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time in problems with daily functioning as experienced by the patient themselves (Law, Baptiste et al. 1990). The COPM is a semi-structured interview conducted by the occupational therapist in order to take stock of a patient\u2019s daily functioning; the aim is to map out the problems experienced by the client in the areas of living and caring, learning and working, play and recreation. Once the problems have been mapped out, the patient scores the importance of each activity with which he or she experiences problems on a scale of 0-10. According to the literature, applicability, validity and responsiveness of the test are good. The test-retest reliability, however, is poor, due to the semi- structured nature of the interview (Carswell, McColl et al. 2004).\u000DIn addition to the COPM, complaint-specific measures can be helpful in charting the consequences of symptoms like pain and fatigue. The guideline Oncological Rehabilitation recommends that, for measuring cancer-related fatigue, a multi-dimensional questionnaire should be used that measures the physical, emotional and mental aspects of fatigue. A consensus has been reached on using the Multi-dimensional Fatigue Index (MVI), which allows for the systematic measurement of cancer- related fatigue (IKNL 2011). At the Netherlands Cancer Institute this questionnaire is conducted by the physical therapist. A clinimetric assessment of pain complaints is performed by the head and neck/oncology nurse with the Visual Analogue Scale (VAS) (IKNL 2011).\u000D5.6.3 Interventions offered and evidence\u000DOnce the occupational therapist, together with the other multi-disciplinary team members, has mapped out a patient\u2019s functional problems, SMART goals (see paragraph 2.4, page 91) are formulated and a rehabilitation plan is made. Goals are aimed at the patient\u2019s functioning and participation level in their own environment. When the specific desired rehabilitation outcomes and goals have been formulated, the therapeutic situation and the types of interventions can be discussed within the rehabilitation team and with the patient. Interventions are aimed at improving the performance of meaningful activities, in which these activities function as a form of therapy. In the following paragraph occupational therapy interventions will be discussed that are frequently offered within the head and neck cancer rehabilitation programme.\u000D5.6.3.1 Health Counseling\u000DWithin occupational therapy, the therapist plays a facilitative role in increasing the patient\u2019s self- management and problem-solving skills. To this end, the Netherlands Cancer Institute offers Health Counselling (Gerards and Borgers 1997). Health Counselling is defined as the guidance of patients with the aim of motivating them to take on health advice, to put it into practice and to persist in the long run. This requires active participation and personal responsibility from the patient. Autonomy, active participation and personal responsibility are essential to obtaining the goals in daily functioning (Gerards and Borgers 1997). Often used in Health Counselling are the principles of motivational interviewing. Motivational interviewing is aimed at encouraging behavioural changes by helping to clarify and resolve the client\u2019s ambivalence towards change (Rubak, Sandbaek et al. 2005). Using motivational interviewing within therapeutic interventions has been shown to be effective in facilitating behavioural change. Motivational interviewing has proven to be more effective than the traditional approach of advice-giving (Burke, Arkowitz et al. 2003, Rubak, Sandbaek et al. 2005).\u000D131\u000D