Audience: Client

Diagnosis(es)/Condition(s): Schizophrenia, Schizoaffective disorders, Anxiety & OCD disorders, ADHD, ASD, I/DD

Age Range/Population: All ages

Purpose: The purpose of the intervention is to promote gradual participation in community activities such as grocery shopping, church, recess, or other social events to address social, functional, and psychological challenges that occur when engaging with the community to build confidence and reduce social isolation. Schizophrenia can make maintaining relationships difficult so integration will give opportunities for social interactions and teach clients how to communicate and navigate social norms. Using activities that are meaningful and applicable to the client's life like grocery shopping or using public transportation, can allow them to feel more confident in managing their routines. This will help support clients in accessing and engaging with their community to increase independence and strengthen their connections & skills. 

Instructions: Begin by collaborating with the client to identify a specific community-based goal or activity that aligns with their interests, values, and needs. This could include exploring public spaces, practicing transportation use, joining a social group, or accessing a community resource like a library or grocery store. A discussion will occur to assess the client’s readiness, address potential anxieties, and review the purpose of the activity, providing clear, detailed guidance on expectations and plans for managing potential challenges. During the activity, accompany the client as a supportive presence, providing coaching while allowing them to take the lead to promote independence and confidence. Use challenges as teaching opportunities to identify solutions and refine coping strategies. Afterward, debrief with the client to reflect on successes, address challenges, and plan next steps 

Rationale & Impact on Function: The activity will address the social and functional challenges clients with schizophrenia often face, such as isolation, impaired social skills, and difficulty navigating public environments. These challenges can limit their ability to engage in meaningful occupations and maintain roles in their community. By supporting clients in practicing real-world skills, this intervention helps build confidence, develop coping strategies, and improve problem-solving abilities in community contexts. The impact on function includes greater independence, increased social participation, active participation in health management of symptoms, and enhanced engagement in roles and routines that improve overall quality of life. 

Reference: Children's ADHD skill packet. (n.d.). Therapist Aid. https://www.therapistaid.com/therapy-worksheet/adhd-kangaroo-packet 

Audience: Client

Diagnosis(es)/Condition(s): Schizophrenia, Schizoaffective disorders

Age Range/Population: Young Adult, Adult, Geriatrics

Purpose: The purpose of the intervention is to assist in the executive & adaptive functioning that is typically lost in clients with schizophrenia. Using a remedial approach, the strategy will teach "clients to use their assets to achieve performance and gradually improve their underlying cognitive deficits" (Katz & Keren, 2011). Through this combined approach of strategy learning with goal management and its application of everyday tasks, the intervention will provide a dual effect for clients to increase their functional independence and performance.

Instructions: To start, the client will identify goals that are related to meaningful occupations within their daily life, including personal care, social participation, employment, or leisure activities. Goals that are specific, measurable, and realistic will be set that will guide the client towards their desired outcome. They will then be broken down into smaller, manageable sub-steps, creating a pathway towards success. Barriers to success will be identified and collaborative problem-solving will ensue to address the barriers, incorporating skill-building activities like time management or coping strategies. Goals will be reviewed progressively to recognize the achievements and reflect on challenge areas for adjustment. 

Rationale & Impact on Function: Using this evidence-based approach, clients will receive treatment that emphasizes three main functional activities -- food preparation, money management, and information-seeking using reading, writing, and computer skills. By performing these necessary, everyday tasks, clients will learn strategy and improve cognitive functioning along the way.  The clients identify meaningful occupational goals they want to achieve related to any of the occupational domains and breaking down the goals into more achievable subparts provides the clients with the structure needed to organize thought patterns and work on building up the skills relevant to the goals collaboratively with the OT, which will increase motivation, performance and engagement, and confidence.

Reference: Katz, N. & Keren, N. (2011). Effectiveness of occupational goal intervention for clients with schizophrenia. American Journal of Occupational Therapy, 65(3), 287-296. https://doi.org/10.5014/ajot.2011.001347