Occupational Performance History Interview-Version 2.1

Abstract

The Occupational Performance History Interview-Version 2.1 (OPHI-II) is a comprehensive, three-part Occupational Therapy evaluation instrument. Developed to align with the Model of Human Occupation (MOHO), it is designed to gather both qualitative and quantitative data regarding a client’s occupational performance history, focusing on life events, routines, and roles. The instrument consists of a semi-structured interview, rating scales, and a life history narrative form.

The OPHI-II enables the therapist to graphically map the client’s life history and assign standardized scores across three core dimensions: **Occupational Identity**, Occupational Competence, and the **Impact of the Environment**. By highlighting the client’s strengths and weaknesses within these areas, the OPHI-II provides a robust clinical foundation for developing personalized treatment goals and intervention strategies aimed at improving general participation.

Keywords

Occupational Performance, OPHI-II, Model of Human Occupation, Occupational Therapy, Life History, Occupational Identity, Occupational Competence, Environmental Influence, Participation.

Authors

Kielhofner G, Mallison T, Crawford C, Nowak M, Rigby M, Henry A, Walens D (2004); Dutch version: Baaijen RI, Boon JA, Tigchelaar E, Pol MC (2008).

Purpose

The fundamental purpose of the OPHI-II is to obtain a deep, historical perspective on how a client views their own occupational life and how they have achieved or maintained function over time. It moves beyond current functional deficits to explore the client’s values, interests, roles, and patterns of engagement, which are crucial determinants of therapeutic outcomes.

The instrument provides a systematic method for organizing complex biographical information, allowing the therapist to identify patterns of success, adaptation, and breakdown in occupational life. This structured approach facilitates clinical reasoning and ensures that intervention goals are meaningful and client-centered, addressing both internal capacities and external environmental factors.

Construct

The OPHI-II is conceptually driven by the Model of Human Occupation (MOHO). It measures three distinct but interconnected psychological and occupational constructs:

• Occupational Identity: Reflects the client’s subjective sense of who they are and who they wish to become as an occupational being. This includes self-perception regarding roles, values, and goals.
• Occupational Competence: Refers to the client’s ability to sustain a pattern of engagement that meets their personal needs and societal expectations. It assesses participation in roles, maintenance of routines, and successful achievement of tasks.
• Environmental Impact: Evaluates how the physical and social environments (including culture, economic factors, and support systems) facilitate or impede the client’s occupational performance.

Validity

The OPHI-II demonstrates strong evidence of **content validity**, as the interview questions and rating scales were meticulously developed to operationalize the core theoretical concepts of the MOHO framework. Expert review and consensus were utilized during its development to ensure comprehensive coverage of essential occupational domains.

Studies supporting **construct validity** confirm that the three rating scales—Identity, Competence, and Environment—are distinct constructs, yet they correlate in ways consistent with MOHO theory. Furthermore, the OPHI-II has been shown to successfully discriminate between individuals with varying levels of occupational functioning, particularly in clinical populations, supporting its utility as a measure of occupational adaptation.

Reliability

The reliability of the OPHI-II is primarily established through rigorous testing of its scoring component. The instrument shows good to excellent **inter-rater reliability** (typically Intraclass Correlation Coefficients above 0.80) when therapists receive standardized training in the administration of the interview and the application of the 4-point rating scales. This high consistency is vital given the instrument’s reliance on the therapist’s interpretation of qualitative data.

The internal consistency of the individual rating scales is also robust, indicating that the items within each scale (Identity, Competence, Environment) measure a unified underlying dimension of occupational functioning.

Factor Analysis

Although the initial structure of the OPHI-II is theoretically derived from MOHO, subsequent factor analysis has generally supported the existence of the three primary factors measured by the rating scales: Occupational Identity, Occupational Competence, and Environmental Impact. These analyses confirm that the quantitative scoring system accurately reflects the hypothesized multi-dimensional nature of occupational performance history.

The factor structure affirms the OPHI-II’s ability to provide a differentiated, yet integrated, profile of a client’s strengths and challenges, moving beyond a single global score of function.

Instrument

Test Type: Interview-based evaluation instrument.

Format: The OPHI-II is a three-part tool: (1) a semi-structured interview, (2) a life history graphic, and (3) three corresponding 4-point rating scales (Focal Problem, Identity, Competence, and Environment).

Language Available: Original English (2004); Dutch (2008); numerous other translations are available internationally.

Population Group: Clinical and non-clinical populations.

Age Group: Children, Adolescents, Adults, and Elderly (though most commonly used with adolescents and adults who can participate in a reflective interview).

Population Details: Individuals requiring Occupational Therapy services who possess sufficient cognitive and communication skills to engage in a detailed discussion of their life history and occupational roles.

Test Methodology: The therapist conducts a qualitative interview, recording the narrative. They then use standardized guidelines to translate this narrative data into quantitative scores on the 4-point ordinal rating scales (Extreme Difficulty, Some Difficulty, Competent, Exceptionally Competent).

Keywords

Occupational Identity, MOHO, Life Roles, Daily Routine, Environmental Barriers, Treatment Planning, Quantitative Data, Qualitative Data.

Authors

Author ORCID Identifier: [Information not available in source content]

Affiliation Email addresses: [Information not available in source content]

Correspondence Address: [Information not available in source content]

Permissions & Fee and Test Year

The OPHI-II (Version 2.1) was formally published in 2004. The instrument is typically distributed through the MOHO Clearinghouse or affiliated publishers, and fees apply for the purchase of the manual, interview forms, and scoring sheets necessary for clinical use. Users must obtain permission for reproduction or modification.

Reference’s

• Kielhofner G, Mallison T, Crawford C, Nowak M, Rigby M, Henry A, Walens D. (2004). Occupational Performance History Interview (OPHI-II), Version 2.1. Chicago: Model of Human Occupation Clearinghouse, Department of Occupational Therapy, University of Illinois at Chicago.
• Baaijen RI, Boon JA, Tigchelaar E, Pol MC. (2008). Nederlandse versie van de Occupational Performance History Interview (OPHI-II). (Dutch Version).

Items of the Occupational Performance History Interview-Version 2.1

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The original PDF explanation form can be downloaded here: Toelichtingsformulier (Explanation Form).

The OPHI-II interview structure is organized around the following themes:

• rollen
• dagelijkse routine
• handelingssituaties
• activiteit/handelingskeuzes
• beslissende levensgebeurtenissen