The Vona du Toit Model of Creative Ability
(VdTMoCA) (Van der Reyden et al. 2019) is an Occupational Therapy practice model originating from the theory of creative ability developed by South African Occupational Therapist, Vona du Toit (du Toit, 1974; du Toit, 2015).
This model's unique contribution to the Occupational Therapy profession is understanding people in terms of sequential levels of creative ability. The term creative refers to one's ability to change in response to life‘s demands (the creation of oneself), as well as creation of tangible things and solutions to problems. From a developmental perspective, each level of creative ability is comprised of interrelated volition, motivation and action (behaviours, skills, performance). Identifying and understanding a person's level of creative ability enables therapists to understand and provide therapeutic intervention for people of all degrees of volition, motivation and ability (Van der Reyden et al. 2019). Such knowledge can also guide intervention by other disciplines, family, carers and health and social care support staff (Van der Reyden & Sherwood, 2019).
The VdTMoCA is client-centred, ability and recovery focused. Occupational Therapy is offered to match what the person has volition, motivation and ability for, but which also poses a challenge, mastery of which has the potential to result in growth in volition, motivation and ability. The individual's experience of having his/her motivation (needs) met, and experiencing ability to do activities of daily living, both motivates and enables him/her to engage. Through engagement, behaviour and skills are developed towards the next level. Equally, the model informs intervention to maintain and/or prevent decline in ability, e.g. when improvement and growth into higher levels is not possible, or a person has a progressive condition such as dementia.
The model provides a detailed guide to the selection, structuring and presentation of intervention (Casteleijn & Holsten, 2019). This includes the use of activity, activity groups and differing situations as the core of Occupational Therapy treatment, but informs all interactions with the individual, including how to approach him/her, structure self-care intervention, and how to develop a meaningful routine that attends to all aspects of daily living including use of free time (leisure). Therefore, this model has effectively enabled a multidisciplinary approach (Murphy, 2017, 2019; Quan & Zywicka-Rospond, 2017), including family and carers in the design and delivery of care plans according to the person's level (Schon et al. 2017). This supports individuals to meet their potential.
The model provides a means of measuring increase and decrease in motivation and ability, including the Creative Participation Assessment form (Van der Reyden & Sherwood, 2019) and the Activity Participation Outcome Measure (Casteleijn, 2010, 2012a, 2012b). The latter is available to Occupational Therapists with depth of knowledge and experience of assessing creative ability.
The VdTMoCA is of particular interest to mental health and learning disabilities practice, but is applicable to any service including working with people in wellness (Joubert, 2013) and for staff development (Wilson & Casteleijn, 2017; Zywicka-Rospond & Khatri, 2015). The model is purported to be effective for all diagnoses and severity of illness/problems (Van der Reyden & Sherwood, 2019). For example, in relation to mental health clients, clients perceived as unresponsive and difficult to engage can receive therapeutic intervention from day one rather than waiting for clients 'to get a bit better‘ in response to medication whilst potentially being deemed as 'not ready‘ or 'unsuitable for OT‘. Through this model, therapists may realise that it is not that clients are unsuitable for Occupational Therapy, but that the occupational therapy traditionally offered, may not have been suitable for these clients. Therapists realise that they are able to work therapeutically with these and all clients (all levels of creative ability).
For Occupational Therapists, the model brings together all the core aspects of Occupational Therapy practice (activity analysis, grading, purposeful activity, activity groups, therapeutic use of self and the non-human environment), enabling occupational therapists to be occupational therapists through the application of activity as a powerful therapeutic tool.
The theory of creative ability and the VdTMoCA have been used extensively for over 40 years. The model has gained a great deal of interest in the UK and is known to be in the curriculum of four BSc (Hons) / PgDip OT programmes, and explored at several others through problem-based learning and OT Society’s. The model is used in approximately 21NHS Trusts and 9 Independent healthcare providers, charities and other agencies. The largest field of practice is forensic (VdTMoCA Foundation UK, 2013; 2016), including Broadmoor High Security Hospital (London, 2017; Carpenter 2018; 2018a) and has been used at a therapeutic community prison for people with a diagnosis of personality disorder and learning disability/intellectual impairment (see Wilson, 2017; Sherwood, 2017).Dr Wendy Sherwood
PhD, MSc, Dip COT is a Consultant Occupational Therapist recognised nationally and internationally as an expert in the Vona du Toit Model of Creative Ability (VdTMoCA), and is a co-author of the model.
Wendy founded the VdT Model of Creative Ability Interest Group in 2005, becoming the VdTMoCA Foundation (UK) Community Interest Company in 2012. Wendy is a contributing author and co-editor of the first full text on the VdTMoCA (see Van der Reyden, Casteleijn, Sherwood & De Witt, 2019), and co-authored and edited two texts on the practical application of the model in acute mental health (Sherwood et al. 2015) and learning disabilities/intellectual impairment services (Sherwood, 2017).
As the owner of ICAN
, Wendy provides training and CPD initiatives for Occupational Therapists, support staff and Multi-disciplinary teams nationally and internationally. A broad range of initiatives are provided to enable newcomers to the VdTMoCA to gain confidence in applying basic knowledge
to practice, and for more experienced practitioners to gain advanced knowledge and skills
for challenging aspects of practice. With expertise in enabling Occupational Therapists and other disciplines to learn and apply the VdTMoCA to multidisciplinary practice in Japan and Singapore, Wendy is involved in projects to enable healthcare professionals implement the model in undeveloped and developing countries.
Dr Sherwood has 14 years of experience as a lecturer in Occupational Therapy
, and is currently a guest lecturer at London South Bank University; a visiting Prof lecturer in Singapore and an Honorary Fellow at St George’s University, London. ICAN also delivers an international conference
on the model every two years in the UK (see Events
).ReferencesCasteleijn D (2010)
Development of an outcome measure for occupational therapists in mental health care practice. (PhD PhD), University of Pretoria, Pretoria. Retrieved from http://upetd.up.ac.za/thesis/available/etd-02102011-143303/Casteleijn D, Graham M (2012a)
Domains for occupational therapy outcomes in mental health practices. South African Journal of Occupational Therapy, 42(1)
, 26-34.Casteleijn D, Graham M (2012b)
Incorporating a client-centred approach in the development of occupational therapy outcome domains for mental health care settings in South Africa. South African Journal of Occupational Therapy,42(2)
, 8-13.Casteleijn D, Holsten H (2019)
Creative ability - its emergence and manifestation, IN Van der Reyden D, Casteleijn D, Sherwood W, de Witt P (2019) (Eds.) The Vona du Toit Model of Creative Ability: Origins, Constructs, Principles and Application in Occupational Therapy
. Vona & Marie du Toit Foundation, Pretoria, South Africa. Chp 4, pp. 106-146.Du Toit, V (1974)
An investigation into the correlation between volition and its expression in action. South African Journal of Occupational Therapy
, pp.6-9.Du Toit, V (2015) Patient Volition and Action in Occupational Therapy
. 5th ed. Pretoria: Vona and Marié du Toit Foundation. [Available from email@example.com]Joubert R (2013)
Exploring new dimensions and looking beyond the current potential of the Vona du Toit Model of Creative Ability. Keynote address to the 3rd ICAN International VdT Model of Creative Ability Conference, London. [Available from firstname.lastname@example.org]Murphy L (2017)
Embracing change: Introducing the VdTMoCA to the MDT on an inpatient adult mental health rehabilitation ward. Poster presentation at the 5th ICAN International Vona du Toit Model of Creative Ability Conference, London. [Available from email@example.com]Murphy L (2019)
Healthy Habits: How the VdTMoCA was used to re-structure a substance misuse group. Presentation at the 6th ICAN International Vona du Toit Model of Creative ability Conference, London. [Available from firstname.lastname@example.org]Quan S, Zywicka-Rospond G (2017)
From the Outside Looking In: Incorporating a non-occupational therapy perspective on using the VdTMoCA. Presentation delivered at the 5th ICAN International VdT Model of Creative Ability conference, London. [Available from email@example.com]Schon J, Hooper F, Robertson G, Walsh Z, Wilson R, Sherwood W (2017)
Reflections on applying the VdTMoCA to practice, In: W Sherwood (Ed.) (2017) The Vona du Toit Model of Creative Ability: a practical guide to occupational therapy for people with learning disabilities. Chapter 4, pp.24-31. Northampton: Vona du Toit Model of Creative Ability Foundation (UK).Sherwood W, White B, Wilson S (2015) The Vona du Toit Model of Creative Ability: a practical guide for acute mental health occupational therapy practice
. Northampton: Vona du Toit Model of Creative Ability Foundation (UK).Sherwood W (2017)
(Ed.) The Vona du Toit Model of Creative Ability: a practical guide to occupational therapy for people with learning disabilities
. Northampton: Vona du Toit Model of Creative Ability Foundation (UK).Van der Reyden D, Casteleijn D, Sherwood W, de Witt P (2019)
(Eds.) The Vona du Toit Model of Creative Ability: Origins, Constructs, Principles and Application in Occupational Therapy
. Vona & Marie du Toit Foundation, Pretoria, South Africa.Van der Reyden, D, Sherwood, W (2019)
The Vona du Toit Model of Creative Ability core constructs and concepts, IN Van der Reyden D, Casteleijn D, Sherwood W, de Witt P (2019) (Eds.) The Vona du Toit Model of Creative Ability: Origins, Constructs, Principles and Application in Occupational Therapy
. Vona & Marie du Toit Foundation, Pretoria, South Africa. Chp 3, pp. 58-104.VdTMoCA Foundation (UK) (2013)
Survey of occupational therapy managers' perspectives of the VdTMoCA. Northampton:.Vona du Toit Model of Creative Ability Foundation (UK).VdTMoCA Foundation (UK) (2016)
Improving and promoting OT: a national survey of occupational therapists’ and support workers’ perspectives of the Vona du Toit Model of Creative Ability. Poster presented at the OT Show, Birmingham.Wilson R (2017)
The VdTMoCA Behind Bars: becoming a VdTMoCA occupational therapy service in a therapeutic community prison. Presentation delivered at the 5th ICAN International VdT Model of Creative Ability Conference, London.Wilson S, Casteleijn D (2017)
Could the levels of Creative Ability be applied to supervision and development of staff in the workplace? Presentation delivered at the 5th ICAN International Model of Creative Ability Conference, London.Zywicka-Rospond M, Khatri R (2011)
The implementation of MOCA in a medium secure ward. Poster presentation at the Vona du Toit Model of Creative Ability Conference, Johannesburg, South Africa.