Everyone who has tried to change their behavior can appreciate the difficulties in sustaining this effort despite their best intentions. Imagine, then, the effort required to adhere to occupational therapy recommendations after the onset of disability when the associated everyday changes are not necessarily of one’s own choosing. Many people who receive occupational therapy services face this scenario, especially those with chronic health conditions. Many patients with stroke, brain injury, and spinal cord injury do not follow discharge recommendations or prescribed therapy protocols (Andrews & Stewart, 1979; Ditor et al., 2003; O’Brien & Bailey, 2008; Schönberger, Humle, Zeeman, & Teasdale, 2006; Wallenbert & Jonsson, 2005) even though doing so is associated with optimal outcomes of care (Clay & Hopps, 2003). The rates of nonadherence to chronic illness regimens are estimated at...

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