What is MOHO?

MOHO is a conceptual practice model for Occupational Therapists first published in 1980 by Kielhofner. Born directly from Kielhofner’s work with US military veterans, MOHO still remains relevant today in both physical and mental health settings due to ongoing research and regular updates. This internationally based research has enriched and expanded the model and provided a broad and robust evidence base, as well as standardised assessments covering all areas of MOHO.

Not only has this continued research enabled the model to remain current and adapt to the ever changing health and care landscape, it has enabled the model to be successfully implemented world wide, across many health care settings, in different health care systems and in role emerging settings, as well as taking into account and addressing cultural and language differences.

Since it’s concept forty years ago, Kielhofner’s Model of Human Occupation has been by OT’s working with clients who have Mental Health and / or Physical Health diagnosis, in the inpatient setting, within the community and within "the margins". It is a client centred, occupation focused model, which identifies what motivates the individual into action and then, uses this to collaboratively set and achieve intervention goals.

MOHO does not only focus on a person’s volition but, also how their habituation, performance capacity and / or environment impact on their ability to participate in their chosen and / or essential occupations.

Habituation looks at existing habits and routines and, how they support or disadvantage participation in occupation. Assessment identifies scope for and ability for change to enable participation in a balanced daily routine, that promotes health and wellbeing. While, performance capacity focuses on the experience of the body and the mind when one is participating in occupations. It is objectively observable, measurable and quantifiable but, most importantly it is a lived experience. These are then considered along side the person's environment; how a person interacts with and is supported or restricted by their physical and / or social environment on an immediate, local and global level. The “environment” does not just encompass physical aspects such as layout and communication links but, also cultural influences, political conditions and economic factors. A person's environment creates both demands (which offer opportunities) and constraints. I will address each of these areas in more depth latterly.