The Seeds OT Model
Clinical Guidebook
A guided workbook for applying the Seeds OT Model to one real clinical example from your current practice. Work through this at your own pace with a genuine case in mind.
Choose one child or family from your current or recent caseload — ideally one that feels complex, uncertain or difficult to explain clearly. De-identify the case before you begin. You do not need a neatly resolved case. A messy, ongoing or stuck one is better.
Work through each section in order. Some sections have brief orientation notes explaining what the prompts are designed to surface. Take your time with those. The goal is not to answer quickly — it is to notice what you have not yet noticed.
By Section 13, you will have produced a complete clinical reasoning summary for your case. This can be used directly in supervision, in clinical notes, or as the basis for a formulation section in a report.
This guidebook counts toward the Seeds OT Model CPD module (10 hours self-directed learning). Retain it as evidence for your CPD portfolio.
Choose a clinical example
Before anything else, anchor this workbook to a real case. Do not choose the simplest one on your caseload. Choose one that genuinely puzzles you — where you feel uncertain, where the pattern is not fully clear, or where your current approach does not feel quite right.
De-identify completely. Use a code name or initials you will recognise. Do not include surname, date of birth, address, school name or any other identifying detail. This document may be retained in your CPD portfolio and should not contain identifying information.
Name the visible problem
Before you look underneath the presenting difficulty, describe it clearly. What do people actually see? Where does it happen? Who is most concerned? This section is about the surface — which you will look behind in Section 3.
From problem object to recurring pattern
The Seeds OT Model asks you to look at the presenting difficulty differently — not as a fixed thing located inside the child, but as a pattern that keeps emerging under certain conditions. This shift changes what questions become useful.
Instead of: "This child has explosive behaviour."
Try: "A pattern of escalation occurs most days between 4 and 5pm, most intensely on school days, particularly when the transition from school to car is abrupt and no food is available. The pattern rarely appears on school holidays or when the afternoon is structured around outdoor play."
Notice how the second version immediately reveals conditions that might be changeable.
Map the surrounding conditions
Work through each condition domain below. For each one, note what you currently know, what may be contributing to the pattern, what seems protective, and what you still need to find out. Not every domain will be relevant — that is fine. Work with what you know and note the gaps.
Be specific rather than general. "Sleep is poor" is less useful than "Child settles after 10pm most nights, wakes once or twice, and is difficult to rouse in the morning — this has been ongoing for approximately eight months."
| Condition domain | What is currently known or observed | Increasing strain? | Supporting regulation? | What do I still need to find out? |
|---|---|---|---|---|
| Biology & neurodevelopment | ||||
| Nervous system & regulation | ||||
| Sensory processing & environment | ||||
| Sleep, fatigue, hunger & pain | ||||
| Family & relationships | ||||
| Caregiver capacity | ||||
| School & peer context | ||||
| Daily occupations & routines | ||||
| Play, movement & rest | ||||
| Community & structural conditions |
Identify maintaining loops
In complex human systems, the effects of a pattern often become new conditions that keep the pattern going. Poor sleep leads to dysregulation. Dysregulation leads to conflict. Conflict leads to stress. Stress worsens sleep. Once a loop stabilises, every part maintains every other part — which is why targeting one element sometimes produces little change. This section asks you to map the loops sustaining the pattern in your case.
School masking → afternoon depletion → meltdown at home → family tension → caregiver stress at bedtime → poor settling → less sleep → reduced capacity for masking → more difficult school day → greater afternoon depletion.
Each part of this loop is simultaneously cause and effect. Asking "which came first?" becomes less useful than asking "where in this loop can we realistically make a change?"
Identify protective conditions
Patterns do not appear constantly — they fluctuate. The times when the pattern is absent or less intense are clinically important data. They reveal conditions that are supporting regulation, participation or recovery. These protective conditions are often leverage points in disguise.
Fixed, changeable and supportable conditions
Not all conditions can be changed. Some must be accommodated. Some must simply be respected. Knowing the difference is one of the most practically important things this model offers — it focuses effort where change is genuinely possible and prevents the frustration of pushing against what cannot move.
Fixed or less changeable: neurological profile, diagnosis, genetic factors, disability, housing situation, school resourcing, cultural context, family structure, financial constraints.
Supportable or accommodable: school accommodations, sensory adjustments at home, NDIS supports, routine modifications, communication adaptations.
Changeable: morning pacing, after-school decompression structure, mealtime pressure, screen use timing, caregiver support access, sleep routine, sensory environment in key rooms.
Leverage points
A leverage point is a place within the web of conditions where a realistic change may influence the wider pattern — including areas that seem indirect or unrelated to the presenting difficulty. The most useful leverage point is not always the most obvious one. It is the one that is both influential and genuinely accessible right now.
In the post-school meltdown case, the most obvious intervention target is the meltdown itself. But the leverage points that actually shift the pattern are: (1) a predictable five-minute warning before school pickup, reducing transition threat; (2) a snack available immediately at pickup, reducing physiological load; and (3) 30 minutes of undemanded decompression time at home before any further requests. None of these targets the meltdown directly. All of them change the conditions that were making it highly probable.
Intervention direction
Before deciding what specifically to do, it helps to be clear about what direction you are trying to move the system in. Intervention direction is not a technique — it is an orientation. It tells you whether a proposed action is moving toward your clinical goals or away from them.
"The intervention direction for this case is to..."
Example: "The intervention direction is to reduce cumulative sensory and social load across the school day and create consistent decompression conditions in the after-school period, so that evening regulation becomes more possible and family routines become less adversarial."
What will I trial?
Intervention in complex systems is rarely one strategy applied once. It is usually a thoughtful set of small shifts across several conditions, introduced carefully and watched closely. This section asks you to be specific about what you will actually do — and what you will deliberately not focus on for now.
Watch the system respond
When you shift a condition, the system responds — sometimes in expected ways, sometimes in surprising ones. Good clinical work watches carefully for what changes, what does not, and what the system is showing you about itself in response to the intervention. This section helps you plan that observation.
Reflection on uncertainty
This section is about your own clinical experience — not the child or family, but you. It asks where you felt pressure to be certain, where you may have closed the picture too early, and what a more open clinical stance might look like for this case.
Clinical reasoning summary
Use the template below to write a concise clinical reasoning summary for your case. This can be used directly in clinical notes, as the basis for a formulation section in a report, or as preparation for a supervision conversation. Write in plain language — as if you were explaining your thinking to a thoughtful colleague.
Translating into practice
The clinical reasoning in Section 13 needs to translate into real conversations and real documents. This section asks you to practise explaining your thinking in the language appropriate for each context — family, school, clinical notes and reports.
| Context | How would you explain your clinical reasoning here? |
|---|---|
| To the family — in plain, warm, non-blaming language | |
| To the classroom teacher — focusing on what the school can do | |
| In a clinical progress note — specific and observable | |
| In a report formulation — professional and evidence-referenced | |
| In supervision — sharing your uncertainty as well as your direction |
Final CPD reflection
This final section is for your own professional development record. It asks you to step back from the case and reflect on what the process of working through this guidebook has revealed — about the case, about your own clinical reasoning, and about your practice going forward.
I declare that I have completed the Seeds OT Model Clinical Guidebook as a self-directed CPD activity, applied the clinical reasoning process to a genuine de-identified case from my clinical practice, and engaged with the reflection questions in good faith. I am recording this activity in my CPD portfolio in accordance with AHPRA registration requirements for occupational therapists.