models engel's biopsychosocial model takes into account how disease and illness can be impacted by social, environmental, psychological and body functions. the biopsychosocial model is unique in that it takes the client's subjective experience and the client-provider relationship as factors to wellness. this model also factors in cultural diversity as many countries have different societal norms and beliefs. this is a multifactorial and multi-dimensional model to understand not only the cause of disease but also a person-centered approach that the provider has more of a participatory and reflective role. other models which incorporate biology (body and brain), psychology (mind), and social (relational, attachment) elements influencing human health include interpersonal neurobiology (ipnb), polyvagal theory (pvt), and the dynamic-maturational model of attachment and adaptation (dmm). the latter two in particular provide detail about the source, mechanism and function of somatic symptoms. kasia kozlowska describes how she uses these models to better connect with clients, to understand complex human illness, and how she includes occupational therapists as part of a team to address functional somatic symptoms. her research indicates children with functional neurological disorders (fnd) utilize higher, or more challenging, dmm self-protective attachment strategies to cope with their family environments, and how those impact functional somatic symptoms. pamela meredith and colleagues have been exploring the relationship between the attachment system and psychological and neurobiological systems with implications for how occupational therapists can improve their approach and techniques. they have found correlations between attachment and adult sensory processing, distress, and pain perception. in a literature review, meredith identified a number of ways that occupational therapists can effectively apply an attachment perspective, sometimes uniquely. frames of reference frames of reference are an additional knowledge base for the occupational therapist to develop their treatment or assessment of a patient or client group. though there are conceptual models (listed above) that allow the therapist to conceptualise the occupational roles of the patient, it is often important to use further reference to embed clinical reasoning. therefore, many occupational therapists will use additional frames of reference to both assess and then develop therapy goals for their patients or service users. biomechanical frame of reference the biomechanical frame of reference is primarily concerned with motion during occupation. it is used with individuals who experience limitations in movement, inadequate muscle strength or loss of endurance in occupations. the frame of reference was not originally compiled by occupational therapists, and therapists should translate it to the occupational therapy perspective, to avoid the risk of movement or exercise becoming the main focus. rehabilitative (compensatory) neurofunctional (gordon muir giles and clark-wilson) dynamic systems theory client-centered frame of reference this frame of reference is developed from the work of carl rogers. it views the client as the center of all therapeutic activity, and the client's needs and goals direct the delivery of the occupational therapy process. cognitive-behavioural frame of reference ecology of human performance model the recovery model sensory integration sensory integration framework is commonly implemented in clinical, community, and school-based occupational therapy practice. it is most frequently used with children with developmental delays and developmental disabilities such as autism spectrum disorder, sensory processing disorder and dyspraxia. core features of sensory integration in treatment include providing opportunities for the client to experience and integrate feedback using multiple sensory systems, providing therapeutic challenges to the client's skills, integrating the client's interests into therapy, organizing of the environment to support the client's engagement, facilitating a physically safe and emotionally supportive environment, modifying activities to support the client's strengths and weaknesses, and creating sensory opportunities within the context of play to develop intrinsic motivation. while sensory integration is traditionally implemented in pediatric practice, there is emerging evidence for the benefits of sensory integration strategies for adults. icf the international classification of functioning, disability and health (icf) is a framework to measure health and ability by illustrating how these components impact one's function. this relates very closely to the occupational therapy practice framework, as it is stated that "the profession's core beliefs are in the positive relationship between occupation and health and its view of people as occupational beings". the icf is built into the 2nd edition of the practice framework. activities and participation examples from the icf overlap areas of occupation, performance skills, and performance patterns in the framework. the icf also includes contextual factors (environmental and personal factors) that relate to the framework's context. in addition, body functions and structures classified within the icf help describe the client factors described in the occupational therapy practice framework. further exploration of the relationship between occupational therapy and the components of the icidh-2 (revision of the original international classification of impairments, disabilities, and handicaps (icidh), which later became the icf) was conducted by mclaughlin gray. it is noted in the literature that occupational therapists should use specific occupational therapy vocabulary along with the icf in order to ensure correct communication about specific concepts. the icf might lack certain categories to describe what occupational therapists need to communicate to clients and colleagues. it also may not be possible to exactly match the connotations of the icf categories to occupational therapy terms. the icf is not an assessment and specialized occupational therapy terminology should not be replaced with icf terminology. the icf is an overarching framework for current therapy practices. global occupational therapy occupational therapy is practiced around the world and can be translated in practice to many different cultures and environments. the construct of occupation is shared throughout the profession regardless of country, culture and context. occupation and the active participation in occupation is now seen as a human right and is asserted as a strong influence in health and well-being. as the profession grows there is a lot of people who are travelling across countries to work as occupational therapists for better work or opportunities. under this context, every occupational therapist is required to adapt to a new culture, foreign to their own. understanding cultures and its communities are crucial to occupational therapy ethos. effective occupational therapy practice includes acknowledging the values and social perspectives of each client and their families. harnessing culture and understanding what is important to the client is truly a faster way towards independence. the world federation of occupational therapists is an international voice of the profession and is a membership network of occupational therapists worldwide. wfot supports the international practice of occupational therapy through collaboration across countries. wfot currently includes over 100 member country organizations, 550,000 occupational therapy practitioners, and 900 approved educational programs. the profession celebrates world occupational therapy day on the 27th of october annually to increase visibility and awareness of the profession, promoting the profession's development work at a local, national and international platform. wfot has been in close collaboration with the world health organization (who) since 1959, working together in programmes that aim to improve world health. wfot supports the vision for healthy people, in alignment with the united nations 17 sustainable development goals, which focuses on "ending poverty, fighting inequality and injustice, tackling climate change and promoting health". occupational therapy is a major player in enabling individuals and communities to engage in "chosen and necessary occupations" and in "the creation of more meaningful lives".