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Model of Human Occupation

Case study on Susan (Cole, p. 103) with application of MOHO
by

Angie Mendoza

on 26 March 2013

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Transcript of Model of Human Occupation

What were her problems related to areas of occupation? Performance skills? Performance patterns? What are the environmental and/ or contextual factors to be considered in this client? What are activities based on the MOHO that you may use for intervention with this client? Susan Emotional regulation skills: can't control sadness, guilt for letting family down, angry for thinking about suicide, blame for the relationship she was in, lost without husband or daughter. No coping skills or relaxation techniques
Cognitive skills: difficulty concentrating, maintaining responsibilities
Communication & Social skills: no strong support system, diminished activities in social activities Areas of Occupation Performance Patterns "It isn't the mountains ahead to climb that wear you out,
it's the pebble in your shoe." Social Environment Meticulous homemaker in the past
seems like it was part of husband's request
Not allowed to go out without husband's permission Habits: rely on others to structure her time
Routines: Difficulty maintaining daily homemaking responsibilities and routines
Rituals: unsure if she participates in any religious or cultural traditions
Roles: wife, mother, daughter, teacher's helper, formerly employed as a secretary ADLs: Personal Hygiene and Grooming
IADLs: Care of others, child rearing, home establishment and management
Work: Employment interests and pursuits, volunteer participation
Leisure: making crafts/ ceramic pieces, tennis, piano, sewing, reading
Social Participation: lacking community, family, friends Strengths & Weaknesses of Volition Strengths & Weaknesses of
Performance Capacity Neurologically Musculoskeletal Depressed
Lack of focus and concentration Almost catatonic
Lack of energy due to depression certain occupations she engaged in were for her controlling and abusive husband
need to find occupations that are meaningful to her Unstructured Assessments Remotivation Process Competency
learn to do
goals: sense of efficacy and control over decisions and performance
e.g. introduce challenges and skill development Exploration
work, educate, play
goals: sense of capacity, personal significance, security
e.g. introduce change to environment Presented by Kerry Lamson, Laura Leppke, Jessica Lam, & Angie Mendoza An analysis on the case of Performance Skills not a lot of personal causation!
strength in the value of family, but also a weakness because she stayed in abusive marriage
previous interests that the OT can engage her in Symbolic Losing meaning of live Mind-Brain-Body all connected and all being suppressed due to her sadness Habits in how she kept the house
How she structured time

Internalized the role of wife and mother
= her identity depended on these roles Strengths & Weaknesses of Habituation Physical Environment Was in an abusive marriage for 10 years
husband was controlling
just separated recently
beating was severe; caused concussion and suicidal ideation
10 year old daughter she enjoys doing things with
Did no engage in occupations she enjoyed because time went to husband and daughter
No strong peer social support system
Feels like she let her parents down; parents are supportive and close by What evaluation/ assessment procedures could you use with Susan? observe susan at home talk to family members observe her participating in opccupations she enjoys talk to her doctors & tx team give her a journal to write thoughts and feelings occupational collage casually interview her about interests and goals Structured Assessments Role Checklist self-reported checklist which documents cx's perceptions or participation in 10 occupational roles throughout their life and value placed on these roles Occupational History Interview-II (OPHI-II) semi-structured interview that delves into the client’s life history in the areas of work, play, leisure, and self-care The Volitional Questionnaire (VQ) an observational assessment, which provides the OT with insight into the client’s inner motives and information about how the client’s environment affects volition (motivation) Occupational Questionnaire self-reported questionnaire which documents the client’s participation in occupations in 30 minute intervals throughout the day and classifies each activity as work, play, or leisure, as well as level of enjoyment in each activity modify or alter Susan's environment
activity exploration
skill development
integrate daughter into re-establishing habits and routines
identify enablers and barriers in her natural environment
enabler: daughter
barrier: reminders of husband
establish schedule
group work An intervention that uses environmental support to aid in recovering from mental disability
Focused on motivation and participation in meaningful activities
Based on a volitional continuum of 3 stages: Exploration, Competency, and Achievement
Each phase indicates a different level of volition, and is further broken down into more specific stages. Designed to be used along with Volitional Questionnaire. Completion, competition
Goals: motivation for participation in a variety of occupations
Independence and seeking challenges Achievement -Muhammad Ali
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