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

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

3. MOHO Volition Habituation Performance Capacity
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
Why we chose occupation based model.
Alanna - Page 95 C&T

4. 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.
Megan
Why we chose this FOR CO
Change occurs when self-awareness is increased and through practice of

5. 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
Cassie
SOURCE:
Kielhofner, G., Mallinson, T., Forsyth, K., & Lai, J.-S. (2001). Psychometric properties of the second version of the Occupational Performance History Interview (OPHI-II). American Journal of Occupational Therapy, 55, 260–267.

6. OPHI Narrative
Brandy
Highs and lows of Mandy’s life

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

8. 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,
Katy

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

10. 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
Brandy

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

12. 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
Lauren

13. ACIS Summary Physicality Information Exchange Relations Ineffective
Ineffective/Questionable
Relations
Lauren

14. Goal 1
The client will improve self-awareness as measured by identifying three meaningful life goals in three weeks.
Alanna
MOHO
Toglia – “change” on CO = improve self-awareness
Help her find out what her values you are so you can find roles
manage her finances, have a satisfying routine, accomplish what I set out to do, expressing myself to others

15. Intervention 1 Value Card Sort Occupational functioning problems.
Help Mandy to identify values according to the OPHI- II.
Assisting in increasing self-awareness of values.
Just-right challenge
Megan and Cassie
Chose this due to results of assessments
Helping Mandy find her self-awareness and figure out what she truly values

16. 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”.
Megan and Cassie

17. 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.
Katy
Why this is a good goal
MOHO and TOGLIA (checklist)
Educate her on finances, make budget then complete a grocery trip

18. Mandy’s Daily Routine (TEMPLATE)
Intervention 2
Reusable Checklist
Dry erase board in her room that the 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
5/15
/15
PERCENTAGE
33%
Brandy

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

20. 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.
Lauren
This will establish a routine
Educational intervention
First we decided what was important to Many and she wanted to be financially stable so can provide for her family

21. 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
Lauren

22. Instructional Approach
Acquisitional
Provide a budget planner which will promote self-evaluation
Focus: modify performance skills
Materials: written directions, budget planner
Lauren
We used this approach to guide our intervention for educational purposes

23. 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), doi: Garrett, B. (2011). Brain and behavior (3rd 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), Retrieved from 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: /ajot

24. 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: / ajot Kielhofner, G., & Burke, J. P. (1980). A model of human occupation, part 1. American Journal of Occupational Therapy, 34(9), doi: /ajot 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: /ajot Schell, B.A.B., Gillen, G., Scaffa, M. E. (2013). Willard and Spackman's occupational therapy (12th 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,