During this lab we learned about different cognitive approaches used in practice with occupational therapy. Some approaches we may use include cognitive behavioural therapy, cognitive restructuring and socratic questioning. By deconstructing and understanding someone’s thought processes we, as well as the client are able to learn how a client views things in their daily life and how their perspective may affect their behaviour and interactions.
Occupation enabling thought processes: Thought processes can inhibit or enable an individual in participating in occupations in their daily lives. Our thoughts colour our behaviour and if they are negative, they can especially become disabling. In turn our thought processes can affect our action, self-evaluations, affect/mood and internal processes. Brown and Stoffel (2011) indicate that “beliefs and thoughts reside within the person, and both influence and arise from what a person perceives and the meaning that is attached to those perceptions. They are cognitive content that is stored in memory, which can unconsciously or consciously affect the person”.
Thoughts can elicit different interpretations which can influence our emotional response and behaviour. For instance, if someone “called their friend and they had not returned the call” we have two responses that can come from the situation- one that is extreme (ie: she does not want to be my friend anymore) and one that is understanding (ie: she is busy and will call me back when she can). However, the situation and the history of the friendship can also be a factor in the response. This exercise below in class is to allow us to see how different thought processes can arise based from different individuals and circumstances. It is also important that we make sure not to minimize someone’s experience, even if we believe their thoughts are “irrational” as something may be externally happening in their life, causing them to feel that way. As an OT it is important not to disable someone by making their feelings and thoughts feel invalidated.
Cognitive Therapy approaches
CBT is a problem-oriented approach that works to improve emotional states by changing distorted thinking (Brown & Stoffel). Click this online pamphlet to read more about CBT and Occupational therapy practice.
Socratic Questioning is a method of disciplined questioning used to understand and explore the truth of thoughts
Brown & Stoffel (2011) have a chart that exemplifies how we can use socratic questioning in therapy sessions:
TIC TOC Technique focuses on identifying and reframing thoughts or cognitions that interfere with accomplishing tasks. First the client identifies what he wants or needs to do then completes a worksheet to identify tasks, interfering cognitions, related distortions and a reframed task oriented oriented cognition related to the occupational task issue (Brown & Stoffel, 2011).
Brown, C. and Stoffel, V. (2011). Occupational Therapy in Mental Health: A
vision for participation. Philadelphia: FA Davis Company.
Edgelow, M. (2013, April). Enabling change through thoughts and feelings:
Cognitive Approaches. Lecture conducted from Queen’s University,
Krupa, T. (2013, March). Week 2- conceptual model. OT 845
psychoemotional determinants of occupation. Lecture conducted from
Queen’s University, Kingston, ON.