Model of Human Occupation

1
Model of Human Occupation

• Georgina Wrack, Zarli Treskow and Joel Byrnes

• Long Term Objectives
• Back to full work capacity. During her depressed
  state, Martina has been unreliable, unpunctual
  and not motivated to go to work. After
  intervention, Martina would like to be motivated
  and restore her occupational performance in her
  role as a worker.
• Engaging in meaningful occupations (art, Zumba).
  Through these occupations, Martina hopes to
  restore her occupational life balance. Through
  attending classes, Martina can also meet new
  people and build her support network. Zumba will
  improve her self efficacy, and contribute to
  restoration of endorphins in the brain,
  increasing her mental wellbeing. Martina is very
  passionate about art, and sees it as a
  therapeutic tool, which will help Martina
  incorporate leisure occupations in her life
  (balancing the occupations that she currently
  engages in).
• Martina would like to improve her role as a
  mother. Her occupational therapist feels that
  involvement in a support group for her sons
  condition would be beneficial to her recovery and
  understanding her sons autism (providing
  support, advice and skills).
• Currently Martina sees a psychologist irregularly
  , and when she is feeling overwhelmed or overly
  depressed, she cancels appointments so that she
  does not have to deal with her problems. Her
  occupational therapist has suggested constant
  involvement with a psychologist to determine why
  Martina relapses into depressive states. The
  psychologist will also provide grief counselling
  after the death of Martinas mother (which was
  the cause of her relapse into depression this
  time). Martina has also agreed to attend
  Alcoholics Anonymous meetings as she feels more
  severely depressed when intoxicated, and also
  unable to think rationally or give her son the
  support he needs.
• ENABLERS Lives close to school, town, shops.
  Owns own car. Has a licence. Sister willing to
  babysit. Seeing a psychologist. Gotten past
  depression before. Medication. Enjoys art/ Zumba.
  Support group (help with son). Son at school
  during the day, giving her time to help herself).
• BARRIERS Sons learning difficulty. Mothers
  passing. Low motivation levels, low self esteem.
  Sons soccer training etc. Work roster. Anxiety
  levels. Low support network after mother dying
  (father is mourning). Irrational thought
  patterns. Lack of sleep. No consistency with
  medication. Unreliable car (and she lives 20 mins
  from work).

Introduction Brief description of model.... The
Model of Human Occupation was first published in
1980 by Gary Kielhofner..... The Model of Human
Occupation was applied to Martina, a 31 year-old
woman with a history of chronic depression and
substance abuse. Her 7 year-old son Ben has
recently been diagnosed with a mild case of
autism. Ben was conceived to a man in a one-off
sexual encounter while Martina was intoxicated
(at a time when she was severely depressed and
using alcohol as a support). Bens father is
therefore not present in his life. Her mother
recently died, leading to the return of her
depression. Martinas father lives 2 blocks away
but is currently grieving the loss of his wife.
Martinas older sister lives interstate and
visits once a month, but is currently living with
their father to assist him with the grieving
process.
Model Application Volition) At present Martina
sees herself as a bad mother, as she is unable to
provide ben with the support and patience he
requires due to her depression. This has made
Martina loose her self-worth and feel unable to
cope with her sons condition and everyday living.
Normally Martina prides herself on being a good
mother whom is able to juggle her work schedule,
her sons needs and look after her own health.
Martina usually values a good self image and
enjoys forfilling the role of being a mother and
provider. Martinas interests include painting
and drawing, and attending Zumba sessions at her
local gym. However Since the return of her
depression, Martina has discontinued her
involvement in these occupations. Habituation
Martina has a routine that she follows daily, she
gets her son dressed, fed and ready for school,
walks him to school, comes home and does the
cleaning and is then free to enjoy her zumba and
art interests, until she picks ben up and then
spends time with him doing homework, she gets ben
bathed and fed and they sit down together to
watch their favourite programs on tv, she reads
to ben before putting him to bed. Martina is
employed as a checkout operator at Target three
days a week during school hour and fits her Zumba
classes in on the days she is not working martina
paints on weekends. She also takes her son to
soccer training and a game every Saturday
morning. However since the relapse of her
depression martina has been struggling to keep up
with her routine, as she has been lacking
motivation to do her zumba and art and has been
knocking back work shifts due to feeling unwell
with her depression. She would prefer to sleep
when ben is at school and drink day and night for
comfort. Performance Capacity Martina is quite a
healthy capable woman. She has good
co-ordination, muscle strength, cognitive
functioning, sequencing and endurance skills.
This makes her very capable of carrying out her
worker role, her zumba classes, her role as a
mother and her artistic hobbies. But due to her
depression martina has had no energy and a lack
of interest in doing any of her usual
activities. Environment Martina lives in a two
bedroom townhouse, which is within walking
distance of bens school, shops and public
transport. Her father lives two blocks down the
road. Martina has quite a good social
environment. She has a good work environment, her
boss is approachable and she has a few friends
that are staff. Her gym has a very supportive
environment. Her father living two blocks away
provides martina with a shoulder to lean on when
she requires it and whilest her sister is staying
she is able to drop ben there whenever she needs
time to herself or to go to work.. Skills
Generally, martinas motor skills, processing
skills and communication skills are quite good,
however her depression has affected martinas
communication skills in that she would prefer to
stay at home and keep her problems to herself.
Her processing skills have also been affected as
she has been having irratioinal thought
processes, affecting her occupational roles,
performance, identity, competence and
participation. This is due to martinas feeling
of low self-esteem and lack of motivation to want
to do anything due to her depression, affecting
her occupational balance.
Model Description Within MOHO, humans are
conceptualised as being made up of three
interrelated components volition (the motivation
for occupation) habituation (the process by
which occupation is organised into patterns or
routines) and performance capacity (the physical
and mental abilities that underlie skilled
occupational performance) (MOHO Clearinghouse,
2011). MOHO views therapy as a process in which
people are helped to do things in order to shape
their occupational abilities and identities,
helping to maintain, restore and reorganise their
occupational lives (Forsyth, Kielhofner,
2001). MOHO explores the importance of
understanding physical and social environments in
which occupational performance takes place (MOHO
Clearinghouse, 2011).
Conclusion The MOHO was designed to be applicable
throughout the lifespan, making it relevant to
Martina, who has experienced depression at
multiple times, at different stages and with
different results. Her depression was affecting
her involvement in meaningful occupations.
References MOHO Clearinghouse, 2011. Forsyth, K.,
Kielhofner, G. (2001) Foundations for Practice
in
Occupational Therapy. Chapter 6., p. 69-107.
Elsevier Limited, 2006. Churchill, Livingstone.