wk 6/7/8 Flashcards
what does MOHO stand for?
Model of Human Occupation
what does the MOHO integrate concepts from?
- sociology
- phenomenology
- enviro
- systems theory
when was the MOHO first introduced?
in 1980s in American Journal of OT
when was the first book of MOHO introduced?
1985
what does the MOHO guide?
occupation focused, client-centered evidence-based OT practice
what are the person specific concepts of the MOHO?
- volition
- habituation
- performance capacity
what are the dynamic interactions of the person and enviro in the MOHO?
- enviro
- dimensions of doing
- occupational adaption
what is volition the process of doing?
process by which persons choose and are motivated toward what they do?
what are examples of volition?
interests, values, personal causation
what is habituation the process of doing?
process by which a person’s occupations are organised into patterns and routines
what are examples of habituation?
roles and habits
what is performance capacity the process of doing in the MOHO?
the underlying object capabilities and subjective experience that shape a person’s ability
what are examples of performance capabilities in the MOHO?
- mental and physical performance capacities
- ‘lived body’ experience
what are volitional choices shaped by and linked to?
past experiences and future possibilities
what are patterns of interest?
the unique configuration/repertoire or preferred activities that each of us develop
what is a value?
what a person finds important
what are two types of values?
- personal convictions
- sense of obligation
what is personal convictions?
a view of how the world is and identification of what matters
what is a sense of obligation?
strong emotional dispositions to follow perceived right ways to act
what do values determine?
a person’s view of the worth of different occupations
what are examples of personal causation for volition?
- recognising strengths/weaknesses
- sense of capacity
- self efficacy
what is a role?
a socially and/or personally defined status, and accompanying attitudes and behaviours
what are the two different forms of subjective experience in performance capacity?
- external/observable
- internal/subjective
what are the steps of the MOHO?
- generate theory-driven questions
- choose relevant assessment
- occupational formulation of situation
- identify occupational changes
- develop measurable goals
- implement intervention
- assess outcomes
what are examples of assessments that address most MOHO concepts?
- screening: MOHOST
- interviews: OPHI-II
- self report: OSA
what does OPHI stand for?
occupational performance history interview
what is OPHI-II based on?
model of human occupation
what are the five content/thematic areas of the OPHI-II?
- occupational roles
- daily routine
- occupational setting (enviro)
- activity/occupational choice
- critical life events
what are the two parts of the OPHI-II?
- interview
- rating scales
what are the three parts of the rating scale for the OPHI-II?
- occupational identity scale
- occupational competence scale
- occupational setting (enviro scale)
what clients is the OPHI-II not suitable for?
- young children
- emotionally distressed
- clients without cognitive and language skills
what setting is the OPHI-II unsuitable for?
where you only see the client once or twice
what are some pointers for administration of the OPHI-II?
- gather background info
- be aware of cultural factors
- aim for comfortable, spontaneous interview
what is the aim for the administration of the OPHI-II?
for therapist to internalise the purpose and content areas of the interview sufficiently to complete it spontaneously without aid of notes
how long should be allowed for the OPHI-II?
60mins
how are the three rating scales rated?
according to 4 point scale (4 being good, 1 being bad)
what are the benefits of the OPHI-II?
- structured way to gather detailed history
- allows time for clarification
- therapeutic
what are the negatives about the OPHI-II?
- takes alot of time
- wont work with clients who cant verbalise or have little insight
what is professional reasoning?
how therapists actually think when engaged in practice, used to plan, direct, perform and reflect on client care
what type of process is professional reasoning?
metacognitive
what do OTs use observations, sensory experiences and theoretical knowledge to identify?
- client factors contributing to occupational issues
- contextual factors
what are frames or scripts development process?
- cue acquisition
- pattern recognition
- limiting problem space
- problem formulation
- problem solving
what does theoretical knowledge help the OT do?
- avoid unjustfied assumptions
- use ineffective techniques
what is scientific reasoning?
involves use of applied logical and scientific methods such as hypothesis and statistical evidence
what is scientific reasoning used to do?
- understand condition affecting
- select interventions for best interest
what is scientific reasoning recognised in discussions as?
- impersonal
- focus on diagnosis
- evidence from what “typically occurs”
what is diagnostic reasoning?
involves investigation or cause or nature of conditions requiring intervention
what is diagnostic reasoning used for?
- recognise and explain condition affecting
- select interventions of best interest
what is diagnostic reasoning recognised in discussion as?
- both personal and impersonal iinfo
- therapist attempts to explain problems using science and clien-based info
what are the different types of professional reasoning?
- diagnostic
- scientific
- narrative
- interactive
- procedural
- conditional
- pragmatic
- ethical
what is narrative reasoning?
involves understanding meaning of disease, illness or disability of individual
what is narrative reasoning used for?
- understand client’s perspective
- understand roles, occupational functioning, desired occupational future
what is narrative reasoning recognised in discussion as?
- personal, includes past/present/future
- appreciation of client culture
- relates to the ‘so what’ of the condition for person’s life
what is interactive reasoning?
involves understanding of current supports, engagement and attitude towards service systems. relied on communication process
what is interactive reasoning used for?
- build positive interpersonal relationships
- permit collaboration
- understand enviro influences
what is interactive reasoning recognised as in discussion?
- concern with what client likes/dislikes
- use of praise, empathy and non-verbal behaviour to encourage
what is procedural reasoning?
involves understanding clients conditions, likely prognosis and evidence-based interventions likely to support optimal outcomes
what is procedural reasoning used for?
- guide intervention to achieve desired outcomes
- consider advantages/disadvantages
what is procedural reasoning recognised as in discussion?
using therapy regimes thought to be effective typically in clients given setting
what is conditional reasoning?
involves understanding the client’s condition and how change is conditional upon participation
what is conditional reasoning used for?
- anticipate situations
- imagining future possibilities
what is conditional reasoning recognised as in discussion?
typically seen with more experienced therapists who see multiple futures based on past experience and current info
what is pragmatic reasoning?
involves implementation of therapy possibilities into current realities of service delivery
what is pragmatic reasoning used for?
consider how therapy can operate given resources and reimbursement issues
what is pragmatic reasoning recognised as in discussion?
- generally not focused on client or condition, but rather physical and social aspects
- therapists sense of capabilities/time/energy
- discussing realistic treatment
what is ethical reasoning?
involves moral conflict where one moral stand or nation conflicts another
what is ethical reasoning used for?
- analyse ethical dilemma
- generate alternative solutions and determine actions
what is ethical discussioins recognised as in discussion?
tension is often evident in attempt to determine what is right, particularly when there us competing principles, risks and benefits
what are the stages of professional reasoning?
- formulating an impression
- info gathering and planning
- monitoring
what is the formulating an impression stage of professional reasoning?
initial stage where OT tries to understand based on typically limited info
what is the info gathering and planning stage of professional reasoning?
- more detailed assessment
- collaborative engagement
what is the monitoring stage of professional reasoning?
continual evaluation and improvement
what is the occupational profile a practice resource for?
occupational therapy practice framework (OTPF-II)
what is the occupational profile?
a summary of occupational history/experience, patterns of daily living, interests, values and needs
why may an OT use an occupational profile?
provides an understanding of client’s perspective and background
what type of info should be gathered in an occupational profile?
- what is currently important and meaningful
- past experiences and interests