Vona believed that the client’s personal decision to participate was key.
Vona considered that the patient’s personal decision to participate was key to each patient finding the ultimate meaning in his new reality and fulfilling his singular task. Drawing on her clinical experience and influenced by existentialist thought, Vona states “That MAN through the use of his body (which is himself) in purposeful activity can, and indeed must influence the state of his own Physical and Mental Health and Spiritual Wellbeing” (Patient Volition and Action in Occupational Therapy p2). Occupational therapy she defined “very simply as the treatment of man as the Totality (sic) through his active participation in purposeful activity”.
Vona held that persons have varying levels of volition, or psychical recovery, to engage the world, enabling them to function freely and with originality at a maximum level of competence.
In 1965 she defined 6 stages of psychical or ‘volitional’ recovery which indicate the quality of self directedness in the total functioning pattern of the individual. Later she created a table with corresponding ‘action’ or creative behaviors as evidenced in a product whether tangible or intangible. By objective observation and evaluation of these behaviors and the structuring of situations to elicit the desired creative response, the therapist affords the patient the opportunity to reestablish himself in a pattern leading to creative ability. This approach has formed the basis of the practice model VdTMoCA with its clear guide to grading and using activity for therapeutic intervention. However ‘ this must not be pursued at the cost of losing the very essence of the models underpinning theory i.e. The uniqueness and spirituality of each client, the meaning of his world, and the importance of truly purposeful activity’ (Focus vol 1 2010)