Wong Su Ren, Chan Mu Rong, Chong Edlina, Dancza Karina Michelle
Department of Rehabilitation, National University Hospital, Singapore, Singapore.
Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore.
Front Psychiatry. 2024 Sep 26;15:1428811. doi: 10.3389/fpsyt.2024.1428811. eCollection 2024.
Global mental health issues, particularly anxiety and depression, significantly impact people's everyday activities. While psychotherapies are commonly used, there is a growing interest in problem-solving approaches within mental health. These approaches focus on enabling individuals to develop personalized strategies to address emotional and psychological challenges and enhance their engagement in meaningful activities, known as occupational performance. This paper examines the feasibility of the Cognitive Orientation to daily Occupational Performance (CO-OP) in assisting adults with mood, anxiety, or adjustment disorders.
The study employed a mixed methods single-subject design with replication, using an inductive/deductive approach for qualitative analysis. Ethical approval was obtained, and participants were recruited from a Singaporean hospital's occupational therapy service. CO-OP sessions were conducted either in-person or via telehealth. The intervention involved setting goals collaboratively, followed by weekly sessions over 10 weeks. Various data sources, including demographics, field notes, recordings of sessions, assessments and interviews were collected. Data analysis involved comparing pre- and post-intervention scores, thematic analysis of interviews, and triangulation of quantitative and qualitative data for validity. The study results are organized according to five feasibility domains: acceptability, demand, implementation, practicality, and limited efficacy.
A total of 10 participants, mostly female, were recruited, with two dropping out during the baseline phase. All remaining participants completed the intervention and 1 month follow-up data collection. CO-OP was perceived as acceptable and beneficial in enhancing occupational performance, satisfaction and managing mood and anxiety symptoms. Participants expressed increased confidence and self-efficacy but desired continued therapist support for strategy application and reinforcement.
Participants generally embraced CO-OP, favoring its personalized nature over therapist-directed approaches, with high retention rates observed. Building a strong therapeutic relationship was essential. Also using complementary approaches like supportive counseling proved beneficial. CO-OP emerges as a viable intervention alongside existing therapy approaches, offering a promising avenue for addressing the complex needs of individuals with mental health conditions.
全球心理健康问题，尤其是焦虑和抑郁，对人们的日常活动产生了重大影响。虽然心理治疗方法被广泛使用，但心理健康领域对解决问题的方法的兴趣与日俱增。这些方法侧重于帮助个人制定个性化策略，以应对情感和心理挑战，并增强他们参与有意义活动的能力，即职业表现。本文探讨了日常职业表现认知取向（CO-OP）在帮助患有情绪、焦虑或适应障碍的成年人方面的可行性。
本研究采用了混合方法单受试者设计并进行重复实验，使用归纳/演绎方法进行定性分析。获得了伦理批准，并从新加坡一家医院的职业治疗服务部门招募了参与者。CO-OP课程通过面对面或远程医疗的方式进行。干预包括共同设定目标，随后在10周内每周进行一次课程。收集了各种数据来源，包括人口统计学信息、实地记录、课程录音、评估和访谈。数据分析包括比较干预前后的分数、对访谈进行主题分析，以及对定量和定性数据进行三角验证以确保有效性。研究结果按照五个可行性领域进行组织：可接受性、需求、实施、实用性和有限疗效。
总共招募了10名参与者，大多数为女性，有两名在基线阶段退出。所有剩余参与者完成了干预和1个月的随访数据收集。CO-OP被认为是可接受的，并且在提高职业表现、满意度以及管理情绪和焦虑症状方面有益。参与者表示信心和自我效能感有所提高，但希望治疗师在策略应用和强化方面继续提供支持。
参与者普遍接受CO-OP，相较于治疗师主导的方法，他们更青睐其个性化特点，且保留率较高。建立牢固的治疗关系至关重要。此外，使用支持性咨询等辅助方法也被证明是有益的。CO-OP作为一种可行的干预措施，与现有的治疗方法并存，为满足心理健康状况个体的复杂需求提供了一条有前景的途径。
