OCCUPATIONAL THERAPISTS’ PERCEPTIONS OF BENEFIT OF COGNITIVE BEHAVIORAL THERAPY ON CLIENT ADHERENCE AND OUTCOMES: A MIXED METHODS DESIGN

Abstract

A holistic approach to healthcare is essential to understanding strengths and barriers when progressing towards therapeutic goals. Limited client participation occurs when clients experience barriers, leading to lack of adherence to medical advice and plan of care (POC) (Collado-Mateo et al., 2021). Without proper attention, barriers impact therapeutic outcomes, quality of life, and relapse recurrence (Ezawa et al., 2020). Cognitive behavioral therapy (CBT) techniques can address some frequently identified client barriers to adherence including anxiety, depression, pain, insomnia/sleep issues, difficulty with self-management/self-efficacy, dysfunctional beliefs/attitudes, and prevent relapse (Ezawa et al., 2020; Gardiner et al., 2018; Hur et al., 2018; Murphy et al., 2018; Serrat et al., 2021; Tester & Foss, 2018). CBT aims to identify dysfunctional thoughts (barriers) and restructure them to promote well-being (Fenn & Byrne, 2013). Both CBT and occupational therapy (OT) have theoretical commonalities striving to be client-centered, empirical, and promote autonomy. They are holistic methods of treatment promoting engagement in meaningful life activities. The CBT for OTs Toolkit is designed for educating OTs on interventions to address barriers during treatment. Thirteen OT clinicians participated in a pre-survey, reviewed an infographic and CBT for OTs Toolkit, and completed a post survey to determine changes in perception, beliefs, and identify feasibility for future use. The program was expected to increase OT’s perceived understanding of CBT, benefits of CBT, comfort of implementation, and the likelihood of future use when addressing barriers to improve adherence. Results indicated that most participants (OT clinicians) were aware of the benefit of CBT but most did not incorporate CBT techniques into practice. Results demonstrated significant changes from pre to post surveys, with OT clinician’s reported improvement in themes of self-efficacy and knowledge translation. Prior to review of infographic and toolkit only 23% of respondents reported they were very comfortable or extremely comfortable in application of CBT techniques. Following review of educational infographic and toolkit, 59% reported their comfort increased to very or extremely comfortable with CBT technique implementation, indicating that the CBT for OT toolkit impacted participant’s self-efficacy. Knowledge and familiarity with CBT increased by 22% following exposure to CBT for OT programming. These results reveal that OT practitioners will benefit from increased education and resources to support the realistic incorporation of CBT techniques into their practice to better address barriers to client adherence and promote carryover of prescribed treatment plans. Ultimately, this support for the OT clinician will lead to the use of more holistic intervention techniques in practice for better overall client outcomes.