The Role Checklist

Background  

Within the occupational behavior tradition, roles are characterized as critical

determinants of productivity. Occupational roles organize behavior by contributing to
one's personal identity, conveying social expectations for performance, organizing use
of time, and including the individual within the social structure. The occupational
therapist’s unique view of disability involves understanding how illness or injury affects
occupational role performance. Successful adaptation after illness or injury may
depend on a person's ability to competently resume or to establish new occupational
roles.

The Role Checklist was designed to elicit information about a person's

occupational roles. Occupational roles consist of both playful and productive behaviors.
Playful behaviors are characterized as ”non work” such as hobbies, sports, or social
recreation. Productive behaviors contribute some service or commodity that others
need or desire.

The Role Checklist has been translated into ten languages (Arabic, Dutch,
French, German, Japanese, Portuguese, Spanish, Swedish, Chinese, & Hebrew) for
international use. It is a reliable and valid assessment tool that provides:

1. Data on individuals’ perception of their participation in roles throughout

their lifespan.
2. Data regarding the degree to which each role is valued.
3. Supplemental information regarding an individual’s capacity to maintain a
balance among roles.

Description  of  the  Role  Checklist  

The Role Checklist is a written inventory, requiring approximately fifteen (15)

minutes to administer, and is appropriate for use with an adolescent, adult, or elderly
population. It is divided into two parts. Part 1 assesses, along a temporal continuum,
the major occupational roles that organize an individual's daily life. Part 2 identifies the
degree to which each occupational role is valued.

The occupational roles included in the Role Checklist are: student, worker,
volunteer, care giver, home maintainer, friend, family member, religious participant,
hobbyist/amateur, and participant in organizations. There is also an "other" category
where individuals can enter additional roles not listed. It should be noted that the role
definitions include examples that are not meant to be all encompassing. The intent of
the checklist is to identify roles with occupational components that serve to organize an
individual's daily life. Thus, reference to frequency of performance is included in role
definitions. For example, the role of family member refers to spending time or doing
something, at least once a week, with a family member such as a spouse, child, parent,
or other relative. The key phrase is once a week. People may view themselves as
family members, but their family may reside out of town resulting in infrequent contact.
Consequently, that role is not available to organize present daily life.

Administration  of  the  Role  Checklist  

Instruct individuals to complete the demographic information at the top of the checklist.
Remain with them until the checklist is completed.

Part  1  
1) Ask them to read the instructions.
2) Inquire if they understand the instructions and answer any questions
pertaining to the administration of Part 1.
3) Define the time frames as follows:
a) “Present refers not only to today, but also includes the previous
seven days.”
b) “Past refers to the period of time up until seven days ago. “
c) “Future is anytime from tomorrow onward.”

Part  2  
1) When individuals have completed Part 1, ask them to read the instructions for
Part 2
2) Inquire if they understand the instructions and answer any questions
pertaining to the administration of Part 2.
3) Define "valuable" as follows:
"Valuable refers to the worth you place on each role, that is, how
important or desirable the role is to you."

Recommended Reading
The following book by Dr. Gary Kielhofner discusses the theoretical framework upon
which the Role Checklist was developed and presents numerous cases in which the
checklist was used clinically.

Kielhofner G. (Ed.) A Model of Human Occupation: Theory and Application, (3rd

Edition), Baltimore: Lippincott, Williams and Wilkins, 2002.

Publications using the Role Checklist

Colon, H & Haertlein, C. Spanish translation of the role checklist. American Journal of
Occupational Therapy, 56, 586-589, 2002

Gillard M & Segal M. Social roles and subjective well-being in a population of

nondisabled older adults. Occupational Therapy Journal of Research, 22 96S-96S,
2002.

Hachey, R, Boyer, G & Mercier, C. Perceived and valued roes of adults with severe
mental heath problems. Canadian Journal of Occupational Therapy, 68, 112-120, 2001.
Prusti, S & Branholm, IB. Occupational roles and life satisfaction in psychiatric
outpatients and vocational disabilities. Work, 14, 145-149, 2000.

Dickerson A. The Role Checklist. In B Hemphill-Pearson (Ed.) Assessments in

Occupational Therapy Mental Health: An Integrated Approach. New Jersey: Slack, 175-
191, 1999.

Ponsford J, Olver J, Nelms R, Curran C & Ponsford M. Outcome measurement in an

inpatient and outpatient traumatic brain injury rehabilitation programme.
Neuropsychological Rehabilitation, 9, 517-534, 1999.

Kinebanian, A, Thomas, C, Verhoef, JAC, & Verschuur. Model of Human Occupation 4-

Rollenijst (Role Checklist): Rollen en gewoonteijst (role and habits), Hogeschool von
Amsterdam, Inst. Ergotherapie, 1998.

Levitt VB. Anxirety disorders. In A. MacRae & E Cara (Eds.) Anxiety Disorders in
Psychosocial Occupational Therapy – A Clinical Practice. New York:Delmar Publishers,
359-403, 1998.

Crowe TK, VanLeit B, Berghmans KK & Mann P. Role perceptions of mothers with
young children: The impact of a child’s disability. American Journal of Occupational
Therapy, 51, 651-661, 1997.

Frosch S, Gruber A, Jones C, Myers S, Noel E, Westerlund A & Zavisin T. The long
term effects of traumatic brain injury on the roles of caregivers. Brain Injury, 11, 891-
906, 1997.

Tompson H & Werner J. The impact of role conflict/facilitation on core and discretionary
behaviors: Testing a Mediated model. Journal of Management, 23, 583-601, 1997

Asher I. Occupational Therapy Assessment Tools: An Annotated Index, (2nd Edition),

Bethesda, MD, American Occupational Therapy Association, 1996.

Kusznir A, Scott E, Cooke RG & Young LT. Functional consequences of Bipolar

Affective Disorder: An occupational therapy perspective. Canadian Journal of
Occupational Therapy, 63, 313-322, 1996.

Dickerson A & Oakley F. Comparing the roles of community-living persons and patient
populations. American Journal of Occupational Therapy, 49, 221-228, 1995.

Hachey R, Jumoorty J & Mercier C. Methodology for validating the translation of test
measurements applied to occupational therapy. Occupational Therapy International, 2,
190-203, 1995.

Kielhofner G. (Ed.) A Model of Human Occupation: Theory and Application, (2nd

Edition), Baltimore: Williams and Wilkins, l995.

Branholm IB & Fugl-Meyer AR. On non-work activity preferences: relationships with

occupational roles. Disability and Rehabilitation, 16, 205-216, 1994.

Hallett JD, Zasler ND, Maurer P & Cash, S. Role change after traumatic brain injury in
adults. American Journal of Occupational Therapy, 48, 241-246, 1994.
Rosenfeld M. Wellness and lifestyle renewal: A manual for personal change. Rockville,
MD: American Occupational Therapy Association, 1993.

Branholm IB & Fugl-Myer AR. Occupational role preferences and life satisfaction.
Occupational Therapy Journal of Research, 12, 159-171, 1992.

Egan M, Warren SA, Hessel PA & Gilewich G. Activities of daily living after hip fracture:
pre- and post discharge. Occupational Therapy Journal of Research, 12, 342-356,
1992.

Stoffel VC. The Americans with disabilities act of 1990 as applied to an adult with
alcohol dependence. American Journal of Occupational Therapy, 46, 640-644, 1992.

Baker F, Curbow B & Wingard, JR. Role retention and quality of life of bone marrow
transplant survivors. Social Science and Medicine, 32, 697-704, 1991.

Bavaro SM. Occupational therapy and obsessive-compulsive disorder. American

Journal of Occupational Therapy, 45, 456-458, 1991.

Vause-Earland T. Perceptions of the role assessment tools in the physical disability

setting. American Journal of Occupational Therapy, 45, 26-31, 1991.

Watson MA & Ager CL. The impact of role valuation and performance on life satisfaction
in old age. Physical and Occupational Therapy in Geriatrics, 10, 27-62, 1991.

Sepiol JM & Froehlich J. Use of the role checklist with the patient with multiple
personality disorder. American Journal of Occupational Therapy, 44, 1008-1012, 1990.

Asher I. An Annotated index of OT Assessment Tools. Rockville, MD: American

Occupational Therapy Association, 1989.

Ebb EW, Coster W & Duncombe L. Comparison of normal and psychosocially

dysfunctional male adolescents. Occupational Therapy in Mental Health, 9, 53-74,
1989.

Pizzi M. The model of human occupation and adults with HIV infection and AIDS.
American Journal of Occupational Therapy, 44, 257-264, l989.

Barris R & Dickie V. Response to commentary on “A Comparison of Psychiatric

Patients and Normal Subjects Based on the Model of Human Occupation”.
Occupational Therapy Journal of Research, 8, 32-37, 1988.

Barris R, Dickie V & Baron KB. A Comparison of psychiatric patients and normal
subjects based on the model of human occupation. Occupational Therapy Journal of
Research, 8, 3-23, 1988.

Barris R, Oakley F & Kielhofner G. The Role Checklist in B. Hemphill (Ed.) Mental
Health Assessment in Occupational Therapy. New Jersey: Slack, Inc. 73-9l, l988.
Mann WC & Klyczek J. Commentary on “A Comparison of Psychiatric Patients and
Normal Subjects Based on the Model of Human Occupation”. Occupational Therapy
Journal of Research, 8, 24-31, 1988.

Elliott MS & Barris R. Occupational role performance and life satisfaction in elderly
persons. Occupational Therapy Journal of Research, 7, 215-224, l987.

Jackoway IS, Rogers JC & Snow TL. The role change assessment: An interview tool
for evaluating older adults. Occupational Therapy in Mental Health, 7, 17-37, 1987.

Oakley F. Clinical application of the model of human occupation in dementia of the

Alzheimer’s type. Occupational Therapy in Mental Health, 7, 37-50, 1987.

Rust KM, Barris R & Hooper FH. Use of the model of human occupation to predict
women’s exercise behavior. Occupational Therapy Journal of Research, 7, 23-35, l987.

Barris R, Kielhofner G, Martin RMB, Gelinas I, Klement M & Schultz B. Occupational

function and dysfunction in three groups of adolescents. Occupational Therapy Journal
of Research, 6, 301-317, 1986.

Duellman MK, Barris R & Kielhofner G. Organized activity and the adaptive status of
nursing home residents. American Journal of Occupational Therapy, 40, 618-622,
1986.

Kielhofner G. A review of research on the model of human occupation: Part one.

Canadian Journal of Occupational Therapy, 53, 69-74, 1986.

Kielhofner G. A review of research on the model of human occupation: Part two.

Canadian Journal of Occupational Therapy, 53, 129-134. 1986.

Oakley F, Kielhofner G, Barris R & Reichler R. The role checklist: Development and
empirical
assessment of reliability. Occupational Therapy Journal of Research, 6, l57-l70, l986.

Kielhofner G. (Ed.) A Model of Human Occupation: Theory and Application, Baltimore:

Williams and Wilkins, l985.

Lederer JM, Kielhofner G & Watts JH. Values, personal causation and skills of
delinquents and nondelinquents. Occupational Therapy in Mental Health, 5, 59-77,
1985.

Oakley F, Kielhofner G & Barris R. An occupational therapy approach to assessing

psychiatric patients' adaptive functioning. American Journal of Occupational Therapy,
39, 147-154, 1985.

Smynteck L, Barris R & Kielhofner G. The model of human occupation applied to

psychosocially dysfunctional adolescents. Occupational Therapy in Mental Health, 5,
21-40, l985.

Gusich RL. Occupational Therapy for Chronic Pain: A Clinical Application of the Model
of Human Occupation. Haworth Press, Inc., 59-73, 1984.
Kielhofner G. An overview of research on the model of human occupation. Canadian
Journal of Occupational Therapy, 51, 59-67, 1984.
Frances Oakley, MS, OTR, FAOTA
National Institutes of Health

Building  10    Room  6s235  

10 Center Dr MSC 1604
Bethesda, MD 20892 - 1604
5/04
 ROLE CHECKLIST
NAME AGE DATE

SEX: ❑ MALE ❑ FEMALE ARE YOU RETIRED? ❑ YES ❑ NO

MARITAL STATUS: ❑ SINGLE ❑ MARRIED ❑ SEPARATED ❑ DIVORCED ❑ WIDOWED

The purpose of this checklist is to identify the major roles in your life. The checklist, which is divided
into two parts, presents 10 roles and defines each one.

PART I
Beside each role, indicate, by checking the appropriate column, if you performed the role in the past, if
you presently perform the role, and if you plan to perform the role in the future. You may check more
than one column for each role. For example, if you volunteered in the past, do not volunteer at present,
but plan to in the future, you would check the past and future columns.

ROLE PAST PRESENT FUTURE

STUDENT:
Attending school on a part-time or full time basis.
WORKER:
Part-time or full-time paid employment.
VOLUNTEER:
Donating services, at least once a week, to a hospital,
school, community, political campaign, and so forth.
CARE GIVER:
Responsibility, at least once a week, for the care of someone such as
a child, spouse, relative, or friend.
HOME MAINTAINER:
Responsibility, at least once a week, for the upkeep of the home
such as housecleaning or yard work.
FRIEND:
Spending time or doing something, at least once a week, with a
friend.
FAMILY MEMBER:
Spending time or doing something, at least once a week, with a
family member such as a child, spouse, or other relative.
RELIGIOUS PARTICIPANT:
Involvement, at least once a week, in groups or activities affiliated
with one’s religion (excluding worship).
HOBBYIST/AMATEUR:
Involvement, at least once a week, in a hobby or amateur activity
such as sewing, playing a musical instrument, woodworking, sports,
the theater, or participation in a club or team.
PARTICIPANT IN ORGANIZATIONS:
Involvement, at least once a week, in organizations such as the
American Legion, National Organization for Women, Weight
Watchers, and so forth.

OTHER:
A role not listed which you have performed, are presently
performing, and/or plan to perform. Write the role on the line
above and check the appropriate column(s).
PART II
The same roles are listed below. Next to each role, check the column which best indicates how
valuable or important the role is to you. Answer for each role, even if you have never performed
or do not plan to perform the role.

ROLE NOT AT SOME VERY

ALL WHAT VALUABLE
VALUABLE VALUABLE
STUDENT:
Attending school on a part-time or full time basis.
WORKER:
Part-time or full-time paid employment.
VOLUNTEER:
Donating services, at least once a week, to a hospital, school,
community, political campaign, and so forth.
CARE GIVER:
Responsibility, at least once a week, for the care of someone
such as a child, spouse, relative, or friend.
HOME MAINTAINER:
Responsibility, at least once a week, for the upkeep of the
home such as housecleaning or yard work.
FRIEND:
Spending time or doing something, at least once a week,
with a friend.
FAMILY MEMBER:
Spending time or doing something, at least once a week,
with a family member such as a child, spouse, or other
relative.
RELIGIOUS PARTICIPANT:
Involvement, at least once a week, in groups or activities
affiliated with one’s religion (excluding worship).
HOBBYIST/AMATEUR:
Involvement, at least once a week, in a hobby or amateur
activity such as sewing, playing a musical instrument,
woodworking, sports, the theater, or participation in a club
or team.
PARTICIPANT IN ORGANIZATIONS:
Involvement, at least once a week, in organizations such as
the American Legion, National Organization for Women,
Weight Watchers, and so forth.

OTHER:
A role not listed which you have performed, are presently
performing, and/or plan to perform. Write the role on the
line above and check the appropriate column(s).

© Copyright 1981 and Revised 1984 by Frances Oakley, MS, OTR/L, FAOTA