Behavioral Cognitive Continuum

Reference: Cole & Tufano, Chapter 12

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Roots of Behaviorism

Pavlov classical conditioning Skinner operant conditioning Applied scientific method to human behavior Foundation for learning theory Began 1930s & 1940s

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Focus

Behavior that can be observed and measured Rules out unconscious motivation Directly opposed to psychoanalytic theory Learning and behavior modification Includes perception & cognition

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Continuum: Behavioral to Cognitive Theories & Theorists

Behavior modification: Skinner, Pavlov, Lazarus Biomechanical, Rehabilitative: Trombly, Denton, Mosey, Fidler Cognitive Perceptual: Toglia & Abreu Cognitive Disabilities: Allen Cognitive Behavioral: Bandura, Beck, Ellis, Linehan

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Behavioral Cognitive Continuum, Client Applications

Behavior Modification: all Biomechanical, Rehabilitative: physical disabilities Cognitive Perceptual: brain injury (TBI), Stroke (CVA), mental illness, drug/alcohol rehab. Cognitive Disabilities (Allen) Cognitive Behavioral: all mental illness except psychosis, emotional aspects of any disorder, prevention

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Behavior Modification, Concepts & Techniques

Includes: goals & objectives, training, shaping, chaining, modeling, external reinforcement, rehearsal & practice, role playing, systematic desensitization, biofeedback OT examples: assertiveness training, social skills training, graded tasks, relaxation, time management, stress management

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Biomechanical Concepts & Techniques

Strength, ROM, endurance, positioning, prevention, restoration, compensation, adaptation, skill training, biofeedback, context of ADL OT Examples: group exercise, group games involving graded movements, learning prevention strategies, ergonomics in the workplace, work hardening, training in use of adaptive equipment, energy conservation

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Cognitive Perceptual Concepts & Techniques

Skill training (remediation) for orientation, attention, visual processing, motor planning, memory, cognition, problem solving. Multicontextual use of strategies, metacognition. Functional approach. Quadraphonic approach (Abreu) OT Examples: group orientation, labels & reminders, cancellation sheets, computer programs, group multicontextual strategy practice

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Cognitive Disabilities, Allen

Assessment & management: ongoing evaluation through crafts or ADL tasks, cuing, assistance through facilitation & probing, home safety screenings, care giver education, modification of task environments OT examples: use of cognitive performance modes to accurately plan future placement, determine competence, predict need for assistance, and adapt environment to produce best ability to function.

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Cognitive Behavioral Therapy, Concepts & Strategies

Social learning, modeling, selfregulation, disputing irrational beliefs, thought stopping, interruption, cognitive reframing or restructuring, dialectical strategies OT Examples: psycoeducational modules, group learning, role playing, worksheets for self awareness & understanding, interpersonal effectiveness, emotion regulation, distress tolerance, mindfulness

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Behavioral Strategies: Goals & Objectives (Cole, 2005 p.142)

Writing Long term goals: these are not always measurable In your notebook write one lifetime goal for yourself in each of the following categories:
Professional Family Financial Spiritual

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Behavioral Objectives

In contrast to long-term goals, these have specific time limits. Short steps toward a longer term goal Should be observable Should imply way to measure Based on similar principles to Allen & Toglia, observe behavior to infer thoughts & perceptions

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Practice: Recognizing Measurable Goals (Cole, 2005,

p. 141)

Worksheets: circle measurable goals. Correct answers: 2,4,9,10,12, 14,15,17,18 Discuss why these are measurable. Homework: write one behavioral objective for each lifetime goal.

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Conditioning & Habits

Pavlov: classical conditioning. What happens when you are hungry and you see a picture of a delicious pizza on TV? Stimulus is associated with visual image, eventually visual image replaces stimulus. Much of todays advertising is based on this principle.

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Conditioning, cont.

Skinner, operant conditioning Behavior that is reinforced in the environment tends to be repeated Behavior that is ignored tends to diminish Many random reinforcements exist in the environment Learning can be both positive and negative, depending on what is reinforced

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Conditioning & Habits, cont.

External reinforcement

What are some examples?

Reinforcement can also be internalized.

What are some examples?

Once a behavior becomes habitual, reinforcement is no longer necessary.

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Habits

Habit diminishes the conscious attention with which our acts are performed. (James, 1985) Familiar objects in the environment serve as stimuli for the habitual performance of tasks. Example: morning routines

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Shaping & Chaining

Uses principle of operant conditioning to learn new behaviors Breaks down task/activity into sequence of steps Reinforces each step as it is performed successfully (shaping) Each step serves as stimulus for next step (chaining).

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

Rehearsal & Practice

Basis of all learning Used in approaches on the continuum Reinforcement needed when motivation is lacking How is this principle used in the biomechanical frame of reference?

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.

The End

Skinner Film
A Phillip P. Blake Production in association with Research Press Company. Written by David Seltzer.

Additional Resource:
Cole, M. (2005). Group Dynamics in Occupational Therapy: The Theoretical Basis and Practice Application of Group Intervention. 3rd ed. Thorofare, NJ: SLACK Incorporated.

From Cole, M. Applied theories in occupational therapy: a practical approach instructors manual. Online document, http://www.efacultylounge.com, based on Cole, M. (2008). Applied theories in occupational therapy: a practical approach. Thorofare, NJ: SLACK Incorporated.