Joey is a 38-year-old man with bipolar I disorder who was referred to a clubhouse after setting a fire in his kitchen. He has difficulty completing tasks independently and requires supervision. Treatment goals include improving his ability to complete IADLs like cooking tasks safely, developing coping strategies, and increasing social participation. Interventions include teaching kitchen safety, having him identify triggers and coping strategies, and participating in group activities. Constant supervision is recommended to ensure safety and progress toward independence.

1. Running head: Case Study 2 1
Case Study 2: Joey
Alexandria Amici
OT 421.02: Occupational Performance III: Behavioral Health
Professor Seamon-Zellers
11/21/16

2. Case Study 2 2
OT 421
Treatment Plan/Case Study 2
35 pts.
Student Name: __Alexandria Amici__
Purpose: Students are expected to complete a treatment plan/case study on a patient/consumer
from their Level I fieldwork site. This plan should contain background information, prior level of
functioning, the individual’s strengths and limitations. Students are expected to base this case
study on an interview with the individual and/or observations and information from staff or
medical chart. The interview should be derived from a MOHO or LSPM assessment,
incorporating the patient’s work history and activity interest. This interview information will be
contained within the individual’s occupational profile. A patient stated goal must be included.
Students are to devise 3 long term goals and 3 short term goals for each long term goal. There
will be no sample goals placed on Blackboard, as students are expected to use their clinical
reasoning to develop appropriate goals. Students should have evidence to support several of their
goals and interventions. A minimum of 4 interventions are required per goal. A minimum of 8
references is required, 5 of which must be journal articles. The references should be cited after
the goal or intervention they are validating. Similar to prior case studies for pediatrics, this may
be in outline form, however headings, page numbers, cover page and references should be APA.
Rubric should be paper clipped upon submission. Additionally, pseudonyms should be used and
as dictated by your site, proper consent must be obtained.
Grading:
APA: headings, page numbers, cover pages, appropriate citations, reference page-4
Presentation: organized, spelling, grammar- 5
Content (26 pts):
Occupational Profile: 15
Background information, PLF, Strengths/limitations, Interview results, patient
stated goal
Goals (3 LTG-4 STG per LTG): 5
Interventions: 5
Recommendations (for individuals and or caregivers): 1

3. Case Study 2 3
Occupational Profile
Joey is a 38 year old white male with a diagnosis of bipolar I disorder. Joey was referred
to Hidden River Clubhouse in Pottsville. He became a member of the clubhouse after setting fire
to his kitchen last year. Joey cannot read or write. His prior level of function was to perform all
ADLs and IADLs under supervision. When supervision was not provided, that is when the fire
occurred. He lives in a two story house with his brother, sister-in-law, and nephew. His brother
has a drinking problem and they consistently have Joey watch their nephew so they can go out
for the night. However, it is a bad judgment call to leave Joey taking care of himself, let alone
anyone else. He cannot be trusted with knives or any other potentially hazard objects due to the
inability to work them correctly. Joey is currently not working and performs tasks at the
clubhouse daily. These activities include a range of ADLs, IADLs, and social participation. He is
typically completing tasks for the kitchen area.
Joey currently has difficulty completing IADLs and being involved in social
participation. During groups, he stares at people making them uncomfortable, but does not
realize how is actions are making others feel. He requires many verbal cues when performing
simple tasks. His strengths include the willingness to learn and all of the supportive groups at the
clubhouse. His limitations include not being able to stay attentive to task, not wanting to
complete anything due to depressed thoughts, and unable to socially participate in functions
involving the clubhouse. Joey is now Max A for any activities he completes by having a constant
reminder of what he needs to do next and needing prompting from a supervisor on what progress
needs to be met.

4. Case Study 2 4
For the interview, Joey was assessed using The Model of Human Occupation, or MOHO.
The initial findings are based on the interview and clinical observation. Joey was assessed with
the MOHOST screening tool. MOHOST addresses volition, pattern of occupation,
communication skills, process skills, motor skills, and the environment the client typically
resides in to complete activities (Raad 2015). As Joey is cognitively impaired, the interview
focused mostly on volition, pattern of occupation, communication skills, and some environment.
Motor skills were not needed to be assessed as he has not dysfunction in that area. During the
interview, it was noted that Joey becomes easily discouraged and depressed when he cannot
complete an activity correctly. Some interests of his include watching TV and going to the bar
with his brother on occasion.
For motivation of occupation in MOHOST, it has been concluded that the client inhibits
occupational performance. He is easily bored, requires constant support to remain optimistic, has
difficulty understanding self potential, and difficulty determining what needs to be done. He was
falling asleep during a group meeting. For pattern of occupation, it was noted that Joey has
extreme difficulty staying productive and following a routine, cannot adapt easily to change, and
has a poor sense of belonging for himself. For communication, I observed his social skills. Joey
has poor nonverbal and verbal skills, cannot facilitate conversation, and does not have any
significant relationships due to not maintaining boundaries with others. For process skills, Joey
has difficulty with organization and cannot apply problem solving skills accurately. He has no
sense of timing or routine. The client stated, “I want to make friends and enjoy my time here”
and “I want to be able to complete jobs myself.” Due to all of these deficits, the interventions for
Joey will focus on completing of IADLs, coping skills, and social participation.
Goals: IADLs, kitchen safety

5. Case Study 2 5
 LTG1: Client will complete a cooking task of a boxed meal while staying attentive to
task with supervision in 5 weeks.
o STG1: Client will perform a simple cooking task with Mod A in the clubhouse
kitchen in 1 week.
o STG2: Client will identify what aspects of cooking are most difficult for him by
meeting with therapist 4 times a week to discuss them with 3 or fewer verbal
prompts in 2 weeks.
o STG3: Client will engage in cooking lessons with the other clubhouse members 3
times a week with Min A in 2 weeks.
Interventions
 Joey will participate in the activity of the snack shack. The snack shack is an area of the
kitchen they created to cook food for members upon request. Joey will observe another
member and assist them as needed.
 There will be pictures of the items in each cabinet on the cabinet it is placed in. Give him
a list of the pictures materials needed for a cooking task. Have Joey gather all of the
preparatory materials.
 Joey will participate in a cooking activity that focuses on kitchen safety.
 Joey will discuss three things about cooking that worry him or make him nervous and
learn how to channel those thoughts into productivity.
Goals: Coping Skills
 LTG2: Client will utilize appropriate coping strategies when feeling distraught with
supervision in 6 weeks.

6. Case Study 2 6
o STG1: Client will identify three triggers that may cause distress with Mod A in 2
weeks.
o STG2: Client will determine 2 positive coping strategies for when he becomes
distraught with 3 or fewer verbal prompts in 2 weeks.
o STG3: Client will discuss any feelings of self doubt and create a positive
comment out of them with Min A in 2 weeks.
Interventions
 Joey will be educated on different coping mechanisms to deal with depressed and
distraught feelings that get in the way of occupational participation.
 He will channel his stress into a magazine collage. Joey will choose pictures out of the
magazine that make him happy, have assistance in cutting them out, and glue them onto a
piece of paper. There is no right answer so he will feel successful.
 Joey will participate in a brochure activity with fellow members of the clubhouse. He will
complete a structured activity of coloring on a brochure, then an unorganized free time
activity. It will show him the importance of activity involvement as a coping skill
(Therapeutic Games).
 An uplifting song will be played for Joey. Joey will describe how the song makes him
feel and how it lifted his spirits.
Goals: Social Participation
 LTG3: Client will participate in group socials Thursday nights weekly with 3 or fewer
verbal cues in 6 weeks.

7. Case Study 2 7
o STG1: Client will engage in the daily morning meetings and stay the entire time
with Mod A in 2 weeks.
o STG2: Client will participate in group tasks for the kitchen clean up every day
with Min A in 2 weeks.
o STG3: Client will facilitate conversation with one of the members of the
clubhouse at least once a day 4 times a week with 3-4 verbal prompts in 2 weeks.
Interventions
 Joey will attend the morning meetings at least 4 times a week and maintain appropriate
social boundaries such as not staring at anyone or making inappropriate comments.
 Joey will help the group complete the video activity they do every week talking about the
main projects and lunches going on for that week. He will be able to have a role in
making the video and have fun while doing it.
 A therapist will meet with the group members and Joey. They will be told to take pictures
of people/places that are in public. After bringing the pictures back, they will discuss how
the public and pictures made them feel (Andonian 2010).
 Joey will participate in the gift from the heart activity at a group meeting. Each member
will be assigned to design a gift for another member. This will raise self esteem and
ability to facilitate conversation with that person without anxiety (Therapeutic Games).
Recommendations
Joey will require constant supervision and follow up visits to determine if he is making
any progress with his areas of concern and deficits. It is extremely important that his family and
members of the clubhouse recognize his destructive behaviors and have him channel them

8. Case Study 2 8
appropriately so he does not damage any parts of the environment, himself, or others. It is
recommended that supervision still be provided for safety precautions. It is recommended that
Joey has a supervisor within close proximity of the area he is in to make sure Joey is completing
the tasks he needs to complete and that he follows the routine of the clubhouse and remains
productive. It is recommended someone meet with Joey every morning and discuss how he is
feeling that day and identify if there is anything that can be done to improve his function in that
day. Joey needs support from the clubhouse supervisors and members in order to have a better
sense of self confidence (Vandervoort 2007). This will give him motivation to complete his
occupational activities. As long as Joey remains willing to learn and these recommendations are
set into place, the intervention plan will be effective and successful.

9. Case Study 2 9
References
(2016). Bipolar I Disorder. WebMD. Retrieved from http://www.webmd.com/bipolar-
disorder/guide/bipolar-1-disorder#1
Andonian, L. (2010). Community Participation of People with Mental Health Issues within an
Urban Environment. Occupational Therapy In Mental Health, 26(4), 401-417.
doi:10.1080/0164212X.2010.518435
Berk, M., Berk, L., & Castle, D. (2004). A collaborative approach to the treatment alliance in
bipolar disorder. Bipolar Disorders, 6(6), 504-518. doi:10.1111/j.1399-
5618.2004.00154.x
Minardi, H., & Hayes, N. (2003). nursing older adults with mental health problems: therapeutic
interventions -- part 2. Nursing Older People, 15(7), 20.
Raad, J. (September 2015). Model of Human Occupation Screening Tool. Rehab Measures
Database. Retrieved from
http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=1247
Steinkuller, A., & Rheineck, J. E. (2009). A Review of Evidence-Based Therapeutic
Interventions for Bipolar Disorder. Journal Of Mental Health Counseling, 31(4), 338-
350.
Therapeutic Games. Games for Groups. Retrieved from
http://www.gamesforgroups.com/therapeuticgames.html

10. Case Study 2
10
VAN DER VOORT, T. G., GOOSSENS, P. J., & VAN DER BIJL, J. J. (2007). Burden, coping
and needs for support of caregivers for patients with a bipolar disorder: a systematic
review. Journal Of Psychiatric & Mental Health Nursing, 14(7), 679-687.
doi:10.1111/j.1365-2850.2007.01158.x