1. @jamieson2015
@MOHOspark
OTnews March 2017 pp36-38

2. OT role in HMP Grampian
understanding and creating opportunities to improve occupational skills, performance and participation
OTnews June 2016 pp14-16

3. Case formulation
constructing narratives within a chosen conceptual framework
(Loftus & Higgs 2008)
to support decision-making and convince others of our efforts
(Melton et al 2009)

4. Case formulation
“Creating a conceptualisation of the client’s strengths and challenges”
Kielhofner
- describing occupational identity & competence, and the key occupational issues

5. Environment Person Participation Performance Occupational Identity
Volition
Habituation
Performance
capacity
Performance
Occupational Adaptation
Skill
Person
Occupational Competence

6. Occupational Identity
past roles/relationships volition
life turning points volition
current roles/relationships + volition
interests + volition
volition = feelings related to:
values satisfaction goals appraisal of ability & expectation of success

7. Occupational Competence
How a person’s
skills
performance
routines
environment
match their identity

8. Case formulation
Introducing Scott

9. Revised Case formulation
N.B. Therapeutic use of self is widely accepted as the most important determinant of therapy
Taylor 2008

10. Introduction Name, age and gender
Brief history of health conditions /forensic history
Reason for referral
Occupational assessments completed

11. Occupational Identity
Roles and relationships
family acquaintances job interests
Voltion
feels +++
identifies as important
would like to have motivated
does not feel confident

12. Occupational Competence
Routine – no contact with family, rarely comes to hall
Performance – avoidance + good work standards
Environment – minimising stimulation
Skills – would benefit from information regarding strengths

13. Key issues and Summary Occupational issues Summary
Skills, performance or participation relating to self-care, productivity or leisure
Worded neutrally
Summary
Positives re identity
Contextualising the issues
Less than 100 words

14. Measurable goals
Timeframe + MOHO verb + person + issue + setting if needed + level of support

15. MOHO Taxonomy – verbs specifying the process of change
choose
commit
explore
identify
negotiate
plan
practise
re-evaluate
sustain

16. ‘a catalyst for change’ ‘graded goals make change seem possible’
‘keeps me focussed’
‘a catalyst for change’
‘graded goals make change seem possible’
‘a way to manage yet communicate complexity’
‘helps identify and articulate key points’

17. 'I feel stuck and OT gives me a structure to think about what I need to do and I think I can do that'
'I get where you are coming from and what OT is about'
‘It helps me understand what you are looking at'
‘Thats me! - Can I share this with others?'

18. References
Jamieson L (2016) Building occupational skills in the prison population. OTnews 24(6), 14-16
Jamieson L, Parkinson S (2017) Unlocking Potential. OTnews, 25(3),
Kielhofner G (2008) Model of human occupation: theory and application. 4th ed. Baltimore MD. Lippincott, Williams and Wilkins.
Loftus S, Higgs J (2008) Learning the language of clinical reasoning. In: Higgs J, Jones MA, Loftus S, Christensen N eds Clinical reasoning in the health professions. 3rd ed. Butterworth Heinemann
Mattingley C (1991) The narrative nature of clinical reasoning. American Journal of Occupational Therapy, 45(11),
Melton J, Forsyth K, Freeth D (2009) Using theory in practice. In: Duncan EAS ed. Skills for practice in occupational therapy. Churchill Livingstone
Parkinson S, Di Bona L, Fletcher N, Vecsey T, Wheeler K (2015) Profession-specific working in mental health: impacts for occupational therapists and service users. New Zealand Journal of Occupational Therapy, 62(2),
Parkinson S, Shenfield M, Reece K, Elliott J (2011) Enhancing clinical reasoning through the use of evidence-based assessments, robust case formulations and measurable goals. British Journal of Occupational Therapy, 74(3),
Rex S,(1999) Desistance from offending: experiences of probation. The Howard Journal, 38(4),
Taylor R (2008) The Intentional Relationship: Occupational Therapy and use of self. Philadelphia. FA Davis Company