Using the Cognitive Orientation to Occupational Performance (CO-OP) with Adults with Executive Dysfunction following Traumatic Brain Injury

Abstract

The CO-OP approach has the potential to improve performance in daily functioning for adults with executive dysfunction following TBI.

A multicontext approach to promoting transfer of strategy use and self regulation after brain injury: An exploratory study

“…A core issue that presents challenges to rehabilitation is decreased ability of persons with brain injury to transfer learning from one situation or context to another [1][2][3]. In cognitive rehabilitation, the extent of generalization of treatment and how to broaden it is a major research issue; however, there are little-to-no guidelines for strategy training and few studies that have directly examined the ability to transfer strategies across trained and untrained tasks [4].…”

“…Disorders of executive function including decreased ability to formulate and maintain goals, plan, organize and monitor or regulate actions are thought to underlie difficulties in managing complex everyday tasks. Intervention studies provide preliminary support for the effectiveness of selfinstructional strategies [22], verbal mediation [23], problem-solving frameworks [1,24], goal management training [20] and checklist support [25] for persons with EF disorders. These strategies can be incorporated within the multicontext approach, depending on the person's preferences, personal style, goals and abilities.…”

“…Decreased self-monitoring abilities can influence sense of personal control and limit transfer of learning [16,26,36]. There is growing interest and support for use of metacognitive training [1,37,38]. Recently several single case studies and a pilot randomized control study provide initial support for the use of metacognitive training techniques that have been described within the multicontext approach [39][40][41].…”

Goal-directed outpatient rehabilitation following TBI: A pilot study of programme effectiveness and comparison of outcomes in home and day hospital settings

“…While the 'client-centred' dimension has been endorsed in the literature, in practice, goal-setting is often still therapist-driven [10], particularly within traditional hospital rehabilitation settings. The effectiveness of rehabilitation based on a client-centred goal-planning approach has received only limited research attention, mainly in the field of occupational therapy [11][12][13][14][15][16][17]. Occupational therapy programmes that have used the Canadian Occupational Performance Measure (COPM) to plan goals and guide interventions have been shown to be effective in improving the self-perceived occupational performance and satisfaction of people with TBI [11-13, 16, 17].…”

“…Occupational therapy models of practice such as the Occupational Performance Model [19] and the person-environment-occupation model [20] similarly acknowledge the impact of the environment on a person's performance and define the environment as those contexts and situations (including the personal, social and physical environment) which occur outside individuals and which elicit responses from them [20]. Environmental factors can act as a barrier or facilitator to performance [15,20] and previous qualitative findings suggest that there may be advantages to providing rehabilitation in the person's most pertinent environment, their home and local community. Therapeutic relationships have been described as 'friend' and 'partner' when rehabilitation is conducted in the home environment compared to 'expert' and 'teacher' when therapy is carried out in a clinic environment [21,22], contributing to a different experience of rehabilitation [21].…”