The application of MOHO in the treatment of a patient with depression in Taiwan: A case study

Yun-Ling Chen, Ay-Woan Pan, Tsyr-Jang Chen
Department of Occupational Therapy, National Taiwan University

Background:
Although the current treatment of depression centers on anti-depressant medication use and specific psychotherapy techniques, such as cognitive-behavioral therapy, there are still needs to employ different psychosocial approach to assist the patients with depression to live independently and happily. The purpose of the case study is to illustrate the application of the Model of Human Occupation (MOHO) in the assessment and treatment of a patient with recurrent depression.

Methods:
The patient was recruited from a psychiatric inpatient unit in a medical center in northern Taiwan. She was diagnosed as recurrent depressive disorder with previous history of anorexia nervosa, conversion disorder and obsessive-compulsive disorder. Multiple Chinese version MOHO assessments were applied to her at initial stage. The therapeutic relationship with the patient was developed through the discussion of the results of the assessment and treatment planning.The process focused on facilitating patient’s change and the most frequent therapeutic strategies used in the treatment included identifying, negotiating, advising, structuring and feedback.

Results:
The patient obtained high scores on all symptom checklists and lower satisfaction of her lifestyle and performance initially. A set of meaningful occupations were constructed with her and the steps to apply to her life were negotiated. Before her discharge in a month, her daily living function, role performance, occupational identification and competence improved from previous state. The most important point is the mobilization of her to initiate subtle change.

Conclusion:
The MOHO is a useful theoretical base in the clinical assessment and treatment of patients with minor mental disorder. The emphases of enhancing client’s motivation to engage in occupation and the employment of the therapeutic strategies to support client’s change are essential components of effective intervention.