Occupational Profile

1. Client name: Mike Carlton

2. Age: 28
3. Sex: Male
Briefly discuss each of the following:
4. Who is the client?
Mike Carlton is a 28 year old male who currently lives with his family in Tujunga,
California.
5. Why is the client seeking services and/or what are the clients concerns relative to engaging
in occupations and in daily life activities?
Client is seeking services secondary to injury in the lower back (protruding disc L5-S1). As a
result of the injury, client is unable to engage in areas of occupations, particularly his work as
an artist making paintings. The injury affects his ability to complete tasks while painting,
such as lifting, bending, and standing for an extended period of time. The negative effects of
the clients back injury and pain on his ability to engage in the occupation of painting
prompted his referral to occupational therapy services. Client expressed an interest in
developing strategies to reduce pain in order to improve participation in valued occupations.
6. In what occupations does the client feel successful and what barriers are affecting his or her
success?
Client feels successful in the occupation of painting. His inability to lift heavy objects and
stand for long periods of time disrupts his participation and efficiency in completing projects
and/or paintings for work.
7. What aspects of his or her environments or contexts does the client see as supporting
engagement in desired occupations and what aspects are inhibiting engagement?
Clients physical, social, and virtual environment support engagement and participation in
occupation. Client paints in the garage of his house where there is appropriate lighting and
minimal noise to help carry out the activity. Clients social environment provide support and
resource to occupation. Presence of family, friends, and colleagues help network and
generate referral of clients. As an active participant in the Los Angeles art community, client
displays his work at monthly art exhibits. In addition to this, social networks, such as
Facebook, Instagram, Twitter, and the clients personal webpage, enable him to sell and
promote his artwork. Aspects of the clients physical environment, such as arrangement of
the garage (packed boxes), lack of ventilation, and the hot temperature from the weather
inhibit the clients occupational performance. Currently, the clients family utilizes the garage
as storage space. As a result, the space is over-cluttered with boxes and equipment. In
addition to this, the client resides in Tujunga, California, which is located in the San
Fernando Valley of Los Angeles. The weather there is typically very hot, surpassing a 100
degrees in the summer. This makes it difficult for the client to work as efficiently and carry
out tasks.

8. What is the clients occupational history?

Client is 28 years old. He completed his Bachelors degree in Psychology and Theatre Arts
from the University of California, Irvine in 2006. He currently lives with his family in
Tujunga, California. During the day, he works as a behavioral therapist with children
diagnosed with autism. After work, he produces art, primarily installations, paintings, murals,
stencils, and illustrations. Some of his recent projects include a mural created for the Los
Angeles Unified School District, an installation for a restaurant in Pasadena, California, and a
set of paintings for Uniti Bank in Los Angeles, California.
9. What are the clients values and interests?
The client values his two jobs, both as a behavioral therapist and as an artist. As a therapist,
he provides behavioral services for children diagnosed with autism. In this setting, he views
himself as an educator, role model, and friend to the children. He introduces new skills to the
children and through the use of applied behavioral analysis (ABA) helps promote positive
and socially appropriate behaviors. The client strongly believes in setting a good example for
the children by modeling appropriate behaviors, and instilling confidence in them so that they
can achieve independence in various aspects of life. He finds his job as a behavioral therapist
both fulfilling and rewarding. As an artist, the client values the beauty and effects of art. It
provides him with the opportunity to bring many aspects of his style alive. Through art, he is
able to take personal experiences in his life and narrate them into a story. Although he enjoys
working in the field of behavioral therapy, the client wishes to pursue art as a full-time
occupation. He continues to take on new and ambitious projects while exposing his name and
work to the local community.
10. What are the clients daily life roles?
The client has many valued roles and responsibilities. In the home setting, the client is a son,
brother, and twin. In the professional setting, the client is a behavioral therapist and an artist.
In the social setting, the client is a friend and boyfriend.
11. What are the clients patterns of engagement in occupations
The client wakes up at 6:50am, Monday through Friday. In order to arrive to work on time
(8:30am) he must leave his house by 7:20am. His morning routine consists of showering,
getting dressed, making a breakfast smoothie, and feeding his dog, Kisher, before leaving
the house. The client is able to shower in approximately 10 minutes, gets dressed in about 5
minutes, makes a smoothie in 10 minutes, and feeds his dog in 5 minutes. Due to the heavy
traffic in Los Angeles, it takes the client approximately 1 hour and 10 minutes to arrive to
work on time. The school setting in which the client works provides him with a reserved
parking spot, therefore it takes him only a few short minutes to park and walk into work. The
client leaves work at 2:30pm and arrives home at approximately 3:00pm. During this time, he

takes a shower for 20 minutes and then takes a power nap for 30 minutes. At approximately
4:00pm, the client goes to a caf to research potential art projects, contact clients via
telephone/email, and develop digital concept drawings on his laptop. The client then returns
home at 7:00pm. He has dinner with his family and watches movies on Netflix for 1 hour.
Following this activity, the client enters the garage at 9:00pm to paint. He engages in this
activity until 12:00am or until he feels he is too tired to continue working. The client usually
goes to sleep around 12:00am-1:00am.
12. What are the clients priorities and desired targeted outcomes related to occupational
performance?
Due to an injury in the lower back (protruding disc L5-S1), the client experiences pain while
engaging in meaningful activities, such as painting. As painting requires bending, lifting, and
standing for an extended period of time, the client complains of lower back pain. He
expresses that the pain in his back increases the following morning after spending the night
in the garage painting. The client wishes to collaborate with therapist to identify potential
strategies that can reduce the pain in his lower back while continuing to participate in the
activity of painting.
Occupational Analysis
1. Occupation: Painting
Categorization of occupation for the client:
Subcategory:
1. Activities of daily living
2. Instrumental activities of daily living
3. Education
4. Work
Work Participation
5. Play
6. Leisure
7. Social participation
2. Values, beliefs, spirituality associated with participation:
Art enables the client to translate his values, beliefs, and views onto canvas. He expresses
that ideas come to us with the opportunity to give them life. Instead of bottling them up, art
should be used to give feelings, ideas, and concepts physical form.
3. Contexts:
Context
Physical/space
demands

Supports
A garage large enough to
allow the patient to move
around without bumping into
any obstacles or objects in the
environment. The space
should be sufficient in size.
Objects in the space should be

Inhibits
A small garage over cluttered
with tools, objects, and
equipment, as well as dim
lighting and lack of windows
for ventilation.

Social

Cultural

carefully arranged in order to

prevent any potential risks or
hazards to safety. Stable
surfaces (those that do not
shift) are important to the
environment, as well as the
height of surface (e.g., sturdy
table at waist level) to help set
and organize tools, materials,
and objects. Appropriate
lighting should be present to
help the client see and
complete tasks more
efficiently. Temperature
should be at a comfortable
level. Background noise can
be tolerated, but is not
required for the specific
activity of painting.
Ventilation is needed in order
to exchange and circulate air.
This is particularly important
as painting requires the use of
paint which holds a strong
odor.
Presence of friends, family,
and colleagues with whom the
client can interact and
network with to promote his
artwork to different groups
and populations (e.g.,
companies, businesses, and
clients seeking art services).

The cultural context can

A rather intrusive relationship

with friends and/or girlfriend
can potentially inhibit the
clients occupational
performance. More
specifically, friends/girlfriend
can place demands on the
client and restrict them from
attending to their priorities to
art. Social environment must
be well-balanced and
controlled in order for the
client to meet deadlines,
requirements, and overall, to
advance his future and career
in the field of art.

Personal

Temporal

Virtual

potentially influence and

inspire the clients work.
Specific customs and beliefs
can help shape concepts,
themes, and ideas in the
clients work. For instance,
the client has created many
pomegranate pieces
(recognizable symbol of
Armenia) and has displayed
them in Armenian cultural
events in Los Angeles. The
cultural context can
ultimately influence the
clients concept or pieces.
The personal context contains
many factors that can
influence occupational
performance. The client is a
28 year old man with a degree
in Psychology and Theatre
Arts from the University of
California, Irvine. As a
member of many alumni and
student-related organizations,
he is requested to attend and
display his artwork at events.
Client schedules
approximately 3-5 hours to art
each evening. He utilizes this
time to research projects,
contact clients, develop
concept drawings, and paint
in his garage. Maintaining
this consistency in schedule
enables the client progress in
his field and generate new
clients.
Client utilizes social
networking sites, such as
Facebook, Instagram, Twitter,
as well as his personal
website, to promote his

After a long day at his

behavioral therapy job, client
returns home and is too
exhausted to do art. Instead, he
showers, eats dinner, and goes
straight to bed.

While engaging in the activity

of painting, client is interrupted
by incoming calls, emails, text
messages, and alerts from
social networking sites.

current projects and

upcoming events where his
work will be displayed.

Attending to these distractions

will prevent him from working
efficiently and/or reaching his
deadlines in a timely manner.

4. Objects and their properties used:

Tools:
2 trays - to mix and arrange paint
2 Rags
4 cups to mix colors
1 drawing utensil preferably a pencil
1 empty can to hold paintbrushes
8 acrylic paintbrushes - round brush, flat brush, bright brush, filbert brush, fan brush,
angle brush, mop brush, and rigger brush
20 rubber bands
1 roll of saran wrap
Materials:

1 canvas -size will vary depending on desired piece

1 painters stick utensil utilized to mix paint
1 bar of soap
1 cup or jar of water
1 roll of paper towel
1 role of masking tape (optional) to prepare the edges of the canvas
1 can of acrylic gesso - white paint mixture used to add base for paint or other
materials
1 notepad
1 can of spray paint
2 spray bottles with water
10 cans of acrylic paint - colors will vary depending on desired piece
8 tubes of acrylic paint - colors will vary depending on desired piece

Equipment:
1 easel
1 table
1 sink with running water
1 laptop In case the client may need to reference digital concept of painting
Properties:

The brushes have smooth bristles. The cups are made of plastic and are reusable. The
paper towel is absorbent and strong for cleaning up paint. The roll of masking tape is

thin and easy to tear off without leaving any marks. The acrylic gesso is a white paint
mixture. The notepad has a binding and cover. The can of spray paint has a valve
stem that helps transfer and release paint. The spray bottles are made of plastic and
are light-weight to carry. The paint cans have a handle with a foam grip. The easel has
an angle of about 20 degrees to the vertical. The table has a flat and secure surface.
The sink knobs have sharp corners. The laptop is a mac. The rubber bands are made
of elastic. The tray has a flat surface. The rags are brown and woven with cloth. The
acrylic paintbrushes consist of different shapes and sizes: round brush, flat brush,
bright brush, filbert brush, fan brush, angle brush, mop brush, and rigger brush. The
saran wrap is made of a thin and clingy, plastic wrap which helps seal the paint cans
and prevent the paint from running dry.

5. Social demands:
Social interaction is not required for the activity of painting. It is generally an individual
activity that is performed alone. However, social rules, norms, and expectations are still
applicable. In regards to social rules, it is expected for the client to wash his/her hands after
completing the activity. The culture and environment in which the activity occurs can
influence social rules and norms. For instance, the association of art with altered states of
consciousness is prevalent in American culture. As a result, individuals engaging in the
activity of painting may decide to engage in preparatory activities, such as consuming
alcohol or drugs, to elicit creativity. These maladaptive behaviors are hazardous to ones
health. However, it is important to understand how these components of culture can shape
social norms and expectations of behavior toward individuals engaging in the activity of
painting.
6. Sequence and timing:
1. Gather all tools, materials and equipment in one area to establish a conducive work
environment (i.e., removing your paint cans, paintbrushes, canvas, and tray from the cabinet
in the garage). During this time, you will select the tools and materials that are appropriate
for the piece you will paint.
2. Place the canvas on top of the easel
3. Organize and arrange all your supplies on a table, setting up everything you need in an
efficient manner. (e.g., divide paintbrushes into empty can)
4. Walk over to sink
5. Turn on sink
6. Fill empty can with water - to dip paintbrushes while painting
7. Return to table
8. Place the can of water on the table
9. Remove the lid of the paint cans and paint tubes you will be using
10. Group the cans and tubes in close proximity so they can be reached and accessed more
efficiently

11. Mix the paint with a painters stick. You will be repeating this step continuously
throughout the process in order to mix, modify, and create new colors. Continue this step
until you have your desired color.
12. Add the paint from the can or the tube onto the tray tray is used to mix and arrange
colors
13. Reach for a large brush across the table
14. While stabilizing the tray in one hand, use the other hand to dip the paintbrush into your
desired color
15. Gently grip the paintbrush and apply brushstrokes onto the canvas
16. Divide different areas of the canvas you will paint. This is where you can use masking
tape or a writing utensil to draw lines/block off sections of the canvas.
17. Continue to mix different colors and apply them to the canvas using gentle brushstrokes.
Apply colors in order (dark to light).
18. Continue to apply layers to the canvas
19. Take a break and wait for the canvas to dry. This takes approximately 30 minutes,
however will vary depending on the quality of paint you are using.
20. Continue to add layers with textures, applying thicker paint in desired areas
21. Grab spray paint from table
22. Remove spray paint cap
23. Mix paint in spray paint bottle
24. Pour water into spray paint bottle
25. Dilute the texture using a painters stick to mix/stir the paint and water
26. Grab the cap and securely refasten it on the spray paint bottle. Make sure it is tight.
27. Shake the spray paint bottle for a few minutes
28. Hold the spray paint bottle at least 8 away from the canvas
29. Push down on the valve of the spray paint bottle and spray the canvas
30. As the paint drips down the canvas, grab a rag from the table and wipe the canvas. This
helps create more textures and layers.
31. Continue to give more form to the canvas while adding texture, repeatedly
32. Meanwhile, place the paintbrushes you are not utilizing in the cup of water
33. Take another break and wait for the canvas to dry. This takes approximately 30 minutes,
however will vary depending on the quality of paint you are using.
34. Once you feel satisfied with the piece or feel it is complete, grab saran wrap and rubber
bands from the table
35. Open the lid of the saran wrap box
36. Lift the sheet from inside
37. Pull out the saran wrap (approximate how much is needed depending on the
circumference of the lid of the can)
38. Cut the saran wrap against the sharp edges of the box
39. Cover the lid of the paint can with saran wrap and place a rubber band around the lid of
the can to preserve the paint and prevent it from getting dry.
40. Determine whether your canvas is wet or dry by gently tapping a small corner of the
canvas
41. If the paint is not dry, allow the canvas to stay out on the easel. Opening the windows will
help dry the paint faster. You can return to the canvas the following day so that it is dry.

42. If the canvas is dry, remove it from the easel and place it on a secure surface. Make sure
the surface is clear of objects.
43. Begin restoring all tools and equipment, making sure to cover all lids on the cans and
tubes.
44. Grab the brushes from the table and walk across the garage to the sink
45. Place the brushes on the side of the sink
46. Turn the knob of the sink counter-clockwise for warm water
47. Place one hand under running water to make sure it is warm
48. Grab the brushes from the side of the sink
49. Grab the bar of soap and begin washing the paintbrushes
50. Rinse the paintbrushes in clean water
51. Shake the paintbrushes dry
52. Smooth the bristles of the brush back into shape
53. Restore all tools and equipment by walking over to the cabinet and placing all the items
back
7. Body functions required:
Function
Judgment

Concept formation

Metacognition

How It Is
None
Used
Client uses
judgment to
formulate a
concept and
theme for
painting.
Concept
formation is
used when
the client
selects colors
to describe
and/or
compose
scenery (e.g.,
warm tone to
create
harmony).
Metacognitio
n is used
when the
client begins
thinking

Minimally
Challenged
x

Greatly
Challenged

Cognitive flexibility

Insight/awareness

Concentration

Sustained attention

through
strategies for
mixing paint
(e.g., mixing
gray paint to
lower
saturation of
color)
Client
changes
strategies by
switching
from a large
paintbrush to
a small
paintbrush to
use a
different
technique.
Client
utilizes
insight/awar
eness to
determine
energy level
and whether
he needs a
rest break.
When
utilizing a
small
paintbrush,
concentratio
n is required
to fill in
small and
narrow
spaces on the
canvas.
Client
focuses on
the effect of
the brush on

Selective attention

Divided attention

Short-term memory

Working memory

the canvas to
determine if
he/she needs
more paint
or less paint
(e.g.,
reloading
color on
paintbrush or
dabbing
paintbrush
against a
surface)
Client is able
to attend to
painting
despite
external
stimuli, such
as music
from laptop.
The client
focuses on
stabilizing
the tray
while
dipping the
paintbrush
into the
paint.
The client
make sure
the lid of the
paint can is
closed before
transferring
it over to the
other side of
the room.
The client
walks across
the room to
grab art

Long-term memory

Discrimination of senses:
Auditory

Discrimination of senses: Tactile

Discrimination of senses: Visual

Discrimination of senses:
Olfactory

supplies and
remembers
specific
brushes and
paint colors
he needs.
The client
remembers
the specific
techniques
he can use
with each
different
paintbrush.
The client
hears the
sound of the
paintbrush
stroke
against the
canvas as
paint is
running dry.
The client is
able to feel
how dry the
bristles of
the
paintbrush
are before
dipping it in
water.
The client is
able to see
the different
colors on the
tray and
determine
what color
needs to be
reloaded.
Due to the
clients

Discrimination of senses:
Vestibular-proprioception

Multisensory processing

Sensory Memory

sensitivity to
smell,
particularly
of paint, he
must open
the windows
of the garage
for
ventilation.
The client
ensures he is
in
appropriate
proximity to
the canvas in
order to
begin
brushstrokes.
The client
utilizes
senses of
touch and
visuals
provided by
the
environment
to determine
if he must
open the
windows for
the paint to
dry faster
(e.g., paint
on canvas).
When paint
spills on the
clients arm,
he quickly
cleans it
using his
sensory
memory to
recall where

Spatial relationships

Temporal relationships

Recognition

Categorization

Generalization

the paint was

spilled.
The client
ensures the
environment
is clear of
people or
objects
before
setting up
the easel and
canvas.
Without the
use of a
timer or
clock, client
knows the
length of
time needed
to wait
between
adding
layers, or
colors, onto
canvas.
Client
recognizes
when he
must reload
the
paintbrush
when it is
dry.
Client
organizes
colors on the
tray (i.e.,
mixing and
arranging
colors on
display).
The client is
able to grip

Awareness of reality

Logical/coherent thought

Appropriate thought content

Mental functions of sequencing

complex movement

and utilize a
paintbrush
because
he/she has
used a pencil
before.
The client
realizes that
he cannot
paint in the
garage if it is
being
occupied by
family
members.
The client
uses logical
or coherent
thought
when
selecting
what colors
to use for the
painting.
When the
client selects
a paintbrush,
he realizes it
must be
appropriate
to the paint
he is using
(i.e., oil
brushes are
not efficient
with waterbased paint).
Sequencing
of movement
is utilized
when the
client
engages in

Regulation and range of emotion

Appropriateness of emotion

Coping

Behavioral regulation

motions
needed to
complete the
task (i.e.,
coordinating
movements
of hand/arm
while
stroking the
brush).
Client does
not allow
frustration or
agitation
from hot
weather to
prevent him
from
completing
the task.
Client
displays a
smile after
completing
the piece.
The client is
still able to
enjoy the
activity of
painting
despite not
being able to
keep the
painting
(e.g.,
installation
for
customer).
Client is able
to control his
frustration
and reaction
when he

Body image

Self-concept

Self-esteem

Arousal

Consciousness

spills paint
on his new
pants.
The client is
confident
and aware of
his body
image. Thus,
he is able to
paint
shirtless in
front of
others.
Client
identifies
himself as an
artist. Thus,
he updates
his website
and seeks
projects from
potential
customers,
companies,
and
businesses.
The client
feels
accomplishe
d when he
completes a
piece.
When the
paintbrush
runs dry, the
client dips
the brush
bristles into
the paint to
load the
brush.
The client
displays a

Orientation to self

Orientation to place

Orientation to time

Orientation to others

state of
alertness as
he looks for
signs that he
has
completed
painting one
space of the
canvas and
can move on
to the next.
The client
signs the
canvas with
his name
after
completing
the piece.
The client
realizes that
he is in his
garage to
paint.
The client is
aware that it
is Friday and
he can stay
up late to
paint. He
does not
have work
the following
morning.
The client
realizes that
he must
complete the
piece in a
timely
manner in
order to
satisfy his
customer.

Energy level

Function
Motivation

Impulse control

Appetite

Sleep

Detection/registration

The client
displays
difficulty
standing and
painting for
an extended
period of
time.
How It Is
None
Used
The client is
eager to
complete the
piece and
share it with
his friends.
The client
resists the
temptation to
gesso the
canvas
(apply white
paint
mixture)
because he
has made a
mistake.
Appetite is
x
not required
for this
activity.
Sleep is not
x
required for
this activity.
The client
feels the
width of the
paintbrush
and
determines
how tightly

Minimally
Challenged
x

Greatly
Challenged

Visual modulation

Integration of senses

Awareness at distances

Tolerance of ambient sounds

to grip it.
The client
organizes the
visual
stimuli
involved
with painting
so that nonessential
information
on the
canvas is
ignored (e.g.,
focusing on
one area of
the canvas
while
painting).
The client
uses a sense
of vision
(empty paint
can) and
touch
(dipping
brush in
paint can) to
determine
whether
more paint is
needed.
The client
recognizes
how close or
far in
proximity
the canvas is
located from
his/her body
in order to
begin
painting.
Client is able

Location and distance of sounds

Moving against gravity

Taste

Smell

Body in space

to tolerate
noise from
outdoor
environment,
such as birds
chirping and
cars passing
by.
The client
determines
whether a
family
member is
home by
hearing the
sound of the
car as it
approaches
the garage.
The client
leans
forward
outside of
his center of
gravity to
pick up the
paint can.
Taste is not
x
required for
this activity.
Client
perceives
smell of
paint, despite
windows left
open, and
decides to
wear a face
mask.
The client
can sense
where the
bristles of

Comfort with touch

Localizing pain

Thermal awareness

Joint mobility

Joint stability/alignment

the brush are

in relation to
the canvas
while
painting.
Client is able
to tolerate
the texture of
paint spilled
or dropped
on his/her
body.
The client
realizes
when his/her
lower back
and/or legs
are fatigued
from
standing
long periods
of time.
The client
reacts to the
temperature
in the garage
by removing
articles of
clothing.
The client is
able to move
the joints in
his wrist
with a
normal range
of motion in
order to
engage in
painting.
Joints must
be aligned in
order to
grasp the

Muscle power

Muscle tone

Muscle endurance

Stretch reflex

ATNR

STNR

Righting and supporting reflex

Eye-hand coordination

paintbrush.
Client
displays
enough
strength to
transfer paint
cans across
room.
The client
demonstrates
normal
muscle tone
when he
applies
brushstrokes
to the
canvas.
When
standing for
an extended
period of
time, the
clients
endurance is
challenged.
Stretch
x
reflexes are
not required
for this
activity.
ATNR is not x
required for
this activity
STNR is not x
required for
this activity.
Client is able
to maintain
balance
while
standing to
paint.
When

Bilateral coordination

Crossing midline

Fine motor control

Gross motor control

Occulomotor control

loading paint
on the brush,
the client
coordinates
hand
movement in
order to
assure that
the paint
ends up on
the brush.
Client holds
the tray in
one hand
while
painting with
the other
hand.
Client
reaches over
to grab a
smaller
paintbrush
from the set.
Client
demonstrates
fine motor
skills when
grasping
paintbrush to
paint.
The client is
able to rotate
his arm in
order to stir
or mix the
paint in the
can.
When
reaching for
a paintbrush
in the can,
the client

Gait patterns

Blood pressure

uses his eyes

to focus on
the brush
and reach
forward
based on
visual
information.
The client
utilizes
normal gait
patterns to
move around
the garage
(e.g., if he
needs a new
can of paint,
he walks
across the
garage to
grab one
from the
cabinet).
In order to
stand and
engage in the
activity of
painting, the
client
requires
normal blood
pressure.
Normal
blood
pressure
needed in
order to
supply the
muscles of
the body
with oxygen.
This helps

Heart rate

Respiratory rate

Respiratory rhythm

Respiratory depth

prevent the
client from
feeling
fatigued or
ill while
painting.
The clients
heart rate
had to stay
within
normal
ranges in
order for him
to complete
the activity
of painting.
However,
completing
the piece
may elicit an
adrenaline
rush,
consequently
increasing
the clients
heart rate.
The demand
for oxygen
increases due
to the odor
that emits
from the
paint.
The clients
respiratory
rhythm may
increase due
to
excitement
from
completing
the piece.
The clients
x

Physical endurance, aerobic

capacity

Voice functions

Voice rhythm and fluency

respiratory
depth had to
stay within
normal range
in order for
him to
successfully
complete the
activity of
painting.
The client
requires
good
endurance
and aerobic
capacity in
order to
successfully
complete the
activity of
painting
without
taking a
break.
The client
engages in
verbal
communicati
on with other
individuals
who are
present to
view his
artwork in
the garage.
When
clarifying the
concept of
varnishing,
the client
speaks in a
rhythm that
is conducive.

Alternative vocalization

Digestive system

Metabolic system

Endocrine system

The client
demonstrates
sustained
vocalization
as he sings
and hums
while
painting.
The clients
digestive
system was
functioning,
however not
interfering
with the
activity of
painting.
The client
consumes a
proper meal
prior to the
activity. His
digestive
system is
working, and
is able to
break down
food and
convert it
into energy.
This energy
helps the
client
complete the
activity of
painting.
The clients
endocrine
system was
functioning,
but was not
challenged
by the

Function
Urinary functions

Genital and reproductive function

Protective functions of the skin

activity of
painting.
How It Is
None
Used
Due to
excessive
intake of
water, the
client steps
away from
the activity
to use the
restroom and
thus, release
fluids from
his body.
The clients
genital and
reproductive
functions are
secondary to
the activity
of painting.
This system
functions to
maintain the
clients
hormone
balance.
The
repetitive
motions of
applying
brushstrokes
while tightly
gripping the
paintbrush
can
potentially
challenge the
clients skin
functions of
the hands.

Minimally
Challenged
x

Greatly
Challenged

Repair functions of the skin

If the client
cuts his skin
against the
edge of the
pail on the
paint can, the
skins
protective
functions
will initiate
wound
healing.

8. Muscular analysis of movements required:

Muscle

Not used

Shoulder flexion
Shoulder extension
Shoulder abduction
Shoulder adduction
Shoulder internal rotation
Shoulder external rotation
Elbow flexion
Elbow extension
Wrist supination
Wrist pronation
Wrist flexion
Wrist extension
Thumb flexion
Thumb abduction
Finger flexion
Finger extension
Trunk flexion
Trunk extension
Trunk rotation
Lower extremities

Minimally
challenged
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x

Greatly
challenged

x
x
x
x

9. Performance skills required:

Skill- Motor
Aligns

How It Is
Used
When

No
ne

Minimally
Challenged
x

Greatly
Challenged

Stabilizes

Positions

Reaches

Bends

Grips

Manipulates

stepping back
to view the
painting, the
client aligns
his body with
the canvas.
The client
maintains an
upright
position while
painting.
The client
holds the
spray can
approximatel
y eight inches
away from
the surface of
the canvas
being
sprayed.
The client
reaches across
the table to
grab a wider
paintbrush.
Client bends
over to lift
paint bucket
from floor in
order to refill
the tray.
Client gently
grips the
paintbrush to
make fine
details.
Finger
dexterity is
utilized to
operate the
lock on the
cabinet where

Coordinates

Moves

Lifts

Walks

Transports

Calibrates

the clients
paint cans are
stored.
The client
holds the tray
still while
dipping the
brush in the
paint (e.g.,
reloading
paint brush).
The client
sways to
maintain
balance while
painting.
The client
lifts the
canvas off the
easel when he
has completed
the piece.
The client
walks over to
the canvas
where he will
paint.
Client carries
paint buckets
from storage
shelf to area
of canvas.
When
applying
brushstrokes
to the canvas,
the client
makes long
strokes,
allowing the
paint the flow
smoothly. He
avoids

Flows

Endures

Paces

Skill- Process
Paces

Attends

dabbing small
areas on the
canvas as this
leaves marks
in the paint.
Client applies
brushstrokes
in a fluid
motion.
The client is
able to stand
while painting
without
feeling tired
or fatigued.
Client pours
paint onto
tray at an
appropriate
pace. This is
to ensure
efficiency
while
preventing the
overflow of
paint.
How It Is
No
Used
ne
Client opens
the paint can
gently to
prevent it
from bending.
The client
does not look
away from
the canvas
while
applying
brushstrokes.
He proceeds
with the task,
despite

Minimally
Challenged
x

Greatly
Challenged

Heeds

Chooses

Uses

Handles

Inquires

interruptions.
The client
purchases a
canvas from
Michaels,
an art supply
store.
For optimal
results, client
chooses the
correct or
appropriate
paintbrush
(e.g., small
brush for tight
spaces; wide
brush for
large, flat
surfaces).
The client
mixes and
arranges
colors on the
tray and not
on the easel.
The client
uses an
appropriate
amount of
grip strength
to hold the
paintbrush
when
applying
brushstrokes.
(e.g., gentle
grip for fine
details).
The client
requests for
feedback
regarding the
painting. He

Initiates

Continues

Sequences

Terminates

takes a step
back to view
the canvas
from a
different
perspective
and asks,
How does it
look?.
The client
taps the tip of
the brush
against the
tray
immediately
after loading
too much
paint on the
brush.
The client
continues to
mix the paint
in the can
with a
painters stick
until the
correct color
is produced.
Once the
activity is
complete, the
client cleans
all the
brushes in
warm water
before
restoring
them in the
cabinet.
The client
places the
paintbrush in
a cup of water

Searches/locates

Gathers

Organizes

Restores

Navigates

once a
different
paintbrush is
needed.
When
additional
and/or
different paint
is needed, the
client looks in
the cabinet
where the
paint is
stored.
The client
retrieves
additional
paint from the
cabinet and
brings it over
to the canvas.
The client
places the
cans, tubes,
rags, sponges,
brushes close
enough to the
canvas to be
conducive for
the activity of
painting.
Once the
piece is
complete, the
client cleans
the garage
and puts away
all the art
supplies and
tools in the
cabinet.
Client is
careful not to

Notices/responds

Adjusts

Accommodates

Benefits

hit or bump
his arm, hand,
or body
against the
canvas while
applying
brushstrokes.
The client
identifies the
dryness of the
brush as it
begins to drag
against the
canvas. The
client
responds by
stopping and
reloading the
paintbrush.
The client
plays music
while
painting.
When his
favorite song
comes on, he
increases the
volume.
Client
remembers to
stretch
hand/wrist
every 20-30
minutes in
order to
release
tension in
muscles.
Client
repositions
body when
hand/arm
unintentionall

Skill- Social interaction

Approaches/starts

Produces speech

Gesticulates

Speaks fluently

y touches
canvas while
painting.
How It Is
No
Used
ne
Client waves
at or verbally
greets family
members as
they walk
through the
garage to
enter the
house.
While at the
art supply
store, client
verbally
requests for
an appropriate
sized canvas
in a coherent
manner.
The client
steps back to
view the
canvas and
gesticulates a
thumbs up,
indicating his
satisfaction
and
completion of
the piece.
Client
requests
sibling to help
bring supplies
over by using
appropriate
vocabulary
and speaking
slowly

Minimally
Challenged
x

Greatly
Challenged

Turns Toward

Looks

Places self

Touches

enough to
comprehend
message.
When sharing
final piece
with family
and friends,
client
positions
his/her body
in the
direction of
the other
individual
while turning
toward the
canvas to
point out
aspects of the
painting.
Client
establishes
eye-contact
with other
individuals
while
conversing
with them
regarding the
painting.
Client is able
to maintain
appropriate
distance and
space
between
his/her body
and others
he/she is
conversing
with.
After
completing

Regulates

Questions

Replies

Discloses

the piece, the

client gives
and receives a
hug.
The client
keeps his
hands to
himself while
conversing
with others in
the garage. If
it is socially
appropriate,
he will touch
the social
partner (e.g.,
hugging his
parents when
they enter the
garage).
Client
requests
family and
friends to
provide
feedback
regarding
direction of
painting.
Client
elaborates on
the painting,
describing its
theme and
concept,
when
individuals
inquire
questions.
When another
individuals
requests
information

Expresses emotion

Disagrees

Thanks

Transitions

Times response

regarding the
painting, the
client
responds by
divulging
information
about the
concept and
theme of the
painting.
The client
smiles when
he completes
the art piece.
If family or
friends
suggest using
colors
inappropriate
to the overall
theme of the
piece, client
disagrees in a
polite manner.
When
complimented
on the final
art piece,
client smiled
and said,
thank you.
The client
moves from a
conversation
about his dayjob
(behavioral
therapy) to
his night-job
(art), fluidly.
When asked a
question
regarding

Times duration

Takes turns

Matches language

Clarifies

Acknowledges and encourages

color of paint,
client
responded in
a timely
manner.
The client
responds to a
question
about the type
of paint he is
using by
providing a
concise
answer.
Turn-taking is
not required
in this
activity.
The client
does not
shout in the
garage, as his
family is
asleep in the
house.
Confused
regarding the
concept of
varnishing,
the client
removes the
can of varnish
from the
cabinet and
re-explains
the concept
by showing
the can and
using
different
wording.
The client
encourages

Empathizes

Heeds

Accommodates

Benefits

other
individuals to
provide
feedback
regarding the
piece.
This aspect of x
social
interaction
was not
observed
during the
activity.
When the
clients father
complains
about the
level of
noise/music
in the garage,
the client
turns down
the volume
and closes the
garage door.
When the
clients
parents are
sleeping, he
avoids turning
up the music
in the garage
as he paints.
As the clients
family
complains
about the
smell of paint
in the garage,
the client
ensures he
saran wraps
the lid of each

can and
leaves the
windows
open overnight as the
painting dries.
This is to
prevent the
garage from
smelling in
the morning.
10. Performance patterns:
Parts of this occupation has elements of which of the following: (check all that apply)

Pattern
Useful habit
Dominating habit

Describe

Routine

Engaging in the activity of painting is a part of the clients daily

routine. Between the hours of 9:00pm-12:00am/1:00am, the client
spends time in the garage painting. He follows a specific routine
or sequence to completing the activity of painting. Please
reference steps to sequencing and timing above. These behaviors
are repetitive and embedded in the clients performance patterns,
which helps structure or create better flow for the activity. These
steps are followed in a specific sequence in order to help the
client perform the activity more efficiently. For example, the
client makes sure to clear the environment before setting up all
the tools, materials, and equipment in order to paint.

Ritual

After completing the activity, the client reinforces himself with a

can of cold beer. This ritual occurs after the activity is completed
and prior to going to bed. The client views this as positive
reinforcement. Since he likes and values beer, he rewards
himself for his hard work. This ritual has meaning to the client
and contributes to his motivation in completing the activity.

Role

As an artist who is paid for his services, it is important for the

client to meet all project deadlines. This is to ensure that he
maintains good rapport with his customers, and is able to do
business with them in the future. In order to fulfill the role of an

artist, the client is expected to engage in activities related to art,

such as painting. Completing his pieces with accuracy is critical
to fulfilling his role and strong reputation as an artist.

Intervention Plan
1. Identify 1 objective and measurable goal of the intervention:
Client will be able to paint independently using conservation strategies with decreased
back pain within 1 month.
A conservation strategy will be defined as any of the following methods: completing
the activity while sitting, taking rest periods, and positioning tasks on a table to prevent
lifting and bending of heavy objects.
According to OTPF what type of outcome is this?
Occupational performance Improvement

2. Intervention approach:

Approach
Create/promote
Establish/restore

Describe

Maintain
Modify

A conservation strategy will be defined as any of the following

methods: completing the activity while sitting, taking rest periods as
needed, or positioning all tasks on a table to prevent lifting and
bending of heavy objects, such as paint cans. Educating the client on
techniques to reduce energy expenditure with painting activity. The
therapist can advise the client to complete the activity while seated
when possible and to take rest periods as needed to maintain safety. In
addition to this, the therapist can advise the client to organize all tasks
on a table. This will prevent him from continuous bending and lifting,
as he reaches to grab heavy paint cans from the floor. Implementing
the following techniques to the clients intervention program would
enable him to engage in the occupation of painting while reducing the

pain in his lower back. As the client adheres to these modifications, he

will display measurable improvements, including decreased back
pain.
Prevent

3. Activity selection
a. Activity selection: Identify 1 example of each for the intervention plan

Activity
Occupation

Describe
The client is able to engage in the desired occupation. More specifically,
he is able to participate in the activity of painting, which is a meaningful
and purposeful goal.

Activity

The client practices safe ways to engage in the activity of painting using
conservation strategies: sitting while painting, taking rest breaks, and
modifying environment by placing task objects on table to avoid
movements such as bending and lifting.

Preparatory
method

The therapist suggests environmental modifications and advises the client

to organize task objects (e.g., paint cans, paint tubes) on a table in order to
avoid bending and lifting of heavy objects that can potentially worsen the
pain in the clients back. This will facilitate the clients ability to engage
in the desired activity while reducing the risk of back pain.

Preparatory task

The client will practice a home-based strengthening program, such as

yoga, to relieve pain and enable the client to keep his back strong and
properly positioned.

b. Discuss how activity selection relates back to occupational profile and

occupational analysis
The selection of activities relate back to the clients desired goals and interests
relating to the occupation of painting. The client was interested in collaborating
with the client to develop strategies that would alleviate the pain in his lower back
while still participating in painting. The client reported an increase in back pain
following days he would engage in painting and expressed an interest in address
this specific issues in the intervention.

c. Discuss how activity selection will support achievement of client identified goals
and goal of the intervention plan
The main objective of the intervention is to reduce the clients lower back pain.
As mentioned before, the following conservation strategies will help the client
return to a higher level of function and improve participation in valued
occupations. By implementing rest breaks, completing the activity while sitting,
and modifying the environment by organizing task objects on a table, these
specific techniques will reduce energy expenditure while painting. The client
complained that his back would hurt due to standing for an extended period of
time. As a result, by completing the activity while sitting the client would lead to
a less strenuous activity. In addition to this, by taking rest periods as needed, the
client can pace himself and ensure that he is providing his body with enough rest
and relaxation before proceeding with tasks. Furthermore, through observation of
the clients activity, it was demonstrated that the client placed task objects such as
paint and brushes on the floor. As a result, he would continuously bend and lift
heavy-objects during the activity. By adhering to the environmental modifications
advised by the therapist (placing task objects on table), the client can move
around more efficiently and engage in the activity of painting without worsening
his back.

4. Describe how intervention can be graded or adapted and why

Grading up: The activity can be graded up by having the client paint a bigger canvas
while standing. This would extend the duration of the activity.
Grading down: The activity can be graded down by having the client paint a smaller
canvas while remaining seated for the entire duration of the activity.
Adaptation: The client can be issued adaptive devices by his therapist. This would entail
using a reacher to pick up items (e.g., brushes, spray can) off the floor to decrease
specific movements, such as bending and lifting.
5. Discuss any safety concerns and/or precautions
Due to the clients motivation and passion for painting, he tends to engage in the activity
for an extended period of time, at times forgetting to assess whether is body is feeling
fatigued or tired. When focusing on the activity, he fully attends to the task and does not
allow any interruptions to interfere with this work. A major safety concern of the activity
is that the client is standing for a duration of 3-4 hours, often failing to recall the pain in
his lower back till the following morning approaches. Due to his back injury (protruding
disc L5-S1) he is at risk of worsening his condition by engaging in strenuous activities
that require repetitive movements of bending, lifting, and standing. He displays deficits in
proper body mechanics, safety awareness, and lower extremity strength. In addition to
this, he uses ineffective movement patterns which increase his fatigue and frequency of
pain in the lower back the following morning.

6. Discuss the role of the occupational therapy practitioner during the intervention
The role of the therapist is to implement an intervention program that is both meaningful
and purposeful to the client. The intervention must be client-centered, utilize therapeutic
and functional tasks, and provide a secure environment in which the client can perform
his valued occupations. It is important for the therapist to collaborate with the client and
implement strategies that align with his goals and interests. In doing so, the therapist must
educate the client and ensure that he is able to understand the purpose of the intervention,
and essentially the path that he and the therapist will take in order to achieve progress. In
addition to this, it is important for the therapist to maintain good therapeutic use of self
by exhibiting empathy and reasoning while dealing with the client. This will help the
therapist develop rapport with the client, which is a critical aspect of therapy. The role of
the therapist is to help the client develop therapeutic strategies and skills that will enable
them do the things they want to do, need to do, and have to do in their day-to-day lives.
7. Discuss what is expected of the client during the intervention
The therapist expect the client to fully participate in the intervention process by providing
their full effort and commitment. The client-therapist relationship is an interactive one.
The client is always prompted to ask questions and provide honest feedback and/or
insight regarding the intervention process. If the client is experiencing any pain during
treatment or feels as though an activity is too challenging or too easy, he is expected to
express his feelings and views. In addition to this, the client contributes to the therapy
process by sharing their narrative experience and their aspirations in life. By sharing their
life experiences, the therapist and client can develop a stronger relationship and thus,
work together to implement an intervention plan that prioritizes the clients desires and
needs.