occupational therapist theory

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OT 321
Using MOHO in Practice
CH 44 in W & S
Noor Ismael, PhD, MSc, OTR/L
8/10/2019
Six Steps of Therapeutic Reasoning using MOHO
• Generating Questions
• Gathering Information
• Creating a Theory-Based Understanding of the Client
• Generating Therapy Goals and Strategies
• Implementing and Monitoring Therapy
• Collecting Information to Assess Outcomes

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1) Generation Questions
• A therapist who uses MOHO generates questions about the client
regarding his or her: environmental impact, volition, habituation,
performance capacity).
• For example, asking clients about their feelings regarding personal
causation, roles, interests,….
2) Gathering Information
• After generating questions, we need to find ways to answer them.
• We have a wide range of MOHO assessments (see table 44.2)
• For Example:
1- MOHOST
2- Interest Checklist
3- Role Checklist

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3) Creating a Theory-Based Understanding of the Client
The assessments that we used to gather information generates
strengths and challenges in volition, habituation, performance capacity
or environment.
4) Creating therapy Goals and Strategies
• Goals indicate the type pf changes that therapy will aim to achieve
• For example, the client feels in-effective, the therapy will help him
feel effective. Also, if the client has a few roles, therapy will help find
new roles.
• MOHO also provide therapeutic strategies. See next slides and table
44.1.

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Therapeutic Strategies Identified by MOHO
1) Validating: Attending to and acknowledging the client’s experiences
2) Identifying: Locating and sharing a range of personal, procedural,
and/or environmental factors that can facilitate occupational
performance.
3) Giving feedback: sharing your understanding of the client’s situation
or ongoing action.
4) Advising: Recommending intervention goals/strategies
5) Negotiating: Engaging in a give-and-take with the client
Therapeutic Strategies Identified by MOHO
6) Structuring: Establishing parameters for choice and performance by
offering a client alternatives setting limits, establishing ground rules
7) Coaching: Instructing, demonstrating, guiding, verbally or physically
prompting.
8) Encouraging: Providing emotional support and reassurance in
relation to engagement in an occupation.
9) Physical support: Using one’s body to provide support for a client to
complete an occupational form/task