INTERVENTION PLAN FOR COMMUNITY CLIENT WITH REFLECTION

Copy/paste one LTG and the matching STG from your evaluation SOAP note. This will be the goal set around which you design your treatment session.
For this and all subsequent weeks, please answer the following questions before designing your treatment plan for the next week. If you were unable to see
your client the past week, you do not need to answer these questions. Answer the questions based on the treatment that you implemented:

What went well with your treatment? Did things go as you planned or not? Explain. What will you do differently with this next treatment plan?

Client did not attend treatment session due to a family funeral.

Long-Term Goal: By discharge, client will independently place contacts in both eyes with use of a one-handed
technique.

Short-Term Goal: Within 2 sessions, client will independently use finger to manipulate eyelid 80% wide in
preparation for placement of contact.

OCCUPATIONAL OPM and CPM TREATMENT SESSION GRADING THE ACTIVITY

PERFORMANCE PROBLEM
Specifically identify only the client
factors and/or performance skills
that are barriers to the
achievement of this goal. This
should not be a bullet list, rather
you should describe how the client
factor impacts this client’s
performance of the occupation in
the goal.
Our client is currently unable to put
his contacts in independently due
to his inability to grip and
manipulate objects, as well as grab
and release objects with his R
hand. He can initially use a pincer
grasp and a 3-jaw chuck to grab
and release 1 inch items, but after
3-5 repetitions, his tone increases
in digits 1-3 and he cannot extend
AND RATIONALE
Identify your OPM and all relevant
CPM’s that best addresses the
performance problem and describe
how each will be used to design
treatment for this client’s specific
problems.
PEO:
The main outcome of this model is
to increase the client’s satisfaction
with their occupational
performance. Our client is currently
dissatisfied with being dependent
on his girlfriend to put his contacts
in. The client will need
modifications and adaptations to
the occupation/task as well as the
environment to be able to put his
DESCRIPTION
Provide details of how you will set up
the activity and how your intervention
addresses the performance problem.
Your description should detail how
the activity will be set up to make it
therapeutic.
First we will work on opening the
contact container. The client will use
his R hand to stabilize the bottom of
the container, and use his L hand to
untwist the top open. Once the
container has been opened, he will
use his L index finger to take the
contact out of the container. He will
then lift his R hand and place it close
to his body at about chest level in a
Choose one client factor or
performance skill that you address
in your treatment session. Describe
one way (only one) that you can
grade the activity up and one way
(only one) to grade the activity
down based on that one factor or
skill.
Factor/Skill:
Ways to facilitate task:
Make the activity closed chain by
placing his L elbow on a table to
decrease the number of joints used
in his LUE
Provide something for his 3rd digit to
create friction to open up his eye
better, such as a rubber thimble
Utilize a mirror
 his fingers to grab and release
items. Once his tone increases, he
uses a raking grasp with digits 4-5.
He has hemiplegia in his RUE and
moves in a flexor synergy pattern.
His PROM in his RUE are WFL,
however, when he activates his
RUE, he can activate 160 degrees
of shoulder flexion- but has
difficulty extending his wrist and
fingers to reach for items in high
shelves, 85 degrees of shoulder
abduction, and 45 degrees of MCP
flexion. He has some finger
extension in digits 4-5, about 2-5
degrees. He has limited finger
extension and cannot actively
open his R hand fully. He
displayed difficulty extending his
wrist and MCP/finger extension in
digits 1-3. He also displays neglect
of his RUE, proprioception deficits,
and no tactile sensation issues.
Home Program:
-continue practicing one-handed technique to put in contacts
-keep track of how many times you practice every day, and how many times you succeed
contacts in independently. This will,
in turn, increase his satisfaction in
his occupational performance.
Rehabilitation model:
Client wants to be able to put his
contacts in independently. To be
able to accomplish this goal, this
treatment session will focus on
teaching him a compensatory one-
handed technique using his L hand
to place the contacts in his eyes.
Motor Control/Motor Learning
model: While learning a one-
handed technique with his L hand,
he will incorporate his RUE into the
activity to increase the use of his
paretic arm through task specific
training in order to strengthen the
neuropathways. He will utilize his
RUE into the task such as
stabilizing the contact container
while his L hand twists the cap
open to help decrease R neglect.
pronated fist position, where he will
place the concave side of the contact
faced up on the dorsal side of his R
hand.
Once the contact is on his R hand,
he will use his L index finger and pick
up the contact so that the concave
side of the contact is placed in the
middle of his distal phalanx. Once
the contact is in this position, the
client will bring his L index finger up
towards the center of his eye, and
use his 3rd digit to pull his lower eye
lid down. He will then look up while
his eyelid is pulled down so that his
eye is opened wide enough to fit the
size of the contact, and then place
the contact in his eye with his index
finger.
He will practice the motion of this
one-handed technique multiple times
without the contact on his finger so
that he can work on pulling his eyelid
down with his 3rd digit, and looking
up at the same time. We will provide
him feedback and verbal cueing to
correct his positioning or if he needs
to pull down his lower eyelid more or
remind him to look up. Once he has
practiced this motion, he will then
practice putting his actual contact in.