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Occupational Theoretical Approach: People And Environment

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Discuss about the Occupational Theoretical Approach for People and Environment.



Cognitive retraining

It is a therapeutic approach that I would focus on grooming on clients with cognitive defects so as the shortcomings would be overcome. For example, keeping him repeating some of the activities such as how to make his lunch and attend to his laundry to facilitate learning of some new skills and develop the ability to solve some problems on his own. Some of the areas to train include triggering the memory by involving him in decision making,  training him on the executive skills, how to organize himself, making him more attention and be able to concentrate on the retraining practices, jogging the memory on memory retraining and being able to reason for himself (Priyamvada, Ranjan & Shukla, 2017).

Peo Model

This is an approach that I would use to examine the person's interaction with the other clients. It is subsequent of the dynamic international method that I would use to explore the occupation and the setting of the person. I would also use the PEO model (Metzler & Metz, 2010) approach that would involve bridging from the bio Medicare care to social-cultural model and provide tools to have organized evidence for practical use. I would also use the MOHO approach in such a way that I could explain how his schedule has been assembled, raised and motivated (Lee, Kielhofner, Morley, Heasman, Garnham, Willis & Taylor, 2012). The conceptual criteria that I would use include the client-centered practice whereby I would practice client-centered consistently. The other plan is the family-centered whereby I would partner with the family in monitoring whether the client is adapting to what I teach him. I would, therefore, allow the family to present their case educate the professional to learn to adhere accordingly to the client. I would also use an approach of information processing to improve the perception processing of information.


Strategies for assessing

The procedure for evaluating the client varies from the short-term conditions to the long-term requirements. On the short-term, the NHS would provide an occupational therapy. On the long-term, I could access the OT through my local council. I would also ensure that I'm fully qualified and registered with a recognized body, eg. BAOT.

Assessing the needs. This is done by carrying out a health and sociocultural assessments to figure out which areas are causing problems to the everyday. I would also identify the equipment to use such as the bed to ensure that he attends the bed every day and as well the laundry to ensure he grasps how to attend to his clothes (Krebs, Cruz, Monzani, Bowyer, Anson, Cadman & Mataix-Cols, 2017).

Equipment cost.  In case the prior assessment has demanded a piece of equipment, it can be gotten either on free or on a charged fee.

Equipment for employment. In case of need for equipment, the work scheme may be able to provide funding. It would also be necessary to source advice either on how to use the material or to add on the existing knowledge on how to handle a client. These assessments include;


This is the act of being worn which is caused by exhaustion. Under this, what I would assess is the Modified fatigue impact, scale, 25-foot walk, assessment of the equipment, the sleeping questionnaire among others.

Walking difficulties

What I could examine the walking challenges includes the manual muscle test, 6 and 25-foot minute walk, the analysis of the gait, the environmental analysis and tasks. 


The assessments would include the analysis of the gait, the review of the environment and the tasks, the evaluation of transitional movements.

Poor balance or the fall risk.

The assessments would include the 6 and 25-minute foot walk, the manual muscle test and the timed up and go.

Stiffness, spasms, spasticity

The assessments include the range of motion, the modified Ashworth and continuous communication with the neurologists.


This would include the clinical bulletin and the pain in muscle multiple sclerosis.


Poor vision

This would include the clinical bulletin and diagnosis management of poor vision problems.

Adolescence sensory profile

This would be important to improve the behavior of the client on everyday sensory experiences.

Evaluation of his handwriting.

The handwriting of the client should be improved as from his childhood experiences in writing. The assessment would be done on his books and the papers he writes on and encourages on a proper and suitable handwriting.

Practitioner assessments

This is the clinical assessments of the fitness to perform tasks such as driving, which is administered by the occupational therapists and clinical driving rehabilitation specialists. 

Family assessments

This refers to the fitness to drive screening. It also includes the relations records between the family members and the clients and his improvement on the relations overdue.


Why use the assessments

The fundamental importance of the evaluations is to help the pediatric occupational therapist design a useful program that will aim to improve the deficiencies of the individual (Ciucurel & Iconaru, 2012). The individual then works on the occupational therapist, developing essential skills to help in the improvement of the client’s life. This is so since the OT evaluations help to determine the areas a client is experiencing a deficiency in.

The data would be collected using both the standardized and non-standardized assessments.  The client's data is recorded by an individual as part of the patient's accessories inventory cards. The information recorded here is the simple information that can be retracted quickly from the patient. For example the client's appetite, sleeping duration, cognitive abilities among others.

The short-term goals are achieved in a shorter duration of time, unlike the long-term goals that take longer to effect. These goals when they work and succeed helps the patient learn to be independent. The goal that I would ensure that Michael has performed as a short-term OT goal is the making up of his bed and performing other household chores such as washing utensils and attending clothes on a laundry. This would be attained by continuous repetition of the same thing and allow him to perform under the supervision and gradually perform on his own (Bar & Ratzon, 2016). On the other hand, the long-term goal could mean that the client has reached the ultimate goal. This means that he can live independently fully with his disability. He may even perform better without the aid of the therapist. This would take even more than a year to achieve fully. My ultimate goal here as the guider would be to ensure that he can live a better standard life, work unaided and be able to perform other tasks such as car driving (O’May, McWhirter, Kantartzis, Rees & Murray, 2016).

Task analysis

Job details



Step by step


Long-term goals


Occupational Therapy records and goals



·         Walking 6 minutes every day

·         Take a shower by himself

·         Learn how to pronounce words and learn new words every day

·         Feed himself once in every week

·         Attend to laundry

·         Attend to his bed

·         Learn how to use a computer mouse

·         Send him to shop

·         Teach him to feed himself

·         Pick something on the floor

·         Climb on a ladder

·         Take care of a pet

·         Make his bed and room tidy

·         Go to  a normal school

·         Earn by himself

·         Drive a vehicle

·         Live a normal life

·         Ability to read and write

·         Ability to live alone

·         Be able to ride a bicycle

·         Have a general sense of well being






Purpose of session

Planned therapy session

Week one



·         25-metre 6 minute walk

·         Learn new words

·         Understanding clients life experience

·         Manage and control treatment

Week two



·         Make his bed

·         Keep his room tidy


Week three



·         Teach him how to write

·         Learn how to use a computer mouse

·         Maintaining appropriate hand strength

·         Stabilization of the books when writing

·         Visualizing what he has learned.

Week four



·         Identify and take care of his pet

·         Feed himself

·         Cook

·         Learn to be responsible

·         Learn to be independent

·         Carry out certain tasks individually

Week five



·         Put him in a crowd

·         draw

·         learn communication skills

·         Improve the ability to be creative.

·         Learn how to socialize with the people especially members of the opposite sex

An outcome measure is an assessment that can be reliable in helping someone count on the real changes that have been noted in patients regarding the OT treatment that has been provided. It involves pursuing tests and using that analysis to treat and determine the outcome. I would use the any of the two outcome measurements. These include the Functional Autonomy Measurement System (SMAF) and the assessment of motor and process skills (AMPS) (Ayres & Panickacheril John, 2015). The SMAF is an instrument or a tool used to measure the needs of an older adult or a disabled person. It can perform 29 functions in 5 different sectors inactivity. These activities are such as the mobility function, daily living activities, communication, and cognitive dysfunctions. On the other hand, the Assessment of Motor Process Skills can be used to measure how the client is performing the daily activities. Its main advantage is that it can be used with any client. It uses software to produce an AMPS results that include the client’s measures. An outcome measure is vital in the management of a patient care, and for the opportunity, they give the profession in comparison and efficient determining.



This is a model that describes the theory and the clinical application in the interaction of a person by the people, environment and the occupation. It, therefore, consists of three components namely the person, the background and the occupation of the individual. The intervention plan would be significant in that it would help identify whether the P.E.O. has achieved it in determining the situation of Michael. Therefore, the components of the P.E.O (Maclean, Carin-Levy, Hunter, Malcolmson & Locke, 2012), would be of great importance in assessing the effectiveness of the intervention plan. On the person component, the focus of the behavior of the individual would, therefore, be noted. These ate such as the motivation seen in the person, the levels of interest, the degree of autonomy, skills being developed in the person, emotional changes among others. I would, therefore, be in a position to know the progress of the individual skills on a basic personal level (Hébert, Kehayia, Prelock, Wood-Dauphinee & Snider, 2014). The environment can be defined primarily as the surroundings. It can be categorized as socioeconomic, cultural, physical and the social environment. It would be therefore necessary to see to it that the client has this in his evolution and can participate and relate well to the environmental activities. Occupation is the tasks that an individual is involved in his lifespan. The intervention would be critical in such a way that it would monitor the progress of the individual in pursuing his daily tasks and his occupation at large.



Ayres, H., & Panickacheril John, A. (2015). The Assessment of Motor and Process Skills as a measure of ADL ability in schizophrenia. Scandinavian Journal Of Occupational Therapy, 22(6), 470-477. doi:10.3109/11038128.2015.1061050

Bar, M. A., & Ratzon, N. Z. (2016). Original article: Enhancing Occupational Therapy Students' Knowledge, Competence, Awareness, and Interest in Accessibility. Hong Kong Journal Of Occupational Therapy, 2718-25. doi:10.1016/j.hkjot.2016.04.001

Ciucurel, C., & Iconaru, E. I. (2012). Occupational Therapy for Children with Down Syndrome – a Case Study. Procedia - Social And Behavioral Sciences, 46(4th WORLD CONFERENCE ON EDUCATIONAL SCIENCES (WCES-2012) 02-05 February 2012 Barcelona, Spain), 3825-3829. doi:10.1016/j.sbspro.2012.06.154

Hébert, M. J., Kehayia, E., Prelock, P., Wood-Dauphinee, S., & Snider, L. (2014). Does occupational therapy play a role for communication in children with autism spectrum disorders?. International Journal Of Speech-Language Pathology, 16(6), 594. doi:10.3109/17549507.2013.876665

Krebs, G., de la Cruz, L. F., Monzani, B., Bowyer, L., Anson, M., Cadman, J., & ... Mataix-Cols, D. (2017). Long-Term Outcomes of Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder. Behavior Therapy, 48462-473. doi:10.1016/j.beth.2017.01.001

Lee, S. W., Kielhofner, G., Morley, M., Heasman, D., Garnham, M., Willis, S., & ... Taylor, R. R. (2012). Impact of using the Model of Human Occupation: A survey of occupational therapy mental health practitioners' perceptions. Scandinavian Journal Of Occupational Therapy, 19(5), 450-456. doi:10.3109/11038128.2011.645553

Maclean, F., Carin-Levy, G., Hunter, H., Malcolmson, L., & Locke, E. (2012). The usefulness of the Person-Environment-Occupation Model in an acute physical health care setting. British Journal Of Occupational Therapy, (12), 555. doi:10.4276/030802212X13548955545530

Metzler, M. J., & Metz, G. A. (2010). Analyzing the barriers and supports of knowledge translation using the PEO model. Canadian Journal Of Occupational Therapy, 77(3), 151. doi:10.2182/cjot.2010.77.3.4

O’May, F., Gill, J., McWhirter, E., Kantartzis, S., Rees, C., & Murray, K. (2016). A teachable moment for the teachable moment? A prospective study to evaluate delivery of a workshop designed to increase knowledge and skills in relation to alcohol brief interventions (ABIs) amongst final year nursing and occupational therapy undergraduates. Nurse Education In Practice, 2045-53. doi:10.1016/j.nepr.2016.06.004

Priyamvada, R., Ranjan, R., & Shukla, P. (2017). Cognitive Retraining in Subdural Haematoma. Indian Journal Of Clinical Psychology, (1), 41.


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