Describe the impact that the client’s deficits will have on participating in her occupations. List at least 4 occupations based on the goals identified and elaborate on how they will be impacted.

Ms. Little is a 21-year-old black woman who sought treatment after the Department of Social Services threatened to take her two children, a boy aged 6 and a girl aged 2. Client stated that her neighbor reported her for leaving her children alone. Client is unemployed and on welfare. She said she can’t make enough money working to pay bills and child care. Client has drunk alcohol and abused drugs since age 15. She is currently still drinking and abusing diazepam (Valium).
Ms. Little stated she has used cocaine for the past 9 months and denies any other drugs since then. She also reports drinking at least 3-4 alcoholic beverages a day which don’t affect her at all. Client admitted to using her welfare check for drugs and selling her food stamps to obtain money. She was never married and does not receive financial support from the father of her children. Client, who is slightly overweight, was observed purging food in the bathroom of the detoxification unit and admitted to episodic purging to control weight.
Ms. Little described herself as a good student in high school until her drug use became more important than studying. She has a high school diploma but did not attempt college, as she felt she could not afford it. Client’s parents both drank and were physically abusive to one another. Ms. Little denies physical or sexual abuse of self or siblings by parents. Client reported she cooks, cleans, and takes care of all household chores independently. She stated she has been “out of control”, “snorting” approximately $200 worth of cocaine 1 to 2 days per week at friends’ homes or on the street. She admitted to leaving the children alone twice over the last month and was appalled to having slept with drug dealers to obtain drugs. Client stated that she knows she has to get clean or she will lose her children. She has never obtained a driver’s license but does have a car of her mother’s that she drives. She has no friends except other users, and other than drug use her only leisure activity is renting a movie for the children. Ms. Little stated that she feels depressed much of the time and has no energy.
OT goals identified:
Client will obtain a driver’s license
Client will complete 1 job interview.
Client will identify leisure activities to pursue with children at home and in the community
Client will improve energy level through exercise and explore healthier methods of losing weight, as well as maintain healthy and balanced nutrition for her and her children.
QUESTIONS:
1. Describe the impact that the client’s deficits will have on participating in her occupations. List at least 4 occupations based on the goals identified and elaborate on how they will be impacted.

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