Inside the O'Briens

Inside the O'Briens is a novel that gives an inside look at a family dealing with a diagnosis of Huntington's disease to Joe O'Brien. Joe is a husband to a loving wife Rosie, and a father of four children who are all around their twenties. During the first half of this book, the depth and impact of Joe O'Brien dealing with his diagnosis is addressed. Joe must deal with his changing role in the family, and his changing role as he begins to figure what he, as a veteran in the police force, will be sent to do with this diagnosis. This book really gives light to the psychological aspect of the diagnosis. As roles are changing and what his everyday will look like is changing, Joe goes through a range of emotions in dealing with the consequences of his disease. As the book progresses, it shows the impact of the diagnosis goes much wider than just Mr. O'Brien. His family must deal with the 50% chance that they may have acquired the disease. Some of them desire to get tested and some of them do not. The book shows the ideas behind each side, none of which, I would say were the wrong choice. When reading a book like this, it suggest more to the OT side of things when we look beyond what are the physical impairments that happen with Huntington's Disease. In order to maintain an OT mindset about the situation that this book addresses, here is an occupational profile report which would be vital to sessions with Mr. O'Brien.
Text Box: Client Report
Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)
Mr. Joe O’Brien is seeking OT services for concerns related to diagnosis with Huntington’s Disease. Joe is a 44 year old male police officer who is a husband and father to 4 children. 
Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)
Mr. O’Brien has seen barriers such as temper outbursts and erratic movements. Prior to diagnosis, he attributed this behavior to the psychological stress of the job upon seeking further guidance, he was diagnosed. 
Personal interests and values (p. S7)
The clients primary interest lies in his family.  He strives to be a devoted husband and father two his 4 children who are all older. He also was an respected police officer and has a high level of interest being involved in law enforcement.  
The client’s occupational history/life experiences
The client has worked for many years as a police officer but has recently been relieved of his duties due to his worsening bouts with his disease. 
Performance patterns (routines, habits, & rituals) – what are the client’s patterns of engagement in occupations and how have they changed over time? What are the client’s daily life roles? Note patterns that support and hinder occupational performance. (p. S8)
Joe’s performance patterns have changed very rapidly in a short amount of time. His day did begin with preparing and leaving for his daily job as a police officer. During his working time, he would conduct things such as directing traffic. During once incident, because of his symptoms, Joe is accused of directing traffic while drunk as his patterns of erratic movements have worsened. His roles include being a dedicated husband and parent however he now deals with many psychological challenges in identity with this diagnosis and loss of his job. Joe also notes patterns that he cannot tell that the movements are occurring throughout his day unless he sees them in the mirror. 
Text Box: Context
Aspects of the client’s environments or contexts, as viewed by the client (p. S28)
Supports to Occupational Engagement:
Barriers to Occupational Engagement:
Physical 
The genetic testing can been bee seen as good or bad depending on how it is perceived
Side effects of medication and Erratic movements that have occurred causing problems at work.
Social
A wife who is willing to figure out the best route for him
People around Joe in public who notice his uncommon behavior
Cultural
Increasing awareness of HD and options of things such as genetic testing
 Unacceptable behavior and challenges of fulfilling roles in his job and as a family member
Personal
Encouraged and motivated by his family around him
Dealing mentally with the idea that he can no longer work his job and fulfill all of the roles he previously did 
Temporal
He now has knowledge and diagnosis and can prepare for what will progress
 Huntington’s works very fast in the body and the acquired symptoms can be unpredictable
Virtual
Mr. O’Brien enjoys watching his baseball team play. 

Text Box: Client Goals
Client’s priorities and desired target outcomes (consider occupational performance – improvement and enhancement, prevention, participation, role competence, health & wellness, quality of life, well-being, and/or occupational justice) (p. S34)
The client desires to maintain as much as health as possible and also figure out what it means to fulfill his role as a husband. Joe also desires to possibly find some role within the police force in order to maintain his work.

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