week 3 and 4 Flashcards
who created MOHO
- Gary Kielhofner
dates around MOHO
- First introduced in 1980s
- First book 1985
- Edition 2 1955 substantial revisions in the performance component
- Edition 3 2002 substantial refinement to the model and more related assessment
- Edition 4 2008 substantial new information on how to put MOHO into practice
- Edition 2017 further emphasise on illustrating how to put MOHO into practice
what is MOHO
: is a theory that occupational therapist use to guide their practice.
- A way to identify and frame issues and to find solutions for problems
- An explanation of some phenomena
why learn MOHO
- Helps explain the relationship between the person environment and occupation.
- Provides an evidence base for occupation focused practices
- 75% of OTS in the US use it in practice
- Addresses all areas of OT practice.
how is MOHO interdisciplinary based
- Psychology and anthropology- human needs and motives
- Sociology, social psychology and early OT literature- how occupation is organised into everyday patterns
- Philosophy- performance capacity
- Environmental psychology and sociology- influence of the environment
- Systems theory- how these factors are organised together in human action and experience
whats the three key concepts of MOHO
person
environment
occupation
whats the there components of person
volition
habituation
performance capacity
whats volition
the process by which persons are motivated toward and choose what they do.
whats the tree types of thought patterns that influence movies
interests:unique configuration of preferred things to do that one has accumulated from experience.
values: what a person finds important and meaningful to do
personal caustaiton: how capable an effective one feels- recognising strengths and weaknesses, feeling confident or anxious
whats personal convictions
- a view of how the world is and the identification of what matters
whats a sens lof obligation
a strong emotional disposition to follow what are perceived as right ways to act
whats a sense of personal capability
self assessment of ones physical, intellectual and social abilities.
whats a sense of efficacy
a persons thoughts and feelings about his/her effectiveness in using personal abilities to achieve desired outcomes in life. People who feel capable and effective will seek out opportunities, use feedback to correct performance and persevere to achieve goals. Individuals who feel less capable and lack a sense of efficacy will shy away from opportunity, avoid feedback and have trouble persisting.
whats habituation
- the process whereby doing is organised into patterns and routines.
- Connects people to and makes them functional within their familiar context
- Regulate routine ways of doing things allowing people to automatically recognised and respond to familiar environments and situation
- Relies on ability to appraise cues in the environment.
whats habituation broken into
habits
roles
whats habits
ways of doing things that are patterns of behaviours that are easily repeatable. Helps us respond to repeated time cues or time frames. Eg brushing teeth. Learned from repetition. Creates a sense of routine and regularity in everyday life. Allows us to perform in a consistent and effective way, decreases the effort required for occupation performance and frees up conscious attention for other purposes.
whats roles
give people an identify and sense of obligations that go with that identify. Give us the necessary social bearing to act effectively.
- Through interaction with others, people internalise attitudes and ways of behaving that belong to a given role. Eg student
- Roles serve as a framework for looking out on the world and for acting.
purpose of roles
- Shapes ones attitudes and actions but also profoundly influence a persons sense of identity/who they are.
- Provide wat to behave.
habits and roles together
- Together give a person a sense of order and purpose.
- Participating in a specific role develops habits and routines to sustain this role that in turn organise his or her time
- A person who lacks socially or personally defined roles is more likely to have difficulty maintain habits and routines.
whats role loss
- May lead to lack of identity, purpose and structure in everyday life.
- Patient or suck role- passivity and compliance expected, rather than being a role that brings purpose and meaning.
what’s performance capacity
- the underlying objective mental and physical abilities and the lived experience that shapes performance.
- Dependent on the capacities of musculoskeletal, neurological, cardiopulmonary, cognitive and other body systems.
- When we are doing, we exercise our physical and mental capacities.
- Capacity for doing/performing depends on underlying objective physical and mental capacities and corresponding subjective experience.
- Interval viewpoint: what the individual is experiencing/feeling
- External viewpoint: what is observable by others.
whats environment broken into
physical features
social features
occupational forms
occupational setting
whats physical features
spaces
oobject
what social feature
social group
whats occupational forms
- The typical way a particular occupation is done.
- Usually rule bound sequences of how to do it.
- Culturally recognizable
- Eg sport, dancing. Soccer vs AFL.
whats occupational setting
a unique combination of spaces, objects that constitutes a meaningful context for performance.
Eg workplace, gym, school etc.
whats can feautures of the environment do
- Influence the range of occupations
- Provide resources to sustain motivation, facilitate performance, maintain routine.
whats the three dimensions of doing
participation
perfomacne
skill
whats participation
engaging in occupations of personal and social significance. Eg surfing
whats performance
doing a specific occupation form /task eg riding the waves
whats skill
goal directed, observable actions that a person uses while performing; motor skills, process skills and communication skills. Eg balance
whats three types of skills and explanations
Motor skills: refer to moving self or task objects eg lifting and transporting objects
Process skills: logical sequencing actions over time, selecting and using appropriate tools and materials and adapting performance when encountering problems eg organising, initiation and terminating steps in task performance.
Community and interaction skills: ability to convey interactions and needs and to coordinate social action to act together with other people eg gesturing or speaking.
consequence three sections
occupation adapction
occupational identity
occupational competence
whats occupation adaption
the construction of a positive occupational identity and competence in ones occupations in ones environment and over time
whats occupational identity
a persons sense of who they are and wishes to become an occupational being generated from his/her history of occupational participation. It serves as a means of self determination and a blueprint for action.
whats occupational competence
the degree to which a person sustains a pattern of occupational participation consistent with his/her occupational identity.
using MOHO concepts to guide therapeutic reasoning
- Guide you in choosing relevant assessment to conduct with a client
- To frame your understanding of a clients occupational life and occupational issues
- To identify potential occupational changes that may be possible in OT
- To develop interventions that facilitate occupational changes
- To select and evaluate intervention outcomes
MOHO assessments for clinical practice
OSA
OPHI
OCCIAS
volitional questionare
what happened to the lady in the interview
- sist on the brain
- used her own language
- fed back information he was understanding
- teaching was really important to her
- wanted to see children develop (values) supporting family and not needing mother to take care of her. (volition) strong values that motivate her but personal causation blocking her.
- hiding herself away
- difficulties with performance
- feels like a different person
features of OPHI
FEATURES:
- Based on model of human occupation
- 5 content / thematic areas
- Generic interview uses with a variety of clients
- Flexible, begin point can vary, described as maximally flexible.
whats OPHI stand for
Occupational performance history interview
five content/thematic areas of OPHI
- Occupational roles: questions made up to explore the occupational roles that make up the persons lifestyle. Work, student, caretaker roles, friend roles, home maintenance role, religious/ organisation participation.
- Daily routines: includes questions about how the person organises and uses time, satisfaction with daily routine, and typical occupational that fill in their time.
- Occupational settings: environment: questions aimed at the persons occupational environments, including people and their influence on occupation.
- Activity/occupational choices: questions that aim to understand how a person makes choices relevant to occupations and the values, interests and personal causation behind these choices.
- Critical life events: questions that ask about turning points, good times, bad times, successes and failures in a persons life.
whats the 2 parts of OPHI
- Interview; includes a set of recommended questions
- The rating scales:
- Occupational identity scale
- Occupational competence scale
- Occupational settings
whats the rating scale for OPHI
rated according to a 4 point scale:
4 Exceptionally competent occupational funding
3 good, appropriate satisfaction occupational functioning
2 some occupational functioning problems
1 extreme occupational functioning problems
whats the life histrtoy narrative form
drawing a slope between the good and bad times and stating why things are bad and why things are good.
- this can be complete in collaboration with the client during the critical life events
- end of the interview as a means of recapping the life history narrative
After the interview is completed for later dissuccion with client
client group used for OPHI
- Over 12 years old
- Mature
- Emotionally prepared
- Unsuitable when you only see client once or twice
- Allow 60 minutes to complete
- Data is always subjective
- Narrative data- includes how client makes sense of his or her life.
pros OPHI
- Offers a structure way to gather a very detailed history, which is based on theory
- Allows time for clarification
- Therapeutic, in and of itself completing it
cons OPHI
- Takes a great deal of time to complete
- Will not work with clients that can not verbalise or have little insight.
