DCM OCT1111
November 29/04
Questions Address in Paper Submitted
*** Find it useful to separate past and present for questions with a chart!
1. From your perspective which one of the 2 models offers a better framework for
your analysis? Provide rationale for your choice.
MOHO
 Person
o Volition - Judith’s
 Personal causation
 Values
 Interests
o Habituation
 Habits
 Roles
o Performance Capacity
 Subjective – asking person of their view of things
 Objective – looking at the components (motor skills, process skills
Occupational Adaptation = P & E Fit

Environment
o Physical Environment
o Social Environment

Occupation
o Occ. Forms = purposeful, understood, culturally influences set of actions
o Occ settings = meaningful context for O
o Occupational Competence (skills of individual; sustained pattern of
occupation participation – who you are as a person)
o Occupational Identity (sense of self as an occ. Being – who you are, who
you want to be, based on who you were)
These concepts are linked to provide occupational adaptation
MOHO Applied to Judith
Past
Person
Volition
Personal causation
 Drug-use
(sense of
“competence”
competence and
 Math she felt she was
effectiveness)
good at
values
 Doing drugs

interests
 using drugs
habits
Habituation
Habits
Roles
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
Performance
Capacity
Subjective

Objective
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
Environment
Physical
Social
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Present

Needs increase competence

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
motherhood (wants her kids back)
being clean (sober)
crafts (?)
cooking skills
going back to school
making friends




Room-mate
“Mother”
Member/client of rehab program
Starting to become a friend (becoming
one)
Affective –
depression
Math (perhaps
problem solving)
Affective –
depression




Starting to make friends (maybe)
Cooking – basic skills
Cooking
Friendships – inter-actional skills (would
need to do more assessment as OT)
Physical health is good (?) – capacity for
motor movement …
Crack house

Family & associates
were doing drugs
Grandma (only clean
& sober; provided
support)
Children were in and
out of foster care
after grandma died

Getting & using
drugs
“Mother”
Patient/client
Drug user
Grandchild
Student




Apartment & setting of the program she
attends
2 roommates also in rehab (same
program)
Therapists and counsellors (including OT)
Child of 2nd roommate lives in apartment
(assumption!)
family is still doing drugs and not
supportive of her sobriety (assumption) 
relapse research should be included to
support this position
Past
Occupation
Occ. Forms

Present
doing drugs
Occ. Settings
Occ. Competence
Occ. identity
EHP applied to Judith’s Case
Past
Person
Skills (unique to the
person):
sensorimotor,
cognitive,
psychosocial
Meaning associated
with task is specific
to the person
Tasks

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
self care
cooking
cleaning
laundry
diapering
feeding
nursing
bottle feeding
give attention
play
bonding with child

Present


demonstrating independence and fit
parent – that she can look after her
children
cooking (related to parental role &
independent person
 basic child care tasks (Parent role)
 Money Management (parental and
independent role)
* tasks may overlap over a number of roles
and learning tasks is a way of
increasing/learning skills and abilities
(illustrated by Fig. 3 in article)
EHP Cont’d
Context
Temporal
(chronological)
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Environment

Cultural - drug culture;
everything tied up with
getting and using drugs

21 years of age (chronological)
Young adult (development phase)
Aspiring parent
Learner (perhaps aspiring to)
Worker (perhaps aspiring to)
Physically healthy but a
recovering/struggling with recovery
(Health status)
One year in program (period) – US
Physical – apartment; physical rehab
setting
Social – therapists, roommates, family
situation (not supportive) – NB in
terms of resources
Cultural - drug rehab setting goals are
different
Performance


Performance Range
- goal with Judith is

to increase her pr so
that she can cope
with her children,
her own life and
with her recovery
struggle
Interventions
Establish & Restore
(targets the person)
Alter (targets
context)
Adapt/Modify
(targets context or
target)
Prevent (targets:
Person, context, task
or some combination
Create ( target:
Limited support form
important others in
her life



Self-care (wants to perform tasks
related to
Care-giving
Limited support from others outside
program (family and community)
Limited skills & abilities
Goal would be increasing support or
limited skills and abilities (one or the
other or both) so that performance range
can be expanded

Establish skills related to parenting or
restore math skills
(These are examples of what we can do)
 Look at Judith’s skills and the context in
which she is in (don’t want her to be
overwhelmed)
 For cooking maybe put her in an
environment where people are at her skill
level or that they have gone through the
same things that she is and they are giving
her tips (so a cooking group for mom’s
like her)



Prevention maybe a huge thing for Judith
– preventing from feeling discouraged;
Judith has a lot of things ahead of her
person, context, task
or some combination


Need to build up skill and abilities but Judith will also be entering community so
needs to develop support in the community so her environment will support what she
needs to do (so links between skills & abilities and supportive network)
Part of self-care may be recovery
National Institute on Drug Abuse www.drugabuse.gov/stressanddrugabuse.html
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CAN MAKE ASSUMPTION ABOUT JUDITH’S BACKGROUND
ASSUMPTION IS THAT IT IS A US CASE