MOHO

Model of Human Occupation

MOHO Description

• Established by Dr. Gary Kielhofner, published book in 1970
• Focus: understanding and developing the person’s motivation for occupation, with the assumption that skills, performance and ultimately adaptation, will follow.
• Person- centered: three components
• Social, cultural and physical environments
• Behavior is context dependent, provide opportunity and demand
• Occupation leads to self organization
• Most widely used theory in practice
• Applicable across the lifespan

Participation Barriers with Depression

• Face obstacles when participating in physical activity
• 2010 study concluded that clients' motivation to engage in activities was significantly impacted by their negative self perceptions
• Participation is closely linked to volition

Character Description

Carl Fredrickson

• Age: 78
• Diagnoses: Depression, physical handicap
• Lived environments: same home
• Character flaws: Isolated, stubborn
• Family dynamics: Wife (Ellie) passed, he never had children
• Occupational status: retired balloon salesman, no income
• Situation: Home is going to get destroyed and will be sent to live in a nursing home

Disability

Carl's Disability:

• Uses a cane to get around (mobility)
• Has hearing aids (sensory)
• Suffers from depression

Disability

• The inability to perform occupations, an interruption in role performance, and an inability to meet role responsibilities (Barris,Kielhofner, & Watts, 1983).
• Disability is represented by helplessness, incompetence, and inefficacy.

Function

Carl's functions:

• Very independent
• Avoids nursing home
• Did not need Russel's assistance
• Sense of pride when he was able to transport his house with only balloons

Function

According to MOHO:

• Person is able to engage in occupations within a certain environment with a sense of mastery and accomplishment.
• Performance with adaption is seen as a "reward" to the client

Motivation and Change

According to MOHO:

• Motivation is influenced by a person's interests, values, and a sense of personal causation.
• Change is a shift in a person's thoughts, feelings, and behaviors that make the overall dynamic different.

Carl's Motivation:

• Seeing Paradise Falls, "The Adventure Book"
• Russell encourages his adventuous side
• Staying out of the nursing home

Carl's Change:

• Beginning: avoids change
• Relocating his home
• Ending: sense for adventure

Intervention and Evaluation

• Client acts as the "agent of change", must be involved
• Goal: client can participate in life and societal activities to the extent that health conditions allow
• Activity must have personal significance to client

As OTs we would:

• Advise, give feedback, coach, and offer support.
• We want the client to be able to engage in meaningful occupations

References

Barris, R., Kielhofner, G., & Watts, J. (1983). Psychosocial occupational therapy: Practice in a pluralistic arena. Laurel, MD: RAM Association.

Cole, F. (2010). Physical activity for its mental health benefits: Conceptualising participation within the model of human occupation. British Journal of Occupational Therapy. 73(12), 607 - 615. doi:10.4276/030802210X12918167234280

Cole, M. B., & Tufano, R. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK.

Hinojosa, J., Kramer, P., & Brasic-Royeen, C. (2017). Perspectives on human occupation: Theories underlying practice. Philadelphia, PA: FA Davis. 2, 93-132.

Myers, S. (2013, May 24). Great Character: Carl Fredricksen. Retrieved October 08, 2017, from https://gointothestory.blcklst.com