Intervention & Goal Update for Annalise (SP lab)

Taylor Stamper

1. Summary of peer feedback and discussion

Overall, the goals remained the same in regard to their “intent”, but details were added to make them
more measurable. By making them more measurable we were able to brainstorm activities that sort of
worked to quantify the goal, i.e. prior to being able to create a calendar we need to know what an ideal
day looks like so performing the Pie of Life assessment would be a good start. We also discussed how
visual aids and the use of peer/colleague support could play a role in interventions or overall skills that
could be used to combat Annalise’s anxiety and prioritization difficulties. We agreed that in order to
address the overarching issue – sleep quality and its effects on performance – we needed to address the
reason why there was issues with sleep quality – anxiety surrounding work. It was really great to be
able to get things out in the open for feedback and helped with the creative process for the intervention
development.

2. The 2-3 goals you decided upon

 By discharge, patient will independently complete an hourly calendar once a week that
identifies hours of work and specific leisure activities and will stick to the calendar at least
5/7 days to decrease anxious thoughts regarding the structure/items of her day in order to
more adequately pursue her leisure interests.
 By discharge, patient will delegate at least 25% of her work tasks to an intern by noon of
each workday after creating a physical to-do list in the morning in order to properly
proportion her day and reduce anxious thoughts regarding time constraints in order to more
effectively complete her tasks at work.

3. 3-4 general intervention names/ideas 

 My 24 hours: Use an adapted version of the Pie of Life assessment to determine how
Annalise’s typical day is set up compared to her ideal day, and then discuss realistic
expectations for what can be accomplished within 24 hours. Potentially done in a group (3
person max) format to reinforce the idea that everyone’s day can look different.
 Visual Scheduling: Create a visual schedule of the day (either in clock or chart format
depending on her day) where Annalise is able to identify/prioritize her day so she can see
what is coming next and what she can be focused on in a particular hour.
 Work Simulation: Similar to the Complex Task Performance assessment, create a
simulation centered around the role of one of Annalise’s interests (piano or reading) where
she performs tasks similar to what she would in her normal job. However, instead of
performing the tasks herself from the get-go, she will create a prioritized to-do list and
delegate some (25%) to an intern prior to finishing out the ones she has to do.

My 24 Hours
Intervention PROTOCOL

Population: Patients with generalized anxiety or that generally struggle with maintaining a schedule that is

Flinn, S. (2014)
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appropriate for their overall well-being (seeks balance between “work” and self-care)

Frame of Reference/Model: MOHO

Frame of Reference Rationale: MOHO takes into consideration volition or intrinsic motivations so that the
client is able to prioritize their day according to their wants, but it also considers their roles and scheduling that
allow for optimum performance across occupational areas. It is because of these characteristics that MOHO
best works with the “My 24 Hours” intervention plan.

Focus of Intervention: The focus of the intervention is for clients (Annalise in particular) to gain an
understanding that their 24 hours does not have to look the same as another individual’s, and that what is best
for their productivity and well-being on a particular day is entirely up to them. It will also allow them to see
their day in more of a scheduled format as opposed to an arbitrary to-do list.

Purpose Demonstrate that often the schedules we make for ourselves are not the ones that are the
most productive to us, and that days have no particular “format”, they can look different
each day or for each individual based on what each person needs. Create an overall
understanding of what a “realistic” day is or how to achieve an ideal.
Outcome Criteria  Client will be able to generally verbalize an ideal schedule that includes at least
1 self-care and leisure activity with a specific time-of-day it is to be performed
i.e., morning, evening, etc..
 Client will be able to identify when/what areas of life are “taking over” their
schedule – evident through either a discussion of their original, or when given an
example is able to identify the “problem”.

Supplies, Pie of life for each group member and a pack of erasable colored pencils (3 each)
Equipment, Costs Costs: Pie of Life can be found as a free pdf (printing should be free at facility, colored
pencils are usually around $2 a pack (personal pack assuming COVID precautions)
Precautions If any patients in the group experience depressive symptoms or are at-risk you will want
to count the colored pencils upon start and end of session.

Description of Session
Format and Group session led by OT with encouraged, semi-structured conversation/discussion: 45
Estimated Time minutes
1. Introduction of selves and then activity (10 min.)
2. Activity with discussion incorporated (25 min.)
3. Debrief/Summarize/Homework explanation (10 min.)
Introduction How will you introduce the activity to the client and explain why you’re doing what
you’re doing?

I would introduce the group members to each-other to start, asking them to explain what
their roles are as far as work and home life, and then state at least 1 leisure activity they
enjoy doing. I will introduce myself first as an example and then when the group
finishes, I will explain how everyone completes their own combination of roles and
activities within the same 24 hours, and each of those set ups may look a little different.
I would then pass out the Pie of Life (probably just the typical weekday portion after
cutting them in half) and the colored pencils. I would show an example of how my
chart was set up and how to create their own, identifying that in order to find what
schedule is best for ourselves, we need to first see where we are typically at.
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Activity Describe and outline your activities (be detailed)

1. Introduction
2. Have a group discussion/sharing of each individual’s ‘typical weekday’ pie
chart
a. Once everyone has gone, explain how certain areas may seem to take
over our lives, causing anxiety, decreased productivity, low motivation
for our interests/leisure, etc..
3. Show an example of my ‘ideal weekday’ and pass out the blank ‘ideal weekday’
pie chart for them to complete with the colored pencils. Be sure to instruct
individuals to clear their heads of any current “to-do” list with a big deep breath
(go through this mindful moment with them if needed) and try to schedule a day
that they would absolutely enjoy, but still accomplishes their roles. Remind
clients to include at least one leisure activity or moment of self-care in their day.
4. Have a discussion/share time of each individuals’ ‘ideal weekday’ pie chart.
a. Have individuals identify the most important moments of those days.
b. Have a conversation about what areas differ from the typical day to the
idea, and how everyone’s schedule differs from each-others.
5. Debrief/summarize

Sharing List any types of questions you might ask the client: Such as things you might ask to
Processing facilitate thinking, processing, emotion sharing, how this activity applies to their life,
Generalizing help them express barriers or supports to implementing this in real life, etc.
Application  How do you feel on days that look like your typical, or that are over-run with
one occupation, compared to days that look more like your ideal?
 Do you think it is important to take time for yourself or your own leisure
opportunities everyday? Why or why not?
 Do you feel confident in your ability to compare your day to this ideal day you
have created?
 Does having a different type of schedule from someone make you more or less
productive that them? Why or why not?

Summary How will you summarize this activity session to the client, are you giving them any
“homework” or home programming to work on in between this session and the next?

I would summarize the activity session based on the answers provided in the discussion,
being sure to remind them that schedules will look different for each individual, and
that productivity is better accomplished when all of your needs are being met physically
and emotionally, so it is imperative to take time for themselves and to strive for that
ideal. I would also want to remind them that not being able to reach the idea does not
make them a failure either, it just means they have a new goal for tomorrow.

A “homework” activity I would challenge them to do until our next session is to strive
for the ‘ideal day’ and see how their actual day compares, i.e., are they implementing
any plans or scheduling strategies we talked about today.

References