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Writer's pictureThe MoHO OT

Interests; the chocolate of MOHO

Updated: May 25, 2021

Interests are what we find enjoyable and are maybe the most valuable tools in the OT’s tool box; a person’s interests can continue to energise volition even in the depths of the wildest storm. When we consider a person’s interests we look at what a person enjoys doing, what satisfies them and the unique pattern of participation that a person has.


Enjoyment ranges from a simple satisfaction derived from a daily ritual, to an intense pleasure through achieving a much strived for goal and can come from a wide range of factors which include; bodily sensations, fulfilment of intellectual intrigue and/or creative ambition and social interaction. It is these factors that influence our occupation choice and the occupations that we are most drawn to, generally tick more than one of those boxes at once.


It is the enjoyment factor of participating in occupations from which the term occupational flow stems. Flow occurs when we reach an optimal level of enjoyment through participation. It is a complete saturation of one’s awareness with the positive experience of performing the activity and a person's capacities are optimally challenged (Csikszentmihalyi, 1990).


As we do not experience our participation in occupations in the exact same way as our counter parts, we each develop a unique pattern of interests. Some patterns follow an underlying theme such as creativity or, being a thrill seeker, while, others may appear to have a completely unrelated interests.


Although commonly overlooked, one of the most pervasive effects of impairment on occupation, is its influence on how we obtain satisfaction and pleasure from our interests (Wook Lee and Kielhofner, 2017). There are many things that come hand in hand with disabilities (congenital / acquired and physical / mental) that impact on our ability to experience pleasure; pain, fatigue, cognitive impairment, physical inability, social stigma and lack of opportunities to name a few. And, it has long been known that inactivity and an inability to participate in our chosen occupations can result in a low mood, as well as, depression and other mental health conditions negatively impacting on people's ability to enjoy their interests, which leads us very nicely to the fact that physical and mental health are intertwined. Our role as Occupational Therapists is to enable our clients to reconnect with their interests, or where this in not possible, support the development of new interests and harness these to achieve occupational flow and therefore, reignite volition.


"Reduced access to satisfying activity can certainly lower mood, which tends to lower a person's interest in activity, which further lowers mood. Thus a vicious circle evolves"

Trieschmann (1989)


Interests are not only a great way to ignite a patient's lost volition but they are the truffles of an intervention plan. By gaining an insight into a person's interests and using them to develop an intervention plan we can embrace and apply patient centred care into our practice. A good therapist always remembers that a person's interests are important to them and can provide the basis for goal setting by giving patients' something to work towards and offer a physical marker by which they can assess their recovery.


Within MOHO, there are a number of ways to garner information about your patient's interests, i.e. checklists, observation, conversation and semi structured interview, all of which can be applied in any setting. The purpose of this blog is not to explore these different methods but how to apply them in order to gain insight into your patients' interests, establish their likes/dislikes, what makes them happy/sad so that you can build a rapport with them and therefore, reinforces patient centred care. It's the interests that evoke happy memories that you need to utilize whilst avoiding those that produce negative emotions. By building an intervention plan around happy emotions and memories, you are more likely to build a rapport with your patient, strengthen the therapist/patient relationship and thus achieve their goals. Remember that interests have a history and are built on past experiences happy or sad, providing a basis for empathising thus, providing the foundations for a good patient/therapist relationship.


Sounds simple doesn't it but, how do we apply someone's interests to our intervention plans? Perhaps the easiest way to translate this into practice is by using an example.

Take Barabara for example, Barbara loves to garden as it brings back fond memories of spending time with her beloved husband but at the moment her arthritis, associated pain and muscle weakness are resulting in reduced function meaning that she can't manage the three steps into her garden or walk to the potting shed. This is affecting Barabara's mood and she is therefore reluctant to engage with therapists. However, by incorporating her garden into your assessment and future treatment sessions, you will likely increase Barbara's willingness to engage whilst establishing what her barriers are and how these can be reduced or removed. Whether this be use of a walking aid, environmental adaptation or referral to other services/professions. These observations can then be applied to other settings and activities of daily living within the home or community, improving Barabara's general quality of life.


Now comes the next step in applying theory to practice. Using your preferred method of reflection whether this be Kolb or Gibb's reflective cycle or a clinical reasoning form, recall a patient you have struggled with and then explore how you may have improved treatment outcomes by applying their interests to your treatment sessions before considering how you can adapt your practice accordingly in the future.



The Modified Interest Checklist can be found here: https://www.moho.uic.edu/productDetails.aspx?aid=38


and, for UK readers, or clinicians that may need an easy read version (there are two assessments on this link)... https://www.moho.uic.edu/productDetails.aspx?aid=39




References:

Csikszentmihalyi, M. (1990) Flow:The psychology of optimal experience. New York: Harper and Row


Kielhofner, G. and Neville, A. (1983) The modified interest checklist. Model of Human Occupation Clearinghouse, Department of Occupational Therapy, University of Illinois at Chicago


Trieschmann, R. B. (1989) Psychological adjustment to spinal cord injury. In B. W. Heller, L. M. Flohr and L. S. Zegans (Eds.) Psychological Interventions with physically disabled persons New Brunswick, NJ: Rutgers University Press


Wook Lee, S. and Kielhofner, G. (2017) Volition. In Taylor, R. (Ed) Kielhofner's Model of Human Occupation 5th Edition Philadelphia, PA: Lippincott Williams & Wilkins



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