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MOHO second reading assign.
MOHO second reading 141-213
30
Other
Graduate
06/18/2011

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Cards

Term
two important ways MOHO is client centered
Definition
1. it views each client as unique individual whose characteristics determine the rationale for and nature of the therapy goals and strategies

2. It views what the client does, thinks and feels as the central mechanism of change
Term
clients unique characteristics do what?
Definition
always define the goals and strategies of therapy
Term
central dynamic of the MOHO based therapy
Definition
client's occupational engagement

thinking, feeling and doing
Term
6 steps of therapeutic reasoning
Definition
1. generating questions to guide information gathering
2. collecting information on and from the client to answer the questions one has generated
3. using the information gathered to create an explanation of the client's situation-creating a conceptualization of the client that includes strengths and challenges.
4. generating goals and strategies for client engagement and therapeutic strategies
5. implementing and monitoring therapy
6. determining outcomes of therapy

NOT SEQUENTIAL STEPS-MOVE THROUGH THEM AND BACK UP AND DOWN WITH TIME
Term
step 2 gathering info. on and with the client
Definition
the first step is to GENERATE questions and now you are going to answer them

This is done using standardized and non-standardized assessments approach data gathering with these concerns:
kind of info. that is needed to answer the questions one has generated

The best method to gather that info given the circumstances.
Term
Reasons that therapists use other structured assessment with MOHO
Definition
MOHO is used in association with other conceptual practice models that have their own assessments

other assessments specifically target occupational performance in ways that MOHO based assessments do not.

assessments that gather info. directly or partly related to constructs in MOHO. An example is the use of structured interest inventories. Since the MOHO based interest assessments focus mainly on leisure interests, therapists wishing to gather information on work-related interests ordinarily use one of a number of standardized vocational interest assessments.
Term
elements involved in planning the therapy
Definition
creating therapy goals with the client

deciding what kinds of occupational engagement will enable the client to change

determining what kind of therapeutic strategies will be needed to support the client to change.
Term
therapy goals
Definition
indicate the kinds of changes that therapy will aim to achieve.

EX: if client feels ineffective then therapy should seek to enable the client to feel more effective.
Term
step 6: collecting information to assess outcomes
Definition
this is done by
reassessment
examining the extent to which goals have been achieved.
Term
Trombly quote about assessments
Definition
we can not ethically treat what we do not measure
Term
assessment from MOHO perspective
Definition
comprehensive assessment means that a therapist will at minimum raise and seek answers to questions pertaining to the client's occupational adaptation, volition, habituation, performance capacity and environmental impact
Term
when to make use of unstructured information gathering methods
Definition
*THere is no appropriate structured assessment for the question one wants to answer or for the type of client one has
*The client is uncomfortable with or unable to complete a structured assessment
*The therapist wishes to augment info. collected from structured assessments
*An unexpected opportunity to obtain useful info. arises.
Term
unstructured info collection can occur in a wide range of circumstances including:
Definition
*having a conversation with a client while beginning a therapy session
*Observing a student's performance when visiting the classroom
* Listening to a client's comments about the work place where he was injured
*Noting the affect of a client during a group session
*Listening to a client's occasional stories about what happened since the last therapy session

any opportunity to observe and/or talk with a client yields potentially useful info.
Term
critical to unstructured info gathering
Definition
having questions to guide you
you need to know what you are looking for when observing or conversing with the client.
Formulating theory based questions must precede this.
Term
best ways to assess the lived body experience
Definition
no formal assessments
observe
and informal interview
Term
three important strategies for ensuring dependability of information gathered by unstructured methods
Definition
evaluating context

triangulation

validity checks
Term
evaluating contexts
Definition
contexts affect information-client may be "showing off" or may have fears that will go away once they are home. Take context into account
Term
triangulation
Definition
method of helping to ensure that information is accurate by comparing it with information from another source.
can be information from past therapy, other caregivers
Term
validity checks
Definition
when using unstructured methods therapists should be vigilant to ensure that their interpretation of the meaning of the information is valid.
Term
ensuring client-centered assessment
Definition
requires that therapists choose the form of assessment that maximizes client involvement to the extent possible
Term
assessments good for those low functioning or minimal ability to contribute to the assessment
Definition
VQ, PVQ, MOHOST, and the Short Child Occupational Profile + unstructured means
Term
Limits on MOHO
Definition
MOHO assessments are not designed for use with a specific diagnosis. MOHO focuses on understanding the impact of a disease or impairment on the person's occupational life, not on the disease or impairment itself.
Term
Things to consider in selecting assessments for specific diagnosis or impairments
Definition
Is the diagnosis better addressed by this assessment

Whether the impairment limits the client's ability to do what is necessary to participate in the assessment
Term
steps in choosing assessments
Definition
become familiar with all potentially relevant MOHO assessments and identify those that appear most suitable for use

Pilot these assessments in practice to evaluate their utility

Develop an assessment strategy that allows flexibility to meet individual needs.
Term
occupational engagement
Definition
refers to clients' doing, thinking, and feeling under certain environmental conditions in the midst of or as a planned consequence of therapy.
Term
9 dimensions of occupational engagement that contribute to change
Definition
choose or make decisions
commit-to make a change
explore-new ways of doing
identify-problems or areas needing work
negotiate-give and take for mutually agreed upon
plan-establish action plan
practice
reexamine
sustain
Term
commitment to therapy
Definition
is one of the dimensions

committing to a course of action is also an act of hope since the client's intention is to achieve some goal, occupy a place in the world or modify lifestyle in anticipation of improving life
Term
therapeutic strategies
Definition
those actions of the therapist tht are directed specifically to supporting client occupational engagement

a therapist's action that influences a client's doing, feeling, and/or thinking to facilitate desired change.
Term
therapeutic strategies
Definition
validating-experiences the client experiences
identifying-ways to get back to occupations
giving feedback
advising
negotiating
structuring-establishing parameters for choice, ground rules, etc.
coaching-verbally prompt or physically prompt
encouraging
providing physical support

p.195 sums this up
Term
validate
Definition
to convey respect for the client's experience or perspective
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