For each level of creative ability, there are aims of treatment/intervention which are generally relevant to each individual on that level. Achieving those aims is predicted to result in a change in creative ability towards the next level of creative ability.

To achieve this, the VdTMoCA provides a detailed guide on the selection and grading activities and use therein of materials (e.g. flour, water, paper, metal), objects/tools (e.g. spoon, brush, chair) in activities (differ, people (familiar, unfamiliar, different roles, interactions) and situations (e.g. group, library, travelling on the train).

Four principles are graded: Therapeutic use of self (Handling principles), Activity requirements (the characteristics of an activity e.g. provides sensory stimulation, requires focus of attention), Structuring principles - how long the activity will be, where, with who, and Presentation principles - how the activity will be facilitated, how the activity will happen (Fig. 1).

Figure 1. Treatment principles for grading to the level and phase of creative ability.

Meaningful and purposeful activities are graded according to the level of creative ability, aims and these principles so that all intervention (including our interaction and other staff's interaction) is literally pitched at the client's level, and at the just right challenge . Intervention is doable, and the demands are graded for the person to develop new abilities and experience success through own EFFORT - experiencing "I CAN" moments.

If the person has a condition which will progressively cause deterioration, intervention is pitched at their current level to maintain ability for as long as possible, grading down as creative ability declines.

Knowing the phase of creative ability also influences grading. It is more common for a person to experience frequent changes in the phase rather than change a whole level of creative ability on a regular basis. The VdTMoCA enables therapists to detect (and measure)small changes in creative ability through knowing and being sensitive to the phases of creative ability, and intervention is graded accordingly. This enables therapists to be very responsive to changes in the client.