Running head: OCCUPATIONAL PROFILE & INTERVENTION PLAN

Occupational Profile and Intervention Plan

Kristin Caroza
Touro University Nevada

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Occupational Profile
Client
Bridget is a 24-year-old Nevada native who lives in the Desert Regional Center (DRC), a
facility for individuals with severe mental illnesses and developmental disorders. She goes to
work five days a week at Carpe Diem (CD), a secured job training program for individuals with
disabilities. She is a very energetic woman who enjoys exercise related hobbies including
bowling, soccer, and basketball. Bridget also describes herself as an artist because she loves to
paint pictures of flowers in her spare time. She has a very supportive grandmother in which she
calls every day. Her grandmother frequently visits her at least once a week and takes her out to
restaurants, shopping malls, and recreational centers.
Services Seeking and Concerns
Bridget is diagnosed with bipolar disorder, mild intellectual disability, hypothyroidism,
strabismus, as well as hypotonic hemiplegia cerebral palsy (CP) on the left side of her body.
Bridget is currently receiving mental health counseling to help address her emotional regulation.
Most of the time, she is very animated and commands the attention of the people around her.
This behavior makes it difficult for group situations because she easily gets upset when the focus
is not on her. To cope with her stress, Bridget engages in screaming and self-biting behaviors.
Bridget and her mental health counselor discuss her self-injurious behavior quite often because
one of the primary concerns for Bridget is her strong desire to participate in community
activities. Community integration is addressed in the DRC through field trips to bowling alleys,
stores, and recreation centers. Community integration is difficult for Bridget because she easily
gets overwhelmed by auditory stimuli. Loud sounds in the community often trigger Bridgets
stress, causing her to bite herself. When she reaches an aggressive state, she requires maximum

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verbal cues to calm herself. If her behaviors escalate to the point in which she is considered
dangerous, Bridgets supervising staff may utilize physical restrain and isolation. When Bridget
engages in self-harm, she is not allowed to go on such field trips because she is considered
unsafe to be out in the community. Bridget would highly benefit from occupational therapy (OT)
to address her practical social skills and sensory regulation for community integration.
Furthermore, an OT services can help address the environmental factors that induces Bridgets
stress as well as educate supervising staff about alternative responses to aggressive behaviors as
opposed to physical restraint.
Contexts and Environments
Bridget is currently living in a supervised home with four other female residents. Within
the social environment of the home, the women treat each other like sisters. They are very
supportive of one another and provide each other with a sense of belonging. They also tend to
bicker with one another about boys, clothes, and each others attitudes like typical sisters (I.
Burke, personal communication, May 14, 2015). These women help support Bridgets
development in social skills because they are all learning about themselves and developing the
skills to be a part of the community together. This camaraderie has strongly impacted how
Bridget interacts with other people. As stated before, Bridget is working on sharing the attention
with other individuals around her. By living with the other women, Bridget has more
opportunity to practice appropriate social skills such as respecting others or having polite
manners. Unfortunately, the physical environment of the DRC allows limited leisure
opportunities for Bridget. The DRC is heavily guarded facility with locked exits and 24-hour
supervision. Bridget is required to ask for permission from staff for every activity that she would
like to try, restricting her abilities to make free choices about her occupations.

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Success and Barriers in Occupations
For leisure, Bridget feels very confident in her abilities to paint and go bowling.
Although Bridget lacks coordination skills for these activities due to her CP, the mere aspect of
being able to participate in sports and art is enough for her to feel good about herself. Of all the
sports Bridget participates in, she proudly displays her trophies that she earned for bowling.
However, she is also very competitive. Winning games causes her a great deal of stress and has
been known to scratch herself when she loses. Although she loves sports, Bridget lacks social
and emotional regulation skills to be a part of a team. Furthermore, Bridget does not always
understand how her CP impacts her ability to participate in her beloved sporting activities. For
example, Bridget tries to use her affected left side as much as possible when she plays sports and
begins to feel pain in her joints due to the increased effort. Bridget is not always safe while
playing sports as well because, in the previous year, Bridget had sprained her ankle while playing
basketball.
Occupational History
Bridget had a very challenging upbringing because both her mother and father was
diagnosed with a drug and alcohol addiction as well as depression. From an early age, Bridget
displayed aggressive behaviors. With both of Bridget's parents combatting their issues with
substance addiction, they were no longer able to take care of her. However, Bridget's
grandmother took full custody. Since then, Bridget's grandmother has been extremely supportive
of her and has been an active advocate for her to receive the services that she needs. Throughout
childhood, Bridget received special education services at Variety School, a specialized facility
for individuals with intellectual disorders. There, Bridget learned how to read and write up to the
fourth-grade level. Under the Clark County School District, Bridget received OT services to

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address her fine motor and gross motor deficits due to her CP. In 2008, her performance had
plateaued, and OT services were discontinued. As Bridget got older, it became more difficult for
her grandmother to take care of her because her behaviors became more severe. Bridget moved
to a group home for adolescents when she turned 17 and has been moving to different specialized
facilities since then.
Values and Interests
Art is an occupation that Bridget enjoys doing every day because it helps her feel better
whenever she felt sad. Bridgets staff note that she is calmer and more focused when
participating in an arts and crafts activity. Other than her interest in art, Bridget also values
being a good friend. Bridget regularly tells her friends that she is excited to see them and always
voices her concern about them. Through her mental health counseling, Bridget is learning how
to show appropriate behaviors towards individuals she cares for. Some topics that are usually
discussed in her counseling sessions include listening to others, noticing good qualities about
people, and respecting boundaries.
Roles
Bridget is currently employed at CD. Unlike regular jobs, CD is considered a sheltered
workshop because it is a protected work environment in which basic vocational skills are taught
along with behavioral interventions (Siporin & Lysack, 2004). Sheltered workshops are
considered to be a stepping stone toward regular employment. Her job usually entails sorting
tasks and janitorial work. A job is significant in Bridgets life because being employed and
getting paid for her work helps increase her independence. She enjoys being able to have money
for her to participate in community activities such as going out for dinner at a restaurant and
going shopping at the mall. Bridget also has the role of a granddaughter. Bridget is beginning to

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understand that her grandmother is getting older and growing weaker. Bridget is very concerned
about her grandmother and routinely calls her every day to check if she is feeling well.
Patterns of Engagement
Having a job is very beneficial for Bridgets quality of life because it helps provide her
with a daily routine and a sense of responsibility. Bridget can independently get ready for work
and identify which van takes her to CD. Most of the time, she is can have healthy behaviors at
work and put a lot of effort into her job tasks. In recent months, however, a lot of Bridgets
major behavioral issues has occurred at work. She is reported to have a short attention to task
and display outbursts towards the end each work day. Bridget is very vocal about how much she
does not enjoy her job. Furthermore, CD is also a very hectic work environment. Bridgets
sensitivity to loud noises at work leads to aggressive behaviors. Over time, Bridgets
employment at CD is increasingly contributing to her issues with her overall behavioral, social,
and emotional regulation.
Priorities and Desired Outcomes
The primary goal that Bridget would like to achieve is to be a part of a community.
Bridget thrives when she is given new opportunities to learn and has the freedom to make her
own choices. However, the DRC strives for all of their residents to be safe in the community.
Due to her poor sensory and emotional regulation, Bridget is often overwhelmed during
community outings despite her desire to participate in them. In particular, bowling appears to be
a very rewarding activity for Bridget, and she would like to have more opportunities to get better
at the game in order to participate in competitions. Second, Bridget does not enjoy her job. At
the DRC, Bridget was assigned to a job at CD without her input. Recently, Bridget and her
grandmother have become very vocal about finding a more meaningful place of employment that

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will allow her to practice her love for art. With this in mind, Bridgets mental health counselor
and social worker agree that Studio 8 Ten would be a very appropriate job placement. Like CD,
Studio 8 Ten is a secure work environment. However, job tasks in this setting focus on creating
art projects to be sold in charity auctions or at the Studio 8 Ten store. For this to be possible,
Bridget must complete a job interview and improve her work productivity.
Occupational Analysis
Context and Setting of Services
At the DRC, there are 48 beds available between 6 houses. There is 24-hour staff
supervision, recreational therapy, and mental health counseling services for the residents.
Community integration is the focus of this facility and is taught through field trips and job
training services. OT is currently not available at the DRC. However, it is imperative that it is
implemented to teach basic independent living skills and facilitate a transition to the community
and group homes. Bridgets work performance at CD was observed. There are 50 employees
under the CD work program who are heavily supervised with one to one staffing. Inside, there
are 30 cubicles to allow people to practice job skills. CD building itself is a warehouse and
could be described as a very hectic and busy environment. It is very loud inside CD due to the
screaming and combative behaviors of individuals with intellectual disabilities. Staff in this
setting utilize physical restraint and isolation when severe behaviors arise. As explained by her
mental health counselor, this leaves Bridget with no opportunity to learn from her actions in the
future (I. Burke, personal communication, May 14, 2015).
Activity Observation of Clients Performance
Bridget has been working with CD for over a year and is able to perform all of the work
tasks efficiently. During the time of observation, Bridgets responsibilities included sorting and

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mopping floors. For the sorting task, Bridget was seated at her desk with dozens of erasers of
different colors. She then separated the erasers by color and placed them into separate small
boxes. Once this is completed, her supervisors take all of the erasers out of the boxes and mixes
them for Brooke to sort again. During this task, she primarily used her dominant right hand to
grab the erasers. She also utilizes her affected left hand to help stabilize the boxes. Bridget
sometimes makes the mistake of putting the erasers in the wrong colored box. Bridget tends to
make more mistakes on items that are placed on the left side more than on her right, which could
be attributed to the strabismus on her left eye. For mopping, Bridget primarily only uses her
right hand to hold the mopping stick. During this task, she can easily push the mop and walk it
around the CD building. However, she does not pay close attention to the dirty areas of the floor
to clean. As she performs this work task, however, Bridget often gets distracted and socializes
with her co-workers. Thus, decreasing her efficiency at work. Bridget requires maximal
redirections and verbal cues to maintain her attention to task throughout each job task. At CD,
Bridget is given a one-hour lunch and several breaks throughout her work session.
Key Observations
Upon visiting Bridget at CD, it was quite apparent that she lacked attention some
attention to personal hygiene. She went to work with unkempt hair, an unwashed face, and
untrimmed fingernails with dirt underneath them. When Bridget was asked about how she got
ready that morning, she did not notice anything wrong with her appearance. When she was
instructed to wash her hands she needed 3 verbal cues to clean the dirt under her nails. While
performing job responsibilities, Bridget appears to not be challenged enough because she usually
finishes her tasks with ease and complains about being bored frequently. It was also apparent that
Bridget gets overwhelmed within her work environment. During an incident in which another

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employee was screaming, Bridget's body tensed up, and she plugged her ears with her fingers.
Bridgets sensitivity to noise caused her to stopped working and started to cry because it was
giving her a headache.
Significant Impact
Based on observations of Bridget at work, she is functional with performance skills
involving motor ability despite her CP. However, the areas in which significantly impacts her
ability to work are related to her physical environment. According to the American Occupational
Therapy Associations Occupational Therapy Practice Framework, physical environments
include structures, objects, and the sensory qualities that surround a person (AOTA, 2014). It is
very loud and visually stimulating inside CD. Bridgets level of anxiety due to the environment
was apparent when she plugged her ears in response to another employee was being loud and
aggressive. Although it was not seen during the time of observation, Bridget's work staff note
that she can be verbally aggressive toward others and engage in self-biting. Bridget currently
lacks the specific mental functions to regulate her emotions, which is a significant impact
because Bridget will not always be able to control her physical environment when she is out in
the community. Bridget currently does not have the emotional and self-regulation skills to be
considered safe to participate in the community.
Although Bridget may not have any motor issues to perform her work tasks, Bridget
struggles with being productive due to her visual and mental functions. Bridgets vision results in
left-sided neglect due to her strabismus. As a result, she makes more mistakes on tasks to her left
and constantly requires more time to complete tasks because she needs to fix her work. Also
contributing to Bridgets decreased work productivity was her deficits in the specific mental
function of attention which includes aspects of sustaining and shifting attention as well as

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limiting distractibility (AOTA, 2014). Bridget was highly unfocused and frequently engaged in
conversation with her coworkers. Although socializing with others is not discouraged at her
workplace, Bridget often has difficulty attending to work tasks when other people are around.
Adding to Bridget's distractibility is her pain. When Bridget was overstimulated, she complained
of having a headache and could no longer concentrate on her work. When this occurred, she
stopped working altogether and would not continue until she received medicine to treat her pain.
These factors highly impact Bridget's productivity at work and contribute to her having negative
behaviors at work. A change in Bridget's employment is vital to limiting her incidences of severe
behaviors and increase vocational satisfaction.
Problem List
1. Clients self-injurious behavior during stressful situations results in limited transitional
opportunities for community participation.
2. Client is unable to progress toward employment at Studio 8 Ten due to her short attention
to task and decreased emotional regulation skills during work tasks.
3. Clients poor gross motor coordination results in an increased safety risk when
participating in sports activities.
4. Client requires maximum verbal cues for group activities due to attention seeking
behaviors.
5. Client requires moderate verbal cues to fully participate in hygiene and self-grooming
routines.
Priorities
Problem 1 is listed as a high priority to address because it is the area in which the client
poses the greatest threat to herself. When Bridget engages in self-injurious behaviors, her

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supervising staff at the DRC deem her as unsafe to be out into the community, and she loses the
privileges to participate in group field trips which causes a great deal of stress for Bridget. Thus,
leading to her hurting herself again. This behavior needs to be addressed because it is often a
dangerous cycle of self-harm for Bridget. This is fitting for this population and setting because
the main goal of this facility is to prepare individuals to be participants in the community. It is
imperative that Bridget learns more appropriate coping strategies in response to stress to increase
her quality of life and participation in the community.
Problem 2 is listed high on areas to address due to its importance to Bridget as well as her
grandmother. In order to increase Bridgets quality of life, allowing her to have a personal
choice in vocational participation is essential to increasing her satisfaction (Haertl, 2011). All of
the team members on Bridgets caseload agree that a job at Studio 8 Ten is the most appropriate
level for her because she is consistently unchallenged at CD. Furthermore, Bridget is still
required to prove that she is qualified to be in this new job program. This involves having
consistent good behavior at work as well as a one on one interview. Occupational therapists
(OT) can work with Bridget to improve her social skills during an interview and develop a
behavioral plan for work to limit her distractibility and promote job performance at CD.
Problem 3 is also put on the list of priorities because of Bridgets risk of injury. Bowling,
basketball, and soccer are all very important occupations to Bridget. Nevertheless, safety should
always be a primary concern to any client. With Bridget, she often complains of joint pain after
playing sports. It is important to prevent the possibility of future injuries through the teaching of
compensatory strategies and activity modifications so that Bridget can engage in these
meaningful occupations as long as possible.

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Problem 4 is addressed because the main goal of the DRC is to have individuals develop
the social skills to transition to a community living facility. Eventually, the DRC would like to
see residents like Bridget progress to a group home setting in which typically have less staff to
supervise the residents. Individuals in group homes typically display less severe behaviors as
those in the DRC and have fewer restrictions upon them from staff. With this in mind, Bridget
must show to her that she can live with other individuals without requiring constant attention.
The reason why it is lower in priorities is because Bridget is currently making some progress
while working in groups but still requires moderate verbal cues.
Problem 5 is lower on the list because Bridget is functionally able to perform all of her
self-care routines independently. However, she still requires moderate verbal cues to execute
hygiene and self-care activities thoroughly. If she progresses to a group home, she may not have
the supervision to help her with grooming or hygiene routine. Bridget needs to develop a sense
of self-awareness of her body in order to prevent viral illnesses or the spread of disease causing
organisms (Haertl, 2011). It is also vital for Bridget to maintain a standard level of personal
hygiene and a groomed appearance to adhere to cultural norms to enter the community.
Intervention Plan and Outcomes
Long-Term Goals, Short-Term Goals, and Interventions
Long-term goal one. Client will obtain a part time job at Studio 8 Ten through a job
training plan with supervision within six months.
Short-term goal one. Client will complete a mock interview with supervision and using
a visual reference in a simulated office room within one month.
Intervention one with graded variations. Bridget will complete a worksheet with a list
of questions that are frequently asked in a job interview. Bridget will then rehearse answering

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the frequently asked interview questions with an OT in an office that simulates an interview
room. If Bridget has difficulty remembering how to answer a question, she will be allowed to
refer to her worksheet as a visual reference.
Grading up. If Bridget appears to complete the mock interview with ease ask three
more additional questions that were not addressed in the worksheet.
Grading down. Instead of having Bridget independently answer interview questions on
the worksheet prior to the mock interview, an OT will provide the answers for her verbally as the
client copies what is said.
This intervention utilizes a modify approach in order to improve performance by
adjusting activity demands (AOTA, 2014). This approach is utilized because completing a full
interview would be too difficult for Bridget to do independently. Allowing Bridget to use her
worksheet during an interview simplifies the interview activity and decreases the need for her to
memorize the answers to a question. Many research articles related to job employment for
individuals with an intellectual disability emphasize the need for support in order to attain a
vocation. Furthermore, Kamens, Dolyniuk, & Dinardo (2003), explain that services should also
focus on searching for jobs and applying for employment along with teaching job skills. Often
individuals with disabilities need support to engage in an interview process and determine what
type of vocation they would find meaningful. This study emphasized the utilization of roleplaying activities because they were the most effective intervention strategies for improving job
skills and job attainment (Kamens et al., 2003). Outcomes that are expected with this
intervention would include improvement in occupational performance during an interview.
Short-term goal two. Client will volunteer at Studio 8 Ten to attend to an art project and
stay on task for 15 min with moderate verbal cues within three months.

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Intervention two. Clients will attend a painting workshop at Studio 8 Ten. She will
follow the directions of a lead artist at the job site to paint and color in the drawings on a canvas.
During job tasks, the client will wear sound canceling headphones to prevent auditory distraction
to improve attention to task. The client will work with an aid to help her understand and follow
directions for painting task. After the client has finished coloring, she will assist in the cleaning
process by washing brushes and putting away the paint.
This intervention will utilize a quality of life approach to increase life satisfaction toward
goals (AOTA, 2014). Bridget will be allowed to experience a working environment in which she
gets to practice her love for art. By giving Bridget the opportunity to practice job tasks that
reflect her interests, it may increase her attention to task during work. In a qualitative study
related job training programs, it found that it was beneficial to implement a pre-work phase to
expose individuals with a mild intellectual delay to their work environment prior to employment
(Arikawa, Goto, & Mineno, 2013). In this study, the clients were given simple work tasks at a
job site while an OT observed their performance and helped with transitioning to full-time
employment. Through OT, the work environment was adapted to suit the sensory needs of the
client and staff was educated about their client's abilities to improve job performance and sustain
employment (Arikawa et al., 2013). This intervention will reflect the treatment of this study
because therapists made necessary accommodations to improve job performance. The expected
outcome of this intervention would be an increased participation, occupational justice, quality of
life, and role competence within the work setting at Studio 8 Ten.
Long-term goal two. Client will attend community field trips without performing any
self-injurious behaviors four out of five times with moderate verbal cues for redirection and
using noise canceling headphones within six months.

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Short-term goal three. Client will play one bowling game at a local bowling alley with
a team and demonstrate good sportsmanship to peers four out of five times with moderate verbal
cues within 1 month.
Intervention three. Bridget will go to a bowling alley during a community field trip with
the OT. She will play one game with an OT and another DRC resident using noise canceling
headphones to modulate auditory overstimulation. Throughout out the game, the OT will model
examples of good sportsmanship such as allowing others to play first, saying "good job" after
others have played, and shaking hands when the game is over. Bridget will receive moderate
verbal cues to say positive comments during the game and verbal positive reinforcement when
she says it independently.
This intervention will utilize an establish approach in order to develop skills that are
currently not present (AOTA, 2014). Bridget currently has very little social and emotional
regulation skills in competitive group activities. This will help her understand that whether she
is winning or losing a game, it is always important to have good sportsmanship. Related
research addresses the promotion of social skills through group activities. According to
Laugeson, Frankel, Mogil & Dillon (2009), the participation of parent-assisted social programs
for adolescents with autism had contributed to significant improvement in social skills. During
such group activities, positive social skills were modeled and reinforced by the assistance of
parents. When utilizing the same methods as the research, an OT can mimic the role of the
parents in cueing and modeling appropriate social skills during a group game activity. The
expected outcome of this intervention would be an increased participation in team-based
activities as well as role competence of being a team member of a bowling game.

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Short-term goal four. Client will identify appropriate coping strategies to stress 3 out of
5 times with mod VC during community field trips within 3 months.
Intervention four. Bridget will participate in a Dialectical Behavioral Therapy group that
addresses mindfulness and distress tolerance. She will be given a cartoon picture of a body and
identify areas in which she experiences the physical symptoms of stress and what happens. For
example, if Bridget may circle the hands and ears in the picture. She will then explain that she
balls her hands into a fist, and her ears feel hot when she is stressed. Bridget may share her
results with the group and discuss coping strategies that she could do when she notices her
physical symptoms of stress. Some of the coping strategies taught will include deep breathing,
asking for breaks, talking to another person, and squeezing a stress ball. With the group, Bridget
will participate in a role-play activity in which simulates a stressful situation. She will then
practice some of the coping strategies that were taught during the group discussion.
This intervention utilizes an establish approach because Bridget does not have the skill
set to help her regulate her emotions and behavior. By teaching Bridget new strategies for
identifying her stress, we are helping her change her current coping mechanism of biting to safer
and appropriate methods. According to Brown, Brown, & Dibiasio (2013), DBT emphasized
self-control showed clinical and statistical improvement in all challenging behaviors within a
year and were maintained for four years among individuals with an intellectual disability.
Furthermore, DBT was most beneficial for study participants who had Bipolar disorder and
engaged in self-injurious behaviors. Through mindfulness and distress tolerance, Bridget could
learn to take control over her behaviors and improve her quality of life. Other outcomes that
could be expected are the prevention of further injuries from Bridget's self-harming as well as an
improvement of occupations.

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Precautions
When working with Bridget, there are many precautions to consider. Since many of her
goals will address community integration, it is important to monitor Bridget's behavior when she
is out in public. As stated before, she easily gets overwhelmed in loud environments with intense
visual stimuli and requires constant monitoring for signs of stress before she escalates into her
self-injurious behavior. It is also vital to mention Bridget's regard to safety. She is a very social
person and has been known to talk to strangers. It is on her record that she had once wandered
away from her group during a community field trip when a stranger had asked her to follow him.
Lastly, Bridget also has a history of having seizures in response to the behavioral medications
she takes. Although her last reported seizure was in 2013, it is essential to understand the side
effects of the medications she takes and if there are any changes in her prescriptions.
Frequency and Duration
Considering the fact that Bridgets intervention plan is addressing behavioral and social
goals for community integration, she will be seen twice a week. Bridget will have a one on one
session with an OT once a week for 60 minutes and participate in a group therapy session for 60
minutes each week. Bridget will receive OT services for six months and will be reevaluated if
more services are needed.
Model
The Person, Environment, and Occupation (PEO) model would be the primary model
utilized for Bridgets intervention plan. The PEO model puts consideration into of both a
persons ability to participate in roles that are important to him/her, environmental factors, and
their occupations to facilitate improvement in occupational performance through a lifespan
(Brown, 2014). For Bridget, we are trying to increase her quality of life to improve her abilities

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within community participation and vocational satisfaction. This will be done by helping
Bridget increase her abilities to regulate herself during stressful situations. For her environment,
caregivers and staff will be educated about Bridgets issues with sensory integration and triggers
to stress in order to prevent future behaviors when she is out in the community. Lastly,
occupations will be addressed by introducing Bridget to more opportunities for community
participation as well as a new work program at Studio 8 Ten in which fits with her desires to
pursue art. Overall, this model will focus on providing a goodness of fit for Bridget within the
various environmental, personal, and occupational factors.
Caregiver or Staff Training
In order for therapy to be effective for Bridget, it is important that everyone in her
interdisciplinary team are on the same page with interventions, especially those who work with
her in the home and job setting. This is vital for ensuring that there is carrying over of skills
taught in OT. First and foremost, Bridget's staff will be educated on utilizing alternative
strategies for addressing her aggressive behaviors. Instead of implementing physical restraint,
the OT will teach staff about sensory integration and noticing signs and symptoms of Bridgets
distress before it escalates. Furthermore, they will also be educated on the effects of Bridgets
sensory environment and strategies to address them including giving her headphones when it is
too loud or going out for a walk when she is overwhelmed.
Monitoring and Assessing Client Response
An OT will monitor Bridget's progression towards her goals by documenting her
behaviors and the coping strategies she has utilized during therapy sessions. The OT will also
consider the daily documentation reported from other individuals in her interdisciplinary team
including her supervising staff at work and home as well as her mental health counselor to see if

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there is any carryover of progression in different contexts. If Bridgets engages in self-injury, an
Antecedent, Behavior, and Consequence or ABC log will be recorded. This form of
documentation identifies the trigger of Bridgets self-harm, her specific behavior, and what staff
had done in response. At the DRC, individuals are reviewed bi-annually during a meeting with
the client, family members, administers, and individuals who are on his or her caseload. At this
event, all of those who attended will discuss Bridget's current level of behavior as well as
function and devise a plan for the continuation of her treatment.

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Brown, C.E. (2014). Ecological Models in Occupational Therapy. In B. A. B Schell, G. Gillen, &
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