evaluate
The person rates relative mastery.
-
Generalise
Apply the adaptive process to new challenges.
Case example
Ms Garcia, 52, has rheumatoid arthritis and works as a teacher. Flare-ups make it hard to write on the board and carry books.
- Occupational challenge: keep teaching during flare-ups
- Occupational readiness: joint protection and energy conservation education
- Occupational activity: she trials a tablet and projector instead of the whiteboard, and a trolley for books, in her own classroom
- Relative mastery: she rates efficiency (less pain, less time), effectiveness (lessons delivered) and satisfaction (proud; students engaged)
- Generalisation: she applies the same problem-solving to marking and school trips
OA vs other frames
| Occupational adaptation | Rehabilitative | MOHO | |
|---|---|---|---|
| Focus | The person's internal adaptive process | Compensating with techniques and equipment | Volition, habituation, performance capacity and environment |
| Therapist role | Facilitator of self-evaluation | Teacher of compensatory methods | Supporter of occupational engagement |
| Outcome | Better adaptation to future challenges | Independence in specific tasks | Occupational identity and competence |
Quick self-check
0 / 3 correct
-
Who introduced Occupational Adaptation?
Show answer
B. Janette Schkade and Sally Schultz introduced OA in 1992.
-
Relative mastery includes efficiency, effectiveness and…
Show answer
B. Relative mastery is efficiency, effectiveness, and satisfaction to self and society.
-
A rigid response that keeps repeating the same approach is…
Show answer
A. Hyperstable behaviour is rigid; hypermobile is disorganised; a blend is most adaptive.
Summary
Occupational Adaptation focuses on how people adapt to occupational challenges. Instead of only teaching skills, the OT strengthens the person’s ability to generate, evaluate and integrate adaptive responses, judged through relative mastery. The result is a person better equipped to handle new challenges on their own. Read more about the rehabilitative frame of reference and the Model of Human Occupation.
References
- Schkade JK, Schultz S. Occupational adaptation: toward a holistic approach for contemporary practice, part 1. American Journal of Occupational Therapy. 1992;46(9):829–837.
- Schultz S, Schkade JK. Occupational adaptation: toward a holistic approach for contemporary practice, part 2. American Journal of Occupational Therapy. 1992;46(10):917–925.
- Grajo LC. Theory of occupational adaptation. In: Boyt Schell BA, Gillen G, eds. Willard and Spackman’s Occupational Therapy. Wolters Kluwer.
- Cole MB, Tufano R. Applied Theories in Occupational Therapy. SLACK.
Frequently asked questions
What is the occupational adaptation model?
What is relative mastery?
What is the press for mastery?
What are the three occupational environments in occupational adaptation?
How do OTs use occupational adaptation?
Written by
Deepam Pawar, OT
Deepam Pawar is an occupational therapist and co-founder of Occupational Therapy OT. He focuses on clinical frameworks, assessment, and evidence-based practice.
All articles by Deepam →This article is for general education and is not a substitute for individualized assessment or treatment by a licensed occupational therapist. Always seek the guidance of a qualified professional for specific concerns.
