Mandy CBL CASE KATY CASSIE LAUREN S BRANDY

Mandy CBL CASE KATY, CASSIE, LAUREN S. , BRANDY, ALANNA, AND MEGAN D.

Mandy 35 -year-old female Diagnosis: Depression, AIDS, Addiction Currently in a 2 -year transitional living facility Five children

MOHO Volition Client needs help identifying values Client is able to identify interests such as cooking Habituation Client needs to eliminate destructive habits and establish new, healthy ones Client needs help internalizing and interpreting her roles Performance Capacity Client has the musculoskeletal, neurological, cardiopulmonary and symbolic means to perform daily activities and functional tasks

Toglia’s Dynamic Interactional Goal: to restore client’s functional performance and improve cognitive function Dysfunction Deficiencies Organizing and structuring incoming information Anticipating, monitoring, and verifying the accuracy of performance Flexibly applying knowledge and skills to a variety of situations Change: cognitive strategies within multiple contexts.

Assessments Occupational Performance History Interview II (OPHI II) Life history interview using scales and narrative reports. Cost: $43. 50 Target population: adolescent or adult client who has cognitive and emotional ability to participate in the interview. Validity: 90% valid

OPHI Narrative

OPHI Scores Occupational Identity Present: Some problems Past: Extreme problems Occupational Environment Some problems Occupational Competence Present: Some problems Past: Extreme problems

Assessments Worker Role Interview (WRI) Semi-structured interview that rates impact of volition, habituation, and perceptions of the environment on readiness to return to work. Focus on psychosocial readiness. Cost: $43. 50 Target population: workers with recent injuries/disabilities, chronic disabilities,

WRI Summary Personal Causation: Interferes with function Values: Interferes with function Interests: Supports function Roles: Interferes with function Habits: Interferes with function

Assessments Occupational Self Assessment (OSA) Client self-report on 21 daily activities and their importance to the client. Allows client to set priorities for change. Cost: $43. 50 Target population: adult mental health clients

OSA Summary Myself: Managing finances Expressing self to others Satisfying routine Accomplishing goals Environment: Living arrangements Resources Opportunities to participate

Assessments Assessment of Communication and Interaction Skills (ACIS) Observation tool that gathers information about communication and interaction while engaged in an occupation. Cost: $40. 00

ACIS Summary Physicality Ineffective Information Exchange Ineffective/Questionable Relations Ineffective/Questionable

Goal 1 The client will improve self-awareness as measured by identifying three meaningful life goals in three weeks.

Intervention 1 Value Card Sort Occupational functioning problems. Help Mandy to identify values according to the OPHI- II. Assisting in increasing selfawareness of values. Occupational functioning problems. Just-right challenge http: //www. motivationalinterviewing. org/content/personal-values-card-sort

Adaptations Reduce number of value cards Give her the option of choosing “very important to me” or “not important to me”. Eliminating the option of “important to me”.

Goal 2 The client will improve organizational habits and routines according to her previously identified goals as measured by 80% adherence to a daily checklist by the end of four weeks.

Intervention 2 Reusable Checklist Dry erase board in her room that therapist can check Process of organizing occupations into routines Mandy’s Daily Routine (TEMPLATE) Things to Do Sunday Monday Tuesday Wednesday Thursday Friday Saturday Make Bed Personal Hygiene Get Dressed Make Breakfast Update Budget Job Search Write in my Journal Go to Bed TOTALS PERCENTAGE 5/15 33% /15 /15

Adaptations Therapist identifies daily routines to be completed Add pictures to identify task instead of words Divide up day into times (morning, afternoon, evening)

Intervention 3 Financial Management: creating a weekly budget Mandy is required to attend courses to educate her on finances and maintaining a budget. In the occupational profile, Mandy stated she wanted to improve financial management. http: //www. docstoc. com/docs/40707030/Weekly-Budget-Planner

Adaptations Reduce the number of categories Creating a monthly budget instead of weekly Color code the categories Changing structure by providing money envelopes for each budget category based on a certain percentage

Instructional Approach Acquisitional Provide a budget planner which will promote self-evaluation Focus: modify performance skills Materials: written directions, budget planner

Resources Cole, M, & Tufano, R. (2008). Applied theories in occupational therapy: A practical approach. Thorofare, NJ: Slack. Custer, V. L. , & Wassink, K. E. (1991). Occupational therapy intervention for an adult with depression and suicidal tendencies. American Journal of Occupational Therapy, 45(9), 845 -848. doi: 10. 5014 Garrett, B. (2011). Brain and behavior (3 rd ed. ). Thousand Oaks, CA: Sage. Gates, L. B. , Akabas, S. H. , & Oran-Sabia, V. (1998). Relationship accommodations involving the work group: Improving work prognosis for mental. Psychiatric Rehabilitation Journal, 21(3), 264 -272. Retrieved from http: //web. a. ebscohost. com Giles, G. M. , Radomski, M. V. , Champagne, T. , Corcoran, M. A. , Gillen, G. , Kuhaneck, H. M. , & Toglia, J. (2013). Cognition, cognitive rehabilitation, and occupational performance. American Journal of Occupational Therapy, 67(6). doi: 10. 5014/ajot. 2013. 6759

Resources Cont. Helfrich, C. A. , Chan, D. V. , & Sabol, P. (2011). Cognitive predictors of life skill intervention outcomes for adults with mental illness at risk for homelessness. American Journal of Occupational Therapy, 65, 277– 286. doi: 10. 5014/ ajot. 2011. 001321 Kielhofner, G. , & Burke, J. P. (1980). A model of human occupation, part 1. American Journal of Occupational Therapy, 34(9), 572 -581. doi: 10. 5014/ajot. 34. 9. 572 Paul-Ward, A. , Kielhofner, G. , Braveman, B. , Levin, M. (2005). Resident and staff perceptions of barriers to independence and employment in supportive living settings for persons with AIDS. American Journal of Occupational Therapy, 59, 540– 545. doi: 10. 5014/ajot. 59. 5. 540 Schell, B. A. B. , Gillen, G. , Scaffa, M. E. (2013). Willard and Spackman's occupational therapy (12 th ed. ). Philadelphia: Lippincott, Williams, & Wilkins. Wagner, C. C. , & Sanchez, F. P. (2002). The role of values in motivational interviewing. Motivational Interviewing: Preparing People for Change, 2, 284 -298.