Model of Human Occupation

Model of Human Occupation Archived List Serv Discussion Role Checklist February 7, 2012 Hello, This is a message to find out about how many of you out there may be currently using the Role Checklist (Oakley et. Al. 1986, 2006), and if you are, what population you are using it with, How (self-completion, interview, mail, or whatever), and whether or not it meets your needs. I have been using it in longitudinal research, and am fiddling with a scoring system to see how it reflects change and if it could be used as an outcome measure. I appreciate any experiences and thoughts on this. I am very interested in anyone who may be attending the MOHO Institute in Stockholm next October who may want to collaborate. You can reply to the LISTSERV or to me privately if you prefer. Thanks, Patty Patricia J Scott, PhD, MPH, OT, FAOTA Associate Professor, Department of Occupational Therapy School of Health and Rehabilitation Sciences Director, Student Learning and Research Facilitation Lab Adjunct Associate Professor, IU School of Medicine, Division of Surgery February 7, 2012 Hi Patty, Here at the Utah State Hospital, a state inpatient psychiatric facility, we use the Role Checklist sporatically, but most often with our young adult clients and sometimes with Forensics patients. We generally administer it in small groups (2-3 patients) as an interview or self-completion after being given verbal directions, and use it to facilitate discussion about the individual's value of occupational participation. I feel that it meets our needs and helps us better understand the impact that chronic mental illness has on a person's ability to engage in occupational roles that they find meaningful and important. In terms of populations, I often find this tool to be most efficacious in working with people with Cluster B Personality disorders such as Borderline Personality Disorder, and this can be impactful in high functioning people suffering from the diagnoses of schizophrenia or schizoaffective disorder. The effectiveness of this as an outcome

measure is something that I would be highly interested in, so PLEASE share your research in that regard. Thanks a bunch! Rick Ericksen, MOT, OTR/L Director of Occupational Therapy Utah State Hospital February 7, 2012 Dear Patricia: I use the role checklist with adolescents (close to twenty),young adults, adults and my client s parents and caregivers. It is an extremely useful tool. I used mixed methods. Usually, self completion followed by an interview to relate variables with personal causation and other occupational personal and environmental aspects. I have also done an OPHI-II flowing from the analysis of the role checklist. I have used it repeateadly within a time frame with the same person to offer him/her a visual format to see his/her changes and achievements in their occupational participation. I am doing my best to go to the Institute. I remember you presenting your research plans on the checklist on January 2011 and I am very interested in the outcomes! Warm hug Carmen Gloria de las Heras, MS, OTR Chile February 10, 2012 Dear Pat, I have been using the role checklist with Older Adults with mental health problems. I find that I have to extensively explain what a 'role' is, as many of my clients find this a difficult concept to take on board. I find that many of my clients respond well to being interviewed about their roles once they understand the concept. I would be interested in learning more about your research. Anne Chatters, Senior OT, Oxleas NHS Foundation Trust UK February 17, 2012 Hi Anne and Pat & others discussion role checklist!

Interesting to hear about the usability of role checklist. In Finland we are faced with challenges of translation from English into Finnish language. We have to consider each concept carefully. A colleague Hanna Viitasalo translated the role check list and used it with clients who have chronic pain. She did find that the word role is difficult because clients connected it with acting. She ended up naming the checklist Doing different tasks and in the following sentence she used word role. I myself also used the role checklist sometimes as a warning up before OPHI II interview. Riitta Keponen, lecturer, Occupational therapy education, Metropolia University of Applied Sciences, Helsinki February 17, 2012 Hi Riitta and all My clinical background was working in acute mental health and many inpatients had very few roles so I always had to be really careful about when to use the role checklist. I thought it worked really effectively with clients who had loads of interests (perhaps identified using the interest checklist) but still have very few roles. One of my favourite anecdotes relates to a client who liked gardening (though not enough to consider herself a gardener ) and who enjoyed going to church on occasion but did not belong to a church. An opportunity arose for her to become a volunteer at a gardening project restoring an old kitchen garden but it would have involved travelling across town and she wasn t sure if she would find the commitment too much. We used the role checklist as a focus for discussing how roles affected our sense of identity in a way that interests might not, and that the long-term commitment was rewarded by a sense of belonging. She had a couple of roles already, as a friend and home-maintainer and we talked about how she could easily strengthen her roles by becoming a volunteer/gardener and perhaps a member of a faith community too. I had known this person for several years, over several admissions, and to my knowledge she was never admitted again. Although I will never know, I like to think that she went on to establish satisfying roles that maintained her mental health! Sue Parkinson February 17, 2012 Dear colleagues, In Brazil, I have trained over 300 OT professionals and students to use the Brazilian version that I validated counting on support from Frances Oakley and MOHO Clearinghouse: Cordeiro, J. R., Camelier, A., Oakley, F. & Jardim, J. R. (2007). Cross-cultural reproducibility of the Brazilian

Portuguese version of the Role Checklist for persons with chronic obstructive pulmonary disease. American Journal of Occupational Therapy.61, 33-40. As in Brazil we still do not have as many validated instruments as other countries (neither the tradition to use them unfortunately) people in my country have been finding it useful for many purposes not only in the clinic but to report data for their managers as: the profile of the patients seen by certain clinic or the new configuration of this profile after the treatment of a group of patients. As Riita observed, patients have difficult with the word role, so when using the instrument we should make sure they understand the concept underling it. February 17, 2012 Junia and all of the other colleagues who have joined the discussion about the Role Checklist, I have followed with interest this discussion which in part at least stemmed from my query about how others are using the Role Checklist. It is amazing how Fran Oakley in 1986 came up a tool that is so comprehensive and so straightforward with ten roles that seem hold 25 years later and enable translation now into at least 12 languages. I truly believe that the Role Checklist, since it is congruent with the ICF, and is such a short simple instrument, can be established as a global outcome measure. Junia, I was happy to read in your post this morning (at least it was morning for me ) that some therapists in Brazil are using it to report profiles of patients and the new configuration of the profile after the treatment. I use it in longitudinal research to track change in participation in valued roles over time and am sure many others are using it. But there are substantial obstacles to overcome first. Let me try to summarize some of them and hope others can add to the lists. Advantages: useful for many purposes not only in the clinic but to report data for their managers as: the profile of the patients seen by certain clinic or the new configuration of this profile after the treatment of a group of patients. Junia J Rjeille Cordeiro, Brazil helps us better understand the impact that chronic mental illness has on a person's ability to engage in occupational roles that they find meaningful and important. Rick Ericksen, MOT, OTR/L, Utah, USA I find it useful it help identify what the client feels their roles are and their interpretation rather than our own or their families interpretation. It is useful to use with the Interest Checklist, share with other members of the Multi-disciplinary team and to incorporate into an Activity of Daily Living Assessment in relation to role identification and role completion. - Ruth Crowley, UK

used it repeatedly within a time frame with the same person to offer him/her a visual format to see his/her changes and achievements in their occupational participation: Carmen de las Heras, Chile Disadvantages: Patients not associating interest/activities with roles; example gardening not listed as a hobby: Sue Parkinson US In Finland we are faced with challenges of translation from English into Finnish language. We have to consider each concept carefully the word role is difficult because clients connected it with acting. She ended up naming the checklist Doing different tasks and in the following sentence she used word role that I have to extensively explain what a 'role' is, as many of my clients find this a difficult concept to take on board. I find that many of my clients respond well to being interviewed about their roles once they understand the concept: Anne Chatters UK Need to use UK rather than US terminology regarding groups they may be engaging with in relation to their interests and age as the examples given are not relevant to some our clients: Ruth Crowley UK As Riita observed, patients have difficult with the word role, so when using the instrument we should make sure they understand the concept underling it: useful for many purposes not only in the clinic but to report data for their managers as: the profile of the patients seen by certain clinic or the new configuration of this profile after the treatment of a group of patients. Junia J Rjeille Cordeiro, Brazil Populations: variety of therapeutic settings and research projects. Junia J Rjeille Corderio Brazil woman s health study with the OSA and OPH-II : Lucy Swan, MOT, OTR/L - USA I use the role checklist with adolescents (close to twenty),young adults, adults and my client s parents and caregivers. Carmen Gloria de las Heras, MS, OTR Chile young adult clients and sometimes with Forensics patients: Rick Ericksen, MOT, OTR/L, Utah, USA mixed sex adult psychiatric Inpatient Rehabilitation Unit. I encourage my clients to complete it themselves (this provides good information itself as to their ability to complete forms and literacy issues) although this depends on their literacy, concentration and selfconfidence. With some clients I prompt to assist them. Ruth Crowley UK acute mental health: Sue Parkinson, USA

Chronic Pain: Finland Older Adults with mental health problems. Anne Chatters, UK Uses/ Administration: small groups (2-3 patients) as an interview or self-completion after being given verbal directions, and use it to facilitate discussion about the individual's value of occupational participation. Rick Ericksen, MOT, OTR/L, USA I used mixed methods. Usually, self-completion followed by an interview to relate variables with personal causation and other occupational personal and environmental aspects. I have also done an OPHI-II flowing from the analysis of the role checklist. I have used it repeatedly within a time frame with the same person to offer him/her a visual format to see his/her changes and achievements in their occupational participation:. Carmen Gloria de las Heras, MS, OTR Chile I myself also used the role checklist sometimes as a warning up before OPHI II interview. Riitta Keponen, Finland This is an interesting start to some of the challenges, I also recall, that when Krisjana (sorry, I did not spell that right) Fenger, from Iceland was working on the Icelandic translation she found the term volunteer had no conceptual meaning in Iceland, and struggled with this term. I have also personally found my patients have trouble with past, present and future. I want to thank each of you who has contributed to this material. I hope this is only a start to the discussion. I know that some of you have been involved in the translation and I am planning to contact the translation contacts as listed on the MOHO Clearinghouse site as to their experiences. I will keep you updated as I continue these plans for establishing some type of Global database. I invite each of you to add, to clarify if I misrepresented your comments, and to urge others that you know use the checklist, to join in the discussion. Again, I hope to meet some of you at the Institute in Stockholm, it would be great to get together in person! Thanks, Patty Patricia J Scott, PhD, MPH, OT, FAOTA February 18, 2012 I have used this tool with inpatients on occasion but agree you need to be careful as many inpatients roles are severely diminished (as another person previously mentioned) as is their interest or feelings of competence to re engage in meaningful past role or consider new ones. That said, I have found that looking at the lack of roles these inpatients may have due to the current crisis that, if high functioning enough, the discussion can be helpful in facilitating them

in identifying possibilities and then we can begin to identify specific step to move toward development of those roles for post dc. This is particularly important if their follow up after dc does not include OT - which in this country is quite often if people are not going to a day hospital or partial hospital outpatient program following their dc. Having the paper assessment to take home, I ve been told, also reminds them of the discussion and the goals they want to work on involving role development. February 18, 2012 Dear Patricia, That is a wonderful gathering of experience around the Role Checklist. Let s keep in touch and sharing February 18, 2012 Thank you Patricia! Great summary and future planns Carmen Gloria Chile February 18, 2012 Sarah, I usually do not recommend it use for in patients at least not using the present as the present time in hospital, because, for sure, their roles will be very diminished. As the literature shows us flexibility in defining past, present and future, I would check their roles considering present as the last week before admission and the future any date after discharge. Doing this way, I will have a real notion of their role career and will use the time spend in hospital to plan future roles (and evaluate role career, etc.) February 20, 2012 Patricia! Thank you for summing the discussion! Such a deep discussion and does show us how the instrument does not need to be complex when there is the strong theory behind it! One thing that I would like to share with you all. I was working on the translation of OPHI II with Professor Gary Kielhofner and a group of colleagues. We discussed the concept of occupation role. Gary highlighted the difference of social role and occupational role. He also said that there are unofficial roles taken by or given to a person. These can be pointed out in a discussion to the client and others, strengthened and this way made more official.

I remember a 33 year old client (with chronic pain) who told me how she will move to her brother s house (apartment upstairs) to save living expenses. She also visioned many tasks she will be able to take on when her nephew will begin school. I loved the example Sue shared with us about the gardening. I noticed that one of the tasks I had when I worked in a rehabilitation programme was to dig out the occupational role the person could have one of them is often enough when you live your life with a chronic illness. It will bring the meaning back to the life! Riitta