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Mae Yan

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Population: 36 people with cerebrovascular accidents who were in a chronic
phase in a Health Care Facility for the Elderly in Japan
Methods: Assigned to two groups one control and one experimental.
Assessments included Activities of Daily Living, WHO Quality of Life 26,
MOS-36-Item Short Form Health before and after a 12-week OT intervention.
Those in the experimental group improved in ADL and QOL scores following
OT intervention.
Significant improvement in experimental group vs. control group in all
MOHO was effective in Japanese culture References Discussion You are an Occupational Therapist planning a therapy group to promote better occupational performance for veterans with Traumatic Brain Injury. Meet your potential clients by watching this short video clip. Within your group select one client to focus on and discuss how your assigned area of MOHO applies to him/her. Then determine 1-2 goals relevant to your assigned MOHO concept and the modality/therapeutic activities you could use to achieve that goal. Activity Ideas for Future Refinement/Research Occupation-Based Application to an Individual Limitations of the Model Strengths of the Model This material reproduced/replicated for fair use for educational purposes in OCTH 611.001, Spring 2013, Towson University and should not be copied without permission of copyright holder. Schematic Principles 1. "Persons have a fundamental and neurologically based need for action and doing. This innate need is the dominate source of motivation for participation in occupation."

2. Behavior emerges from social and physical interactions with the environment.

3. Engagement in human experience promotes health, and disengagement promotes dysfunction.

(Cole & Tufano, 2008, p. 96; Kielhofner, Forsyth, Kramer, Melton, & Dobson, 2009) Philosophical Assumptions First described in 1975 as part of Kielhofner's unpublished master's thesis

Conceptual model published in 1980 after concepts were refined through practice

A Model of Human Occupation: Theory and Application published in 1985; it expanded on the theory and provided clinical applications

The second edition published in 1995; it included a revised conceptual model. The fourth edition published in 2007; it is considered the primary reference and crucial for those wishing to apply it in practice

Extensive literature has been published on the MOHO; theoretical, applied, or research aspects have appeared in more than 235 articles and chapters

The MOHO clearinghouse is used to maintain and distribute assessment manuals, case videos, and written materials

It has been suggested that the MOHO is the most popular and commonly used occupation-based model

(Kramer et al., 2003) Author Shannon Angelopoulos, Angela Eikenberg, Stacey Greenberg, & Brooke Santerre Model of Human Occupation Population: 65 participants from four supportive living facilities for adults living with HIV/AIDS in metropolitan Chicago
Methods: Nonrandomized, two-group design (control and ESD group). Data was collected at 3, 6, and 9 months after completion of the program. Outcomes were compared. "Humans are composed of flexible elements whose interaction with each other and with the environment depends on the situation"

"Thinking, feeling, and doing emerge out of dynamic interactions between elements within the person and those in the environment"

"Dysfunction is the result of the interaction of conditions internal and external to the person

"Function can be enhanced through remediation of a faulty element, compensation by another element within the person, and/or by environmental modification"
(Kielhofner, 2002, p. 38) MOHO explains motivation for occupation, routines for behavior, nature of performance, and environmental Influences
Holistic Approach
Client Centered
Can be applied to a wide range of populations and contexts
Addresses all aspects of client's life
20+ MOHO Assessment Tools
Well Researched
Systematic perspective
Development is continuous and ongoing
Addresses the needs of children through adults

(Cole & Tufano, 2008; Kielhofner et al., 2009) What concept do you find the most important to you?
Which concept was hardest to apply to the activity?
In a therapy session would you use MOHO or the other models?
Since MOHO is based on the idea of having routines and habits does that mean there is little value in the ability to be flexible or adaptable? How does MOHO compare or differ from EHP? Research the effectiveness of habit training for individuals with Autism

Continue to explore the process of occupational adaptation and the factors that influence it

Research the effectiveness of group therapy on return to work programs

Continue using MOHO to explore global health promotion needs

(Scaffa et al., 2010) OT-directed
Not an interdisciplinary model

Does not address biological components of occupation


Subjective Laura is a 26 year old waitress who was admitted to a psychiatric unit for schizophrenia. Concepts
Performance Capacity
Environmental Context Constructs
Occupational Performance
Occupational Participation
Occupational Skills (Scaffa, Reitz, & Pizzi, 2010, pp. 29-30) (Keilhofner & Burke, 1980; Kielhofner et al., 2009) By using MOHO a clinician is able to figure out what Laura values, her daily routine and habits, and what skills she has. The therapist will also consider the environment in which these occur. Because Laura values her employment and wants to continue to fulfill her role as a waitress, therapy might include:
-Coping skills/Illness management sessions
-Practice waitressing skills in controlled
-Adaptions to work environment Research: Study 1 History / Evolution Results:
ESD program showed significantly higher levels of productive participation at all three time points.
Particpiants attending ESD program were at least twice as likely to be productively engaged at all three time points.
Results support the effectiveness of the model program in achieving sustained productive participation in persons living with HIV/AIDS Dr Gary Kielhofner was born in 1949 in Missouri; early exposure to disability inspired him to want to help others

Graduated from St. Louis University with a bachelor's in psychology

Began pursuing a master's in occupational therapy, but became discouraged and considered switching disciplines; a chance encounter with Dr. Mary Reilly changed everything

Outlined the MOHO in his unpublished master's thesis

Obtained his doctoral degree in public health; held faculty positions at Virginia Commonwealth University, Boston University, and finally University of Illinois at Chicago

Passed away in 2010; remembered for his many talents, accomplishments, and lasting impact on the occupational therapy profession

(Kates, 2010; Kramer, Hinojosa, & Royeen, 2003;
University of Illinois at Chicago, n.d.) Researchers used MOHO to relate to population and interventions of the ESD program were based on MOHO. Diagram of the Model of Human Occupation (MOHO). (2008). Retrieved February 13,
2013 from: http://hearingreview.com/all-news/15384-concepts-of-rehabilitation-part-
2-application-of-system-models Cole, M. B. (2012). Group dynamics in occupational therapy: The theoretical basis and
practice application of group intervention (4th ed.). Thorofare, NJ: SLACK Incorporated.

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

Kates, J. (2010, September 7). Dr. Gary Kielhofner, 1949-2010: UIC professor was a leading
expert in occupational therapy. Chicago Tribune. Retrieved from

Kielhofner, G., Braveman, B., Fogg, L., & Levin, M. (2008). A controlled study of
services to enhance productive participation among people with HIV/AIDS.
American Journal of Occupational Therapy, 61, 36-45. Retrieved from

Kielhofner, G. & Burke, J.P. (1980) A model of human occupation, part one. Conceptual
framework and content. American Journal of Occupational Therapy, 34(9), 572-581.

Kielhofner, G., Forsyth, K., Kramer, J. M., Melton, J., & Dobson, E. (2009). The model of human
occupation. In E. B. Crepeau, E. S. Cohn, & B. A. B. Schell (Eds.), Willard & Spackman's
Occupational Therapy (11th ed.). Baltimore, MD: Lippincott, Williams, & Wilkins. Research: Study 2 Kielhofner, G., Braveman, B., Fogg, L., & Levin, M. (2008). A controlled study of
services to enhance productive participation among people with HIV/AIDS.
American Journal of Occupational Therapy, 61, 36-45. Retrieved from
4196-b018-917fa69cea42. Shinohara, K., Yamada, T., Kobayashi, N., & Forsyth, K. (2012). The model of
human occupation-based on intervention for patients with stroke: A
randomised trial. Hong Kong Journal of Occupational Thearpy, xx, 1-10. doi:
10.1016/j.hkjot.2012.09.001 Kramer, J., Kielhofner, G., & Forsyth, K. (2008). Assessments used within the
model of human occupation. B. Hemphill-Pearson (Eds.), Assessments in
occupational therapy mental health: An integrative Approach (2nd ed.). (pp.
159-184). Thorofare, NJ.

MOHO Clearinghouse. (n.d). Introduction to MOHO. Retrieved from

Scaffa, M. E., Reitz, S. M., & Pizzi, M. A. (2010). Occupational therapy in the
promotion of health and wellness. Philadelphia, PA: F.A. Davis.

Shinohara, K., Yamada, T., Kobayashi, N., & Forsyth, K. (2012). The model of
human occupation-based on intervention for patients with stroke: A
randomised trial. Hong Kong Journal of Occupational Thearpy, xx, 1-10.

University of Illinois at Chicago (n.d.). Remembering Dr. Gary Kielhofner.
Retrieved from
Kielhofner.pdf References Researchers used MOHO assessments to determine individual
intervention. Interventions were designed to emphasis personal
volition, habituation, performance capacity, and engagement
with environment to encourage optimal occupational
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