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Rehab Measures Database

Occupational Performance History Interview-II

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The Occupational Performance History Interview (OPHI-II) is a semi-structured interview that explores a client's life history in the areas of work, play, and self-care performance. 

Acronym OPHI-II

Area of Assessment

Activities of Daily Living
Life Participation
Occupational Performance
Mental Health
Quality of Life
Social Relationships
Social Support

Assessment Type


Administration Mode

Paper & Pencil


Not Free

Actual Cost


Cost Description

The product includes access to the full PDF assessment manual, fillable PDF assessment forms, and online forms. Forms can be reproduced for free by those who have purchased the manual.

CDE Status

Not a CDE -- last searched on 5/19/2023

Key Descriptions

  • The OPHI-II is a three-part assessment based on the Model of Human Occupation (MOHO). It includes: a) a semi-structured interview exploring a client’s occupational life history, b) therapist-reported rating scales of interview information that provide an interval-level measure of the client’s occupational identity, occupational competence, and impact of the client’s occupational settings, and c) a life history narrative capturing qualitative features of the occupational life history (Kielhofner et al., 1998).
  • The measure can be administered in one session or broken up into multiple interviews.
  • Suggested interview questions and strategies are available as a guide. However, therapists skilled in administering the OPHI-II may no longer need the guide. Interview thematic areas (can be administered in any sequence):
    ○ Activity/Occupational Choices
    ○ Critical Life Events
    ○ Daily Routine
    ○ Occupational Roles
    ○ Occupational Settings (environment)
  • Rating Scales:
    ○ Occupational Identity
    ○ Occupational Competence
    ○ Occupational Setting (Environment)
  • Scoring: Rating items on three subscales using a 4-point system
    ○ 4 = exceptionally competent occupational functioning
    ○ 3 = good, appropriate, satisfactory occupational functioning
    ○ 2 = some occupational functioning problems
    ○ 1 = extreme occupational functioning problems
  • The two ends of the continuum for the rating scales should be rarely used. Criterion statements are available for each rating to guide selection. If a therapist is undecided between two ratings, the lower one should be chosen.
  • Key forms allow interval-level scores from 0-100 to be generated for each rating scale (even with missing items) without computer-based administration.
  • Developing the life history narrative includes developing a graphic portrayal based on the interview data (including a narrative slope) and validating it with the client. The therapist may also complete a written summary of the narrative.

Number of Items

The assessment has three parts including the semi-structured interview, evaluation scales, and narrative history. There are three evaluation scales: the Occupational Identity scale has 11 items, and both the Occupational Competence and Occupational Setting scale have 9 items.

Equipment Required

  • Pen/Pencil
  • Manual
  • Assessment Forms and Key Forms

Time to Administer

40 - 75 minutes

The interview component should take approximately one hour if done as a single interview.

Required Training

Reading an Article/Manual

Required Training Description

Therapists should be familiar with the assessment tool prior to administering.

Age Ranges


18 - 64


Elderly Adults

65 +


Instrument Reviewers

Sarah Miller, MSOT and Mila Jimenez, MSOT, OTD students at New York University

Kevin Fearn at Shirley Ryan AbilityLab

ICF Domain


Measurement Domain

Activities of Daily Living
General Health

Professional Association Recommendation

None available -- last searched on 5/19/2023


  • Considerations for determining appropriateness of use with clients:
    • Age
    • Emotional/psychological state
    • Cognitive/linguistic ability
  • Culture should be considered when interpreting the interview findings and selecting ratings.
  • The tool is available in 23 languages including: Arabic, Chinese, Danish, Dutch, Filipino, Finnish, French, German, Greek, Hebrew, Icelandic, Italian, Japanese, Korean, Lithuanian, Malaysian, Norwegian, Persian, Portuguese, Slovenian, Spanish, Swedish, and Turkish.

Mixed Populations

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Normative Data

Mixed population: (Kielhofner et al., 2001; n = 249; mean age = 56.05 years; female (n = 139), male (n = 110); physical disability (n = 92), psychiatric disability (n = 66), subjects living independently in the community (n = 91); USA (n = 161), Finland (n = 39), Iceland (n = 15), Australia (n = 13), Belgium (n = 10), United Kingdom (n = 4), Canada (n = 4), Sweden (n = 2))

  • Occupational Competence Scale:
    • Total sample:
      • Mean Person Measure = 53.67, SD = 10.21
      • Mean Item Calibration: 50.00, SD = 6.03
    • Diagnostic groups:
      • No active diagnosis had highest calibration (50.14) followed by physical diagnosis (46.94) and psychiatric diagnosis (information missing in article)
  • Occupational Identity Scale:
    • Total sample:
      • Mean Person Measure = 58.61, SD = 10.10
      • Mean Item Calibration = 50.00, SD = 3.16
    • Diagnostic groups:
      • No active diagnosis had highest calibration (60.30) followed by physical diagnosis (58.59) and psychiatric diagnosis (information missing in article)
  • Occupational Behavior Scale:
    • Total sample:
      • Mean Person Measure = 53.32, SD = 9.61
      • Mean Item Calibration = 50.00, SD = 3.98
    • Diagnostic groups:
      • No active diagnosis had highest calibration (55.21) followed by psychiatric diagnosis (information missing in article) and physical diagnosis (49.59)

Interrater/Intrarater Reliability

Mixed population: (Kielhofner et al., 2001)

  • Rasch Analysis of Fit statistics showed that 139 of 151 raters (92%) used the Occupational Competence, Identity, and Behavior scales validly.
  • Rasch analysis identified a similar level of severity of rating among raters:
    • Occupational Competence Scale: Rater separation 1.28
    • Occupational Identity Scale: Rater separation 1.78
    • Occupational Behavior Scale: Rater separation 1.94


Mixed population: (Kielhofner et al., 2005; International Population; n = 708; mean age = 54.7 years; female (n = 296), male (n = 412); psychiatric problems (n =131), chronic illness or physical impairments (n = 457), other conditions (n = 88), well-elderly (n = 32))

  • Rasch Analysis revealed that rater separation was similar to that reported in Kielhofner et al. (2001), confirming the inter-rater reliability of OPHI-II.

Construct Validity

Mixed population: (Kielhofner et al., 2001)

  • Rasch analysis: The MnSq statistics indicated no item misfit for all three scales and a logical order of item calibrations.


Mixed population: (Kielhofner et al., 2005)

  • Rasch Analysis: “The items continued to work well together to measure the underlying constructs, the item hierarchies remained the same, and the rate of rater and subject misfits and rater separation was similar to that reported in…Kielhofner et al. (2001).” (p. 26)

Content Validity

Mixed population: (Kielhofner et al., 2001)

  • An international team of occupational therapists were involved in the development and pilot testing of the assessment tool. After pilot testing, the tool underwent multiple revisions in order to increase validity.
  • The OPHI-II was translated to various languages and adapted to different cultures in order to minimize cultural biases.
  • Rasch Analysis
    • Occupational Competence Scale:
      • Fit statistics indicated that 226 of 249 subjects (91%) were validly measured by the competence scale.
      • The person separation, which indicates the precision of the scale to detect meaningful differences between persons, was 3.06.
    • Occupational Identity Scale:
      • Fit statistics indicated that 228 of 249 subjects (92%) were measured validly by this scale.
      • The person separation, which indicates the precision of the scale to detect meaningful differences between persons, was 3.06.
    • Occupational Behavior Scale:
      • Fit statistics indicated that 229 of 249 subjects (92%) were measured validly by this scale.
      • The person separation, which indicates the precision of the scale to detect meaningful differences between persons, was 2.75.

Face Validity

Mixed population: (Apte et al., 2005; [Occupational Therapists: (n = 3); 20 years of experience (n = 1), 3 years of experience (n = 1), 0 years of experience (n = 1)]; [clients: (n = 7); age range = 24-50 years; female (n = 1), male (n = 6); African American (n = 6), Latino (n = 1); HIV positive (n = 7)])

  • Therapists and clients both agreed that the OPHI-II was a good rapport-building opportunity that created a better understanding of the client’s life experiences and assisted in planning goals and services.

Mixed population: (Verhoef et al., 2014; n = 11; male (n = 6); age = 16-25 years (Median age = 22); diagnosis of chronic condition causing physical disabilities (cerebral palsy = 3, muscular disease = 2, traumatic brain injury = 2, spina bifida = 1, spinal cord injury = 1; multiple sclerosis = 1, chronic obstructive pulmonary disease = 1); completed education or were completing within 6 months)

  • A 1-year multidisciplinary rehabilitation intervention brought together rehabilitation and vocational services and combined a group program with individual assessment and coaching.
  • Participants showed improvement on overall occupational performance in median total scores as well as median scores for occupational identity and occupational competence

Pre- and post-intervention median scores on OPHI-II scales


OPHI Scale

Pre-intervention (mdn)

Post-Intervention (mdn)

Occupational Identity Scale**



Occupational Competence Scale*



Occupational Settings Scale



OPHI-II Total Score**



*p < 0.05, **p < 0.01



Floor/Ceiling Effects

Mixed population: (Kielhofner et al., 2001)

  • As per a Rasch analysis, the range of item calibrations covered the range of person measures, suggesting no ceiling effect.

Immune System Disorders

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Criterion Validity (Predictive/Concurrent)

Adults With HIV/AIDS: (Levin et al., 2007; n = 65; male (n = 52); mean age = 42.5; age range = 24-59)

  • The narrative slope derived from the OPHI-II was associated with future occupational participation at discharge, 3-month, and 6-month follow-up

Relationships between narrative slope at baseline and engagement in employment and other productive activity at follow-up (Kendall’s tau-b)


Follow-up period


(tau-b, n, p)

Other Productive Activity (tau-b, n, p)


0.35, 45, 0.003

                0.23, 52, 0.006

Three months

0.40, 29, 0.009

                0.50, 29, 0.001

Six months

0.50, 29, 0.001

                0.31, 27, 0.037

Nine months

0.21, 22, 0.297

                0.33, 20, 0.054

Mental Health

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Face Validity

Participants in community mental health program: (Ennals & Fossey, 2006; n = 6; female (n = 6); age range = 28-54; all with psychiatric diagnosis and living in the community at the time of the study)

  • Through the use of the OPHI-II, mental health consumers found benefit in telling their stories and desired to talk about their full range of experiences and emotions as opposed to a more limited discussion of their illness, disability, and risk.
  • The use of the OPHI-II in community mental health settings could facilitate occupational therapist’s understanding of consumers’ life experience and occupational lives.

Neurological Disorders

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Normative Data

Adolescents with Attention Deficit Hyperactivity Disorder (ADHD): (Levanon-Erez et al., 2017; n = 21 adolescents aged 12-17 [male = 17] with valid medical diagnosis of ADHD and referral to occupational therapy intervention during 2012-2014 for experimental group; n = 43 adolescents aged 12-18 [male = 26] recruited through advertising and social media for control group.)

  • The mean score on the occupational identity scale of the OPHI-II was significantly higher in the control group than in the ADHD group [t = 4.564, (1,62), p = 0.000, effect size = 1.26]
  • Significantly higher scores for the control group were found for 7 of the 11 items of the occupational identity scale, with a large effect size found for the item “Felt effective (past)” and low effect sizes for the items “Has interests” and “Recognizes identity and obligations.”





Apte, A., Kielhofner, G., Paul-Ward, A., & Braveman, B. (2005). Therapists’ and clients’ perceptions of the Occupational Performance History Interview. Occupational Therapy in Healthcare, 19(1-2), 173–192.

Ennals, P. & Fossey, E. (2007). The Occupational Performance History Interview in community mental health case management: Consumer and occupational therapist perspectives. Australian Occupational Therapy Journal, 54, 11-21.

Kielhofner, G., Dobria, L., Forsyth, K., & Basu, S. (2005). The construction of keyforms for obtaining instantaneous measures from the Occupational Performance History Interview rating scales. OTJR: Occupation, Participation and Health, 25(1), 23–32.

Kielhofner, G., Mallinson, T., Crawford, C., Nowak, M., Rigby, M., Henry, A., & Walens, D. (1998). A user's manual for the occupational performance history interview OPHI-II (Version 2.1). Model of Human Occupation Clearinghouse, Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago.

Kielhofner, G., Mallinson, T., Forsyth, K., & Lai, J.S. (2001). Psychometric properties of the second version of the Occupational Performance History Interview (OPHI-II). American Journal of Occupational Therapy, 55(3), 260–267.

Levin, M., Kielhofner, G., Braveman, B., Fogg, L. (2007). Narrative slope as a predictor of work and other occupational participation. Scandinavian Journal of Occupational Therapy, 14, 258-264.

Levanon-Erez, N., Cohen, M., Bar-Ilan, R.T., & Maeir, A. (2017). Occupational identity of adolescents with ADHD: A mixed methods study. Scandinavian Journal of Occupational Therapy, 24(1), 32-40.

Verhoef, J.A.C., Roebroeck, M.E., van Schaardenburgh, N., Floothuis, M.C.S.G., Miedema, H.S. (2014). Improved occupational performance of young adults with a physical disability after a vocational rehabilitation intervention. Journal of Occupational Rehabilitation, 24, 42-51.