Occupational Therapy Intervention: Case Study of Rumi

This paper focuses on the occupational therapy intervention for Rumi, a 19-year-old female facing mental health issues. It discusses the assessment, interventions, evidence-base, and factors impacting the therapy.

Occupational Therapy Intervention
Feedback from The Lecturer
These assignment is missing the component of the learning outcomes. For
instance, the intervention is not linked to the patient, like the OT intervention,
is not shadowing the patient.
There are lots of Grammatical errors, punctuation and spelling mistakes. I will
urge you to proofread your work.
The referencing is not adequate, it is not Harvard referencing.
The main issue is Linking evidence-based practice to the patient.
Word count 4000 words plus 10% Max 4400, ensure the word count is within
that range when the feedback are implemented
I believe that about 1500 to 2000 words is required to fix this issue
Just a reminder it’s all about Occupational focused person Centre for mental
health
you can also use MOHO mode
1 | P a g e

Table of Contents
References................................................................................................................................11

Introduction
The purpose of this paper is to understand the occupational intervention by focusing on a case
study of Rumi. An intervention is selected to treat the patient and help her to overcome the
current situation. The process of assessment and intervention to develop, maintain physical or
mental activities to improve human health of individuals, communities or groups is referred
to occupational therapy. The occupational therapy provision and the interventions involved to
treat Rumi will be made. In this regard, this paper will provide an overview of how the
occupational performance of an individual can be affected. This paper will provide an
indication and evaluation of the evidence-base that will be related to the intervention and
indication will be done on how such evidence will be supporting the occupational
participation as well as the occupational performance. The assessment of Rumi will be done
in the paper to acknowledge the factors that have impacted her activities. The paper will end
with the necessary conclusions.
Case Study Overview
The case study is about a 19 year old female, Rumi who's mother was died because of cancer
when she was only ten years old and her father did a second marriage after five years of her
mother's death. The relationship between Rumi and her step-mother is not healthy. Rumi’s
father is a businessman and could not be able to spend time with his daughter because of her
busy schedule. Rumi has an ideal lifestyle with all the luxuries and comfort. Rumi was a
happy child, but since her father’s second marriage she started spending most of her time
alone in her room during day. At night, she spends most of her time at bars and clubs and
because of that she gets indulge in intake of drugs and alcohol in a substantial amount.
However, the main reason behind this was her loneliness and lack of parental support. Rumi
was quite reluctant to spend time with her friends any more. Rumi avoid to indulge in any
sort of social or physical activities after death of her mother which eventually leads to
occurrence of depression, continuous migraine, and Cardiomyopathy and Cognitive
impairment. Lack of physical activity made her obese and cause behavioural changes such as
being violent at times and to react instantly on minor issues. The problems were ignored at
the initial phase.
3 | P a g e

Assessment of the patient
Below is the chart that shows the assessment of Rumi’s condition:
Description Assessment
Medical Condition (Body Health) Cardiomyopathy
Obese
Inactive
Medical Condition (Mental Health) depression
migraine
Cognitive impairment
Aggressiveness
Roles and Occupation (Past) Self-care
goes out with friends every weekend
Shopping
Spa treatments
Gardening
Sports
Swimming
Roles and Occupation (Present) No Self-care
Does not goe out with friends
No sports
No swimming
Spending time alone
Dance Clubs and Bars
Drivers of Issues Early Death of Mother
Messed relationship with step-mother
No attention from father
Isolation
Overthinking
Challenges To increase physical activities
To increase Social activities
To take proper treatment
To overcome drugs and alcohol habit
To control aggression
Appraise the range of possible interventions and specify which you will focus on; and
how this specific intervention addresses the occupational performance needs.
Points to cover in this question:
 Select different interventions (mention 3-4) and focus on one (use ADL your
main intervention as it more suitable to amputee)
Some of the most common occupational intervention therapies that are related with the
Rumi's situation is discussed as follows:

 Assessment of motor and process skills(AMPS)
 Adolescent/adult sensory profile
 Activities of daily life(ADL)
 Sensory Integration and Praxis Tests(SPIT)
 Motor free visual perception test(MVPT-3)
However, the most suitable occupational intervention therapy for Rumi is ADL. It is
both an occupational therapy and a physical therapy. It stands for activities of daily living. It
can also be refer to as self-care activities. The activities can include everyday tasks such as
self-feeding, dressing, bathing, laundry and meal preparation. It is the most suitable therapy
for Rumi as she lost her mother in a very early age and hence, she need to be self dependent
on her to fulfilled her daily activities requirements. In this particular therapy, occupational
therapist provide directions to their clients to engage in meaningful and purposeful daily
activities. They take a lead in analysing ability of clients in order to perform routine tasks
and therapist also work with the client to ensure that basic requirements of the tasks are met.
explain why you focused on that one intervention (ADLS)
The study put a major emphasis on ADLS as it seems to be most appropriate
occupational therapy intervention needed by the selected individual of case study. By
implementing this occupational therapy, Rumi could be able to perform her daily tasks and
activities by her own without any help of her step mother. Therapist of ADLS will assist her
to perform her routine activities in an effective way. It will made her self dependent and she
does not need to seek any help to fulfil her routine tasks. It majorly focus on three basic area
such as self care, productivity and leisure. Self care include all the activities an individual
perform throughout the day in order to look after her or himself. It includes tasks and abilities
like functional mobility, personal care as well as community engagement. Productive can be
define as contribution of an individual to a society by means of paid or unpaid occupation.
However, leisure often include pursuing interest, hobbies, opportunities for the socialization.
In case of Rumi, it is important for her to add some leisure activities in her life such as
engaging with friends and family as it would help her to eliminate the risk of depression and
other mental health issues she is facing.
 critic the evidence
5 | P a g e

 show evidence-based practice for your chosen intervention.
 Explain the OT role in the amputee, rehabilitation using ADLs such as lower
limb dressing, mobility, self-care, pain management.
 Holistic OT will focus on ADLS intervention, research OT intervention around
ADLS.
 Pain management: OT techniques in pain management. E.g activities of daily
living can impact…..
Indicate and evaluate the evidence-base for the intervention and indicate how this
supports occupational performance and occupational participation
Points for this question
o As discuss, your main intervention should be ADL: find evidence based
around the use of ADL as intervention,
 look at what the patient found meaningful prior to the amputation, example
George is a family man and enjoyed taking his son to football which are
meaningful occupations,
 occupational therapist needs to look at the area of participation and engagement
of George, look for evidence of areas of barriers to participation,
 evidence base with people with long term conditions or changes in their life’s.
 how is having this amputation preventing him from performing, so by using
ADL as an intervention will it help in the meaningful occupation of George by
improving his quality of life etc.
 what are the possible barriers to his occupational performance,

Consider the personal, environmental and occupational factors that may impact upon
occupational therapy interventions. You should also include any financial, resource,
staffing and commissioning considerations.
 Use a person cantered model of occupational therapy like PEOP model.
 How can his condition impact his identity as a person, his role might be change
as a bread winner, what’s the impact finically?
 Consider George’s beliefs, culture, language, again what is its effect.
 Use critical thinking tools.
 From evidence you cannot separate the person from the occupation etc
 His beliefs, ‘husband is a bread winner, how will it psychological impact him.
Also Discuss with Rumi realistic expectations and assessment proceeding to discharge.
The interventions of occupational therapy are impacted through various factors such as
personal, occupational and environmental factors as well as through the capacities, abilities
and acquired skills. The personal context reflects the internal environment of an individual
which is derived from the Rumi’s gender, cultural background mind state and belief. These
factors play the pivotal role to determine the unique response of Rumi to the illness such as
depression and contribution to the ability to adapt. It has been analysed that Rumi’s internal
environment aspects such as beliefs and age are stable, whereas mood and stress are in flux
(Skubik-Peplaski, 2012). The Rumi is 19-year-old and her age impacts the occupational
functioning in three distinct ways such as age-related changes in abilities and capabilities,
Rumi’s generation based view of the world and developmental shifts in values, priority and
goals.
Rumi seeks services related to health or the extent to which she follows the advice of
professionals. The coping styles are stable characteristics of her and thoughts are arbitrated
the effects of functional stress. The culture, in which Rumi goes out at night provides the
sufficient guidelines for Rumi’s interactions with her environment, however, evaluation tools
of occupational therapy are based on the norms which advanced for the population of the
white middle class (Smith et al., 2014). The clinicians assess the validity of culture of their
7 | P a g e

standardised tools and choose the norm-referenced tests and criterion-referenced, which is
more suitable for the Rumi’s background.
The occupational functions are referred to the daily occupational performance; it includes the
collection of daily activities; however, for the occupational intervention particular risk of
environment leads to the occupational dysfunction (Hill, 2016). The environmental factor
which includes in the community of Rumi is education and environment of the home as these
both factors have mutual participation and impacts on the intervention. The environment
impacts the occupational therapy interventions and it is recommended that the therapist must
match the Rumi’s goal of the ideal environment for the best intervention. Absence of social
activities, aggressiveness and less self-care also affects the intervention, nevertheless; it is
difficult in the case of Rumi to identify the factors of occupational performance as distinct
entities (Milner et al., 2015).
The intervention focuses on the development of medical routine to assist the Rumi to return
into her routine; however, Rumi is unable to take care of her; therefore, she needs to move to
counsel setting due to the structured supervision. Through analysis of the physical and social
environment in the Rumi’s community and home, the practitioner of occupational therapy
must identify the external resources and cues to optimise the occupational performance of
Rumi. The support of environment is more probable to enhance the functional behaviour of
Rumi with depression and isolation while support is customised for her and situated in the
home of Rumi as she spent her most of time in her room. The resources issue is the primary
factor which acts as a barrier in the occupational performance intervention. Logistic issues
comprise of equipment and resources as well as the context of the environment are also the
barrier of OBI (Cherylin Lew, 2010).
It has been analysed that most of the participants in a study reported that there is lack of the
appropriate equipment’s and resources and the department of the occupational therapy is not
set up for the OBI (Murphy et al., 2019). The available equipment and resources are only for
the treatment of the impairment-based condition. Limited resources and equipment, high
workload and time constraint must be addressed through the reflective practice. The therapist
must need to address and reflect on how they could enhance their practice and effective
occupation-based through the utilisation of challenges as a chance to advance practice. The
client appointments and time should also be considered and scheduled strictly to enable
appropriate time for OBI. It is because OBI consumes more time and is too complicated and
review more time in implementation; therefore, addressing the professional needs of the

client takes more time (Daud et al., 2016). These factors are needed to be resolved for the
better delivery of an intervention and the positive outcome of Rumi as OBI assist in
improving the life quality.
Distinguish and justify which occupational therapy core skills are used while carrying
this intervention
Distinguish and justify which occupational therapy core skills are used while carrying
this intervention
 Talk about OT core skills such as problem solving, collaborative working,
environmental adaptation, treatment and care plan, assessment.
 The core skills should be OT based.
The skills that must be have OT differ from other therapists as the former may be confronted
with diverse range of situations and therefore requires diverse set of skills. On the other hand,
a motivational intervention therapist must carry skills that help motivate the patients to
change their circumstances (Magill et al., 2014). For instance, if we distinguish the skills
possessed by a OT with motivational intervention therapist, the latter is responsible for
motivating patients towards change.
While the core skills required for being OT are discussed in detail in this part, it is essential to
discuss the skills required by other types of therapists. Communication and compassion are
two core skills that must be present in every therapist, regardless of which category they lie
(Duncan, 2011). The reason is that occupational therapy is a sensitive aspect where the
therapist deals with cognitive, self-beliefs, pre-determined self-image and often self-stigma of
individuals. Changing these towards a positive path is difficult, and therefore, patience is
another attribute necessary for any therapist.
A motivational intervention therapist, for instance, has to help the patient in maintaining the
motivation level. He or she has to formulate change plans too, which requires commitment to
consolidate all the information (Adam et al., 2013). He or she has to achieve a balance
between exerting authority on the patient and respecting the patient’s autonomy at the time
same. It is important to respect the pace at which a patient is embarking towards change. The
motivational therapist has to conceive and retain the same level of enthusiasm throughout the
process.
9 | P a g e

The skills which are possessed by OT allow them to work in collaboration with their clients
for carrying out behavioural experiments; they become capable of providing psycho-
education regarding depression, its causes as well as its treatment (Simons et al., 2010).
Generally, such therapists can present OT formulation of the depression, and they also
possess the ability to develop a case-conceptualisation which is specific to the client, and they
are also capable of presenting formulation OT which is related to the specific client (Farmer
& Chapman, 2016). These therapists are Socratic and regularly carry out mood monitoring
which finds the lows and highs.
The OT tend to use the Thought Records for monitoring the Automatic Thoughts as well as
Cognitive Distortions; they tend to develop a link between the cognition, affect and
behaviour. In addition to this, they carry out active scheduling for increasing the experiences
related to Mastery and Pleasure. Also, they tend to teach Cognitive Restructuring as well as
other strategies for the evaluation of problematic thoughts. The OT make the usage of
interventions related to schema change, such as positive logs of data and historical review.
They are supposed to be able to conduct emotion regulation, relaxation, relapse prevention,
and problem-solving (Berking et al., 2013).
Additionally, the following are the skills and qualities that are supposed to be possessed by
OT:
Compassion and empathy
The therapists and counsellors work along with the individuals who tend to possess
complicated emotional problems that can be difficult as well as stressful. For that purpose,
possessing empathy for the clients is a crucial part of developing a positive therapeutic
relationship.
Strong listening skills
As the therapists are required to spend most of their time listening to what their clients have
to say and assisting them in understanding their values as well as goals while solving the
problems. Therefore, active listening is necessary (Newman, 2010).
Excellent organisational skills
Excellent organisational skills are essential for the OT because they are required to keep track
of the schedules, insurance companies and the payments.
Strong communication skills

As the OT are required to work closely with the individuals, the clients may be belonging to
various backgrounds, belief systems as well as cultures; this will become necessary for the
OT to become capable of effectively creating a rapport with the diverse group of the clients.
In addition to this, OT are required to be sensitive to the different needs as well as styles of
communication of them.
Strong skills of relationship building
Not only the development of trusting relationships with the patients are imperative, but it is
also imperative for OT to assist their patients in repairing their broken relationships within
their own. In addition to this, it is of utmost importance for the OT to possess the ability to
successfully navigating the complications involved within the relationships.
Conclusion
Summarise what has been written
Do not introduce new theories or approach
Justifiable the preferred occupational therapy intervention used
Suggest how other implement can be used to improve the quality of life for Rumi
A conclusion is what you will leave with your reader
It “wraps up” your essay
It demonstrates to the reader that you accomplished what you set out to do
It shows how you have proved your thesis
It provides the reader with a sense of closure on the topic
Also Discuss with Rumi realistic expectations and assessment proceeding to discharge.
11 | P a g e

References
Adam, K.., Peters, S. & Chipchase, L., 2013. Knowledge, skills and professional behaviours
required by occupational therapist and physiotherapist beginning practitioners in work‐related
practise A systematic review. Australian Occupational Therapy Journal, 60(2), pp.76-84.
Bailey, L., Vardulaki, K., Langham, J. & Chandramohan, D., 2005. Introduction to
Epidemiology. Open University.
Berking, M.., Ebert, D.., Cuijpers, P. & Hofmann, S.G.., 2013. Emotion regulation skills
training enhances the efficacy of inpatient cognitive behavioural therapy for major depressive
disorder: a randomised controlled trial: psychotherapy and psychosomatics, 82(4), pp.234-45.
Carter, L., 2019. Supporting student wellbeing. Midwives, 22, pp.26-27.
Cherylin Lew, O.T.D., 2010. Occupational therapy's perspective on the use of environments
and contexts to support health and participation in occupations. The American Journal of
Occupational Therapy.
Daud, A.Z.C., Judd, J.., Yau, M. & Barnett, F., 2016. The issue in applying occupation-based
intervention in clinical practice: a Delphi study. Procedia-Social and Behavioral Sciences,
pp.272-82.
Dobson, D. & Dobson, K.S.., 2018. Evidence-based practice of cognitive-behavioural
therapy. Guilford Publications.
Dobson, D. & Dobson, K.S.., 2018. Evidence-based practice of cognitive-behavioural
therapy. Guilford Publications.

Duncan, E.A., 2011. Skills and processes in occupational therapy. Foundations for practice
in occupational therapy, 5, pp.33-43.
Ehde, D.M., Dillworth, T.M. & Turner, J.A.., 2014. Cognitive-behavioural therapy for
individuals with chronic pain: efficacy, innovations, and directions for research. American
Psychologist, 69(2), p.153.
Farmer, R.F. & Chapman, A.L.., 2016. Behavioural interventions in cognitive behaviour
therapy: Practical guidance for putting theory into action. American Psychological
Association.
Graham, H.L., Copello, A., Birchwood, M.J. & Griffith, E.., 2016. Brief Integrated
Motivational Intervention: A Treatment Manual for Co-occurring Mental Health and
Substance Use Problems. John Wiley & Sons.
Hill, W., 2016. The role of occupational therapy in pain management. Anaesthesia &
Intensive Care Medicine, pp.451-453.
Jobes, D.A., 2012. The Collaborative Assessment and Management of Suicidality (CAMS):
an evolving evidence‐based clinical approach to suicidal risk. Suicide and Life
‐Threatening
Behavior, 42(6), pp.640-653.
Magill, M.. et al., 2014. The technical hypothesis of motivational interviewing: A meta-
analysis of MI’s key causal model. Journal of consulting and clinical psychology, 82(6),
p.973.
Milner, J.., Myers, S. & O'Byrne, P., 2015. Assessment in social work.
Murphy, C., Brown, T. & Stagnitti, K., 2019. he influences of personal and environmental
factors on typically developing children’s activity participation — Journal of Occupational
Therapy, Schools, & Early Intervention, pp.68-85.
Newman, C.F.., 2010. Competency in conducting cognitive–behavioural therapy:
Foundational, functional, and supervisory aspects. Psychotherapy: Theory, Research,
Practice, Training, 47(1), p.12.
NHS, 2019. NHS UK. [Online] Available at https://www.nhs.uk/conditions/cognitive-
behavioural-therapy-cbt/.
O'Donohue, W.T. & Fisher, J.E.e., 2012. Cognitive behaviour therapy. Chichester, UK:
Wiley.
Rubinstein, R.A.., 2015. Peacekeeping under fire: Culture and intervention. Routledge.
Semple, R.J. & Lee, J.., 2014. Mindfulness-based cognitive therapy for children. In
Mindfulness-based treatment approaches, pp.161-88.
13 | P a g e

Simons, A.D.. et al., 2010. Training and dissemination of cognitive behaviour therapy for
depression in adults: A preliminary examination of therapist competence and client outcomes.
Journal of Consulting and Clinical Psychology, 78(5), p.751.
Skubik-Peplaski, C.L., 2012. Environmental Influences on Occupational Therapy Practice.
Smith, R. et al., 2014. Occupational performance factors perceived to influence the
readmission of mental health care users diagnosed with schizophrenia. Journal of
Occupational Therapy, pp.51-55.
Wilde, J.., 2013. Treating anger, anxiety, and depression in children and adolescents: A
cognitive-behavioural perspective. Taylor & Francis.
Zettle, R.D. & Hayes, S.C.., 2015. Rule-governed behaviour: A potential theoretical
framework for cognitive-behavioural therapy. In The Act in Context, pp.33-63.