Occupational therapy practitioners provide interventions to promote activity engagement to multiple clinical populations. They help clients develop restorative, adaptive, and compensatory skills to improve their performance in daily activities. The issue addressed in this article is that current clinical frameworks lack translation of learned skills to consistent everyday performance. There is a gap between what clients can do and what clients actually do in everyday life. Behavioral activation provides an explicit, structured, and practical approach that can translate capacity into long-term engagement. This article presents behavioral activation as a transdiagnostic approach that targets populations experiencing chronic illness to bridge the gap between what the client can do in therapy and what the client could do in everyday life. What This Article Adds: People with chronic illness have difficulty translating the skills learned in traditional practice settings to everyday life. Behavioral activation offers occupational therapy practitioners a practical structure to promote the translation of learned skills.

OBJECTIVE. The objective of this study was to assess the feasibility of conducting a future full-scale trial to test the efficacy of an in-home occupational therapy intervention designed to reduce disability in older adult cancer survivors. METHOD. Participants reporting activity limitations during or after cancer treatment were enrolled in a Phase 1 pilot randomized controlled trial comparing the 6-wk intervention (n = 30) to usual care (n = 29). Descriptive data on retention rates were collected to assess feasibility of intervention and study procedures. Potential efficacy was explored through participants’ self-reported disability, quality of life, activity level, and behavioral activation at 0, 8, and 16 wk after enrollment. RESULTS. Retention rates were high regarding completion of the intervention (90%) and outcome assessments (90% of usual-care participants and 80% of intervention participants). Outcomes consistently favored the intervention group, although group differences were small. CONCLUSION. The procedures were feasible to implement and acceptable to participants.

OBJECTIVE. In this pilot study of a home-based occupational therapy intervention intended to reduce disability and improve quality of life, our objective was to identify rates of goal attainment and patterns of goal adjustment of participants. METHOD. Thirty older adults with cancer were randomized to the intervention arm, and 24 participants identified goals and completed the six-session intervention. An exploratory content analysis of qualitative and quantitative session data was performed. RESULTS. Participants set 63 6-wk goals and attained 62% of them. Most of the goals addressed walking (28%), sedentary leisure (24%), exercising (16%), or instrumental activities of daily living (14%). When 6-wk goals were not attained (n = 24), there were 10 instances of goal disengagement and 14 instances of goal reengagement. CONCLUSION. Although most participants were able to meet their goals, many also changed their goals and priorities after reflection and attempts to resume or initiate meaningful activities.

OBJECTIVE. We assessed the psychometrics of a self-administered survey modification of the Activity Card Sort (modified; ACSm) when used to track activity resumption after stem cell transplantation (SCT). METHOD. Thirty-six participants completed the ACSm for a descriptive pilot study of recovery after SCT. Reliability was assessed by determining the longitudinal consistency of participants’ designation of an activity as never done versus done previously and by calculating internal consistency. Construct validity was assessed by correlating the ACSm scores with measures of quality of life, performance status, and perceived cognitive impairment. RESULTS. Participants gave consistent designations for 72% of items. Internal consistency of the total score was α > 0.86 at all assessments. The ACSm scores were correlated with quality of life (r = 0.51, p = .0019), functional well-being (r = 0.59, p = .0002), and performance status (r = 0.42, p = 0.011) and not associated with cognitive impairment (r = .22, p = .19). CONCLUSION. The ACSm demonstrated provisional evidence of reliability, internal consistency, and construct validity.

The ability to effectively communicate thoughts, feelings, and identity to others is an important aspect of occupational performance. The symptoms of Parkinson’s disease can impair a person’s ability to verbally and non-verbally communicate with others. In order to better understand issues of communication functioning for this population, research tools to describe expressive and communicative behavior during occupation and social interaction are needed. In this study, six persons with Parkinson’s disease participated in individual, videotaped interviews focused on problem solving during daily activities. Three trained graduate students viewed edited clips from the videotapes and completed a rating scale of expressive behavior designed by the authors. Data support the reliability and construct validity of the behavioral rating scale, suggesting that measures of expressive behavior of persons with Parkinson’s disease can be effectively derived using short segments of videotaped activity.

Occupational therapy is based on core values of altruism, equality, and honoring the dignity of others. Embedded in these values is the ever-present negotiation of power. To honor the concern for the welfare of others, researchers are challenged to think about issues of power throughout the research process. This paper identifies dilemmas and raises questions researchers might ask themselves as they struggle to share power in the interpretive research process.