ASSESSMENTS
Occupational Self-Assessment
The Occupational Self-Assessment (OSA) is a tool that I used on my Level 1 clinical placement in an acute in-patient mental health unit. This assessment uses a client-centered approach that offers the client the opportunity to experience self-control in intervention planning.
The OSA is based on the Model of Human Occupation (MOHO). The MOHO emphasizes how 4 main factors influence occupational behaviour:
Volition: process by which a person experiences and chooses occupational behaviours (personal causation, values, interest)
“Doing activities I like“
“Working towards my goals”
Habituation: processes that maintain pattern in everyday life (roles and habits)
“Having a satisfying routine”
Performance: innate capacities, foundation for skilled performance
“Concentrating on a task, physically doing”
Social and physical environment
Based on the available evidence, practitioners can confidently use the OSA as an effective tool to help construct an occupational profile and engage the person in a collaborative evaluation process. This assessment is designed to capture clients’ perceptions of their own occupational competence in the occupations they consider important. By providing the client with a fixed set of items representing areas of performance, the occupational therapist communicates to the client something about the kind of issues he/she is prepared to address in therapy. OSA serves as an important purpose of revealing to the client what occupational therapy is and what kind of concerns the therapist is prepared to address. MOHO is a central part of how the therapist thinks about and interacts with the client – actively using the model as a way of theoretically understanding the client.
The OSA has been applied in various studies as an outcome measure to show the efficacy of an occupational therapy program (Chen, Pan, Hsiung, & Chung, 2015; Chen, Pan, Hsiung, Chung, Lai, et al, 2015) and as a predictor for quality of life (Kielhofner & Forsyth, 2001; Kielhofner, Forsyth, Kramer, & Iyenger, 2009). Research testing the psychometric qualities of the OSA demonstrated adequate construct validity, sensitivity, discriminative validity, and internal consistency (Pan, Chen, et al, 2012; Pan, Chung, Chen, Hsiung, & Deepa, 2011).
The Modified Occupational Questionnaire
The Modified Occupational Questionnaire (MOQ) is an assessment tool that functions as a 24-hour time use measure. During the assessment, the therapist learns more about the daily activities the client engages in, how they feel about their performance in those activities and if those activities are enjoyable to the client. With this information, the client and therapist can determine whether there appears to be occupational balance in the life of the client and whether time use needs to be restructured to promote health. Studies reveal that the OQ has good concurrent validity and test-retest reliability. To download a free copy of the OQ, click on the image.
The context in which OTs work can vary extensively between professionals. Some of us might only see a client for a brief moment once, whereas others might continually work with a client in a variety of settings. For those of us that don't spend as much time with our clients, it is very important that we understand more about their time-use to ensure that occupational problems are not arising from this domain. The lives of the client exist before and after their interaction with us, and in order to understand them on a fundamentally deeper level, we should gain perspective about how they spend the other 23 hours of their day. In practice, using this assessment tool will allow me to address possible occupational balance problems and confirm performance problems are not arising from the structure of the time.
Scanlan, J. N., & Bundy, A. C. (2015). Modified Occupational Questionnaire (MOQ).
The Role Checklist
The Role Checklist is simple in nature, yet it can provide a lot of information about our clients that can be used in subsequent interventions. The Role Checklist is a paper-and-pencil checklist originally developed to measure a person’s past and current participation in 10 common roles (e.g., worker, caregiver, student, homemaker, etc.). The person is also asked to project what his or her pattern of participation in these same roles in the future might be and to prioritize the importance of these 10 roles by assigning a value from not valuable to very valuable (Oakley, Kielhofner, Barris, & Reichler, 1986). The tool was designed to apply the Model of Human Occupation and to assist the practitioner to collaborate with the person to address habituation (roles and habits) based on the person’s perception of his or her role participation (Oakley et al, 1986). Practitioners have used the results of this tool to open a conversation with the person about role functioning, including how the number of roles she or he participates in from the past to present to future may reflect changes in his or her participation in society (Dickerson, 2008) and how the priority and value designations placed on them relate to role balance, role overload, or an absence of roles. It has also been used to initiate a conversation about the connection between role participation and time use (Dickerson, 2008).
Understanding the roles that are valuable to a client allows us to plan our interventions with them in mind, ensuring that client-centeredness remains a focal point in our practice. I anticipate using the Role Checklist often in my practice for these reasons. It can be easy to think that the only role present is that of a client, but by using the Role Checklist, I can get definitive information about who the client is/wants to be outside of their time with myself.
Dickerson, A. E. (2008). The Role Checklist. In B. J. Hemphill-Pearson (Ed.), Assessment in occupational therapy mental health: An integrative approach (2nd ed., pp. 251–258). Thorofare, NJ: Slack, Inc.
Oakley, F., Kielhofner, G., Barris, R., & Reichler, R. K. (1986). The Role Checklist: Development and empirical assessment of reli- ability. Occupational Therapy Journal of Research, 6(3), 157–170.
Worker Role Interview (WRI)
Who can you use it with?
Injured workers in vocational assessment/rehabilitation
Intended to be used during the initial assessment as part of a physical and/or work capacity assessment
How long will it take?
30 to 45 minutes for the interview, plus observation of work capacity assessment
Scoring takes approximately 10-15 minutes
What information does it capture?
Identifies psychosocial and environmental barriers influencing a workers ability to return to work
Designed to discuss various aspects of his/her life and job setting that may have been associated with past work experience
Combines information from an interviewwith observations made during the physical and behavioral assessment procedures of a physical and/or work capacity assessment
What are its strengths?
Facilitates rehab planning by offering workers perceptions and information about worker’s ability to adjust habits and routines, and commitment to the worker role
Has a strong theoretical basis
Simple to administer
Can be administered in any relevant setting during a 30 to 60 minute period
Scoring takes approximately 10-15 minutes
Can be used as an outcome measure and re-administered at discharge
What are some drawbacks?
Questions require reorganization for better flow and rephrasing to reduce reactivity
Needs to be more broadly applied and tested in a variety of settings, therapists, and populations before used as an outcome measure
Not clear how the physical capacity assessment fits in
Evaluation of Social Interaction
Who can you use it with?
2.5 years and above, including older adults
Appropriate for use with any person who has or is at risk for experiencing challenges with social interactions and/or behaviour in social contexts. May also be used to test healthy well people.
How long will it take?
1 hour or less
What information does it capture?
Evaluate how a person begins, supports, and maintains, and ends social interactions with others
Measure the degree to which a person’s social interactions are polite, respectful, well-timed, relevant and mature
Measures 27 interaction skills (eg. approaches/starts, Gesticulates, turns toward, takes turns, clarifies)
What are its strengths?
Can be used in any relevant and familiar environments (clinical or community-based)
Not diagnosis specific or limited to certain age groups (2.5 years and above)
Sensitive enough to detect differences in quality of social interaction among groups known to differ (i.e. people without identified diagnoses and people with neurologic and psychiatric disorders)
Can be used in any relevant and familiar environment (clinical or community- based)
Has been standardized on an international sample of 1140 persons with without disabling conditions
Computer generated results can document baseline quality of social interaction, effectiveness of OT interventions, and changes in quality of social interaction over time
What are some drawbacks?
Not designed to be used to evaluate for the presence of underlying biomechanical, neuromuscular, cognitive or psychosocial impairments
It needs to be in a familiar environment-could be hard to administer in a hospital environment
Required specialized training (could also be a strength because utility would be high)
Social desirability responding bias: client knows they are being observed in the the social interaction
Occupational Therapy Quality of Experience and Spirituality Assessment Tool (OT-Quest)
Spirituality is recognized as an important concept in occupational therapy.
The Canadian Model of Occupational Performance and Engagement (CMOP-E) identifies the main domains that the profession of OT is interested in (Polatajko, Townsend & Craik, 2007). The CMOP-E is made up of three components, namely; the person, the environment, and the occupation (Polatajko et al., 2007). The person is situated at the centre of the model, with spirituality positioned at the core of the person. In the CMOP-E, spirituality is shaped and expressed through occupations, and is understood as the essence of the self and the place where meaning is drawn (McColl, Law & Stewart, 2015). This aligns with occupational therapy’s core value of treating people holistically—mind, body, and spirit.
OT-Quest is an assessment tool designed specifically to gather information about the spirituality of the person completing it. Occupational therapy practitioners may find this tool useful to further explore and identify spiritual occupations and help set goals for therapy. The tool is based on a three-dimensional model of spirituality (Schulz, 2008).