While observing Occupational Therapy Assistant Fatima deCouto-Garcia, (a BCC program OTA graduate), at The New Bedford Rehab Hospital, we were tasked with focusing on recognizing the performance skill deficits and contextual factors that brought a client to seek Occupational Therapy services. The facility we visited is considered an acute long term rehabilitation hospital and the patients we observed each had complex multi-facetted symptoms, diagnosis and treatment protocols. For the purpose of this reflection we will focus on one patient, a 45 year old woman, Jane Doe, who 6 weeks prior had her left leg amputated above the knee. Jane was described as a homeless, diabetic, suffering from depression. The high level of Jane’s daily methadone dosage was preventing her acceptance to a skilled nursing…