OCAIRS AssessmentForms

Assessment
Forms
Kirsty Forsyth, PhD, SROT, OTR

UK Center for Outcomes Research (CORE)
University of London
Shilpa Deshpande, MS, OTR/L
Gary Kielhofner, DrPH, OTR, FAOTA
Chris Henriksson, MSc OT, OTR, PhD
Lena Haglund, RegOT, PhD, MSc OT
Linda Olson, MS, OTR/L
Sarah Skinner, MEd, OTR/L
Supriya Kulkarni, BS, IOTR
(Version 4.0) Copyright 2006
Version printed 2005
APPENDICES
INTERVIEW FORMATS:
APPENDIX: A: OCAIRS Mental Health Interview Formats ........................................................... 2

OCAIRS Mental Health Interview (Form 1) Questions ...................................................................... 3
OCAIRS Mental Health Interview (Form 2) Questions, Rating Scales and Notes Form ................... 5
OCAIRS Mental Health Interview (Form 3) Questions and Rating Scales ........................................ 9
OCAIRS Mental Health (Form 4) Key Words Form ........................................................................... 11
APPENDIX: B: OCAIRS Forensic Mental Health Interview Formats ........................................... 12

OCAIRS Forensic Mental Health Interview (Form 1) Questions ........................................................ 13
OCAIRS Forensic Mental Health Interview (Form 2) Questions, Rating Scales and Notes Form .... 15
OCAIRS Forensic Mental Health Interview (Form 3) Questions and Rating Scales ......................... 19
OCAIRS Forensic Mental Health (Form 4) Key Words Form ............................................................ 21
APPENDIX: C: OCAIRS Physical Disabilities Interview Formats ................................................ 22

OCAIRS Physical Disabilities Interview (Form 1) Questions ............................................................. 23
OCAIRS Physical Disabilities Interview (Form 2) Questions, Rating Scales and Notes Form .......... 27
OCAIRS Physical Disabilities Interview (Form 3) Questions and Rating Scales ............................... 31
OCAIRS Physical Disabilities (Form 4) Key Words Form .................................................................. 34
RATING THE INTERVIEW:

APPENDIX: D: OCAIRS Rating Criteria ............................................................................................ 35
DOCUMENTING THE INTERVIEW:

APPENDIX: E: OCAIRS Rating Scales and Notes Summary Form ................................................. 40
APPENDIX: F: OCAIRS Data Summary Form 1 ............................................................................... 44
APPENDIX: G: OCAIRS Data Summary Form 2 .............................................................................. 46
GLOSSARY:
APPENDIX: H: Glossary of OCAIRS Concepts ................................................................................ 48
OCAIRS [Version 4.0]
INTERVIEW FORMATS: remind themselves of the information they will need in order
to rate the client. This helps to ensure that during the inter-
APPENDICES A, B & C view therapists obtain all of the information that will be need-
ed to rate the client. Additionally, the notes section provides
Appendices A, B and C contain tools intended to be used the therapist with space to take notes during the interview.
while conducting the interview. Therapists in mental health, For therapists who are new to the OCAIRS this form may be
forensic mental health and physical disabilities have found overwhelming.
the tools in Appendices A, B and C, respectively, to be most
useful in their practice. However, each therapist must decide Therapists preferring a shorter form, may prefer to use the
which Appendix contains the tools that are most suited for his “Interview (Form 3) Questions and Rating Scales.” This form
or her own setting and clients. contains both the abbreviated versions of the questions and
the full rating scales. Some therapists have reported that their
Within Appendix A, B & C there are four different formats: clients become anxious when they see that the interview
1) Interview (Form 1) Questions contains multiple pages. For these therapists, this form may
be helpful.
2) Interview (Form 2) Questions, Rating Scales and Notes
Form The (Form 4) Key Words Form summarizes key concepts from
3) Interview (Form 3) Questions and Rating Scales MOHO that have been used in the manual. Therapists may
wish to use it as a reference to glance over while conducting
4) (Form 4) Key Words Form the interview to remind themselves of the areas of information
needing to be gathered. It may be used in combination with
Some therapists who are not as familiar with the OCAIRS
any of the interview formats.
prefer to use the “Interview (Form 1) Questions” format dur-
ing the interview. This format provides the therapist with a Each therapist should review the attached interview formats
sequence of questions to ask the client in order to obtain the and choose the one that reflects his or her style. The therapist
information needed to rate the client in the twelve major may want to change, add or delete questions to better address
areas of the OCAIRS. the client’s occupational participation or to suit his/her own
Therapists who are more familiar with the OCAIRS may prefer style of phrasing questions. Additionally, therapists may wish to
to use the “Interview (Form 2) Questions, Rating Scales and change the order of the questions or sequence of the interview.
Notes Form”. This format contains abbreviated versions of the While the interview questions and formats provided have been
questions, the full rating scales and a section for notes. helpful for many therapists, they are only suggestions.
During the interview therapists may check the rating scales to
Appendices further in the manual contain tools that address

rating and documenting the interview.
1
OCAIRS v.4.0:
OCAIRS APPENDICES
[Version 4.0]
OCAIRS v.4.0:
APPENDIX A: MENTAL HEALTH INTERVIEW FORMATS
APPENDIX A:
OCAIRS
OCAIRS MENTAL v.4.0:
HEALTH INTERVIEW FORMATS
ThereAPPENDIX B: FORENSIC
are four different MENTAL
formats included HEALTH
in Appendix A: INTERVIEW FORMATS
1) OCAIRS Mental Health Interview (Form 1) Questions
2) OCAIRS Mental Health Interview (Form 2) Questions, Rating Scales and Notes Form
OCAIRS v.4.0:
3) OCAIRS Mental Health Interview (Form 3) Questions and Rating Scales
APPENDIX C: PHYSICAL DISABILITIES INTERVIEW FORMATS
4) OCAIRS Mental Health (Form 4) Key Words Form
Any of these formats can be used based on personal preference.

OCAIRS v.4.0:
1) OCAIRS Mental Health Interview (Form 1) Questions:
APPENDIX D: RATING CRITERIA
Some therapists may prefer to use the Interview Questions format. This format provides a range of
questions that will elicit OCAIRS information. The therapist may change, add or delete questions to
better address the issues and suite his/her own style of phrasing questions. Therapists may also wish
OCAIRS v.4.0:
to change the order of the questions or the sequence of the interview.
APPENDIX
2) OCAIRS E: RATING
Mental Health SCALES
Interview (Form & NOTES
2) Questions, SUMMARY
Rating Scales andFORM
Notes Form:
This format contains abbreviated versions of the questions, the full rating scales and a section for
notes. The addition of the rating scales provides a visual prompt to ensure all information is collected.
OCAIRS v.4.0:
Additionally, the notes section provides the therapist with space to take notes during the interview.
APPENDIX
3) OCAIRS F: DATA
Mental Health SUMMARY
Interview FORMand
(Form 3) Questions 1 Rating Scales:
This format contains the abbreviated versions of questions and the full rating scales. It may be benefi-
cial to use with clients who may become anxious by interview formats that appear to be longer and
OCAIRS v.4.0:
thus more time intensive.
APPENDIX
4) OCAIRS G: DATA
Mental Health (Form 4)SUMMARY FORM
Key Words Form 2
The Key Words Form summarizes key concepts from MOHO that have been used in the OCAIRS.
Therapists may wish to use it as a reference to glance over while conducting the interview to remind
OCAIRS v.4.0:
themselves of the areas of information needing to be gathered.
APPENDIX H: GLOSSARY OF OCAIRS CONCEPTS
RATING and DOCUMENTING structures can be found in Appendices D, E, F & G.
2
OCAIRS Mental Health Interview (Form 1) Questions
Roles
• What do you do? What are your major responsibilities? should have or try to live up to?
(Parent? Spouse? Worker? Student? Homemaker?) • Is there anything about your life that you feel goes against
• Do you belong to any groups? your values?
• (For each role mentioned) How important is ___ to you? Interests

Do you enjoy ___?
• Is your major occupational role such as, worker, student,
• How well are you able to___ (for each role mentioned)? volunteer, caretaker something you enjoy? What about it
interests or satisfies you?
• What else do you do? What other roles do you fill?
• What do you like to do with your time outside of_________
Habits _____(work or major occupational role)?
• Describe a typical weekday (before you began treatment/ • Do you have any other interests or hobbies?
this program/were hospitalized).
• (For interests mentioned) How often do you ___? Are you
• Describe a typical weekend day (before you began satisfied with the amount of time you are able to spend
treatment/this program/were hospitalized). ___?
• Does your daily schedule let you do the things you need
and want to do?
Skills: Motor Skills, Process Skills, and
Communication & Interaction Skills
• Has your daily routine changed (over the last 6 months/
• Are you able to do the things you want or need to do?
since your accident/since your divorce etc—pick some
(If no) What limits your ability to do things?
pivotal event if possible)? How?
• Are you able to concentrate, problem-solve, and make
• Are you satisfied with your current daily routine? decisions to get things done?
Personal Causation • Do you have the physical ability to accomplish what you
need and want to do?
• What things in your life do you feel you do well, or are
proud of? • Are you able to over come these limitations and barriers?
• What are some things that have been difficult for you? • Do you prefer to work alone or with others? How well do
How did you handle it? you work with others?
• What is the biggest challenge you are currently facing?
Goals
• How successful do you think you will be over the next six
• Do you ever set goals for yourself/make plans for the
months? future? Have you followed through on any of them?
Values • What goals do you have for the next week? The next
month?
• What do you value most in your life? (What is most
important to you?) • What are you doing to accomplish that?
• What are other things or ideals that you value (are • Do you have any long-term goals? (1 year, 5-10 years)
important to you)?
• How will you accomplish those?
• How important are these to you?
• What about your life reflects these values? Are you able Interpretation of Past Experiences
to live life in ways that fit with the values you think you • Overall, do you feel you have had the typical ups and
downs in your life or do you feel your life has been
exceptionally better or worse than typical?
3
• Give an example of the best period of your life. • When someone gives you feedback (asks you to change
your behavior) how does it make you feel? How do you
• Give an example of the worst period in your life. react?
• How was your life affected by these ups and downs?
• Have you been able to choose the important things in your

life?
Physical Environment
• Where do you live? (Location, house, apartment?) Is it easy
to get around and get things done?
• In the area where you live, are there things to do/places to

go that interest you?
• Is there someplace you go to on a regular basis (e.g., work,

school, church, the park district, the doctor’s office)? Is it
easy to get to from your home?
• Are there any physical barriers at ___(from above) or at

home that prevent you from getting things done?
• In terms of activities you would like to participate in, places

you would like to go, what if anything prevents you
from doing so (Money, transportation, safety concerns,
physical barriers)?
• Are there resources available to help you overcome barriers

to getting things done?
Social Environment
• Do you spend a lot of time alone? Who do you spend most
of your time with?
• Who are the most important people in your life right now?
• Does what they expect from you match what you like or
would like to do?
• Would you describe your (work, school, community)

setting as supportive?
• Do the people or situations in your life place limits on you?
• If you need help/support, can you count on family/friends/

community?
Readiness for Change

• Tell me about a time when you experienced a big change
in your life (moving, going away to school, death of a
parent/spouse/child). Was it difficult to adjust?
• How do you handle it when your daily routine changes? (If

needed, use an example from response given in Habits
Section.)
4
OCAIRS Mental Health Interview (Form 2) Questions, Rating Scales and Notes Form
ROLES FINAL NOTES
What do you do? Your major responsibilities?
(Parent? Spouse? Worker? Student? Homemaker?)
Belong to any groups?
For each role: Importance? Enjoyment? How well done?
� Occupational roles reflect a highly productive lifestyle
F � High level of satisfaction with current roles
� Fulfils a wide range of role responsibilities
� Occupational roles reflect a somewhat productive lifestyle

A � Some satisfaction with current roles
� Minor difficulty in fulfilling a wide range of role responsibilities
� Occupational roles fail to constitute a productive lifestyle

I � Very little satisfaction with current roles
� Major difficulty in fulfilling a wide range of role responsibilities
� No occupational roles
R � Alienated from roles
� Cannot fulfill a wide range of role responsibilities
HABITS
Describe typical weekday (before treatmnt/prgm/hospitalization).
Describe a typical weekend day (before tx/prgram/hospitaliz).
Does your daily schedule let you do things you need/want to do?
Has your daily routine changed (over 6 months/ since your accident/divorce, etc
- pick pivotal event if possible)? How?
Are you satisfied with your current daily routine?
� Highly organized daily schedule
F � Good balance between work, rest, self-care and leisure
� Satisfied with daily routine
� Some organization of daily schedule
A � Some balance between work, self-care and leisure
� Somewhat satisfied with daily routine
� Very little organization of daily schedule
I � Very little balance between work, self-care and leisure
� Very little satisfaction with daily routine
� No organized daily schedule
R � No balance between work, self-care and leisure
� Dissatisfied with daily routine
PERSONAL CAUSATION
What things in your life do you feel you do well, or are proud of?
What are things that have been difficult? How did you handle it?
What is the biggest challenge you are currently facing?
How successful do you think you will be over the next six months?
� Strong confidence in abilities
F � Anticipates success in next six months
� Identifies a number of things (3 or more) done well/proud of
� Some confidence in abilities
A � Anticipates somewhat successful outcomes within next six months
� Some difficulty in identifying something done well/proud of
� Very little confidence in abilities
I � Significant concerns about failures within next six months
� Major difficulty in identifying something done well/proud of
� No confidence in abilities
R � Anticipates failure in next six months
� Does not identify anything done well/proud of
5
VALUES FINAL NOTES

What do you value most in your life? (most important to you?)
What are other things/ideals that you value (are important you?)
How important are these to you?
What about your life reflects these values? Are you able to live life in ways that
fit with values you think you should have /try to live up to?
Is there anything about your life that goes against your values?
� Identifies distinct and specific values

� Strong conviction about expressed values
F � Expresses complete congruence between own values and current life
situation
� Identifies somewhat ambiguous values
A � Some conviction about expressed values
� Expresses some congruity between own values and current life situation
� Loosely identifies very ambiguous values

� Very little conviction about expressed values
I � Expresses very little congruity between own values and current life
situation
� Does not identify any values
R � No conviction/alienation about expressed values
� Expresses no congruity between own values and current life situation
INTERESTS
Is your major occupational role such as, worker, student, volunteer, caretaker
something you enjoy? What about it interests/satisfies you?
What do you like to do with time outside________ (work/major occup role)?
Do you have any other interests or hobbies?
(For interests) How often do you ___? Satisfied w/ amount time able to spend __?
� Participates in many interests regularly outside of work
F � High level of interest in primary occupation
� High level of satisfaction with level of participation in an interest(s)
� Participates in few, but clearly expressed, interests regularly
outside of work
A � Some interest in primary occupation
� Some satisfaction with level of participation in an interest(s)
� Few & vaguely defined interest outside work, no regular participation
I � Very little interest in primary occupation
� Very little satisfaction with level of participation in an interest(s)
� Does not participate in any identified interests outside of work
R � No interest in primary occupation
� Dissatisfaction with level of participation
SKILLS: Motor, Process, & Communication/Interactions Skills

Are you able to do the things you want or need to do? (If no) What limits your
ability to do things?
Are you able to concentrate, problem-solve, and make decisions to get things
done?
Do you have phys ability to accomplish what you need/want to do?
Are you able to over come these limitations and barriers?
Do you prefer to work alone/with others? How well do you work w/ others?
� No limitations in performance due to good skills
F � Effectively compensates for any limitations in skills (if any)
Participation is allowed but there are some limitations in performance of:
� Motor Skills
A � Process Skills
� Communication/ Interaction Skills
Participation is inhibited due to significant limitations in:
� Motor Skills
I � Process Skills
Participation is restricted due to severe limitations in:
� Motor Skills
R � Process Skills
6
GOALS
Do you ever set goals for yourself/make plans for the future? Have you followed
through on any of them?
What goals do you have for the next week? The next month?
What are you doing to accomplish that?
Do you have any long-term goals? (1 year, 5-10 years)
How will you accomplish those?
SHORT-TERM GOALS FINAL NOTES

� Identifies achievable yet substantial short-term goal(s)
F � Coherently discusses realistic plan(s) for meeting goals
� Actively participating in the execution of the plan(s)
� Identifies goal(s) that may be difficult to achieve or, if readily achievable,
are insubstantial
A � Discusses somewhat unrealistic plan(s) for meeting goal(s)
� Somewhat participating in the execution of the plan(s)
� Identifies vague or conflicting goals that will be very difficult to achieve
I � Discusses a plan that is not realistic
� Very little participation in the execution of the plan(s)
� Does not identify any short-term goal(s) or has unachievable goal
� Does not discuss plan, abandons his/her plans easily
R � No participation in the execution of the plan(s),
doing nothing to achieve goal(s)
LONG-TERM GOALS
� Identifies achievable yet substantial long-term goal(s)
� Coherently discusses realistic plan(s) for meeting goals (i.e. Short-term
F goals correspond to long-term goals)
� Identifies long-term goal(s) that may be difficult to achieve or, if readily
achievable, are insubstantial
A � Discusses somewhat unrealistic plan(s) for meeting goal(s), i.e. short-
term goals somewhat related to long-term goals
� Identifies vague or conflicting long-term goals that will be very difficult
to achieve
I � Discusses a plan that is not realistic. Short-term goals unrelated to long-
term goals
� Does not identify any long-term goal(s) or has unachievable goal
R � No participation in the execution of the plan(s), doing nothing to
achieve goal(s)
INTERPRETATION OF PAST EXPERIENCES

Overall, do you feel you have had the typical ups and downs or do you feel
your life has been exceptionally better or worse than typical?
Give an example of the best period of your life?
Give an example of the worst period in your life?
How was your life affected by these ups and downs?
Have you been able to choose the important things in your life?
� Expresses very positive feelings about past experiences

F � Characterizes past as time of great performance and accomplishment
� Expresses somewhat positive feelings about past experiences
A � Presents best and worst period(s) with equal emphasis
� Expresses mostly negative feelings about past experiences
I � Places more emphasis on worst period(s) than best period(s) of life
� Expresses only negative feelings about past experiences
R � Discusses only worst period(s), unable to identify best period(s)
7
PHYSICAL ENVIRONMENT FINAL NOTES

Where do you live? (Location, house, apt?) Easy to get around/get things done?
In the area you live, are there things to do/places to go that interest you?
Is there someplace you go on regular basis (e.g. work, school, church, the park
district, the Dr)? Easy to get to from home? Are there any physical barriers at
___(from above) or at home that prevent you from getting things done?
In terms of activities to participate in/places you would like to go, what if any-
thing prevents you from doing so? (Money/transpt/safety phys barriers)
Are there resources available to help overcome barriers to getting things done?
� Demands/Constraints in the physical environment provide strong sup-

port for successful role performance
F � Ample resources/opportunities (money, transportation, facilities etc.) to
support participation in desired activities
� Demands/Constraints in the physical environment provide some support
and allow role performance
A � Sufficient resources/opportunities (money, transportation, facilities etc.)
which provide some support and allow participation in desired activi-
ties
� Demands/Constraints in the physical environment provide very little
support and inhibit successful role performance
I � Limited resources/opportunities (money, transportation, facilities etc)
provide very little support and inhibit participation in desired activities
� Demands/Constraints in the physical environment provide no support
and restrict successful role performance
R � Inadequate resources/opportunities (money, transportation, facilities etc)
provide no support and restrict participation in desired activities
SOCIAL ENVIRONMENT
Do you spend a lot of time alone? Who do you spend most of your time with?
Who are the most important people in your life right now?
Does what they expect from you match what you would like to do?
Would you describe your (work, school, community) setting as supportive?
Do the people or situations in your life place limits on you?
If you need help/support, can you count on family/friends/community?
� Other persons (family/friends/co-workers) provide strong support which

F facilitates participation
� Has ample opportunities for social participation
� Other persons (family/friends/co-workers) provide some support which
A allows some participation
� Has some opportunities for social participation
� Other persons (family/friends/co-workers) provide very little support
I which inhibits participation
� Has very few opportunities for social participation
� Social support (family/friends/co-workers) is missing from the social en-
R vironment which restricts participation
� Does not have opportunities for social participation
READINESS FOR CHANGE

Tell me about a time when you experienced a big change in your life (moving,
going away to school, death of a parent/spouse/child). Was it difficult to ad-
just?
How do you handle it when your daily routine changes? (If needed, use an ex-
ample from response given in Habits Section.)
When someone gives you feedback (asks you to change your behavior) how
does it make you feel? How do you react?
� Adjusts well to feedback/changes in personal/environmental

circumstances
F � Highly motivated to make positive changes; clearly identifies areas
client wants to work on
� Some difficulty in adjusting to feedback/changes in personal/
environmental circumstances
A � Some motivation to make positive changes; has some difficulty in
identifying areas client wants to work on
� Significant difficulty in adjusting to feedback/changes in personal/
I � Very little motivation to make positive changes; has significant difficulty
in identifying areas client wants to work on
� Rejects feedback/changes in personal/ environmental circumstances
R � Makes inadequate changes or modifications; does not identify areas
8
OCAIRS Mental Health Interview (Form 3) Questions and Rating Scales

ROLES VALUES
What do you do? Your major responsibilities? What do you value most in your life? (most important to you?)
(Parent? Spouse? Worker? Student? Homemaker?) What are other things/ideals that you value (are important you?)
Belong to any groups? How important are these to you?
For each role: Importance? Enjoyment? How well done? What about your life reflects these values? Are you able to live life in
ways that fit with values you think you should have /try to live up to?
� Occupational roles reflect a highly productive lifestyle Is there anything about your life that goes against your values?
� Fulfils a wide range of role responsibilities � Identifies distinct and specific values
F � Expresses complete congruence between own values and cur-
A � Some satisfaction with current roles rent life situation
� Occupational roles fail to constitute a productive lifestyle � Some conviction about expressed values
A � Expresses some congruity between own values and current life
� Major difficulty in fulfilling a wide range of role responsibilities situation
� No occupational roles � Loosely identifies very ambiguous values

R � Alienated from roles � Very little conviction about expressed values
I � Expresses very little congruity between own values and current
life situation
HABITS � Does not identify any values
� No conviction/alienation about expressed values
Describe typical weekday (before treatmnt/ prgm/ hospitaliz). R � Expresses no congruity between own values and current life
Describe a typical weekend day (before tx/prgram/hospitaliz). situation
Does your daily schedule let you do things you need/want to do?
Has your daily routine changed (over 6 months/ since your accident/ INTERESTS
divorce, etc - pick pivotal event if possible)? How?
Are you satisfied with your current daily routine? Is your major occupational role such as, worker, student, volunteer,
caretaker something you enjoy? What about it interests/satisfies you?
� Highly organized daily schedule What do you like to do with time outside________
F � Good balance between work, rest, self-care and leisure (work/major occup role)?
� Satisfied with daily routine Do you have any other interests or hobbies?
� Some organization of daily schedule � Participates in many interests regularly outside of work
� Somewhat satisfied with daily routine � High level of satisfaction with level of participation in an
interest(s)
I � Very little balance between self-care and leisure � Participates in few, but clearly expressed, interests regularly
� Very little satisfaction with daily routine outside of work
� No organized daily schedule � Some satisfaction with level of participation in an interest(s)
� Dissatisfied with daily routine � Few & vaguely defined interest outside work, no regular partici-
pation
PERSONAL CAUSATION I � Very little interest in primary occupation
What things in your life do you feel you do well/ are proud of?
What are things that have been difficult? How did you handle it? � Does not participate in any identified interests outside of work
What is the biggest challenge you are currently facing? R � No interest in primary occupation
How successful do you think you will be over the next six months? � Dissatisfaction with level of participation
� Strong confidence in abilities SKILLS: Motor, Process, & Communication/Interaction Skills

F � Anticipates success in next six months Are you able to do the things you want or need to do?
� Identifies a number of things (3 or more) done well/proud of (If no) What limits your ability to do things?
� Some confidence in abilities Are you able to concentrate, problem-solve, and make decisions to
get things done?
A � Anticipates somewhat successful outcomes within next 6 months
Do you have phys ability to accomplish what you need/want to do?
Are you able to over come these limitations and barriers?
� Very little confidence in abilities Do you prefer to work alone/with others? How well do you work
w/ others?
Participation is allowed but there are some limitations in perfor-
mance of:
A � Motor Skills
� Process Skills
� Motor Skills
Participation is restricted to severe limitations in:
� Motor Skills
9
GOALS PHYSICAL ENVIRONMENT

Do you ever set goals for yourself/make plans for the future? Have you Where do you live? (Location, house, apt?) Easy to get around/get things
followed through on any of them? done?
What goals do you have for the next week? The next month? In the area you live, are there things to do/places to go that interest you?
What are you doing to accomplish that? Is there someplace you go on regular basis (e.g. work, school, church, the
Do you have any long-term goals? (1 year, 5-10 years) park district, the Dr)? Easy to get to from home? Are there any physical barri-
How will you accomplish those? ers at ___(from above) or at home that prevent you from getting things done?
In terms of activities to participate in/places you would like to go, what if any-
thing prevents you from doing so? (Money/transpt/safety phys barriers)
SHORT-TERM GOALS Are there resources available to help overcome barriers to getting things
done?
F � Coherently discusses realistic plan(s) for meeting goals � Demands/Constraints in the physical environment provide strong
� Actively participating in the execution of the plan(s) support for successful role performance
F � Ample resources/opportunities (money, transportation, facilities
� Identifies goal(s) that may be difficult to achieve or, if readily etc.) to support participation in desired activities
A � Discusses somewhat unrealistic plan(s) for meeting goal(s) � Demands/Constraints in the physical environment provide some
� Somewhat participating in the execution of the plan(s) support and allow role performance
A � Sufficient resources/opportunities (money, transportation,
� Identifies vague or conflicting goals that will be very difficult facilities etc.) which provide some support and allow participa-
to achieve tion in desired activities
� Very little participation in the execution of the plan(s) � Demands/Constraints in the physical environment provide very
little support and inhibit successful role performance
� Does not identify any short-term goal(s) or has unachievable goal I � Limited resources/opportunities (money, transportation, facili-
� Does not discuss plan, abandons his/her plans easily ties etc) provide very little support and inhibit participation in
R � No participation in the execution of the plan(s), doing nothing to desired activities
achieve goal(s)
� Demands/Constraints in physical environment provide no
LONG-TERM GOALS support and restrict successful role performance
R � Inadequate resources/opportunities (money, transportation,
� Identifies achievable yet substantial long-term goal(s) facilities etc) provide no support and restrict participation in
� Coherently discusses realistic plan(s) for meeting goals desired activities
F (i.e. Short-term goals correspond to long-term goals) SOCIAL ENVIRONMENT
Do you spend a lot of time alone? Who do you spend most of your time
� Identifies long-term goal(s) that may be difficult to achieve or, if with?
readily achievable, are insubstantial Who are the most important people in your life right now?
A � Discusses somewhat unrealistic plan(s) for meeting goal(s), Does what they expect from you match what you would like to do?
i.e. short-term goals somewhat related to long-term goals Would you describe your (work, school, community) setting as supportive?
� Other persons (family/friends/co-workers) provide strong support
� Identifies vague or conflicting long-term goals that will be very F which facilitates participation
difficult to achieve � Has ample opportunities for social participation
I � Discusses a plan that is not realistic. Short-term goals unrelated
to long-term goals � Other persons (family/friends/co-workers) provide some support
� Very little participation in the execution of the plan(s) A which allows some participation
� Does not discuss plan, abandons his/her plans easily � Other persons (family/friends/co-workers) provide very
R � No participation in the execution of the plan(s), doing nothing to I little support which inhibits participation
achieve goals � Has very few opportunities for social participation
� Social support (family/friends/co-workers) is missing from the
INTERPRETATION OF PAST EXPERIENCES R social environment which restricts participation
Overall, do you feel you have had the typical ups and downs or do you
feel your life has been exceptionally better or worse than typical? READINESS FOR CHANGE
Give an example of the best period of your life?
Give an example of the worst period in your life? Tell me about a time when you experienced a big change in your life (mov-
How was your life affected by these ups and downs? ing, going away to school, death of a parent/spouse/child). Was it difficult
Have you been able to choose the important things in your life? to adjust?
How do you handle it when your daily routine changes? (If needed, use an
example from response given in Habits Section.)
� Expresses very positive feelings about past experiences. When someone gives you feedback (asks you to change your behavior) how
F � Characterizes past as time of great performance and does it make you feel? How do you react?
accomplishment
� Expresses somewhat positive feelings about past experiences � Adjusts well to feedback/changes in personal/environmental
A � Presents best and worst period(s) with equal emphasis F circumstances
� Highly motivated to make positive changes; clearly identifies
� Expresses mostly negative feelings about past experiences areas client wants to work on
I � Places more emphasis on worst period(s) than best period(s)
of life
A � Some motivation to make positive changes; has some difficulty
R � Discusses only worst period(s), unable to identify best period(s) in identifying areas client wants to work on
� Significant difficulty in adjusting to feedback/changes in
personal/ environmental circumstances
I � Very little motivation to make positive changes; has significant
difficulty in identifying areas client wants to work on
� Rejects feedback/changes in personal/ environmental
circumstances
R � Makes inadequate changes or modifications; does not identify
areas client wants to work on
10
OCAIRS Mental Health (Form 4) Key Words Form

This sheet summarizes Key concepts from MOHO that have
been used in the OCAIRS that the therapist can view at a
glance for his/her reference
ROLES GOALS
• Primary responsibilities • Future Plans
• Importance • Short-term
• Enjoyment • Long-term
• Success • Follow through
HABITS INTERPRETATION OF PAST EXPERIENCES

• Typical weekday • Good times
• Typical weekend • Bad times
• Satisfaction • Balance
PERSONAL CAUSATION • Impact of ups and downs
• What one is proud of PHYSICAL ENVIRONMENT

• Coping abilities • Barriers/Accessibility
• Anticipation of success • Resources/Opportunities
VALUES • Demands/Constraints
• What is important? SOCIAL ENVIRONMENT

• Lifestyle match values • Value and Attitude Congruence
INTERESTS • Support System
• Interest in primary occupation • Resources/Opportunities
• Interests outside primary occupation • Demands/Constraints
• Level of participation READINESS FOR CHANGE

• Satisfaction • Adjustment to major life changes
SKILLS: Motor Skills, Process Skills and • Adjustment to change in daily routine
Communication & Interaction Skills • Response to feedback
• Strengths: physical, mental, social, emotional
• Limitations: physical, mental, social, emotional
• Compensating for limitations
11
OCAIRS v.4.0:
APPENDIX A: MENTAL HEALTH INTERVIEW FORMATS
OCAIRS v.4.0:
APPENDIX B: FORENSIC MENTAL HEALTH INTERVIEW FORMATS
APPENDIX: B
OCAIRS
OCAIRS v.4.0:
There are three different formats bulleted underneath:
1) OCAIRS Forensic Mental Health Interview (Form 1) Questions
2) OCAIRS Forensic Mental Health Interview (Form 2) Questions, Rating Scales and Notes Form
OCAIRS v.4.0:
3) OCAIRS Forensic Mental Health Interview (Form 3) Questions and Rating Scales
4) OCAIRS Forensic Mental Health (Form 4) Key Words Form
OCAIRS v.4.0:
APPENDIX
1) OCAIRS E: RATING
Forensic Mental SCALES(Form
Health Interview & NOTES SUMMARY
1) Questions: FORM
Some therapists may prefer to use the Interview Questions format. This format provides a range of
questions that will elicit OCAIRS information. The therapist may change, add or delete questions to
OCAIRS v.4.0:
better address the issues and suite his/her own style of phrasing questions. Therapists may also wish to
change the order of the questions or the sequence of the interview.
APPENDIX F: DATA SUMMARY FORM 1
2) OCAIRS Forensic Mental Health Interview (Form 2) Questions, Rating Scales and Notes Form:
OCAIRS v.4.0:
APPENDIX
3) OCAIRS G: DATA
Forensic Mental Health SUMMARY FORM
Interview (Form 2
3) Questions and Rating Scales:
OCAIRS v.4.0:
APPENDIX
4) OCAIRS H: GLOSSARY
Forensic Mental Health (Form OF OCAIRS
4) Key CONCEPTS
Words Form
The Key Words Form summarizes key concepts from MOHO that have been used in the OCAIRS.
Therapists may wish to use it as a reference to glance over while conducting the interview to remind
themselves of the areas of information needing to be gathered.
12
OCAIRS Forensic Mental Health Interview (Form 1) Questions

by Katy Walker, Dr. Kirsty Forsyth, Dr. Edward A. S Duncan
ROLES VALUES
• Do you have any family responsibilities? Are you • What do you value most in your life? (What or who is
managing to keep up with these? most important to you?)
• How much contact do you have with your family or • Are you able to live by your values or ideals at present?
friends? How often do they telephone/visit/write? If not, why not?
• Are you studying now or have any other responsibilities • Are there any other things that are important to you?
here?
• Why are these things important?
• What are your needs relating to your culture or religion?
INTERESTS
• How well are you able to ________ (for each role
mentioned)? • What interests or hobbies do you have? Is there anything
that stops you currently participating?
• (For each role mentioned) How important is __________
to you? Do you enjoy_______? • (For each interest mentioned) How often do you ______?
Are you satisfied with the amount of time you are able to
• What else do you do? What other roles do you fill? ___________?
HABITS • Are there any activities here that you would like to do in
this environment?
• What would you like your routine to be like?
• (If applicable) Do you have an interest in a criminal
• How is your sleep pattern now? lifestyle? (e.g.drugs/alcohol/theft)? What is good or bad
• Describe a typical weekday (before you were admitted about the criminal lifestyle? Would you like to live like
here). this?
• Were your weekends any different? • What would you like to do with your time when you
leave the hospital?
• What is your routine now? Are you able to do what you
want to do? SKILLS
• Has your routine changed (since you index offense/ • Are you able to concentrate, problem-solve, and make
admission here)? If so, how? decisions to get things done?
• Are you satisfied with your current routine? • Do you have any physical complaints which limit what
you do during the day?
PERSONAL CAUSATION • Are you able to overcome any problems you have?
• How well do you think you understand your own
abilities? • Do you complete tasks to your satisfaction (e.g. Too fast,
too slow)?
• What things do you feel you do well, or are proud of?
• Do you prefer to work alone or with others? How well
• What things have been difficult for you? Can you give do you work with others? Do you feel comfortable in a
me an example of something you have found difficult to group situation?
cope with recently? How did you handle it?
GOALS
• What is the most difficult thing for you at the moment?
• Do you ever set goals for yourself/make plans for the
• How successful do you think you will be over the next future? Have you followed through with any of them?
six months?
• What goals do you have for the next week? The next
• How do you think you will achieve this? month?
• Is there anything you thought you may be able to do, but • How are you going to achieve them?
have problems achieving?
• Do you have any long-term goals? (1 year, 5-10 years)
13
• How will you accomplish them? outside the hospital?

• Do you feel able to set goals at present? • Who are the most important people in your life right
now?
• Do you hear from them/see them as often as you would
• When you think about your life so far, do you think you like to?
have had a good deal or a bad deal?
• Where do you feel most vulnerable or at risk?
• What was happening to you around the time of your
index offence? • If you need help or support, who do you turn to? Can
you talk to your family/friends/staff?
• Have you ever taken drugs or alcohol? If so, how has
your life been influenced by your drug taking/alcohol • Are you able to form trusting relationships?
problems?
• Give an example of the best period of your life.
• Tell me about a time when you experienced a big change
• Give an example of the worst period of your life. in your life (around the time of your index offense/change
in mental state). What did you do, did things become
• Thinking about your life so far, when you had to make better or worse?
an important choice about something (say a new job, or
choosing friends) were you able to do this freely, or were • How do you cope when your expected daily routine
there things that got in the way? changes (e.g. when a session/community leave is
cancelled at the last minute/ moving to a secure unit)? Is
• What effect do you think your past experience has had on it difficult for you to adjust?
your current situation?
• How do you react when someone criticizes you or
PHYSICAL ENVIRONMENT challenges you about an issue (e.g. about your behavior
on the ward/in a session)? Do you get angry with them?
• How do you feel about the physical environment here?
What kinds of things do you do when you are angry? Do
How could it be improved?
you feel sad? What kind of things do you do when you
• Is it better or worse than where you were living before? feel sad? Etc.
Why?
• How do you feel about being in a locked environment?
What effect does this have on your being able to move
around the hospital?
• Are there places that you would like to go to that you are
currently not able to access?
• Are there resources that you can use on the ward to
compensate for your limited access to other parts of the
building?
• Do you manage to get things done that are important to
you?
• Are you able to keep your possessions accessible?
• Does your environment afford enough privacy?
• Do you feel the physical environment has an effect on
your behavior?
SOCIAL ENVIRONMENT
• How do you find the other patients on the ward?
• Do you spend a lot of time alone? Who do you spend
most of your time with? Do you have any friends here/
14
OCAIRS Forensic Mental Health Interview (Form 2) Questions, Rating Scales and Notes
ROLES FINAL NOTES
Do you have any family responsibilities? Are you managing to keep up
with these?
How much contact with family/friends? How often do they telephone/
visit/write?
Are you studying now or have any other responsibilities here?
What are your needs relating to your culture or religion?
How well are you able to ________ (for each role mentioned)?
(For each role mentioned) How important is ____ to you?
Do you enjoy_______?
What else do you do? What other roles do you fill?



HABITS
What would you like your routine to be like?
How is your sleep pattern now?
Describe a typical weekday (before you were admitted here).
Were your weekends any different?
What is your routine now? Are you able to do what you want to do?
Has your routine changed (since you index offense/admission here)? If so, how?
Are you satisfied with your current routine?

PERSONAL CAUSATION
How well do you think you understand your own abilities?
What things do you feel you do well, or are proud of?
What things have been difficult for you? Can you give me an example of some-
thing you have found difficult to cope with recently? How did you handle it?
What is the most difficult thing for you at the moment?
How successful do you think you will be over the next six months?
How do you think you will achieve this?
Is there anything you thought you may be able to do, but have probs achieving?
A � Anticipates somewhat successful outcomes within next six months
15
VALUES FINAL NOTES

What do you value most in your life? (What/who is most important?)
Are you able to live by your values/ideals at present? If not, why not?
Are there any other things that are important to you?
Why are these things important?

F � Expresses complete congruence between own values and current life
situation
A � Some conviction about expressed values
� Expresses some congruity between own values and current life situation

I � Expresses very little congruity between own values and current life
situation
R � No conviction/alienation about expressed values
� Expresses no congruity between own values and current life situation
INTERESTS
What interests/hobbies do you have? Is there anything that stops you from
participating?
(For each interest mentioned) How often do you ________? Are you satisfied
with the amount of time you are able to ___________?
Are there activities here that you would like to do in this environment?
(If applicable) Do you have an interest in a criminal lifestyle? (e.g.drugs/alcohol/
theft)? What is good or bad about the criminal lifestyle? Would you like to live
like this?
What would you like to do with your time when you leave the hospital?

� High level of satisfaction with level of participation in an interest(s)
outside of work
SKILLS: Motor, Process, & Communication/Interaction Skills

Are you able to concentrate, problem-solve, and make decisions to get things
done?
Do you have any physical complaints which limit what you do during the day?
Are you able to overcome any problems you have?
Do you complete tasks to your satisfaction (e.g. Too fast, too slow)?
Do you prefer to work alone or with others? How well do you work with
others? Do you feel comfortable in a group situation?
Participation is allowed but there are some limitations in performance of:
� Motor Skills
A � Process Skills
Participation limited due to significant limitations in:
� Motor Skills
� Motor Skills
16
GOALS
Do you ever set goals for yourself/make plans for the future? Have you
followed through with any of them?
What goals do you have for the next week? The next month?
How are you going to achieve them?
Do you have any long-term goals? (1 year, 5-10 years)
How will you accomplish them?
Do you feel able to set goals at present?
SHORT-TERM GOALS FINAL NOTES

� Identifies goal(s) that may be difficult to achieve or, if readily achievable,
are insubstantial
� Identifies vague or conflicting goals that will be very difficult to achieve
R � No participation in the execution of the plan(s),
doing nothing to achieve goal(s)
LONG-TERM GOALS
� Coherently discusses realistic plan(s) for meeting goals i.e. short-term
F goals correspond to long-term goals
� Identifies long-term goal(s) that may be difficult to achieve or, if readily
A � Discusses somewhat unrealistic plan(s) for meeting goal(s), i.e. short-
term goals somewhat related to long-term goals
� Identifies vague or conflicting long-term goals that will be very difficult
to achieve
I � Discusses a plan that is not realistic. Short-term goals unrelated to long-
term goals
achieve goal(s)

When you think about life so far, do you think you have had a good deal/
bad deal?
What was happening to you around the time of your index offence?
Have you ever taken drugs/alcohol? If so, how has life been influenced by
your drug taking/alcohol problems?
Give an example of the best period of your life. Example of the
worst period.
Thinking about life so far, when you had to make an impt choice about some-
thing (say a new job, or choosing friends) were you able to do this freely, or
were there things that got in the way?
What effect do you think your past experience has had on your
current situation?
F � Characterizes past as time of great performance and accomplishment
I � Places more emphasis on worst period(s) than best period(s) of life
17
PHYSICAL ENVIRONMENT FINAL NOTES

How do you feel about the phys envnmt here? How could it be improved?
Is it better or worse than where you were living before? Why?
How do you feel about being in a locked environment? What effect does this have on your
being able to move around the hospital?
Are there places that you would like to go to, currently not able to access?
Are there resources that you can use on the ward to compensate for your limited access to
other parts of the building?
Do you manage to get things done that are important to you?
Are you able to keep your possessions accessible?
Does your environment afford enough privacy?
Do you feel the physical environment has an effect on your behavior?
� Demands/Constraints in the physical environment provide strong support for suc-

cessful role performance
F � Ample resources/opportunities (money, transportation, facilities etc.) to support
participation in desired activities
� Demands/Constraints in the physical environment provide some support and al-

low role performance
A � Sufficient resources/opportunities (money, transportation, facilities etc.) which
provide some support and allow participation in desired activities
� Demands/Constraints in the physical environment provide very little support and

inhibit successful role performance
I � Limited resources/opportunities (money, transportation, facilities etc) provide very
little support and inhibit participation in desired activities
� Demands/Constraints in the physical environment provide no support and restrict

successful role performance
R � Inadequate resources/opportunities (money, transportation, facilities etc) provide
no support and restrict participation in desired activities
SOCIAL ENVIRONMENT
How do you find the other patients on the ward?
Do you spend a lot of time alone? Who do you spend most of your time with? Do you
have any friends here/outside the hospital?
Who are the most important people in your life right now?
Do you hear from them/see them as often as you would like to?
Where do you feel most vulnerable or at risk?
If you need help or support, who do you turn to? Can you talk to your family/friends/staff?
Are you able to form trusting relationships?
� Other persons (family/friends/co-workers) provide strong support which facilitates

F participation
� Other persons (family/friends/co-workers) provide some support which

A allows some participation
� Other persons (family/friends/co-workers) provide very little support which inhib-

I its participation
� Social support (family/friends/co-workers) is missing from the social environment

R which restricts participation

Tell me about a time when you expercd a big change in your life (around the time index of-
fense/change in mental state). What did you do, did things become better or worse?
How do you cope when your daily routine changes? (e.g. session/community leave can-
celled last min/moving to a secure unit). Is it difficult to adjust?
How do you react when someone criticizes/ challenges you about an issue (e.g. your behav-
ior on the ward/in a session)? Do you get angry with them? What do you do when you are
angry? Do you feel sad? What kind of things do you do when you feel sad? Etc.
circumstances
F � Highly motivated to make positive changes; clearly identifies areas

A � Some motivation to make positive changes; has some difficulty in
identifying areas client wants to work on
� Significant difficulty in adjusting to feedback/changes in personal/

I � Very little motivation to make positive changes; has significant difficulty in identi-
fying areas client wants to work on

18
OCAIRS Forensic Mental Health Interview (Form 3) Questions and Rating Scales
ROLES VALUES
Do you have any family responsibilities? Are you managing to keep up What do you value most in your life? (What/who is most important?)
with these? Are you able to live by your values/ideals at present? If not, why not?
How much contact with family/friends? How often do they telephone/ Are there any other things that are important to you?
visit/write? Why are these things important?
Are you studying now or have any other responsibilities here?
What are your needs relating to your culture or religion? � Identifies distinct and specific values
How well are you able to ________ (for each role mentioned)? � Strong conviction about expressed values
(For each role mentioned) How important is ____ to you? Do you en- F � Expresses complete congruence between own values and
joy_______? current life situation
What else do you do? What other roles do you fill?
� Occupational roles reflect a highly productive lifestyle � Some conviction about expressed values
F � High level of satisfaction with current roles A � Expresses some congruity between own values and current life
� Fulfils a wide range of role responsibilities situation
� Occupational roles reflect a somewhat productive lifestyle � Loosely identifies very ambiguous values
I � Very little conviction about expressed values
� Minor difficulty in fulfilling a wide range of role responsibilities � Expresses very little congruity between own values and current
life situation
I � Very little satisfaction with current roles � Does not identify any values
� Major difficulty in fulfilling a wide range of role responsibilities � No conviction/alienation about expressed values
R � Expresses no congruity between own values and current life
� No occupational roles situation
� Cannot fulfill a wide range of role responsibilities INTERESTS
What interests/hobbies do you have? Is there anything that stops you participating?
HABITS (For each interest mentioned) How often do you ________? Are you satisfied
What would you like your routine to be like? with the amount of time you are able to ___________?
How is your sleep pattern now? Are there activities here that you would like to do in this environment?
Describe a typical weekday (before you were admitted here). (If applicable) Do you have an interest in a criminal lifestyle? (e.g.drugs/alcohol/
Were your weekends any different? theft)? What is good or bad about the criminal lifestyle? Would you like to live
What is your routine now? Are you able to do what you want to do? like this?
Has your routine changed (since you index offense/admission here)? What would you like to do with your time when you leave the hospital?
If so, how?
Are you satisfied with your current routine? � Participates in many interests regularly outside of work
� High level of interest in primary occupation
F � High level of satisfaction with level of participation in an
F � Good balance between work, rest, self-care and leisure interest(s)
� Some organization of daily schedule outside of work
� Somewhat satisfied with daily routine � Some satisfaction with level of participation in an interest(s)
� Very little organization of daily schedule � Few & vaguely defined interest outside work,
I � Very little balance between work, self-care and leisure no regular participation
R � No balance between work, self-care and leisure � Does not participate in any identified interests outside of work
� Dissatisfied with daily routine R � No interest in primary occupation
PERSONAL CAUSATION
SKILLS: Motor Skills, Process Skills, and
How well do you think you understand your own abilities?
What things do you feel you do well, or are proud of? Communication & Interaction Skills
What things have been difficult for you? Can you give an example of Are you able to concentrate, problem-solve, and make decisions to get things done?
something you have found difficult to cope with recently? How did Do you have any physical complaints which limit what you do during the day?
you handle it? Are you able to overcome any problems you have?
What is the most difficult thing for you at the moment? Do you complete tasks to your satisfaction (e.g. Too fast, too slow)?
How successful do you think you will be over the next six months? Do you prefer to work alone or with others? How well do you work with others?
How do you think you will achieve this? Do you feel comfortable in a group situation?
Is there anything you thought you may be able to do, but have probs
achieving? � No limitations in performance due to good skills
F � Anticipates success in next six months Participation is allowed but there are some limitations in
� Identifies a number of things (3 or more) done well/proud of performance of:
A � Motor Skills
� Some confidence in abilities. � Process Skills
� Anticipates somewhat successful outcomes within � Communication/ Interaction Skills
A next six months
� Some difficulty in identifying something done well/proud of Participation is inhibited due to significant limitations in:
� Motor Skills
� Very little confidence in abilities I � Process Skills
I � Significant concerns about failures within next six months � Communication/ Interaction Skills
� No confidence in abilities � Motor Skills
R � Anticipates failure in next six months R � Process Skills
� Does not identify anything done well/proud of � Communication/ Interaction Skills
19
GOALS PHYSICAL ENVIRONMENT
Do you ever set goals for yourself/make plans for the future? Have you How do you feel about the phys envnmt here? How could it be improved?
followed through with any of them? Is it better or worse than where you were living before? Why?
What goals do you have for the next week? The next month? How do you feel about being in a locked environment? What effect does this have
How are you going to achieve them? on your being able to move around the hospital?
Do you have any long-term goals? (1 year, 5-10 years) Are there places that you would like to go to, currently not able to access?
How will you accomplish them? Are there resources that you can use on the ward to compensate for your limited
Do you feel able to set goals at present? access to other parts of the building?
Do you manage to get things done that are important to you?
SHORT-TERM GOALS Are you able to keep your possessions accessible?
Does your environment afford enough privacy?
� Identifies achievable yet substantial short-term goal(s) Do you feel the physical environment has an effect on your behavior?
F � Coherently discusses realistic plan(s) for meeting goals � Demands/Constraints in the physical environment provide strong support
� Actively participating in the execution of the plan(s) for successful role performance
F � Ample resources/opportunities (money, transportation, facilities etc.) to
� Identifies goal(s) that may be difficult to achieve or, if readily support participation in desired activities
A � Discusses somewhat unrealistic plan(s) for meeting goal(s) � Demands/Constraints in the physical environment provide some support
� Somewhat participating in the execution of the plan(s) and allow role performance
� Identifies vague or conflicting goals that will be very difficult to
facilities etc.) which provide some support and allow
achieve
participation in desired activities
� Very little participation in the execution of the plan(s) � Demands/Constraints in the physical environment provide very little
support and inhibit successful role performance
� Does not identify any short-term goal(s) or has unachievable I � Limited resources/opportunities (money, transportation,
goal facilities etc) provide very little support and inhibit participation in
R � Does not discuss plan, abandons his/her plans easily desired activities
� No participation in the execution of the plan(s), doing nothing to
achieve goal(s) � Demands/Constraints in the physical environment provide no
support and restrict successful role performance
LONG-TERM GOALS R � Inadequate resources/opportunities (money, transportation,
facilities etc) provide no support and restrict participation in desired
activities
� Coherently discusses realistic plan(s) for meeting goals i.e. short- SOCIAL ENVIRONMENT
F term goals correspond to long-term goals
� Actively participating in the execution of the plan(s) How do you find the other patients on the ward?
Do you spend a lot of time alone? Who do you spend most of your time with? Do
� Identifies long-term goal(s) that may be difficult to achieve or, if you have any friends here/outside the hospital?
readily achievable, are insubstantial Who are the most important people in your life right now?
A � Discusses somewhat unrealistic plan(s) for meeting goal(s), i.e. Do you hear from them/see them as often as you would like to?
short-term goals somewhat related to long-term goals Where do you feel most vulnerable or at risk?
� Somewhat participating in the execution of the plan(s) If you need help or support, who do you turn to? Can you talk to your family/
friends/staff?
� Identifies vague or conflicting long-term goals that will be very Are you able to form trusting relationships?
difficult achieve
I � Discusses a plan that is not realistic. Short-term goals unrelated � Other persons (family/friends/co-workers) provide strong support which
to long-term goals F facilitates participation
� Very little participation in the execution of the plan(s) � Has ample opportunities for social participation
� Does not identify any long-term goal(s) or has unachievable goal � Other persons (family/friends/co-workers) provide some support which
� Does not discuss plan, abandons his/her plans easily A allows some participation
R � No participation in the execution of the plan(s), doing nothing to � Has some opportunities for social participation
achieve goal(s)
� Other persons (family/friends/co-workers) provide very little
I support which inhibits participation
INTERPRETATION OF PAST EXPERIENCE � Has very few opportunities for social participation
When you think about life so far, do you think you have had a good � Social support (family/friends/co-workers) is missing from the social envi-
deal/bad deal? R ronment which restricts participation
What was happening to you around the time of your index offence? � Does not have opportunities for social participation
Have you ever taken drugs/alcohol? If so, how has life been influenced
by your drug taking/alcohol problems? READINESS FOR CHANGE
Give an example of the best period of your life. Example of the
worst period. Tell me about a time when you expercd a big change in your life (around the time
Thinking about life so far, when you had to make an impt choice about index offense/change in mental state). What did you do, did things become
something (say a new job, or choosing friends) were you able to do this better or worse?
freely, or were there things that got in the way? How do you cope when your daily routine changes? (e.g. session/community leave
What effect do you think your past experience has had on your cancelled last min/moving to a secure unit). Is it difficult to adjust?
current situation? How do you react when someone criticizes/ challenges you about an issue (e.g.
your behavior on the ward/in a session)? Do you get angry with them? What do
you do when you are angry? Do you feel sad? What kind of things do you do
when you feel sad? Etc.
F � Characterizes past as time of great performance and accomplish-
ment � Adjusts well to feedback/changes in personal/environmental
circumstances
A � Expresses somewhat positive feelings about past experiences F � Highly motivated to make positive changes; clearly identifies areas client
� Presents best and worst period(s) with equal emphasis wants to work on
� Expresses mostly negative feelings about past experiences � Some difficulty in adjusting to feedback/changes in personal/
I � Places more emphasis on worst period(s) than best period(s) of environmental circumstances
life A � Some motivation to make positive changes; has some difficulty in identi-
fying areas client wants to work on
R � Discusses only worst period(s), unable to identify best period(s) � Significant difficulty in adjusting to feedback/changes in
I � Very little motivation to make positive changes; has significant difficulty

20
OCAIRS Forensic Mental Health (Form 4) Key Words Form

This sheet summarizes Key concepts from MOHO that have been used in the
OCAIRS that the therapist can view at a glance for his/her reference
ROLES SKILLS: Motor Skills, Process Skills and

• Family responsibilities Communication & Interaction Skills
• Religious responsibilities
• Cultural responsibilities
• Other responsibilities
• Importance GOALS
• Enjoyment • Future Plans
• Success • Short-term
• Long-term
HABITS
• Follow through
• Preferred routine
• Sleep pattern INTERPRETATION OF PAST EXPERIENCES
• Typical weekday (pre-admit) • Good times
• Typical weekend (pre-admit) • Bad times
• Current routine • Balance
• Satisfaction • Life situation at time of index offence

• Influenced by alcohol or drug use
PERSONAL CAUSATION
• Impact of ups and downs
• What one is proud of
• Coping abilities PHYSICAL ENVIRONMENT
• Anticipation of success • Resources/Opportunities
• Areas of difficulty • Demands/Constraints

• Privacy
VALUES
• Impact on behavior
• What/who is important?
• Lifestyle match values SOCIAL ENVIRONMENT
• Support System
INTERESTS
• Primary interests/hobbies • Resources/Opportunities
• Level of participation • Demands/Constraints

• Satisfaction • Vulnerability/Risk
• Interest in criminal lifestyle
• Plans for interests/hobbies after discharge
• Adjustment to major life changes
• Adjustment to change in daily routine
• Response to feedback
21
OCAIRS v.4.0:
APPENDIX B: FORENSIC MENTAL HEALTH INTERVIEW FORMATS
OCAIRS v.4.0:
APPENDIX: C
OCAIRS v.4.0:
OCAIRS PHYSICAL DISABILITIES INTERVIEW FORMATS
APPENDIX
There are three D: RATING
different formats CRITERIA
bulleted underneath:
1) OCAIRS Physical Disabilities Interview (Form 1) Questions
2) OCAIRS Physical Disabilities Interview (Form 2) Questions, Rating Scales and Notes Form
OCAIRS v.4.0:
3) OCAIRS Physical Disabilities Interview (Form 3) Questions and Rating Scales Form
APPENDIX E: RATING SCALES & NOTES SUMMARY FORM
4) OCAIRS Physical Disabilities (Form 4) Key Words Form

OCAIRS v.4.0:
1) OCAIRS Physical Disabilities Interview (Form 1) Questions:
Some therapists may prefer to use the Interview Questions format. This format provides a range of questions that
will elicit OCAIRS information. The therapist may change, add or delete questions to better address the issues and
OCAIRS v.4.0:
suite his/her own style of phrasing questions. Therapists may also wish to change the order of the questions or the
sequence of the interview.
APPENDIX G: DATA SUMMARY FORM 2
2) OCAIRS Physical Disabilities Interview (Form 2) Questions, Rating Scales and Notes Form:
This format contains abbreviated versions of the questions, the full rating scales and a section for notes. The
OCAIRS v.4.0:
addition of the rating scales provides a visual prompt to ensure all information is collected. Additionally, the
notes section provides the therapist with space to take notes during the interview.
3) OCAIRS Physical Disabilities Interview (Form 3) Questions and Rating Scales:
This format contains the abbreviated versions of questions and the full rating scales. It may be beneficial to
use with clients who may become anxious by interview formats that appear to be longer and thus more time
intensive.
4) OCAIRS Physical Disabilities (Form 4) Key Words Form
The Key Words Form summarizes key concepts from MOHO that have been used in the OCAIRS. Therapists may
wish to use it as a reference to glance over while conducting the interview to remind themselves of the areas of
information needing to be gathered.
22
OCAIRS Physical Disabilities Interview Questions (Form 1)

By Dr. Kirsty Forsyth, Emma Dobson, Heather Lamb
Social Environment
First, I would like to look at how things are for you at home in regards to family or homecare support and
how this helps you with your daily life.
Do you live alone?
Do you have friends/family/neighbors who visit you regularly?
Do you have any home help?
Are you happy with the help they (family/home help) provide you with at the moment? (Restricted/
more support/more independence)
If you needed help or support do you feel you could count on your friends/family/home help?
Are you able to keep in touch with family/friends?
In your local area, are there places you go to regularly (i.e. church, bingo, drs, visit family etc), do you
manage to get there ok?
We have looked at what social support you have at home, I would like to move on to look at your actual
house and local community to find out what equipment and support you have from that.
Physical Environment
What type of house is it? How many rooms do you have?
Who owns your property?
How do you manage the stairs at home? (Banisters)
What is the layout of the house?
At your front/ back door do you have steps? (Rails)
Do you use a walking aid?
We have looked at your home situation I would now like to find out a bit more about your daily routine.
MORNING SELF-CARE ROUTINE
I’d like you to talk me through your morning routine
(NB: As each activity is discussed a range of questions are asked for each activity)
Activity For each activity ask
Bed Transfer Do you feel confident doing this activity (PC)
Toileting Do you find this activity enjoyable/satisfying? (I)
Bathing/washing How important is this activity for you? (V)
Dressing Can you physically do the activity? (MS)
Chair Transfer Do you have enough concentration to complete the activity? (PS)
Do you have the full responsibility for doing the activity? (R)
Does someone help you? (SE)
Where do you carry out this activity? Do you have any equipment to help you? (PE)
Do you have a routine when doing this activity? (H)
Have you had difficult past experiences doing this activity? (PstE)
Are you satisfied with your morning self-care routine (H)?
23
BREAKFAST
I’d like you to talk me through your breakfast routine

Making Breakfast Do you make you own breakfast? (R)
What do you have for breakfast? Do you have a routine when making your breakfast?
When do you have breakfast? (H)
Do you feel confident with this activity? (PC)
Do you find this activity enjoyable/satisfying? (I)
How important is this activity for you? (V)
Can you physically do the activity? (MS)
Do you have enough concentration to complete the activity? (PS)
Where do you have your breakfast? (PE)
Do you use any equipment to help you make your breakfast? (PE)
Are you satisfied with your breakfast routine? (H)
MORNING
How do you typically spend your mornings?
LUNCH
I’d like you to talk me through your lunch routine

Making Lunch Do you make your own lunch? (R)
What do you have for lunch? Do you have a routine when making your lunch?
When do you have lunch? (H)
Where do you have your lunch? (PE)
Do you use any equipment to help you make your lunch? (PE)
Are you satisfied with your lunch routine? (H)
24
AFTERNOON
How do you typically spend your afternoons?

Do you go out? Do you feel confident doing this activity? (PC)
Attend any clubs/day centers? Do you find this activity enjoyable/satisfying? (I)
Meet friends? How important is this activity for you? (V)
Do you go out to work? Can you physically do the activity? (MS)
Do you have responsibilities? Do you have enough concentration to complete activity? (PS)
Do you have the full responsibility for doing the activity? (R)
Are you satisfied with your afternoon routine?
EVENING MEAL
I’d like you to talk me through your evening meal routine

Evening meal Do you make your own evening meal? (R)
What do you have for evening meal? Do you have a routine when making your evening meal?
When do you have evening meal? (H)
Where do you have your evening meal? (PE)
Do you use any equipment to help you make you evening meal? (PE)
Are you satisfied with your evening meal routine? (H)
EVENINGS
How do you typically spend your evenings?

Do you go out? Do you feel confident doing this activity? (PC)
Attend any clubs/day centers? Do you find this activity enjoyable/satisfying? (I)
Meet friends? How important is this activity for you? (V)
Do you go out to work? Can you physically do the activity? (MS)
Do you have responsibilities? Do you have enough concentration to complete the activity? (PS)
Do you have the full responsibility for doing the activity (R)
Are you satisfied with your evening routine?
25
NIGHT
Undressing/ self care Do you feel confident doing this activity? (PC)
Bed Transfers Do you find this activity enjoyable/satisfying? (I)
Do you have to get up to use How important is this activity for you? (V)
the toilet overnight? Can you physically do the activity? (MS)
Do you have responsibility for Do you have enough concentration to complete the activity? (PS)
supporting a partner to get up
during the night? Do you have the full responsibility for doing the activity? (R)
Are you satisfied with your over-night routine?
Goals Often how we have managed in the past helps us manage in

the future, at the moment you have XXXX and that is why you
What things do you want to be able to do that you are
are in hospital. This may mean things may be different for
currently unable to do?
you when you are discharged from the hospital.
What things are important for you to be able to get back to
Readiness for change
doing at home?
You described XXX as a good / bad time that must have been
Do you ever set realistic plans for the future? Do you feel you
a big event, how did you adjust to this change?
have managed to achieve any of these plans?
Our daily routines change overtime do you feel you cope
Do you have any plans for the next week?
with changes to your routines?
How do you feel you will manage to accomplish that?
If someone gives you advice or feedback about your life, how
Do you have any longer term plans for the foreseeable future? does it make you feel, how do you react to this?
What do you think you will do to achieve these goals?
We often set goals and sometimes looking back over past We have looked at many things within your life and all this in-
experiences helps us figure out how we will achieve future formation helps us together to plan your occupational therapy
goals. treatment. While you have been in the hospital you said you
are worried/ concerned/ not managing XXX. Are these things
Interpretation of past experiences you would like to look at while you are in the hospital to help
you when you are discharged???
Overall in your life do you feel you have had the typical ups
and downs?
Do you feel your life has been better or worse than normal?
You said you have had a better/ worse/normal life; can you
identify a good time in your life?
And a bad?
How did these ups and downs affect you?
26
OCAIRS Physical Disabilities Interview (Form 2) Questions, Rating Scales and Notes Form
Notes
Social Environment Physical Environment
Living situation (alone, with assistance, visitors) What type of housing?
Happy with support provided from friends and family? Who owns your property?
(Too restricted/more support needed?) How do you manage the physical environment?
Can you count on support from friends/family? (stairs, layout, front and back doors, bathroom)
Are there places you visit regularly in your community? Do you use a walking/mobility aid?
(church, bingo, friends, family, etc.)
MORNING SELF-CARE ROUTINE BREAKFAST
Bed transfer Toileting Making breakfast
Bathing/Washing Dressing Value for and interest in activities
Chair Transfer Routines (where and when)
Value for and interest in activities Abilities and assistance
Routines (where and when) Adaptations and assistive equipment
Abilities and assistance LUNCH
Adaptations and assistive equipment Making lunch
Confidence in each activity Value for and interest in activities
MORNING Routines (where and when)
Typical morning Go out (friends, clubs, activities) Abilities and assistance
Work or other responsibilities Adaptations and assistive equipment
Value for and interest in activities EVENING MEAL
Routines (where and when) Making dinner
Abilities and assistance Value for and interest in activities
Adaptations and assistive equipment Routines (where and when)
Confidence in each activity Abilities and assistance
AFTERNOON Adaptations and assistive equipment
Typical afternoon Go out (friends, clubs, activities) NIGHT SELF-CARE ROUTINE
Work or other responsibilities Bed transfer Toileting (overnight)
Value for and interest in activities Bathing/Washing Undressing
Routines (where and when) Chair Transfer Partner assistance needed overnight
Confidence in each activity Abilities and assistance
EVENINGS Adaptations and assistive equipment
Typical evening Go out (friends, clubs, activities) Confidence in each activity?
Work or other responsibilities Interpretation of past experiences
Value for and interest in activities Typical ups and downs in life?
Routines (where and when) Do you feel your life has been better or worse than
normal?
Abilities and assistance Can you identify a good time in your life? A bad?
Adaptations and assistive equipment How did these ups and downs affect you?
Confidence in each activity
Goals How did you adjust to change/ ups and downs in the past?
What do you want to do? Important to do at home? Do you feel you cope with changes to your routines?
Have you ever set goals? Achieved them? How does feedback/advise make you feel?
Do you have any longer term plans for the future?
27
ROLES FINAL NOTES



HABITS
PERSONAL CAUSATION
� Anticipates somewhat successful outcomes within next six
A months
VALUES
rent life situation
� Some conviction about expressed values
situation
life situation
situation
28
INTERESTS
interest(s)
� Participates in few, but clearly expressed, interests regularly out-
side of work
� Few & vaguely defined interest outside of work, no regular par-
ticipation
Participation is allowed but there are some limitations in perfor-
mance of:
A � Motor Skills
� Process Skills
� Motor Skills
� Motor Skills
SHORT-TERM GOALS
� Identifies goal(s) that may be difficult to achieve or, if readily
� Identifies vague or conflicting goals that will be very difficult
to achieve
achieve goal(s)
LONG-TERM GOALS
� Coherently discusses realistic plan(s) for meeting goals
F i.e. short-term goals correspond to long-term goals
� Identifies long-term goal(s) that may be difficult to achieve or, if
readily achievable, are insubstantial
A � Discusses somewhat unrealistic plan(s) for meeting goal(s),
i.e. short-term goals somewhat related to long-term goals
� Identifies vague or conflicting long-term goals that will be very
difficult to achieve
to long-term goals
achieve goals
29

F � Characterizes past as time of great performance and
accomplishment
of life
PHYSICAL ENVIRONMENT
� Demands/Constraints in the physical environment provide strong
support for successful role performance
etc.) to support participation in desired activities
� Demands/Constraints in the physical environment provide some
support and allow role performance
facilities etc.) which provide some support and allow participa-
tion in desired activities
� Demands/Constraints in the physical environment provide very
I � Limited resources/opportunities (money, transportation,
facilities etc) provide very little support and inhibit participation
in desired activities
� Demands/Constraints in the physical environment provide no
facilities etc) provide no support and restrict participation in
desired activities
SOCIAL ENVIRONMENT
F which facilitates participation
� Other persons (family/friends/co-workers) provide some support
A which allows some participation
� Other persons (family/friends/co-workers) provide very
I little support which inhibits participation
R social environment which restricts participation

circumstances
F � Highly motivated to make positive changes; clearly identifies
circumstances
30
OCAIRS Physical Disabilities Interview (Form 3) Questions, Rating Scales and Notes
Notes
Social Environment Physical Environment
Living situation (alone, with assistance, visitors) What type of housing?
Happy with support provided from friends and family? Who owns your property?
(Too restricted/more support needed?) How do you manage the physical environment?
Can you count on support from friends/family? (stairs, layout, front and back doors, bathroom)
Are there places you visit regularly in your community? Do you use a walking/mobility aid?
(church, bingo, friends, family, etc.)
MORNING SELF-CARE ROUTINE BREAKFAST
Bed transfer Toileting Making breakfast
Bathing/Washing Dressing Value for and interest in activities
Chair Transfer Routines (where and when)
Value for and interest in activities Abilities and assistance
Routines (where and when) Adaptations and assistive equipment
Abilities and assistance LUNCH
Adaptations and assistive equipment Making lunch
Confidence in each activity? Value for and interest in activities
MORNING Routines (where and when)
Typical morning Go out (friends, clubs, activities) Abilities and assistance
Work or other responsibilities Adaptations and assistive equipment
Value for and interest in activities EVENING MEAL
Routines (where and when) Making dinner
Confidence in each activity? Abilities and assistance
AFTERNOON Adaptations and assistive equipment
Typical afternoon Go out (friends, clubs, activities) NIGHT SELF-CARE ROUTINE
Work or other responsibilities Bed transfer Toileting (overnight)
Value for and interest in activities Bathing/Washing Undressing
Routines (where and when) Chair Transfer Partner assistance needed overnight
Confidence in each activity? Abilities and assistance
EVENINGS Adaptations and assistive equipment
Typical evening Go out (friends, clubs, activities) Confidence in each activity?
Work or other responsibilities Interpretation of past experiences
Value for and interest in activities Typical ups and downs in life?
Routines (where and when) Do you feel your life has been better or worse than
normal?
Abilities and assistance Can you identify a good time in your life? A bad?
Adaptations and assistive equipment How did these ups and downs affect you?
Confidence in each activity?
Goals How did you adjust to change/ups and downs in the past?
What do you want to do? Important to do at home? Do you feel you cope with changes to your routines?
Have you ever set goals? Achieved them? How does feedback/advise make you feel?
Do you have any longer term plans for the future?
31
ROLES INTERESTS
� Occupational roles reflect a highly productive lifestyle � Participates in many interests regularly outside of work
F � High level of satisfaction with current roles F � High level of interest in primary occupation
� Fulfils a wide range of role responsibilities � High level of satisfaction with level of participation in an interest(s)
� Occupational roles reflect a somewhat productive lifestyle � Participates in few, but clearly expressed, interests regularly
A � Some satisfaction with current roles outside work
� Few & vaguely defined interest outside of work, no regular
participation
� Major difficulty in fulfilling a wide range of role responsibilities I � Very little interest in primary occupation
� No occupational roles � Very little satisfaction with level of participation in an interest(s)
HABITS
� Highly organized daily schedule SKILLS: Motor, Process, & Communication/Interaction Skills
F � Good balance between work, rest, self-care and leisure � No limitations in performance due to good skills
� Satisfied with daily routine F � Effectively compensates for any limitations in skills (if any)
� Some organization of daily schedule Participation is allowed but there are some limitations in performance of:
A � Some balance between work, self-care and leisure � Motor Skills
� Somewhat satisfied with daily routine A � Process Skills
I � Very little balance between work, self-care and leisure Participation is inhibited due to significant limitations in:
� Very little satisfaction with daily routine � Motor Skills
� No organized daily schedule � Communication/ Interaction Skills
� Dissatisfied with daily routine Participation is restricted due to severe limitations in:
� Motor Skills
PERSONAL CAUSATION R � Process Skills
F � Anticipates success in next six months GOALS
SHORT-TERM GOALS
� Anticipates somewhat successful outcomes within next six � Identifies achievable yet substantial short-term goal(s)
A months F � Coherently discusses realistic plan(s) for meeting goals
� Some difficulty in identifying something done well/proud of � Actively participating in the execution of the plan(s)
� Very little confidence in abilities � Identifies goal(s) that may be difficult to achieve or, if readily
I � Significant concerns about failures within next six months achievable, are insubstantial
R � Anticipates failure in next six months � Identifies vague or conflicting goals that will be very difficult
� Does not identify anything done well/proud of to achieve
VALUES
� Identifies distinct and specific values � Does not discuss plan, abandons his/her plans easily
F � Strong conviction about expressed values R � No participation in the execution of the plan(s), doing nothing to
� Expresses complete congruence between own values and cur- achieve goal(s)
rent life situation
� Identifies somewhat ambiguous values LONG-TERM GOALS
situation F (i.e. Short-term goals correspond to long-term goals)
� Loosely identifies very ambiguous values � Actively participating in the execution of the plan(s)
� Identifies long-term goal(s) that may be difficult to achieve or, if read-
ily achievable, are insubstantial
life situation
� Does not identify any values � Somewhat participating in the execution of the plan(s)
R � Expresses no congruity between own values and current life � Identifies vague or conflicting long-term goals that will be very dif-
situation ficult to achieve
I � Discusses a plan that is not realistic. Short-term goals unrelated to
long-term goals
achieve goals
32

accomplishment
of life
desired activities
SOCIAL ENVIRONMENT

circumstances
circumstances
33
OCAIRS Physical Disabilities (Form 4) Key Words Form

This sheet summarizes Key concepts from MOHO that have
been used in the OCAIRS that the therapist can view at a
glance for his/her reference
ROLES GOALS
• Primary responsibilities • Future Plans
• Importance • Short-term
• Enjoyment • Long-term
• Success • Follow through
HABITS INTERPRETATION OF PAST EXPERIENCES

• Typical weekday • Good times
• Typical weekend • Bad times
• Satisfaction • Balance
PERSONAL CAUSATION • Impact of ups and downs

• Level of confidence in task
• Coping abilities • Resources/Opportunities
• Anticipation of success • Demands/Constraints
VALUES SOCIAL ENVIRONMENT

• What is important? • Support System
• Lifestyle match values • Resources/Opportunities
INTERESTS • Demands/Constraints
• Interest in self care activities
• Interests outside self care activities • Adjustment to major life changes
• Level of participation • Adjustment to change in daily routine
• Satisfaction • Response to feedback
SKILLS: Motor Skills, Process Skills and

Communication & Interaction Skills
34
OCAIRS v.4.0:
OCAIRS [VersionAPPENDIX
4.0] C: PHYSICAL DISABILITIES INTERVIEW FORMATS
OCAIRS v.4.0:
RATING THE INTERVIEW: APPENDIX D

OCAIRS v.4.0:
Appendix D contains the “OCAIRS Rating Criteria”. This form
was created for therapists in mental health, forensic mental& NOTES SUMMARY
APPENDIX E: RATING SCALES FORM
health and physical disabilities who choose to use the
“Interview (Form 1) Questions” during the interview. Since
the “Interview Questions” do not contain the Rating Scale
OCAIRS v.4.0:
Criteria, this form is provided so the therapist may rate the
client’s occupational participation.
APPENDIX F: As statedSUMMARY
DATA in the manual,FORM 1
all therapists using the OCAIRS will use the same rating scale
and criteria to rate clients. The “OCAIRS Rating Criteria” is
unnecessary for therapists who choose the “Interview (Form
OCAIRS v.4.0:
2) Questions, Rating Scales and Notes Form” or the “Inter-
view (Form 3) Questions and Rating
APPENDIX G: Scales”
DATA since the rating FORM 2
SUMMARY
scales are already provided in these formats.
OCAIRS v.4.0:
If you have used the Interview (Form 2) Questions, Rating Scales and Notes Form, or the Interview (Form 3) Questions and
Rating Scales the rating scales have already been provided.
35
OCAIRS Rating Criteria

After conducting the interview all therapists should use
the OCAIRS Rating Criteria if they want to quantify the
information gathered in the interview.
36
OCAIRS Rating Criteria

ROLES INTERESTS
� Occupational roles reflect a highly productive lifestyle � Participates in many interests regularly outside of work
F � High level of satisfaction with current roles F � High level of interest in primary occupation
� Fulfils a wide range of role responsibilities � High level of satisfaction with level of participation in an interest(s)
� Occupational roles reflect a somewhat productive lifestyle � Participates in few, but clearly expressed, interests regularly outside
A � Some satisfaction with current roles work
� Major difficulty in fulfilling a wide range of role responsibilities I � Very little interest in primary occupation
HABITS SKILLS: Motor, Process, & Communication/Interaction Skills
� Highly organized daily schedule � No limitations in performance due to good skills
F � Good balance between work, rest, self-care and leisure F � Effectively compensates for any limitations in skills (if any)
Participation is allowed but there are some limitations in
� Some organization of daily schedule performance of:
A � Some balance between work, self-care and leisure A � Motor Skills
� Somewhat satisfied with daily routine � Process Skills
I � Very little balance between work, self-care and leisure Participation is inhibited due to significant limitations in:
� Very little satisfaction with daily routine � Motor Skills
� No organized daily schedule � Communication/ Interaction Skills
� Dissatisfied with daily routine Participation is restricted due to severe limitations in:
� Motor Skills
PERSONAL CAUSATION R � Process Skills
F � Anticipates success in next six months GOALS
SHORT-TERM GOALS
� Some confidence in abilities � Identifies achievable yet substantial short-term goal(s)
A months F � Coherently discusses realistic plan(s) for meeting goals
� Very little confidence in abilities achievable, are insubstantial
I � Significant concerns about failures within next six months A � Discusses somewhat unrealistic plan(s) for meeting goal(s)
� Major difficulty in identifying something done well/proud of � Somewhat participating in the execution of the plan(s)
� No confidence in abilities � Identifies vague or conflicting goals that will be very difficult
R � Anticipates failure in next six months to achieve
� Does not identify anything done well/proud of I � Discusses a plan that is not realistic
VALUES
� Identifies distinct and specific values � Does not discuss plan, abandons his/her plans easily
F � Expresses complete congruence between own values and cur- achieve goal(s)
rent life situation
LONG-TERM GOALS
� Some conviction about expressed values � Identifies achievable yet substantial long-term goal(s)
A � Expresses some congruity between own values and current life � Coherently discusses realistic plan(s) for meeting goals
situation
F (i.e. Short-term goals correspond to long-term goals)
� Very little conviction about expressed values � Identifies long-term goal(s) that may be difficult to achieve or, if read-
I � Expresses very little congruity between own values and current ily achievable, are insubstantial
life situation A � Discusses somewhat unrealistic plan(s) for meeting goal(s),
� Does not identify any values � Somewhat participating in the execution of the plan(s)
R � Expresses no congruity between own values and current life � Identifies vague or conflicting long-term goals that will be very dif-
situation ficult to achieve
I � Discusses a plan that is not realistic. Short-term goals unrelated to
long-term goals
achieve goals
37

accomplishment
of life
desired activities
SOCIAL ENVIRONMENT

circumstances
circumstances
38
DOCUMENTING THE INTERVIEW: APPENDICES E, F & G

Appendices E, F and G contain forms that are intended to be Form”. When used with the “Interview (Form 1) Questions”
helpful in documenting the results of the interview. While it will be necessary to use the “OCAIRS Rating Reference
suggestions are provided on which forms may be used ac- Sheet” to complete the ratings. Neither the “Interview (Form
cording to the interview format chosen, these are only sugges- 1) Questions” nor the “OCAIRS Data Summary Form 1” con-
tions. The therapist must decide which form best suites his or tain the rating scale criteria needed to complete the ratings.
her own documenting purposes.
Appendix G contains the “OCAIRS Data Summary Form 2”.
Appendix E contains the “OCAIRS Rating Scales and Notes This form provides fields to enter demographic information,
Summary Form”. This form provides fields to enter demo- a grid in which the therapist records the client’s final score in
graphic information, the rating scales and criteria, and each of the twelve major areas, and space to write final com-
sections for notes on each of the twelve major areas ments, analysis or treatment plans. This form may also be used
measured in the OCAIRS. This form may optimally be used in combination with either the “Interview (Form 1) Questions”
in combination with the “Interview ( Form 1) Questions”. or the “Interview (Form 2) Questions, Rating Scales and Notes
This form may not be as useful when used in combination Form”. When used with the “Interview (Form 1) Questions”
with “Interview (Form 2) Questions, Rating Scales and Notes it will be necessary to use the “OCAIRS Rating Reference
Form”. The “OCAIRS Rating Scales and Notes Summary Sheet” to complete the ratings. Neither the “Interview (Form
Form” is similar to and only excludes the interview 1) Questions” nor the “OCAIRS Data Summary Form 2” con-
questions provided in the “Interview Questions, Rating Scales tain the rating scale criteria needed to complete the ratings.
and Notes Form”.
In summary, the “OCAIRS Rating Scales and Notes Summary
Appendix F contains the “OCAIRS Data Summary Form 1”. Form” may be most useful when used with the “Interview
This form provides fields to enter demographic information, (Form 1) Questions”. Both the “OCAIRS Data Summary Form
a grid in which the therapist records the client’s final score in 1” and the “OCAIRS Data Summary Form 2” may be used
each of the twelve major areas, and space to write comments with either of the two interview formats. However, when
for each of the twelve major areas. This form may be used in used with the “Interview (Form 1) Questions” the therapist
combination with either the “Interview (Form 1) Questions” will need to use the rating scale criteria found in the “OCAIRS
or “Interview (Form 2) Questions, Rating Scales and Notes Rating Reference Sheet” to complete the ratings.
39
OCAIRS v.4.0:
4.0] D: RATING CRITERIA
OCAIRS v.4.0:
APPENDIX E: RATING SCALES & NOTES SUMMARY FORM
OCAIRS Rating Scales and Notes

Summary Form [OPTIONAL]
OCAIRS v.4.0:
This form provides space to F:
enter demographic
APPENDIX DATA SUMMARY FORM 1
information, the rating scales and criteria, and sections
for notes on each of the twelve major areas measured in
the OCAIRS. This form may optimally be used in
OCAIRS v.4.0:
combination with the “Interview (Form 1) Questions.
This appendixAPPENDIX
contains one G:
formDATA
that may be helpful, FORM 2
SUMMARY
please also review Appendices F & G.
OCAIRS v.4.0:
If you have used the Interview (Form 2) Questions, Rating Scales and Notes Form, or the Interview (Form 3) Questions and
Ratings Scale the rating scales have already been provided.
40
OCAIRS Rating Scales and Notes Summary Form

Client:________________________________________ Age:_____ Gender:_____
ROLES FINAL NOTES



HABITS
PERSONAL CAUSATION
A months
VALUES
rent life situation
situation
life situation
situation
41
INTERESTS
interest(s)
� Participates in few, but clearly expressed, interests regularly out-
side of work
� Few & vaguely defined interest outside of work, no regular par-
ticipation
Participation is allowed but there are some limitations in
performance of:
A � Motor Skills
� Process Skills
� Motor Skills
� Motor Skills
SHORT-TERM GOALS
� Identifies vague or conflicting goals that will be very difficult
to achieve
achieve goal(s)
LONG-TERM GOALS
F i.e. short-term goals correspond to long-term goals
� Identifies long-term goal(s) that may be difficult to achieve or, if
readily achievable, are insubstantial
� Identifies vague or conflicting long-term goals that will be very
difficult to achieve
to long-term goals
achieve goals
42

accomplishment
of life
desired activities
SOCIAL ENVIRONMENT

circumstances
circumstances
43
OCAIRS v.4.0:
4.0] E: RATING SCALES & NOTES SUMMARY FORM
OCAIRS v.4.0:
OCAIRS Data Summary Form 1

[OPTIONAL]
OCAIRS v.4.0:
This form provides space to enter demographic informa-
tion, a grid in which the therapist records the client’s
final score in each of the twelve major areas, and space
to write comments for each of the twelve major areas.
OCAIRS v.4.0:
This form may be optimally used in combination with
the “Interview (Form 1) Questions”, “Interview (Form 2)
Questions, Rating Scales and Notes Form” or “Interview
(Form 3) Questions and Rating Scales.” This appendix
contains one form that may be helpful, please also
review Appendices E & G.
44
Client:______________________________________ Age:_________ Gender:_______
Comments:
Facilitates
Allows
Inhibits
Restricts
Roles
Habits
Personal
Causation
Values
Interests
Skills
Short-Term
Goals
Long-Term Goals
Interpretation of
Past Experiences
Physical
Environment
Social
Environment
Readiness for
Change
45
OCAIRS v.4.0:
4.0] F: DATA SUMMARY FORM 1
OCAIRS v.4.0:

[OPTIONAL]
OCAIRS v.4.0:
This form provides fields to enter demographic informa-
tion, a grid in which the therapist records the client’s
final score in each of the twelve major areas, and space
to write final comments, analysis or treatment plans. This
form may also be used in combination with either the
“Interview (Form 1) Questions” or the “Interview (Form
2) Questions, Rating Scales and Notes Form”. This
appendix contains one form that may be helpful, please
also review Appendices E & F.
46

Client:_______________________________________________ Assessor:___________________________________________
Age:________ Date Assessment Completed:________________Signature:________________________________________________
Summary of Clients Scores

RATINGS KEY
Interpretation
Readiness for
Environment
Environment
Experiences
Facilitates: Facilitates Participa-
Short-Term
Long-Term
F
Causation
tion in Occupation
Interests
Personal
Physical
Change
Values
of Past
Habits
Allows: Allows Participation in
Social
Goals
Goals
A
Roles
Skills
Occupation
Inhibits: Inhibits Participation in
I
Occupation
F F F F F F F F F F F F Restricts: Restricts Participation
R in Occupation
A A A A A A A A A A A A
I I I I I I I I I I I I
R R R R R R R R R R R R
NEED FOR OCCUPATIONAL THERAPY

4 Shows positive occupational participation, no need for OT.
3 Need for minimal intervention/consultative OT services.
2 Need for OT intervention indicated to restore/improve participation
1 Need for extensive OT intervention indicated to improve participation. Referral for follow-up services also recommended.
ANALYSIS /PLAN
47
OCAIRS v.4.0:
APPENDIX
OCAIRS [Version 4.0] G: DATA SUMMARY FORM 2
OCAIRS v.4.0:
Roles: Awareness & satisfaction of a social identity and Social Environment: The people in the person’s environ-
ability to meet related obligations. ment that support/don’t support engagement in work,
activities of daily living and leisure. Interpersonal
Habits: Automatic responses and performance in contacts and supports to which the person has access
certain, consistent ways in familiar environments for engaging in work, activities of daily living and leisure.
and situations. Includes family, partner, friends, neighbors, co-workers,
Personal Causation: Sense of abilities/limitations fellow students, fellow members of any organization or
and effectiveness. group to which the person has access. Also includes
expectations, needs, desires of others that require a per-
Values: What one finds important and meaningful to do son to perform/participate in certain ways and/or affect
and how congruent this is with their life situation. how a person engages in work, activities of daily living
and leisure. Includes such things as a boss, coworker,
Interests: What one finds enjoyable or satisfying to do. teacher’s performance expectations, and the need of a
Skills: Motor-moving self or task objects within occupa- partner/spouse/child for care taking. Can also include
tions. Process-logically sequencing actions over time, negative or unreasonable expectations/requests/
selecting and using appropriate tools and materials, and demands of others with whom the person interacts.
adapting performance. Communication-Interaction-con- Readiness for Change: Ability to make alterations in
veying intentions and needs and coordinating social ac- how a person goes about everyday life in response to
tion in order to act together with people in occupations. personal changes and/or changes in the environment.
Goals: Desires, hopes, aims for future attainments, Includes making choices, planning, sustaining effort,
circumstances, or personal status. altering one’s way of performing, or habits/routines.
Interpretation of past experiences: History of past

occupational participation.
Physical Environment: Physical assets to which the per-

son has access for engaging in work, activities of daily
living and leisure. Includes physical objects and spaces,
financial resources to obtain necessary/desired resources
and opportunities and transportation and other factors
that affect access. Also includes physical circumstances
that challenge or delimit how a person can perform/
participate.
48

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Assessment

Kirsty Forsyth, PhD, SROT, OTR

APPENDIX: A: OCAIRS Mental Health Interview Formats ........................................................... 2

APPENDIX: B: OCAIRS Forensic Mental Health Interview Formats ........................................... 12

APPENDIX: C: OCAIRS Physical Disabilities Interview Formats ................................................ 22

RATING THE INTERVIEW:

DOCUMENTING THE INTERVIEW:

APPENDIX: F: OCAIRS Data Summary Form 1 ............................................................................... 44

APPENDIX: G: OCAIRS Data Summary Form 2 .............................................................................. 46

Appendices further in the manual contain tools that address

Any of these formats can be used based on personal preference.

RATING and DOCUMENTING structures can be found in Appendices D, E, F & G.

OCAIRS Mental Health Interview (Form 1) Questions

• (For each role mentioned) How important is ___ to you? Interests

• Have you been able to choose the important things in your

• In the area where you live, are there things to do/places to

• Is there someplace you go to on a regular basis (e.g., work,

• Are there any physical barriers at ___(from above) or at

• In terms of activities you would like to participate in, places

• Are there resources available to help you overcome barriers

• Would you describe your (work, school, community)

• Do the people or situations in your life place limits on you?

• If you need help/support, can you count on family/friends/

Readiness for Change

• How do you handle it when your daily routine changes? (If

� Occupational roles reflect a somewhat productive lifestyle

� Occupational roles fail to constitute a productive lifestyle

VALUES FINAL NOTES

� Identifies distinct and specific values

� Loosely identifies very ambiguous values

SKILLS: Motor, Process, & Communication/Interactions Skills

SHORT-TERM GOALS FINAL NOTES

INTERPRETATION OF PAST EXPERIENCES

� Expresses very positive feelings about past experiences

PHYSICAL ENVIRONMENT FINAL NOTES

� Demands/Constraints in the physical environment provide strong sup-

� Other persons (family/friends/co-workers) provide strong support which

READINESS FOR CHANGE

� Adjusts well to feedback/changes in personal/environmental

OCAIRS Mental Health Interview (Form 3) Questions and Rating Scales

� No occupational roles � Loosely identifies very ambiguous values

� Strong confidence in abilities SKILLS: Motor, Process, & Communication/Interaction Skills

GOALS PHYSICAL ENVIRONMENT

OCAIRS Mental Health (Form 4) Key Words Form

HABITS INTERPRETATION OF PAST EXPERIENCES

PERSONAL CAUSATION • Impact of ups and downs

• What one is proud of PHYSICAL ENVIRONMENT

• What is important? SOCIAL ENVIRONMENT

INTERESTS • Support System

• Interest in primary occupation • Resources/Opportunities

• Interests outside primary occupation • Demands/Constraints

• Level of participation READINESS FOR CHANGE

Any of these formats can be used based on personal preference.

RATING and DOCUMENTING structures can be found in Appendices D, E, F & G.

OCAIRS Forensic Mental Health Interview (Form 1) Questions

• How will you accomplish them? outside the hospital?

� Occupational roles reflect a highly productive lifestyle

� Occupational roles reflect a somewhat productive lifestyle

� Occupational roles fail to constitute a productive lifestyle

� Highly organized daily schedule

VALUES FINAL NOTES

� Identifies distinct and specific values

� Loosely identifies very ambiguous values