Running head: OCCUPATIONAL PROFILE, ANALYSIS

Occupational Profile, Analysis, and Intervention Plan

Melody Klatt
Touro University Nevada

OCCUPATIONAL PROFILE, ANALYSIS

Occupational Profile
The Client
The client is a 45-year-old male named Bobby, who was admitted to Spring Valley
Hospitals inpatient rehabilitation unit due to the fact that he experienced a cerebrovascular
accident (CVA) 15 days prior to this interview. Bobby is unmarried and lives in a second-floor
apartment with his dog, who is currently in the care of his brother. Bobbys brother works from
home and Bobby reported that he is the only family member of his that lives in the area, though
Bobby has other close friends that are a source of support for him.
Occupational History, Values, and Interests
Bobby was employed full-time as a security officer at a local resort casino prior to his
admission to the hospital. He reported having worked at several different casinos before settling
in his current position, and he worked in security at local malls before that. He stated that his
job is a bit stressful, but he has never minded it much. When asked about his leisure interests,
Bobby stated that he enjoys playing poker with his brother and a group of friends on Wednesday
nights, which had been a long-standing tradition prior to his admission to the hospital. Boating
on Lake Mead was also reported to be a leisure activity that he occasionally enjoys, and he
added that fishing is an activity he has enjoyed since he was a boy. He went on to state that
family time, playing poker, participating in outdoor activities such as hiking, training his dog,
and occasionally traveling were also primary leisure interests to him. He reported that his
parents moved to Texas two years ago, and he and his brother always try to visit them once a
year during Christmastime.
Bobby also discussed life values that he holds, such as being punctual and dependable,
and following through on commitments. He stated that paying his brother back for the help he
has provided in caring for Bobbys dog is important to him, and that he plans to make that a

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priority once he has finished with his recovery. For right now, however, he reported that his
primary goal is to make sure that he can take care of himself and be as independent as possible
while living at home.
Roles
Bobby identified several roles that he considers to be a very important part of his life.
He reported that he is a doggy daddy, a brother, a friend, and an employee. He verbalized that
because he never had children and lives alone, his dog is like his child and best friend. Bobbys
brother is also an important friend and family member to him, and he stated that he does not
want to burden his brother with having to care for him, which is a significant motivator for him
in his recovery process. He expressed that being an employee is important to him because it
pays for his costs of living, and because it is the place where he met the majority of the friends
that he plays poker with.
Patterns of Engagement in Occupations
When discussing his patterns of engagement in occupations, Bobby stated that he
prioritizes what he prefers to do and makes sure that those things are incorporated into his
schedule. He reported that his preference for things to be organized and on time started
approximately 10 years ago, and he stated that his schedule has remained relatively the same
since. Prior to the time when that started, he reported being more spontaneous and focused on
engaging in work rather than making sure that leisure time had its place. When asked further
about the daily routine that he had at home, Bobby reported that his routine was as follows:
Wake up, brush teeth and shower, eat breakfast, let out his dog, feed his dog, make and pack a
sandwich and water bottle for lunch, go to work, come home, let out the dog, eat dinner, feed
the dog, take the dog for a walk, wash dishes, clean up or pay bills if needed, watch TV or meet
with friends, brush teeth, dress down, and go to bed.

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Reason for Seeking Services

Bobby is currently receiving skilled OT services to address motor and self-care deficits
secondary to the right hemiparesis that he is experiencing as a result of his diagnosis. He also
presents with a two-finger right shoulder subluxation, 30 degrees of active elbow flexion, 20
degrees of shoulder abduction and zero degrees of range in his wrist on the affected upper
extremity. He also reported that recently he has begun to experiences a twitching sensation in
the third and fourth digit of his right hand.
Bobby expressed concerns in relation to his independent functional status, particularly in
regards to completing self-care skills while alone at home, being able to take care of his dog,
and being able to participate in activities with his friends and family. He also stated that he
would like to return to work, but reported that standing for long periods of time, walking
distances, speaking through the radio and using both hands were important for his job as a
security officer, and he doesnt feel as though he can meet those requirements at this time. He
expressed that his priorities in treatment are to first be able to take care of himself, and then to
be able to take care of his dog, and then to start participating in activities with friends and
family.
Successful Occupations and Barriers
When asked what occupations he feels successful in, Bobby verbalized that he doesnt
feel successful in anything that he is currently doing. With prompting he amended this
statement and added that he feels that he has recently become better at moving his fingers. He
identified barriers that he believes are hindering his ability to be successful in his valued
occupations, which include having decreased strength, endurance, motor movement, motor
coordination, and difficulty with speech. When asked about recent successes with gaining back
movement in his affected upper extremity, he expressed frustration with the fact that he feels

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that he cannot use his right arm and hand. He also reported that his speech bothers him because
its embarrassing that he sounds like he is drunk and has to keep repeating himself while
conversing with others (Bobby F., personal communication, May 14, 2015). However, later in
the interview, he added that he felt that his speech was slowly improving with the help of speech
therapy and practice.
Environmental Supports and Barriers
Bobby reported that he is currently inhibited from engaging in desired occupations
because of the amount of assistance that he requires to complete daily tasks. He stated that the
only time he has been out of bed and moving since his admission to the hospital is during
therapy, and as a result, his dynamic sitting balance and protective responses on his affected side
are poor. At home, he reports that his brother will be his main source of motivation to do
whatever he can for himself, which is encouraging to him. However, being in a second story
apartment unit means that he wont be able to go shopping, take his dog out, or get the mail
without help until his balance and strength have improved for stair navigation. He reported that
he may attempt to ask to be moved to a lower unit in the apartment building, depending on the
state of his recovery.
Priorities and Desired Outcomes
Regarding his priorities, Bobby verbalized that taking care of himself, taking care of his
dog, being able to participate in poker nights and leisure activities with friends, speaking well
enough that people could understand him, and eventually returning to work were the most
important to him. He stated, Even if it takes me longer or I need something to help me, I just
want to be able to do it (Bobby F., personal communication, May 14, 2015). He reported that
he is not worried about visiting his parents or traveling at the moment. He expressed that his

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first goal is to be able to do basic self-care tasks for himself in his daily life, and after that he
will pursue improvement in other activities.
Occupational Analysis
Bobby was seen by his occupational therapist in his room for a self-care showering
activity in the rehabilitation unit. He was able to transfer from supine to sitting edge-of-bed
with moderate assistance, don a subluxation sling with maximum assistance, complete a standpivot transfer to his wheelchair with maximum assistance, adjust himself in the chair and propel
himself to the bathroom with minimal assistance using his left upper extremity and left foot, and
transfer from his wheelchair to a shower chair with maximum assistance. He was able to doff
his shirt with minimal assistance and his lower body clothing with moderate assistance in
standing and then sitting. He required moderate assistance overall with washing his skin, and
was able to wash his hair with set-up assistance. He occasionally dropped the shower
attachment and required assistance with retrieving it.
During the activity, Bobby appeared to be highly motivated to do well, but was
occasionally impulsive during transfers. He appeared to become frustrated when dropping the
shower attachment, but demonstrated some good problem-solving skills with ways that his
flaccid right arm could assist with holding items down while reaching with his left upper
extremity for other items. He appeared to have difficulty with learning and utilizing techniques
given by the therapist while doffing his clothes, verbalizing, Ive dressed myself for over 40
years and now Im Benjamin Button (Bobby F., personal communication, May 14, 2015).
Domains that appeared to most significantly impact Bobbys performance in this activity
were client factors and performance skills. Performance patterns and context and environment
also affected his success with this task, but not as significantly. He appeared to be most affected
by his physical motor limitations (strength, endurance, active range of motion) and his difficulty

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with communicating. When he required multiple trials to succeed with a specific motor
movement he appeared to become frustrated, and at the same time he became too fatigued to
attempt to communicate. He compensated by taking frequent rest breaks as well as extra time
prior to replying to the therapist, but it was noted that he would have required less trials and
would have become less frustrated if those client factors and performance skills were not as
heavily affected. To successfully engage in these tasks, the factors that are significantly
impacting his success are his inability to effectively use his affected upper extremity, his
decreased strength on his right side, his decreased balance, and his decreased endurance.
Problem List
A list of problems statements were composed for Bobby in regards to his functional
performance and are stated as follows:

Bobby is unable to dress himself without assistance secondary to decreased active

range of motion and strength in his right upper extremity.

Bobby is unable to bathe himself without assistance secondary to decreased strength,

decreased endurance, decreased active range of motion in his right upper extremity,
and decreased balance while sitting and standing.

Bobby is unable to complete toileting without assistance secondary to decreased

strength, endurance and balance while sitting and standing.

Bobby is unable to complete grooming and hygiene tasks without assistance

secondary to decreased strength, endurance and balance while sitting and standing,
as well as decreased active range of motion in his right upper extremity.

OCCUPATIONAL PROFILE, ANALYSIS

Bobby is unable to prepare meals without assistance secondary to decreased active

range of motion in his right upper extremity, decreased standing balance and
decreased endurance for functional mobility and standing.

Bobby is unable to care for his dog without assistance secondary to decreased
strength, endurance and standing balance, as well as decreased active range of
motion and strength in his right upper extremity for holding and tipping the food
bags and water jugs.

Bobby is unable to participate in a routine card-playing leisure activity secondary to

decreased active range of motion, strength, and fine motor skills in his right upper
extremity that are required for card manipulation.

Problem statements in regards to bathing and dressing will be prioritized for Bobby, as
he verbalized several times throughout his interview that he would like to be as independent as
possible in self-care activities so that his brother will not be left with the burden of caring for
him. Bathing encompasses functional movements required for toilet hygiene (i.e. active range
of motion, grasp, etc.); therefore, improving in this skill will assist Bobby with improving in
that task as well. Dressing is also an essential component of self-care, and similarly to
bathing becoming more proficient in this activity will help Bobby to become more proficient
in other tasks that require skills such as active range of motion, endurance, and fine motor skills.
Other activities such as grooming and hygiene, taking care of his dog, and participating in
leisure activities with friends were prioritized in this order. This appeared to be the hierarchy of
his concern during the interview.

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Intervention Plan and Outcomes
After conducting the interview and analysis of occupational performance with Bobby, a
treatment plan has been developed for him. Two long-term goals, with two short-term goals
supporting each one, have been identified, and specific interventions pertaining to these goals
will be discussed in this section. The goals were created in collaboration with Bobby, and the
interventions that have been chosen for him were created to be relevant to the priorities that he
identified and the occupations that are important to him.
Long-Term Goal 1
The first long-term goal that was established for Bobby is stated as follows:

In 4 weeks, the client will demonstrate the ability to dress his upper and lower
extremities cc Mod (I) & AE as needed, 2/2 trials.

Short term goal 1. The first short-term goal that was created to support the first longterm goal for Bobby is stated as follows:

In 1 week, the client will demonstrate the ability to complete upper body dressing
using hemi-techniques cc SPV, 2/3 trials.

The intervention. The intervention would consist of introducing Bobby to one-handed

hemi dressing techniques and assisting him with applying it to the task of upper body dressing.
In a research article written by Guidetti and Tham (2002), the authors reported that using selfcare skills (such as dressing) as an intervention tool was found to be one of the most effective
and frequently-used interventions in occupational therapy to promote independence in daily
living. According to the therapists listed in the article, it was viewed as one of the best ways to
build rapport and get the client used to the new way their body moves (Guidetti & Tham, 2002).

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While the methods used to complete self-care skills varied (as each client performs the task
differently and each therapist facilitates different skills), it was reported to be an intervention
that experienced therapists garnered the most results from while working with their clients
(Guidetti & Tham, 2002). These conclusions support the choice to address self-care skills, such
as dressing, for Bobby while he is in rehab.
The intervention would begin with Bobby completing a supine-to-sit transfer and then
remaining seated at the edge of his bed. To assist with maintaining balance while in a dynamic
sitting position and with visually grasping the dressing techniques, a standing mirror would be
provided for feedback on Bobbys body position in space. Prior to receiving education on the
dressing techniques, Bobby would be asked to maintain a static sitting position while upright
without a lean for one minute. Cues and assist would be provided to him as necessary.
Verbal and visual instruction would be used when educating Bobby on the one-arm
dressing techniques, and questions would be answered as needed with extra time given for
Bobby to process the information and respond. With assistance provided as necessary to help
him remain upright, Bobby would then be given a pull-over garment to practice an over-thehead technique for dressing. Cues and assist would be given as necessary to guide him through
the first attempt. Based on Bobbys response and his physical tolerance and endurance in
relation to the task, this would then be practiced again with sequencing being verbally rehearsed
as necessary. If applicable, Bobby would also then practice donning a button-down shirt while
using a button hook to fasten the buttons. Rest breaks would be given as necessary throughout
these activities.
The intervention approach in this activity is most appropriately represented as a
modification/compensatory approach. The specific goal is to increase independence through an
adaptive technique, while simultaneously restoring strength and endurance overall. The

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11

targeted outcome for this intervention would be for Bobby to improve in his occupational
performance while dressing.
Short term goal 2. The second short-term goal that was created to support the first longterm goal for Bobby is stated as follows:

In 2 weeks, the client will demonstrate the ability to complete lower body dressing cc
Min (A) & AE as needed, 2/3 trials.

The intervention. The intervention would focus on client education with adaptive
equipment for dressing, as well as increasing dynamic sitting and standing balance. In an article
written by Legg et al. (2007), the effects of completing personal daily living activities (such as
dressing) for clients who had experienced CVAs were investigated for evidence of improved
recovery. In this systematic review and meta-analysis, only articles relating to the effects of
self-care activities were reviewed. The results indicated that interventions based on completing
daily living skills resulted in improvement in recovery for the clients overall, and spared 10% of
clients listed as expected to have a poor outcome (Legg et al., 2007). These conclusions support
the focus of helping Bobby to improve in performing dressing skills while in rehab.
The intervention would begin with Bobby remaining supine in bed with the head of the
bed elevated. Bobby would be educated on one-handed lower body dressing techniques while
lying in supine, and he would be given verbal cues and assistance as needed during his first
attempt with the techniques. Adaptive equipment, such as a reacher or a dressing stick, would
be demonstrated if it appeared that Bobbys independence would significantly increase with a
device.
Bobby would then be asked to remove his garments while receiving cues and assistance
as needed. He would then complete supine-to-sit transfer to transition to sitting at the edge of

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12

his bed, and would then complete a stand-pivot transfer to his wheelchair. Education would be
provided to him on one-handed techniques for dressing in a wheelchair with his affected lower
extremity raised on a foot rest. Bobby would then don his lower body garments with cues and
assistance would be provided to him as needed. A front-wheel walker would be used to provide
Bobby with stabilization while he pulls the garments up over his hips while in standing.
Adaptive equipment would then again be demonstrated and practiced with the client if
appropriate.
This intervention is considered to be an activity that focuses on restoring a skill.
Adaptive equipment would be used as needed to compensate for lost motor movement, but only
if necessary as the focus would be for Bobby to complete the task without it. Compensatory
approaches will be taught as appropriate, but will not be fully encouraged unless still heavily
needed later in Bobbys rehab stay. Completing the task itself would increase strength,
endurance, dynamic sitting and standing balance. The targeted outcome for this intervention
would be for Bobby to improve in his occupational performance while dressing.
Long Term Goal 2
The second long-term goal that was established for Bobby is stated as follows:

In 4 weeks, the client will bathe cc SPV & AE as needed, 2/2 trials.

Short term goal 1. The first short-term goal that was created to support the second longterm goal for Bobby is stated as follows:

In 2 weeks, the client will be able to wash his R UE & trunk cc Min (A) & AE as
needed, 2/3 trials.

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13

The intervention. This intervention would be based on Bobbys report of fishing being a
preferred leisure activity for him, with the goal being to address decreased strength, active range
of motion and endurance in his upper body. These skills would be addressed due to the fact that
Bobbys current deficits in these areas are affecting his ability to wash himself thoroughly while
showering.
The incorporation of a meaningful leisure activity for Bobby in this intervention is
supported by evidence in a research article written by Law (2002), in which factors that
influence a clients active participation in rehabilitation are discussed. Within the article, the
author discusses the importance of focusing on activities that hold significant meaning for the
client regardless of whether they may be self-care tasks, leisure activities, social activities, or
any other type of daily activity that they may value (Law, 2002). The authors conclusions
support the use of meaningful occupations as a means for intervention in occupational therapy,
stating that, a persons preference for participation significantly affects choice and actual
participation (Law, 2002, p. 6).
The intervention would take place after Bobby was able to have his fishing pole brought
in from home. Bobby would begin the intervention in the occupational therapy gym, and would
be given the fishing pole to be held in his non-affected, non-dominant hand. 10 paper fish with
sticky-backed, hook-sided Velcro adhered to them would be scattered across the floor within
casting distance. Sticky-backed, loop-sided Velcro would then be placed on different parts of
Bobbys shirt (both shoulders, right side, etc.) to facilitate him reaching to different areas of his
upper body with his affected and non-affected hand. Active assistance for range of motion
would be given as necessary, and Bobby would be educated on ways that his right upper
extremity can assist with stabilization or can be actively assisted to reach an area his left upper
extremity couldnt.

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14

After retrieving a piece of loop-sided Velcro from his shirt, Bobby would then be asked
to place the piece on the magnet at the end of the fishing line, and would use that piece of
Velcro to fish for the paper fish that have the hook-sided Velcro on them. The activity would
end when Bobby had successfully retrieved all 10 pieces of paper fish using the fishing pole.
The focus of this intervention approach would be restoring a skill, as the target would be
to improve Bobbys range of motion in his upper extremities, and would also promote bilateral
use of his hands. These skills would aid him in performing a showering task safely and
effectively. The desired outcome of this intervention would be for Bobby to improve in his
occupational performance in the area of bathing.
Short term goal 2. The second short-term goal that was created to support the second
long-term goal for Bobby is stated as follows:

In 2 weeks, the client will demonstrate the ability to transfer from his w/c to his SC
using his FWW, cc Min (A), 2/3 trials.

The intervention. This intervention would focus on increasing Bobbys strength and
endurance for functional transfers. The focus of this intervention is supported by a research
article written by Ada, Dorsch and Canning (2006), wherein the authors report that
strengthening exercises are effective with improving strength and activity level for clients. This
was noted to be particularly true of subjects engaging in strengthening early after experiencing a
stroke (Ada, Dorsch, & Canning, 2006). Secondary to this, the authors concluded that
strengthening exercises should be included in stroke rehabilitation (Ada, Dorsch, & Canning,
2006).
The intervention would begin with bed mobility for Bobby, including performing a
supine-to-sit transfer to the edge of the bed, and then a stand-pivot transfer from the edge of the

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15

bed to his wheelchair with assistance provided as needed. Bobbys subluxation sling would
then be donned with assistance as necessary. Bobby would be encouraged to propel himself as
much as possible while transitioning to the therapy gym.
Bobby would complete an exercise session with an arm bike in the passive setting to
continue the rotations despite fatigue in his right and left upper extremity during that time. A
glove would be used to assist Bobbys right hand with maintaining a grip on the bike handle.
Active assisted range of motion would then be completed with Bobby, following with digit
flexion/extension, wrist flexion/extension, wrist pronation/supination, elbow flexion/extension,
shoulder flexion/extension, abduction/abduction, elevation/depression, and
protraction/retraction. During these exercises, Bobby would be given education on ways to
complete active assisted range of motion exercises on himself while in bed or in a chair during
the day.
Bobby would then participate in exercises with five-pound weights to strengthen his
non-affected upper extremity, while receiving education in regards to the importance of
increasing strength in his non-affected limb and ways that he can perform strengthening
exercises on his own. Bobby would then transition to a standing endurance activity at a raised
table while incorporating one of his preferred occupations: Playing cards. A goal would be set
for Bobby to complete a five-minute game of War using his non-affected hand with rest breaks
as needed from standing. If tolerated well, this would be repeated prior to ending the session.
The most appropriate focus of this intervention approach would be restoring function, as
the goal would be for Bobby to gain strength in his upper extremities and improve in his ability
to stand for functional periods of time. This would assist him with completing transfers and
standing activities that are components of activities of daily living (i.e. standing at sink while
grooming, lower body dressing, etc.), and in the future would aid him in becoming more

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16

independent in components of instrumental activities of daily living such as being able to lift
and move bags of dog food for pet care. The card-playing portion of the activity would also help
Bobby to improve in his fine motor skills, which would help him not only to improve in the
leisure activity of card-playing, but would also help him perform functional activities that
require fine motor skills (i.e. opening a toothpaste cap for brushing his teeth or opening a bag of
dog food). The desired outcome for this intervention would be to improve Bobbys
occupational performance in functional activities of daily living and leisure participation.
Precautions
Precautions for all intervention activities include the fact that Bobby currently has a
subluxation in his right shoulder, which means that his subluxation sling would need to be
donned whenever possible during times when he is performing activities out of bed. Bobby is
also a fall risk, so contact guard assistance would need to be provided until his balance and
endurance have significantly improved. No contraindications are relevant for these activities.
Frequency and Duration of Intervention Plan
In the context of inpatient rehabilitation, and with the client receiving physical therapy,
occupational therapy and speech therapy, the frequency of service delivery of occupational
therapy for Bobby would be one hour per day, five days a week.
Grading Activities
For the intervention that involved the fishing activity to improve Bobbys reaching
ability and range of motion for showering purposes, an example of a graded-up activity would
be to have Bobby cast a line to a greater distance and use the reel to bring in the paper fish.
This would require Bobby to perform more complex motions and fine motor use of his right
upper extremity. It would also increase the amount of time that Bobby would be required to
hold the pole outward and steady.

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17

A method for grading down this activity would be to decrease the number of paper fish
to retrieve from 10 to five, and to decrease the reaching distance for the Velcro pieces on
Bobbys shirt. This would shorten the duration and decrease the physical demands of the
activity while still requiring Bobbys involvement in reaching motions, and would still require
him to utilize strength in his upper extremities while holding the pole outward with enough
control to reach a paper fish.
Primary Framework for the Intervention Plan
For this intervention plan, the Person-Environment-Occupation-Performance (PEOP)
model was used as the primary framework to guide its formulation. To effectively create
appropriate intervention activities, considerations were given regarding Bobbys individual
needs, the environment he had to work with, the occupational goals he was working toward, and
his performance capacity in relation to those occupations. By incorporating these
considerations, the fundamental components of the PEOP model were supported.
The intervention plan integrated the Person component of the PEOP model in that
Bobbys motivators, personal goals, and individual needs were incorporated into the
formulation of the intervention activities and the goals that were set for him (Baum &
Christiansen, 2005). His physical and emotional status would also be considered and monitored
throughout the implementation of the activities. Bobby is a post-stroke client, and he verbalized
that he experiences some frustration with speaking and completing motor tasks. His
subluxation was also considered during intervention planning, and his desire for independence
with self-care skills was prioritized per his wishes. He reported that fishing had been a
preferred leisure activity, and that his primary goal for returning home was to be able to take
care of himself as independently as possible. The intervention plan incorporated fishing as a

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18

means for increasing Bobbys strength, range of motion and endurance, and the intervention
activities focused on promoting motor skills for self-care overall.
The Environment component of the PEOP model was addressed by taking into
consideration the environment that Bobby was currently living in, and also the environment he
would be returning to after discharge (Baum & Christiansen, 2005). Within the intervention
activities, Bobby would be taught to practice self-care skills in methods as similar to what they
would be at home as possible: In his wheelchair, supine in bed or at the edge of his bed. Bobby
would also be advised about modifications that could possibly be made to his home
environment in order to facilitate success for him in his occupations after he is discharged. The
session would address temporal aspects of Bobbys environment in the hospital by having a
discussion with him about scheduling therapy at times that work best for him, and what the
timeline of his hospital stay will look like.
The Occupation component of the PEOP model was supported in that the intervention
plan was primarily focused on restoring Bobbys ability to participate in occupations that he
deemed to be important to him (Baum & Christiansen, 2005). Bobbys ability to participate in
self-care occupations were addressed in his goals, and all intervention activities were designed
to help him improve in skills that would be required for him to be able to independently
participate in activities of daily living. Meaningful leisure occupations that Bobby identified
were also incorporated in the intervention activities.
Finally, the Performance component of the PEOP model was supported in the
formation of the intervention plan in that Bobbys current level of function and performance
capabilities along with his potential for improved performance were considered throughout
all intervention activities (Baum & Christiansen, 2005). The activities within the intervention
plan were designed to accommodate the needs that Bobby may have for assistance, cues and

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19

adaptive techniques. The intervention activities account for the fact that there are multiple
factors that can play a role in Bobbys performance during an intervention, such as his fatigue
level or the frustration that he may experience during an activity. If Bobby were to verbalize
that he would like to complete a different activity that served the same purpose as one of the
planned intervention activities, the activities would be changed to suit to his needs. As he
progressed the interventions would also continuously be adapted or graded up or down to give
him a just right challenge when completing exercises or therapeutic activities.
Client Education
Client education would be an ongoing process throughout the implementation of the
intervention plan. Education on self-care and safety techniques, body mechanics,
environmental modifications, resources, and adaptive equipment would be provided in the form
of verbal education, with demonstrations and visual aids provided as needed. If Bobbys
brother were to be present for a treatment session (and if Bobby agreed to it), he would also be
educated on resources and possible environmental modifications for Bobbys apartment that
would meet Bobbys needs and facilitate optimal functional engagement for him when he
returns home.
Monitoring and Assessment of Client Response
Throughout the intervention activities, Bobbys progress and response to the activities
would be monitored continuously. This would be accomplished primarily through having
verbal discussions with Bobby about his progress in therapy and his thoughts in regards to the
intervention activities, reading his body language, and making clinical observations in regards
to his performance. Data would also be collected for an objective reading of his progress, such
as the amount of cues, time and repetitions that were required for him to complete a task.

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20
References

Ada, L., Dorsch, S., & Canning, C. G. (2006). Strengthening interventions increase strength and
improve activity after stroke: A systematic review. Australian Journal of Physiotherapy,
52(4), 241-248.
Baum, C. M. & Christiansen, C. H. (2005). Person-environment-occupational performance: An
occupation-based framework for practice. In C. H. Christiansen, C. M. Baum, & J. BassHaugen (Eds.), Occupational therapy: Performance, participation, and well-being (pp.
244-266). Thorofare, NJ: Slack.
Guidetti, S. & Tham, K. (2002). Therapeutic strategies used by occupational therapists in selfcare training: A qualitative study. Occupational Therapy International, 9(4), 257-276.
Law, M. (2002). Participation in the occupations of everyday life. American Journal of
Occupational Therapy, 56, 640649.
Legg, L., Drummond, A., Leonardi-Bee, J., Gladman, J. R. F., Corr, S., Donkervoort, M., . . .
Langhorne, P. (2007). Occupational therapy for patients with problems in personal
activities of daily living after stroke: Systematic review of randomised trials. BMJ, 335,
922. http://dx.doi. org/10.1136/bmj.39343.466863.55