Therapists' experience of the cognitive orientation to daily occupational performance (CO-OP) approach: Shifting from conventional practice

Scand J Occup Ther. 2020 Feb;27(2):133-141. doi: 10.1080/11038128.2018.1483424. Epub 2018 Jul 8.

Abstract

Background: The CO-OP ApproachTM has been increasingly used in research and practice, yet its critical elements and implementation challenges are largely undescribed. Obtaining therapists' perspectives on CO-OP may reveal insights into potential critical and mediating factors.Aim/Objective: To explore the experiences of CO-OP therapists by understanding their perceptions on the approach compared with conventional practice, and by identifying mediating factors in its implementation.Material and Method: This exploratory study utilized a qualitative descriptive design. A purposive sample of occupational therapists (n = 3) was interviewed. Data were analyzed using thematic analysis and themes were validated within a focus group.Results/Findings: Three themes were identified: 'CO-OP works,' 'CO-OP delivery is mediated by contextual factors,' and 'CO-OP shifts the therapeutic approach.' Therapists perceived CO-OP to be efficacious for client-centred goal attainment. Guided discovery and the problem-solving strategy were identified as unique and challenging CO-OP elements. Mediating factors such as level of cognitive impairment and quality of family member involvement may affect CO-OP efficacy.Conclusions: Therapists found CO-OP to be efficacious and adopted unique elements into their professional approaches.Significance: This is the first study to investigate CO-OP therapists' experiences. Future research is recommended to enhance training of therapists in key CO-OP features.

Keywords: CO-OP; brain injury; cognition; qualitative methods; rehabilitation; strategy training.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Cognitive Behavioral Therapy
  • Cognitive Dysfunction / rehabilitation*
  • Female
  • Focus Groups
  • Humans
  • Middle Aged
  • Occupational Therapists / psychology*
  • Occupational Therapy / methods*
  • Qualitative Research