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51 Cards in this Set

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MOHO views...
-Views the person as a dynamic system with the capacity to organize and reorganize
MOHO is the extended work of whom?
-Mary Reilly
What systems theory did MOHO evolve from?
-Open systems theory (1968)
-General systems theory (1968)
-Dynamic systems theory (1996)
What theory is acknowledged in the most recent revision of MOHO?
Chaos theory (2002, 2008)
What was the original systems theory view of MOHO?
-It proposed that we should recognize the universe as interconnected and interdepended
-It drew from science and a cybernetic mechanistic analogy
-It allowed for predictions about functioning
What was the general systems theory version of MOHO?
-Developed to explain processes of living phenomena
-Original insights came from biology
-Still maintained that changes in any part affected the whole
-input->throughput->output->feedback
What systems theory version can change occur in any part of the system and may ripple change in any direction?
Dynamic Systems Theory
In what systems theory version can order arise out of chaos?
Dynamic Systems theory
True or False:
The dynamic systems theory is more heterarchial versus hierarchiacal.
True. More heterarchical
What was one of the first comprehensive models to consider performance in context?
Dynamic system
What are the main concepts of MOHO?
-The motivation for occupation.
-The routine patterning of occupational behavior.
-The nature of skilled performance.
-The influence of environment on occupation.
Other unique qualities of MOHO
-Acknowledges the traditional developmental periods and development achievements.
-Recognizes that one’s life story is unfolding and has respect for past events and situations that impact current behavior.
-Accepts that behavior needs to be observed.
-Confirms that occupation is individualistic, dynamic and context dependent.
The change principles of MOHO does not mean more or less but...
...but a different form of organization for the system.
...adding choices is a mode of change.
What are the three levels of change?
1. Exploration
2. Competence
3. Achievement
When is the human system considered functioning?
-It is considered functioning when order exists in the system.
When is the human system considered dysfunctional?
-Loss of roles
-Low motivation
-Extreme changes in environment
-Lack of skills in the performance area
-Refusal to engage in regular habits
True or False?
Dysfunction is not a state but a process that is continually changing over time.
True!
-Occupational dysfunction is demonstrated when there is impaired occupational performance
-The person has difficulty choosing, engaging or performing occupations and the quality of life is diminished
What are 3 subsystems within MOHO?
1. Volition (motivation)
2. Habituation (habits, routine, and roles)
3. Performance Capacity (skills)
Volition:
-Personal causation: beliefs and efficacy
-Values
-Interests
-Flow
Volitional Process
-Implies acting upon one's motives or how one goes about making occupational choices
Habituation
-Habits and roles
What is habituation structure?
-Habits are done so frequently they are routine or predictable
-automatic level
-Learned
Occupational Circumstances Assessment-Interview and Rating Scale (OCAIRS)
-Interview
-Interview yields information to assess values, goals, personal causation, interests, habits, roles, skills, readiness for change, and environmental impact on participation.
-Used to generate goals and assess outcomes/changes in participation.
Occupational Self Assessment (OSA)
(COSA is the child's version)
-Client self-report
-Clients rate their occupational competence for engaging in 21 everyday activities and the importance of those activities. Allows clients to set priorities for change
-Used to generate goals and assess outcomes/changes in competence and values.
Pediatric Volitional Questionnaire (PVQ)
-Observation
-Guides a systematic observation of a child across multiple environment ts to assess volition and the impact of the environment on volition.
-Used as an in-depth assessment of volition to generate goals and assess outcome/changes in volition.
Occupational Performance History Interview-II (OPHI-I)I
-Interview
-Detailed life history interview that yields (1) scales measuring competence, identity, and envirnmental impact, and (2) a narrative representation/analysis of the life history.
-Used as an in-depth, comprehensive assessment to generate goals, inform intervention, and build therapeutic relationship.
Volitional Questionnaire (VQ)
-Observation
-Guides a systematic observation of a client across multiple enveronments to assess volition and the impact of the environment on volition.
-Used as an in-depth assessment of volition to generate goals and assess outcomes/changes in volition.
Assessment of Occupational Functioning -Collaborative Version (AOF-CV)
-Interview and/or client self report.
-Yields qualitative information and a quantitative profile of the impact of a client's personal causation, values, roles, habits, and skills on occupational participation.
-Used to inform intervention.
Comprehensive Occupational Therapy Evaluation (COTE)
-Look at how specifically a therapist must observe current occupational performance
-Look at how specifically a therapist must document what has been observed
-Look at the graphing of the particular behaviors
-This paper presents the Comprehensive Occupational Therapy Evaluation Scale (COTE Scale) for use by occupational therapists in short-term, acute-care psychiatric facilities. The scale defines 25 behaviors that occur in and are particularly relevant to the practice of occupational therapy. The scale is used as an initial evaluation, as a record of patient progress, and as a means of communicating the evaluation, progress, and treatment to other hospital departments. Ratings of patients that indicate improvement and readiness for discharge are supported by the evaluations of other disciplines.
Who is cognitive behaviorism better used with?
High functioning adults
What does the cognitve behaviorism approach aim to do?
Teaches clients to identify a particular behavior they want to change and then examine the thinking processes associated with that behavior in order to facilitate change.
What are some examples of when using cognitive restructuring approaches in OT is appropriate?
-Pain management
-Stress management
-Health education and prevention modules
-Anger management
-Time magagement
Using Learning theory concepts in OT
-Observe and document current behavior
-Identify clear outcomes with the client
-Use a teaching/learning method with demonstration as needed
-Verbally summarize the learning points of the session at the beginning and at the end to reinforce and shape learning
-Emphasize generalization from clinic situation to home context
What is the behavioral frame of reference's focus?
-Here and now
-Specific observations of behavior
-Targets change and writing of measureable behavioral goals
-Future oriented and intent on changing something
-Works best in a very structured and controlled setting
-Precise, detailed—not necessarily aimed at the big picture
Reinforcer
any event increasing the frequency of a behavior
Shaping
reinforcing the individual small steps required for a larger behavior or goal
Feedback
information that can be positive or negative in influencing one’s behavior
Generalization
being able to apply what an individual has learned in one situation to another situation
Discrimination:
being able to determine what is appropriate in one situation and what is inappropriate in another
Token economy
persons are given points or tokens for appropriate behavior that can be exchanged for special privileges or items
Splinter Skills
-A specific motor or mental skill that is performed only under particular conditions
-Performed in a specific context
-For example:
Learning to be polite and cooperative as a patient in the hospital or in clinic settings, but when returned to the home or school setting the person reverts to inappropriate behaviors
What is the "lived body"?
-“ This concept derives from the work of philosophers who argue that the body must be understood as a site of experience” (Kielhofner, 2008, p.20)
-Helps to know as we observe, evaluate and endeavor to improve performance of a client that we recognize the individualistic and contextual experience that affects performance from the client
How does environment influence behavior?
-Opportunities and resources for performance; evokes interest
-Demands and constraints for particular behavior; also stimulating
What are the dimensions of doing?
Demands and constraints for particular behavior; also stimulating
Participation
refers to engagement in work, play or activities of daily living
Performance
completing an occupational form
Skills
process skills, motor skills and communication skills
Occupational identity
sense of who one is and wishes to become
occupational competence
degree to which one sustains participation that reflects occupational identity
occupational adaptation
incorporates a positive occupational identity and achieving occupational competence over time in the context of one's environment.
When using MOHO to guide treatment intervention decisions
-Must be related to overall occupation of the person– always client centered
-Change in any part of the subsystems will affect the whole
-Should always identify strengths as well as areas to change
-The MOHO uses a holistic understanding of the client’s strengths and deficits within his/her environment