International Journal of Psychosocial Rehabilitation
Guidelines for Practice
Moses N. Ikiugu, Ph.D.,
professor, occupational therapy,
University of Scranton
Address: Department of
Leahy Hall, Room 3005,
University of Scranton,
Scranton, Pennsylvania 18510-4501
Telephone: (570) 941-4158
Fax: (570) 941-4380
Ikiugu, M.N.(2004) Instrumentalism in
occupational therapy: guidelines for
Journal of Psychosocial
This paper discusses the guidelines for
application of the pragmatic construct of instrumentalism (Dewey, 1957;
n.d.) in the practice of occupational therapy. The guidelines are based
theoretical core of the conceptual model developed earlier by the
(Ikiugu, 2003a; 2003b). The model is based on the postulation that the
an instrument for human adaptation to the environment. Use of this
is dependent on the beliefs about self, others, and the world. In this
guidelines for clarification, establishment, and reinforcement of
support performance of activities that lead to desirable consequences
therefore a purposeful and meaningful life are presented.
Ikiugu (2004a; 2004b) suggested that
practice that demonstrates uniqueness of occupational therapy might be
developed by focussing practice on the mind as an instrument for human
occupational functioning. He argued that this was the basic premise of
founders of occupational therapy. In proposing a model of practice that
emphasizes the instrumental role of the mind, he drew theoretical
the occupational therapy historical literature, the literature of
pragmatism, and the complexity/dynamical systems theory. He proposed a
practice based on the theoretical core from the above sources that
three phases, namely, the belief establishment, action, and consequence
appraisal phases (see figure 1).
The purpose of this paper is to extend the
proposed model of practice by outlining specific guidelines for problem
identification and intervention at each of the three phases. The
process using the model is illustrated in the flow chart on figure 2.
The therapeutic guidelines for application
of the conceptual model in clinical practice following the steps
figure 2 and their rationale are discussed below.
Phase 1: Belief Establishment
It is hypothesized in this model that when
clients seek occupational therapy services, it is because they have
Assagioli (1973, p. 44) calls “.... harmony in our being, and harmony
universal law of life.” This view is consistent with Meyer’s (1977)
that mental illness results from a loss of balance between work,
and sleep which must be maintained even under extreme difficult if the
being is to remain healthy. This loss of balance/harmony is a result of
disruption of the “... ordered rhythm of daily activities” (Assagioli,
(2004a; 2004b) proposed that in
occupational therapy the client can be conceptualized as a complex
adaptive system. Such a system is engaged with its environment for the
of creating, changing, adapting and surviving (Alligood, Sauer, &
1996; Anonymous, 2001; Bassingthwaighte, Liebovich, & West, 1994;
1992). It is the quality of engagement with the environment which makes
possible for such a system to evolve and to be alive. When the system
ability to engage the environment and evolve, it becomes maladaptive
than adaptive, and to that extent, it is not fully alive. It is
this paper that loss of rhythm in daily activities and the resulting
leads to the human being, as a live, complex, dynamical adaptive
maladaptive. Such a system is not able to fashion out the environment,
physical or social, to make it suitable for physical and psychological
Maladaptivity may be due to stagnation
resulting from rigid or chaotic behavior, which may originate from
psychosocial difficulties (Schkade & Schultz, 1992; Schultz &
1992). In this paper, it is proposed that such stagnation starts
the mind in the form of maladaptive beliefs and thought patterns which
as the basis for action (Bruce & Borg, 2002; James, 1996; James,
Mounce, 1997; Peirce, 1955; Stein & Cutler, 2002). It is therefore
that therapy begin with clarification of beliefs and thought patterns
the client’s actions are based. The client should be led to attain
regarding how such beliefs and thought patterns lead to maladaptive
Phase 1: Belief
belief and thought pattern clarification
client is first introduced to therapy
by explaining the concept of the mind as an instrument for adaptation.
explained that the mind is a tool, just like any other, that the client
for occupational performance in order to achieve desired goals. Any
useful only if used correctly. It is explained to the client that the
of therapy is to explore how to use the mind to live adaptively in the
environment. To accomplish this goal, the client is shown that a
honest self-exploration and to changing in accordance with
a purpose: Personal mission statement as a systemic attractor
The second step in the belief establishment
phase is to assist the client to clarify his/her perceived purpose in
Purposefulness here refers not only to goal-directed activities, as
defined in occupational therapy literature (Bruce & Borg, 2002),
to a person’s life in general. A person is living a purposeful life
when he or
she has a sense of mission or reason for existence (Covey, 1990;
Purposefulness is closely related to meaningfulness. Frankl (1984)
the task of human beings is primarily to find meaning in life. He
that there are three ways in which people try to discover this meaning.
are, creating work or doing, experiencing a sense of goodness in life
other people, and taking a positive attitude towards unavoidable
Frankl thus identified creativity in work (occupation), the same
purposefulness (Csikszentmihalyi, 1996), as one way that people create
or sense of mission is an attractor
for the human complex dynamical adaptive system (Ikiugu, 2004b). McGraw
illustrates this view particularly well when he compares purpose to
gravitational force. He explains that when people work against their
life, it is like working against gravity. He states:
... You have certain core traits, qualities,
talents, needs, and desires. You have a core purpose for being in this
By suppressing who you were meant and need to be, you are doing
entirely unnatural. If you are living for the fictional self, then you
unnecessarily trying to hold a beach ball under water with one hand
trying to push a boulder uphill with the other... (pp. 32-33).
By holding a beach-ball under water and
pushing a boulder uphill, McGraw (2001) means that you are defying what
natural, as one would defy gravity by pushing a boulder uphill or the
floatation energy of a beachball by trying to hold it under water.
floatation energy, and purposefulness are all natural attractors for
explained in dynamical systems theory (Bassingthwaighte, Liebovich,
1994; Campbel, 1993). This view is reiterated by Briggs and Peat
consider purpose or final goal as a future reference point that pulls
system’s movement in a similar way as an attractor in chaos theory.
That is why
clients need to start by clarifying a sense of mission that informs the
of their lives.
individuals do things that are in
accordance with their purpose, they are inspired (Dyer, 1998; McGraw,
This means that they do what they really enjoy doing. Such activity is
accomplished effortlessly, almost as if it is play (McGraw, 2001). A
living such a life is excited and looks forward to engaging in tasks
activities. Research has shown that a purposeful life consists of: 1)
Subjective well-being (consisting of happiness and satisfaction with
Personal growth (consisting of self-actualization and a sense of
meaningfulness); and 3) Other-centered religiosity (or a focus on
people, a phenomenon known as altruism) (Compton, 2001; Rhoades &
McFarland, 2000). It is suggested in this paper that the therapist lead
client in establishing a personal mission statement, which clarifies
person’s sense of purpose. To accomplish this, the guidelines by Covey
may be helpful.
Covey (1990) states that what we want must
be created in the mind before it is physically realized. Creating a
mission statement is necessary to clarify the purpose in the mind
actualization through activity. To do this, he recommends that you
you are dead and your eulogy is being read. Write down what you would
of the following to say about you in the eulogy: a) Family member, such
spouse, parent, sibling, cousin, and so on. b) Friend. c)
associate. d) Representative of a Church/community organization with
are affiliated. Based on what you have imagined each of the above to
you, write a mission statement. Your statement may begin as follows; “I
committed to accomplishing the following in my life: .....” The mission
statement should include all areas of the client’s life: the family,
relationships (friends), work/profession, and affiliation to a church
activities that are consistent with the personal mission statement
exist in literature
regarding how to discover what activities are consistent with one’s
life and to act on them accordingly. Dyer (1998, p. 20) suggests
honestly questions such as: “When do I feel most fulfilled? When do I
extraordinary or like a great person?” He suggests that answers to such
questions often are associated with doing something for a cause greater
just personal pleasure. Such a cause could be other people, or the
McGraw (2001, p. 29) suggests questions such as: “Why are you doing
what it is
that you do? Is what you are doing with your life something that
utilizes who you really are? Given a choice, would you choose
you even know what you would choose if you had an option? …” He
answers to such questions would enlighten you regarding whether you are
in accordance with your authentic self, which according to him gives
purpose and meaning. Cellini (2000, p. 3) used the following questions
guide to self-exploration: “Why am I not fulfilled? Who do I want to
do I want to do? What level of satisfaction am I seeking?” Answers to
above suggested questions help the therapist to individualize
focussing on what constitutes the client’s personality, desires, needs,
aspirations, or his or her core, or what McGraw (2001) calls the
occupational therapy, the Canadian
Occupational Performance Measure (Law, Baptiste, Carswell, McColl,
& Pollock, 1998) individualizes therapeutic activities in a more
manner. Using the instrument, the therapist asks a client to identify
activities in self-care, productivity, and leisure that he or she
or is expected to perform. The client is asked to rate, on a scale of
to ten (10) the importance of being able to perform each activity, (1)
least important and (10) being extremely important. Next, the client is
to rate him/herself regarding the ability to perform activities rated
important. Each activity is then rated on the same scale regarding
with performance. Eventually, a maximum of five activities are chosen
the basis of goal-setting for the client for the following two weeks.
are used to compute an index for performance and another one for
After two weeks, the client is re-evaluated, and performance and
with performance indexes are then calculated again. The difference
initial and the re-evaluation scores indicate whether or not there is
as a result of therapeutic interventions.
The Canadian Occupational Performance
Measure (Law, et al., 1998) is a good instrument for choosing
perform in therapy using a client-centered approach. However, the focus
instrument is not the purposefulness and meaningfulness of life in
This paper presents an instrument that extends Law et al.’s (1998)
client-centeredness while taking into account the mission statement
provides purpose (attractor) for the client’s life (see the Assessment
Intervention Instrument for Instrumentalism in Occupational Therapy
the appendix). The client is asked to list activities needed in order
achieve the stated mission. In the initial development of AIIIOT, it
suggested that for each area of the client’s life mission: family,
socialization (friends), work/profession, and church/engagement in a
organization, five such activities be chosen based on priority. The
five activities or tasks was derived from Law, et al. (1998). On the
the activities, five short-term goals were to be formulated for each
the life mission. When a pilot test of the model was run with a group
students in the occupational therapy department at the University of Scranton
(n=12), it became apparent that 20 short-term goals (five for each area
mission) were too overwhelming. The instrument was therefore revised so
there are 2 short-term goals for each area (8 short-term goals
For each of the listed activities, the
frequency with which the client performs it, the adequacy of
satisfaction with performance, and beliefs about the ability to perform
activity with acceptable frequency and adequacy are rated on a
Likert-type scale (see the AIIIOT on the appendix). Ratings are added
summed scores for frequency, adequacy, satisfaction, and beliefs
A less than perfect satisfaction score indicates that a person’s sense
meaning and purpose in life may require to be addressed.
beliefs that guide performance of chosen activities
The basic rationale
in this model is that
the mind guides performance. This happens because the beliefs that one
regarding self, others, and the world are the rules of action (Peirce,
In cognitive psychology, such beliefs are conceptualized to be embedded
schemata which are stable knowledge bases consisting of structures
beliefs, theories, and assumptions, about the self, the world and other
(Gardner, 2002). Without identifying such schemata and how they
way clients view their ability to perform activities and the
such performance, it may be difficult to assist them to change their
such a way that what they do is consistent with what gives their life
It is important to clarify what beliefs
guide the person’s performance of each activity and how such beliefs
may or may
not be hindering performance to full satisfaction. The client is then
identify the origin of such beliefs. McGraw (2001) argues that there
defining moments in our lives, which can easily be identified as
beliefs that constitute our self-concept. Such moments consist of
responses to those events that change a person’s outlook to the world
rest of his or her life. A person has a certain view of self, other
the world before the event and a totally different view after the
example, one may be trusting and optimistic before perceived betrayal
significant person, and distrustful and pessimistic after the event.
events tend to stand out in a person’s memory for the rest of his/her
According to Adlerian therapists Marcus and
Rosenberg (1998), defining moments affect a person either positively or
negatively. If the effect is positive, they contribute to a feeling of
superiority in the sense that one feels energized to progress towards
perfection. If the effect is negative, one feels inferior and
attain perfection. Marcus and Rosenberg (1998) assess such defining
asking the client to narrate in detail his or her earliest childhood
recollections or dreams. The effects of such events on one’s lifestyle
McGraw (2001) has
the client identify 10
such defining moments covering the entire lifespan of the person. In
paper, it is argued that identification of 10 defining moments may not
necessary since a person’s occupational lifestyle is postulated to be a
(Ikiugu, 2004b), which means that it has self-similar properties (Bell,
Baldwin, & Schwartz, 2002). This means that identification of only
one or a
few such moments may help the therapist determine the client’s typical
to occupational tasks that are necessary for a purposeful and
This fractal view of occupational life trajectory is consistent with
Rosenberg’s (1998) view that the same theme, which can be traced
back to the
earliest childhood memories or dreams, recurs throughout a person’s
the conceptual model discussed in this
paper, the client is asked to rate the extent to which he or she
he or she is able to perform with acceptable frequency and adequacy
each of the
activities identified as necessary in order to accomplish the stated
mission. For each activity that the client believes that she or he is
capable of performing with acceptable frequency and adequacy, she or he
asked to remember when that belief was first acquired. For example,
that a client's mission is to earn a higher degree and become a
that she can help people solve their problems. For that purpose to be
the client realizes that she needs to fulfill the admission
the relevant degree. One of those requirements may be getting a certain
on the GRE (Graduate Record Examination). Suppose the client says that
not believe that she can attain the required GRE score because she is
mathematics. Questions that the therapist might ask may include, “when
first acquire the belief that you are poor in mathematics?” The client
recollect that it was in the third grade when a teacher told her how
was and how she can never achieve anything requiring intelligence such
required in mathematics.
beliefs that do not support the client’s mission
Once beliefs that do not support
performance of activities that would enable achievement of the personal
are identified, the next step is to examine them critically and decide
or not they are born out by experience. Adlerian therapists such as
Rosenberg (1998) and Stein (1998) accomplish this through Socratic
This involves challenging the client’s beliefs through questions such
do you know when a person is adequately intelligent? Have you ever done
intelligent thing in your life? If so, how come? Such questions are
giving the client insight regarding the fact that the beliefs of
inadequacy are indeed unfounded and that her interpretation of the
event in the
defining moment that led her to decide that she is stupid was wrong. If
client can arrive at the conclusion that such self-defeating beliefs
born out by experience, then she can see the need to formulate new
energize her to perform tasks that are consistent with her personal
For instance, her belief that she is not intelligent enough to complete
involving mathematics may be substituted by a new belief that,
shown that I am intelligent and I can accomplish any task that I set my
to. I therefore choose to take the GRE, get the required score, and
admission into graduate school to pursue the degree that will enable me
serve people in the way that I want to.’
Phase 2: Action
Once activities that
will enable the client
to achieve the stated mission have been identified and the
beliefs have been revised, the next step is to set concrete goals.
therapists are familiar with setting short term and long term goals
& Borg, 2002; Creek, 2002; Early, 2000). Goals should be
specify observable, measurable behavior, and achievable within a
time frame (Bruce & Borg, 2002; Creek, 2002; Early, 2000). This
is familiar in occupational therapy, is similar to the Adlerian view
order to change a person’s lifestyle, “... small progressive action
aimed at overcoming previously avoided difficulties, must be taken, one
time” (Stein & Edwards, 2002, p. 11). In setting goals, the
skills in activity analysis to assist the client to set concrete,
goals that are consistent with the stated mission. For instance, for
who wants to go to graduate school, our knowledge of the task of
test taking helps us to assist the client in setting goals such as: “By
of this week, I will have identified and bought books that I can use to
for the GRE.” “By the end of two weeks, I will have compiled a list of
centers where GRE taking skills are taught and I will have contacted at
two of them to find out what I need to do to get into their program.”
goals are aimed at getting the client to fulfill the prerequisites such
applying for and getting accepted in a graduate program which is the
in getting her to realize her mission of being a professional who helps
people with their problems.
activities to strengthen the newly chosen beliefs
The mainstay of occupational therapy is
doing (Reilly, 1962; Sabonis-Chafee & Hussey, 1998). This valuing
is consistent with James’ (1977b) disdain for any individual who would
talk and fantasize rather than engage in reality through concrete
same idea is reiterated by Marcus and Rosenberg (1998) who recommend
activities as experiments to help dissolve negative imprints of
self in the client. This doing takes the form of occupations which have
defined as: “...chunks of culturally and personally meaningful activity
which humans engage that can be named in the lexicon of our culture”
& Clark, 1996, p. 43).
the pragmatic conceptual model of
practice, activities that are performed by the client both in and out
clinic are those that enable the client to engage in occupations that
lead to a
lifestyle that is purposeful and meaningful according to the formulated
statement. In the example given earlier, the client can engage in
activities in the occupational therapy clinic to strengthen the newly
established belief that she is an intelligent woman who can accomplish
she sets her mind into, and therefore is capable of attaining the
score. One such activity may be to construct items that involve
scaling which requires mathematical calculation skills. The client can
engaged in making items such as a bird house or a picture frame, which
require that she plan out the activity, sketch the object in order to
visual image of what it will look like, calculate its dimensions such
is proportional, and so on.
of the cognitive and physical capabilities to perform chosen activities
The client’s beliefs about his or her
ability to complete requisite activities cannot be realistically
he or she is observed in action. This is when the therapist can see
there are physical or cognitive impediments to the client’s abilities.
instance, the therapist may observe that however much the client tries
visualize the object abstractly in order to sketch it, she is not able
to do it.
This would indicate that the cognitive ability to organize information
abstractly in order to complete the task might be impaired. Or it may
the client can conceptualize the object but does not have the
manual dexterity to work with the wood to create the required shapes.
these difficulties are observed, the
therapist and client decide whether to explore solutions to overcome
adjust the client’s beliefs and mission. At this point, other frames of
reference can be used to supplement the model proposed in this paper.
instance, the Cognitive/Behavioral Frame of Reference (Bruce &
Stein & Cutler, 2002) may be used to assess cognitive deficits that
prevent the client from completing required tasks and provide
correct such deficits or compensate for them. Such an intervention may,
example, be “self-talk” to help the client talk herself through the
and behaviors needed to complete the task such as listing the number of
of wood needed to complete the project, the required shape of each
orientation of the pieces to each other, etc. (Bruce & Borg, 2002).
Once the client learns how to analyze the
task through “self-talk” she can visualize the object, sketch it, and
the dimensions accordingly. Or the client’s cognitive deficits may be
stress. In such a case, she can be taught self-regulation skills so as
manage stress and be able to concentrate and complete cognitive tasks
& Cutler, 2002). The biomechanical model (Kielhofner, 1997) may be
assess physical functioning deficits such as lack of coordination
strength and provide intervention to help the client overcome the
the difficulty cannot be addressed through training or any other
cognitive, or psychological intervention, it may be that the client
change beliefs about what he or she can or needs to be able to do in
lead a purposeful and meaningful life. Thus, the treatment process goes
the belief establishment phase.
activities necessary for achievement
of the personal mission by the client have been identified, beliefs
support performance of such activities have been clarified, and short
term goals have been established, the client must commit to perform the
activities regularly so as to progress towards the personal mission.
activities must be performed both in the clinic with the therapist and
client is on his or her own. Such commitment is achieved by
contract between the therapist and client. This is important because it
beginning of the training process for the client’s “will” so that he or
learn to choose the right goals and to persist in attempts to reach
objectives (Assagioli, 1973). According to Assagioli (1973), such
choice and struggle in volitional activity integrates a person, which
that through such experience, one feels more whole and in balance. The
therapist must teach the client that such will is established through
consciously making choices every day and every moment of his or her
choices are the building blocks of self-creation which occurs from the
out (McGraw, 2001).
Phase 3: Appraisal
of progress towards personal mission
is recommended that the therapist and
client meet on a weekly basis to evaluate what activities have been
and what the consequences have been. The goal is to demonstrate to the
that there is a connection between activities and the consequences. In
short term, scores in the AIIIOT may be used to assess progress in
performance of chosen activities, and satisfaction with performance. In
long term, the more enduring consequences are examined. As McGraw
argues, every decision a person makes has consequences. The
consequences may be
external or internal. External consequences might be a significant
admiring the client’s work. This indicates to the client that his or
is valued in his or her context because it has an effect on that
(environment). An internal consequence may be an increased sense of
In our earlier example, completing a series of chosen activities over
might affirm the client’s newly created belief that she has the skills
accomplish her goals.
At this point, the therapist and client
examine the consequences of the client’s activities carefully and if
what was expected, therapy continues until the client is confident that
he can accomplish the mission. In the example, this may be when the
admitted in the graduate school. At this point, therapy is terminated.
the other hand, the consequences are not what was expected or desired,
client and therapist may need to revisit the client’s beliefs and
therapy from there. In the example given in this paper, if after
the client fails to attain the required GRE score, then in
collaboration with the
therapist, she may need to reassess whether going to graduate school is
the only way that she can lead a purposeful and meaningful life. May be
are other ways she can achieve the goal of helping other people solve
problems. Or possibly there are graduate programs that she can be
without the need for GRE. She may therefore need to adjust her beliefs
her worth, and what makes her a valued human being. Whatever the
therapy however, in accordance with the complex dynamical adaptive
theory, the human being as a system is postulated to be sensitive to
conditions (Arndt & Bigelow, 2000; Bolland & Atherton, 1999;
1993; Whiting, 2001). This means that our interventions may have an
the client’s life that we can never fully predict. Understanding that
client’s mission statement is an attractor however, can give us
that, even though we cannot predict specific changes in his or her life
result of our intervention, the changes made are likely to be positive
her mission in life (attractor) is positive.
Limitations of the
This model is most appropriate for use with
adolescent and adult clients who may be physically and/or emotionally
but are cognitively intact. The example given of the young woman who
go to college and become a counselor is specifically chosen to
focus. The model can however be used to help even those who have
difficulties to live a meaningful life. For example, a person who is
to a cognitively impaired client such as a spouse or a loving sibling
able to help the therapist articulate a possible mission statement for
client and design goals and activities accordingly. The resulting
intervention may still prove to be more meaningful than use of
without trying to take into account what makes the client’s life
meaningful. The model is applicable cross-culturally since it is
client-centered and the individual client determines, in collaboration
therapist, activities and interventions that are important to him or
according to his or her unique background.
It is recommended that the model be tried
in practice with cognitively intact adolescent and adult clients and
gathered through type II applied scientific inquiry (Mosey, 1996), to
adequacy of the guidelines for practice and refine them accordingly.
through clinical research, various assumptions and hypotheses of the
to be tested before adoption of the model for widespread clinical
may be considered.
this paper, guidelines for practice
using “Instrumentalism in occupational therapy: A pragmatic conceptual
practice” have been outlined. Therapeutic intervention using this
model begins with belief clarification and establishment since beliefs
basis of using the mind as a tool for adaptation to the environment.
establishment begins with a personal mission statement that covers all
a client’s life. Activities that the client is required to perform in
achieve the stated mission are identified. The client’s beliefs
ability to perform such activities are examined, and if not
adjusted accordingly. Finally, the client engages in activities that
him or her live according to established beliefs and the personal
Therapy is terminated when the client feels that he or she is clearly
progressing towards the stated mission.
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Intervention Instrument for
Instrumentalism in Occupational Therapy (AIIIOT)
When using this
instrument, the therapist
should find a quiet place where the client can concentrate and respond
detail to all the items without interruption. The client should be
much time as necessary to respond to all the items in this instrument
exhaustively. The instrument consists of four sections. Section (I) is
to lead the client to formulate a personal mission statement to create
purpose towards which to strive. Section II involves identification of
the activities to be performed in order to attain the stated mission.
III evaluates the frequency and perceived adequacy with which the
are performed, the satisfaction with that performance, and the beliefs
the ability to perform the activities adequately. Finally, in section
ratings are added together to give an index of frequency, adequacy,
satisfaction, and beliefs about the ability to perform the listed
The therapist should
read the following
directions loudly and guide the client to complete the exercise (see
Imagine that you are attending your own
funeral. It is now time to read the eulogy. Write down in detail what
like each of the following to say about you: a) Family (Father, mother,
son/daughter, sister/brother, cousin, any other family member that you
close to). b) Friends (one or two close friends). c) Work/professional
associate. d) A member of the church or other community organization to
you are affiliated. Now go over what you have written and take a few
think about what you imagine each of the people saying about you. These
statements represent the kind of person that you would like to be and
can be. Summarize the statements in a few sentences, stating what you
to be your personal mission statement. Your mission statement will
direction towards which you will strive from now on. The statement
consist of four aspects as identified in the eulogy: family, friends,
work/professional life, and engagement in church/community
For each of the
four areas, identify two (2) concrete activities that you will need to
on a regular basis in order to achieve your mission in life.
Affiliation to church/community
For each of the identified activities, rate yourself
on a scale of
one (1) to four (4) regarding; a) The frequency with which you perform
activity; b) The adequacy with which you perform the activity; c)
with your performance; and d) Your beliefs regarding your ability to
the activity with desired frequency and adequacy.
1=does not perform
the activity; 2=rarely performs the activity; 3=regularly performs the
activity; 4=frequently performs the activity.
1=I am not able to
perform the activity; 2=Performs the activity with difficulty and the
is inadequate; 3=Performs the activity with difficulty but the outcome
if I complete it; 4=Performs the activity easily, is always able to
it, and the outcome is always adequate.
disappointed with my performance of the activity; 2=I am somewhat
with my performance; 3=I am satisfied with my performance but would
improve; 4=I am happy with my performance as it is.
1=I do not believe that I am capable of
performing the activity; 2=I believe that I can perform the activity
much help; 3=I believe I can perform the activity with some help; 4=I
can perform the activity adequately and independently.
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D. Affiliation to
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Scores (x11, x12,
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Adequacy Satisfaction Beliefs
Scores (x21, x22,
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To obtain total scores, add the ratings for
each column and put the score at the bottom of the column. These scores
denoted x11, x12, x13, and x14 for frequency, adequacy, satisfaction,
To obtain the scores
at the end of the
therapy week, have the client rate himself or herself again and add the
under each column. Denote the scores x21, x22, x23, and x24. The
in therapy during the week is indicated by, x21-x11, x22-x12, x23-x13,