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Laura Vidaña Moya, practicing occupational therapist
Neuro-rehabilitation Department, Parc Taulí Hospital, Spain

Learning about the Model of Human Occupation was a turning point in my career. I have worked in very different practice areas in Spain through out my professional experience: people with addictions (drugs, gambling, and shopping), in geriatrics, in the community, and now in physical rehabilitation. One of the first things that I learned when using MOHO is that occupational therapists don't work with diagnosis, occupational therapists work with people that experience challenges in occupational participation- this is what makes our profession so valuable across a variety of contexts. As MOHO assessments are also focused on occupational participation, they allow up to communicate to other professionals and clients our unique contribution as occupational therapists.

In my current hospital position, I work with young people with big disabilities. When I used the Role Checklist and the Interest Checklist with these clients, I realized that the environment gave them opportunities to engage in a patient role (working with the physiotherapist, the speech therapy, having doctor's visits) but few opportunities to participate in other roles (hobbyist, friend, worker) . Further more, the majority of these young clients' routines were determined by other people (when to wake up, when to eat, when to take a bath). It was then when I realized that occupational therapy should be a part of an environment that provides these young clients with opportunities to perform other valuable roles related to real life out of the hospital and in the community.

In MOHO, both evaluation and intervention are centred on the person and his or her values and interests, giving each client the individual attention that he or she deserves. Learning to apply the concept of volition in practice resulted in a pleasant surprise, as it allowed me to better understand each person's occupational participation and gave me a starting point for the intervention. In the process of evaluation and intervention planning, the young clients told of their desires: to go out from the hospital, even though for a short time, to socialize with different people, and to have fun. This encouraged me to try something new! Through contact with some associations, I found a group of young people that offered to throw a party to celebrate San Juan, a popular festival in Spain. This festival was a great opportunity to dress up and go out in the street. The young clients prepared a cake for the party and put their best dresses. The environment provided by the festival provided them with opportunities to complete tasks in preparation for the special day, and strengthened their personal causation. Other people from different associations were also invited, and everyone ate, sang and danced all afternoon. Not only did they have fun, but they also had the opportunity to perform other roles and to use other skills that were not required in the hospital. This photo shows me and another staff singing with a young client.

Therefore, MOHO helped me realized that treatment is not a sum of techniques that we do to the client, but a process of change where we as therapists act as a partner with the client. Therapists can support this process by identifying and creating opportunities for participation.

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