What is the Vona du Toit Model of Creative Ability?

What is the Vona du Toit Model of Creative Ability?

The Vona du Toit Model of Creative Ability (VdTMoCA) is an occupational therapy practice model originating from South Africa.  The model as presented by de Witt (2005, 2014), is founded upon the theory of creative ability developed by Vona du Toit (occupational therapist) in the 1960s and early 1970s.  The term ‘creative’ does not refer to artistic flair but to one’s ability to bring into existence something that did not exist before – one’s ability to bring about change within oneself and in one’s world.

The model has a developmental frame of reference combined with existentialism, phenomenology and motivation theory.  The central belief is that motivation governs action and action is the manifestation or expression of motivation. Motivation and action are inextricably linked, and therefore one can identify an individual's motivation by observing the person’s action.

The model describes stages or levels of creative ability – that is, levels of motivation and corresponding action (behaviours and skills – occupational performance).  These levels are sequential and there can be progression and regression through the levels (table 1). Vona du Toit believed that human beings progress through developmental levels of behaviour and skill development and are motivated to develop these in a sequential sequence. That is, we are motivated to develop a variety of skills as environmental/social/relationship/occupational demands change and influence us throughout the lifespan.  In the event of illness, trauma, injury or in response to changing life demands, we can regress to a lower level of ability.  This is recognisable in clients that prior to developing a mental illness were ‘high functioning’ or living effective daily lives.  However, with the onset of a psychotic or other illness, appear to be functioning at a lower level than previously.  For people with dementia, a continuing regression through the levels is evident.  Creative ability develops in relation to four occupational performance areas: social ability, personal management, work ability and use of free time.

The model can be used with any diagnosis and severity of illness or trauma.  The model is recovery and ability focused – it seeks to identify and develop existing ability rather than identify dysfunction or deficit.

Levels of Creative Ability

Table 1.  The levels of creative ability

 

MOTIVATION LEVEL

ACTION LEVEL

9

Competitive contribution

Society-centred action

8

Contribution

Situation-centred action

7

Competitive

Competitive-centred action

6

Active participation

Transcends norms, individualistic and inventive action

5

Imitative Participation

Imitative norm-compliant action

4

Passive Participation

Norm awareness experimental action

3

Self-presentation

Constructive explorative action

2

Self-differentiation

Unconstructive action/Incidentally constructive

1

TONE

Purposeless, unplanned action

There is a term to describe what the person is motivated for and a term to describe the corresponding action that one sees from a person on that level. The levels are described in a lot of detail by de Witt (2005, 2014) (chapters on the model in the 3rd and 4th editions of R Crouch, V Alers (2005) Occupational therapy in psychiatry and mental health. London: Whurr Publishers).  Both editions are extremely useful; each offering essential but differing information.

The first six levels are most commonly seen in healthcare services.

De Witt (2005) categorised the levels into three groups, indicating the similarities in the overall purpose of grouped levels.  The groups most commonly seen in practice are expanded upon here with additional notes (table 2).

Table 2. Grouping of Levels

 

MOTIVATION

ACTION

GROUP 1:  Preparation for constructive action Motivation is predominantly for the development of function in terms of physical components.  For example: muscle control and response patterns, coordination.  Psychologically, individuals develop knowledge of who they are and what they can do with their bodies in terms of movement.  This occurs as individuals interact with the total environment and includes awareness of other people and events.  In this group occupational performance is limited and lacks ability to be occupationally productive

Tone

Self-differentiation

Purposeless, unplanned action

Unconstructive action/Incidentally constructive

GROUP 2: Behaviour and skill development for norm compliance Motivation is for "developing the necessary psychological, physical, social and work skills, as well as occupational behaviours necessary to live and be productive in the community and comply with the prescribed norms of the society and group within which the client lives" (de Witt 2005, p20).      Psychological safety; Sensory awareness; Work skills; independent living skill development; Norm compliance: work and social

Self-presentation

Participation:

Passive
Imitative

Constructive explorative action

Norm awareness experimental action

Imitative norm-compliant action

     

The task of the occupational therapist is to identify the client’s current level of creative ability and how much independence s/he has at that level.  This enables the therapist, team, client and/or carers to understand what the client is motivated for and the extent of his/her skills for doing things that s/he finds meaningful and is motivated towards.  With this understanding, intervention can be offered to elicit motivation and participation in order to facilitate growth towards the next (higher) level of ability.  In the case of a client with dementia, intervention is provided to maintain level of ability and prevent deterioration for as long as possible.

Within each level there are three phases.  First there is the therapist-directed phase when the therapist is required to provide a great deal of in-put to enable the client to participate and explore his/her abilities and occupational performance.  This is followed by the patient-directed phase when the client has gained a degree of competence in occupational performance at the level and requires less input from therapists.  Finally there is the transition stage when occupational performance at the level has been achieved and there are signs of motivation and skills characteristic of the next level.  Being able to identify these phases enables therapists to finely tune therapy to small changes in clients, and to provide a graded approach to enabling clients to grow or move through the levels.

The model provides a means of performing an assessment to identify the level of creative ability and the phase of the level.  In addition, the model uniquely provides a detailed guide to treatment/intervention for the selection and use of activity, the environment and the therapeutic use of self in order to provide the ‘just right challenge’ for growth.  This guide brings together the core occupational therapy skills and enables therapists to use activity as a powerful therapeutic tool i.e. provide occupational therapy.

Research and Networking

Research and Networking

Connections for participation.

Centres of Excellence

Centres of Excellence

Developing UK services as exemplars of the model in practice. Visit the first centre.

Training, CPD and Resources

Training, CPD and Resources

Find out how you can develop your creative ability.

In Global Contexts

In Global Contexts

The cross-national relevance of the VdT MoCA.

Assessment and Treatment

Assessment and Treatment

Assessment, Assessment recording tools and outcome measures

What is the VdT MoCA

What is the VdT MoCA

The Vona du Toit Model of Creative Ability (Vdt MoCA) is an occupational therapy practice model originating from South Africa.