OCCUPATIONAL THERAPY

Treatment Session Plan

Client’s Name: Supervising Therapist: Kristine Barrios

Student OT Practitioner(s): McCall Halvorson
Date: Time in/out: Units: Safety Issues/Precautions:
4
Clients Goals to Address in Session: (DDDM, Step 1, 6, & 8 -Identification of Participation
Challenges, Goals & Measures)
1 Within four months, client will implement Zones Understand Zones, Identify current mood,
implement appropriate emotional regulation
-2, 0, -1, -2
tools when experiencing emotional dysregulation
tool
with younger sister to increase appropriate social
participation, with Min VC in 4/5 trials.
2 Within four months, client will independently Understand blood maintenance, remember
to test, eat/administer insulin according to
-2, 0 -2 -1
monitor blood sugar morning and evening to
results.
improve health maintenance, 5/7 days over three
consecutive weeks.
3 Within two months, client will try at least one bite vc -2 ,-2
of all food placed on his plate at each mealtime
4/5 trials with min VC
4 Date: Date:

5 Date: Date:

Clients Occupations to be treated include: ( Check all that apply; DDDM, Step 7-Design
Intervention)
x ADL’s/Self Care: (bathing, showering, toileting & hygiene, swallowing/eating, feeding, Personal device
care & managing personal belongings, personal organization ,functional mobility, personal hygiene and
grooming)
X Instrumental ADLS & Graphic Communication: (Care of others, Care of pets, child rearing,
Communication management, driving & community mobility, financial management, health
management & maintenance, home establishment & management, meal prep & cleanup,
religious/spiritual activities & expression, safety & emergency maintenance/awareness, & shopping &
Handwriting, Keyboarding, Drawing, Coloring, Art, etc).
Rest & Sleep: (Rest, sleep preparation, sleep participation)
Work: (Employment interests & pursuits, Employment seeking & acquisition, job performance,
retirement preparation and adjustment, volunteer exploration & participation).
x Education: formal education- Participation in academic and vocational educational activities
Informal education- (Beyond formal education- e.g. identifying topics and methods for obtaining
topic-related information or skills).
Informal personal education participating- Participating in informal classes, programs and
activities that provide instruction or training in identified areas of interest.
X Play & Social Participation: (Social Awareness, Building/Maintaining Relationships, Turn-taking,
imaginative play, sharing materials, exploring new play ideas/opportunities, play exploration, social
participation in community, family and with peers)
Leisure: (Leisure exploration & participation)
Client Factors & Performance Skills/Patterns addressed: (Write goal number(s) that
this skill will be addressed in; DDDM Step 7-Design Intervention)
Motor/Muscle/Movement Sensory Skills Social Skills
Skills
X Core X Manipulation Temperatur Pressure Engages/Approaches Others
Stability e
X Endurance X Coordination Hearing Taste Concludes/Transitions/Takes turns
 OCCUPATIONAL THERAPY
Treatment Session Plan

Position/Alig x Motor X Vestibular Smell X Communicates (verbal/non-verbal)

ns Planning
Joint Mobility Reaching/gr Tactile Pain Looks/Turns (Makes eye-contact)
asp
X Joint Stability Reflexes x Propriocepti Visual x Emotional Expression
ve
x Tone & x Controlled Discriminati Modulati Physical behavior (regulates
Strength Movement on on movement, position, touch)

Other Other Other

Processing/Cognitive/Mental functions: Visual Perceptual/Visual Motor Skills
X Attends Experience of self & Oculomotor Skills Object Perception
time
Memory x Emotional Visual Attention Eye-hand
regulation Coordination
Sequences Tasks Energy & drive Visual Discrimination Copying Shapes
x Executive Functions x Notices/responds to Visual Motor Speed Spatial Relations
cues
Chooses/Uses Pacing of activities Visual Memory Form Constancy
materials
Locates/Gathers Organizes Materials Depth Perception Visual Acuity
materials
x Adjusts/Accommodate Navigates Visual Closure Sequential Memory
s Environment
x Initiates/Continues/Ter Orientation to self, Figure Ground Visual Closure
minates other, time & place
Tasks/Activities
Other Other
 OCCUPATIONAL THERAPY
Treatment Session Plan

Intervention: (Briefly describe planned intervention; DDDM, Step 7,9-Design and Conduct
Intervention)
Brief Description of Intervention : This intervention session will begin with an activity that provides needed
vestibular sensory input prior to seated activity. The main activity of this treatment session will focus on
completing a behavior contract we began last session. In this contract client will set a standard of behavior he is
expected to follow. The second activity in this session will focus on typical emotionally deregulating situations
and the appropriate ways to respond to those situations. The last activity will be a yoga activity the client can
add to his toolkit of emotional regulation strategies.

Identify Desired Outcomes (DDDM, 8-Identify Outcomes):

-Proximal Outcomes: set expectations of appropriate reactions to a variety of emotional situations.
-Distal Outcomes: to improve emotional regulation to increase participation in a variety of occupations

Identify How you will Measure Outcomes and Collect data on Intervention Outcomes:
Data will be tracked through documentation of each session, specifically focusing on the amount of cueing the
client needs. Level of attention will also be tracked by monitoring the number of times the client has to be
redirected.

Spac Intervention Description & Approach: Type: Practice Goal(s)

e Time
hallw Warm up: (5 Minutes)
ay -Name of activity: Obstacle course
The client will participate in an
obstacle course in which he will climb
through a fabric tunnel, jump from
stepping stone to stepping stone,
bounce a ball 10 feet, scooter on belly
for 20 feet
-Ways to grade up: add more
proprioceptive based obstacles
-Ways to grade down: Remove
proprioceptive based obstacles
Materials: ball, pillows, stepping
stones, scooter, fabric tunnel, tilt
board, bean bags
Establish/restore Prepatory task Model: addressed:
Sensory 1+2
Processing
Activity Demands (OTPF Anticipated Activity
table 7) Outcome: upon
Relevance and Importance completion of the warm
to Client: fun, engaging was up activity, the client is
to warm up clients large expected to have
muscle groups activated both UE and LE
Objects: ball, pillow, scooter,
stepping large muscle groups.
Space demands: big long Gross motor activity will
area without obstacles provide deep pressure to
besides those added for the fill sensory needs.
course
Social Demands: interaction
with the therapist to set up
and get through course
Sequencing and Timing:
going through the course
obstacle by obstacle
Performance skills: motor
skills (aligns, stabilized,
endures), process skills
(paces, heeds, continues,
navigates, accommodates)
social interaction skills
(questions)
Body structures/functions:
 OCCUPATIONAL THERAPY
Treatment Session Plan

Activity 1: (15 Minutes) Approach: Type: Practice Goal(s)

Establish/Rest Prepatory Model: addressed
-Name of activity: Behavior contract ore Task Behavior
(continued)
:
acquisitional 1+2
client, with therapist, will develop
behavior contract based on CPOM Activity Demands Anticipated Activity
results from two weeks before (Eating, (OTPF table 7) Outcome:
social relationships with younger Relevance and Importance Client will develop a contract
sister, blood sugar management, to Client: Clients main goals of expected behaviors
chore participation). Client will involve emotional regulation. (emotional regulation) for
develop expectation as well as Behavior contract will help specific, common, emotional
consequences and rewards for each keep the client accountable deregulators. Client’s
occupation and will write them out on for his behaviors. This activity participation of writing
a pre printed out behavior contract. will also incorporate his contract will help increase his
Client will then sign the contract and handwriting goals. accountability to the contract.
keep track of the progress throughout Objects: Behavior contract, Activity will also provide
the week on ‘chore chart.’ scratch paper, pencil, table, handwriting component
chair practice. Overall, activity will
-Ways to grade up: identify zones and Space demands: room with hopefully, increase clients
appropriate reactions for each table and chair awareness of behavior and
behavior within the stated Social Demands: interaction provide a predetermined
occupations, expect more strict with therapist and mom about acceptable behavior for
emotional regulation, increase amount expectations and rewards emotionally challenging
of days/week to achieve award for Sequencing and Timing: situations.
good behavior Client will discuss, then write
draft of contract, then final
-Ways to grade down: expect less contract
strict behavior, decrease amount of Performance skills:
days/week to achieve award. Cognition, fine motor, social
skills
Materials: Body structures/functions:
Behavior contract, ‘chore chart’ executive functions
pencil, scratch paper
Activity 2: (25 Minutes) Approach: Type: Practice Goal(s)
Establish/Rest Activity Model: addressed
-Name of activity: Emotion Charades ore
For this activity the therapist will be
Behavior :
provided with a variety of emotional Acquisition 1
situations to choose from and act out. al Model

The client will try to guess what
situation the therapist is acting out.
Once the situation is guessed, the
client will participate in a discussion
about the situation, emotions related
to the situation, appropriate and
inappropriate reactions to the
situation and tools, which could be
used in the situation.
-Ways to grade up: This activity
could be graded up by decreasing the
number of verbal cues given to the
client when discussing each aspect of
the scene. Emotional situation
scenarios could be made more
complicated/personal. Client could
identify Zones of each emotion.
-Ways to grade down: Increasing
VC. Decreasing complexity of social
situation. Could be provided with print
out of emotions and tools
Materials: papers with emotional
situations
Activity 3 (if needed): (___Minutes)
-Name of activity:
-Ways to grade up:
OCCUPATIONAL THERAPY
Treatment Session Plan
Activity Demands Anticipated Activity
(OTPF table 7) Outcome:
Relevance and Importance
to Client: One of the clients By the end of this activity
main goals is maintaining client will have better
emotional regulation in a understanding of appropriate
variety of situations. This emotional reactions for
activity will provide the client specific emotionally
with those specific situations deregulating situations. The
that are most deregulating primary outcome targeted for
and provide him a safe this activity is to improve
environment in which he can Clients emotional regulation
predetermine his reaction to abilities to increase role
those situations. competence as a brother.
Objects: Papers with
emotional scenarios
Space demands: room with
enough space to act out
scenes
Social Demands: interaction
with the therapist and COTA
to guess situations and
discuss emotions and tools
related.
Sequencing and Timing:
client will watch the scene
playing out. Client will then
identify when in his life he
may be faced with this
situation, the emotions
related and appropriate ways
he could react.
Performance skills:
attends, inquires, social
interaction skills (specifically
questions, looks, replies, and
heeds)
Body structures/functions:
specific mental functions
(attention, higher level
cognitive – metacognition,
judgment, concept formation,
emotional) sensory functions
(visual, hearing)
Approach: Type: Practice Goal(s)
Model: addressed
:
(goal #)
 OCCUPATIONAL THERAPY
Treatment Session Plan

-Ways to grade down: Activity Demands Anticipated Activity

(OTPF table 7) Outcome:
Materials: Relevance and Importance
to Client:
Objects:
Space demands:
Social Demands:
Sequencing and Timing:
Performance skills:
Body structures/functions:
Wrap up/Cool Down: (5 minutes) Approach: Type: Practice Goal(s)
Establish/rest Prepatory Model: addressed
-Name of activity: Kid Yoga ore, maintain task sensory :
processing 1

Client will participate in a kids yoga
sequence with a variety of poses.
Client will choose a total of 10 yoga
pose cards. He will then be required to
hold each pose for 10 seconds. If the
client finishes before time is up, he
will draw more cards and continue
with those poses, holding for 10
seconds each.
-Ways to grade up: require the
client to hold poses for longer, require
more proprioceptively difficult poses
-Ways to grade down: allow client
to release poses after shorter amount
of time, require less poses, allow for
break between poses, require less
proprioceptively difficult poses.
Materials: Kids yoga pose cards,
(yoga mat, optional)
Home Program/Homework (DDDM, 11): continue behavior contract adherence tracking,
continue no thank you plate. Encourage use of tools in emotionally deregulating situations.
OCCUPATIONAL THERAPY
Treatment Session Plan
Activity Demands Anticipated Activity
(OTPF table 7) Outcome:
Relevance and Importance At the end of this activity
to Client: Client has client is expected to have
difficulties with regulating better emotional regulation as
emotions, especially when well as an idea of another
transitioning to non-preferred activity that may help with is
tasks. This activity will help Zones of Regulation by
him learn strategies to help providing for his sensory
regulate his emotions as well needs. Greater emotional
as provide needed sensory regulation will directly
input prior to non-preferred improve his focus on
activities. classroom based activities
Objects: This activity and home life activities. It will
requires the use of kids yoga improve his ability to self
cards to suggest which pose regulate according to the task
to do next. and environment.
Space demands: For this By doing this, Client will
activity, there needs to be increase occupational
enough room for the client to participation.
move around while standing
in place and/or lay down.
Social Demands: For this
activity, it would be beneficial
to the client to interact with
the therapist to talk about the
different yoga poses drawn.
Sequencing and Timing:
Client must draw pose from
the stack then perform pose.
Client will need to hold pose
for 10 seconds, then release.
Performance skills: For this
activity, motor skills
(stabilize, bends, coordinates,
flows, paces, endures),
process skills (paces, attends,
heeds, initiated, terminates,
continues, accommodates),
and social skills (expresses
emotion, replies, and clarifies)
will be required.
Body structures/functions:
Body functions primarily
include, specific mental
functions (attention,
perception, thought, and
emotional), sensory functions
(vestibular), joint mobility,
muscle functions, and
movement functions.
 OCCUPATIONAL THERAPY
Treatment Session Plan

Date: 11.17.17
Student Therapist Signature:
Supervising Therapist Signature: Date: