In order to demonstrate how an OT approach may be used in assessment, I have taken an example from a short film and listed the occupational strengths and needs of the individual using a MOHOST framework. I will probably post a narrative case formulation at a later stage. I am sure there are other observations and points that can be included but it gives you a general gist of what an OT assessment of the situation could look like. As always any questions or feedback is very welcome.
The film is found here https://vimeo.com/603058
- the particular excerpt I've used is called "Abandon" which is the final segment starting at 14.45 min
The film is found here https://vimeo.com/603058
- the particular excerpt I've used is called "Abandon" which is the final segment starting at 14.45 min
DOMAIN
|
OCCUPATIONAL
STRENGTHS
|
OCCUPATIONAL
NEEDS
|
Volition
/Motivation
-Appraisal of
ability
-Expectation of
success
-Interests
-Choices
|
Indicates desire
to change “I wish I
could be more
organised”
Has achieved
success with clearing
in the past
Aware that there
is a problem with
his behaviours and
habits “There’s something lacking”
Wants
more social contact
Has various interests such as
music, video and maps, photograph
indicates he has
travelled
Faith appears
important to him
|
Fluctuating motivation
to change and cope with
challenges “Sometime I think
what the hell I live
on my own”
Previously struggled to fulfil goal of
inviting his mother to
his flat which he
regrets
Appears
to have difficulty
engaging in goal
directed behaviour and
making choices “I look
at shelves from top
to bottom”
Appears
to struggle to
maintain control over
his interests e.g
buying books and maps
in spite of
limited space to
keep them- does he have
the finances to pursue
this interest?
Limited self efficacy regarding tackling the problems “There’s something lacking”
|
Habituation/
Pattern of Occupation
-Routine
-Adaptability
-Roles
-Responsibility
|
Maintains a
work role which he
took on after the death of his
mother
Evidence of some basic self care
Appeared to
take some responsibility and change his behaviour in
the past by trying to
clear his flat
|
Struggles
to make time
to maintain a clear
and hygienic
home environment which he attributes limited time due to work role
Difficulty with
maintaining routines around
domestic tasks
Loss of
role of son and
greatly misses his
mother -loss of previous routine of visiting her
Has struggled
to adapt to
smaller flat
|
Skills
-Communication skills
Non verbal skills/conversation
/vocal expression/
relationships
---------------------------------------
-Process
skills
Knowledge/timing/
organisation/problem solving
---------------------------------------
-Motor skills
Posture/mobility/coordination/
Strength
and effort /energy
|
Able to communicate
his needs
Appears to
have skills to
relate to others
------------------------------------
Evidence of
some maintained areas such
as shelves containing records and
videos
------------------------------------
Independently mobile
Fine and
gross motor skills appear intact in order to fulfil occupational roles and tasks relating to maintaining a cleared environment
|
Speech slightly
pressured and repetitive
Historically the
state of flat has impacted on
his relationships with
women of which he appears regretful and preoccupied
Hoarding appeared to
impact on the
relationship with his
mother “What am I
going to do with
you”
-------------------------------------
Inefficient way
of searching for objects
Disorganisation of all
objects leading to
difficulties and delay locating items “churning”
Appears to give up easily
when faced with
problems- difficulty arranging repairs
---------------------------------
Appears easily
fatigued (e.g sweating and breathless)
Repetitive bending
and inefficient searching may
lead to injury and
increased fatigue
|
Environment
-Physical
Physical
space/physical resources
---------------------------------------
-Social
Social groups
Occupational demands
|
Some
areas accessible and organised in categories
------------------------------------
Evidence of
at least one
friend who he
can rely on
for financial support
|
May have
limited funds e.g asks
friend for money
Some
areas of flat appear inaccessible
such as part
of living room
and bathroom ( cleans teeth
in kitchen), no evidence
of a bed
Dust and
mould and
piles of objects presenting environmental health risk to
self and visitors
Potential fire risk- papers near
heater (?working)
Many
objects in poor state of
repair and repair
men refuse to
enter
Many items
are not easily
available to be
used for their
intended purpose
-------------------------------------
Condition
of flat has severely impacted on social contact and practical support
at home
Appears to
struggle with occupational demands
of both maintaining
his home and his
work role at the
same time. Financial
demands of his
hoarding habit possibly in
excess of his available funds
|