The cognitive-behavioral frame of reference (FOR) emphasizes five aspects of life experience: thoughts, behaviors, emotion/mood, physiological responses, and the environment. These aspects are interrelated, meaning that changes in one factor can lead to improvement or deterioration in other(s). Each is influenced by the social and physical environments. One key theoretical component in this FOR is the hierarchical levels of cognition. Automatic thoughts is the most accessible, which are uninvited and immediate thoughts. Beliefs are conditional beliefs we hold about ourselves. Core schema are absolute beliefs that we hold about ourselves, and they represent the building blocks of thought process and are challenging to shift. Assessment is ongoing within this FOR. Assessment focuses on appraising client’s problem through interviews, questionnaires, and clinical observations. A case formulation is developed from conceptualization of a therapist’s understanding of a client’s problems, from the client’s thinking, behavior, physiological responses, emotions, and environments. This formulation is introduced to the client and the process is a collaborative effort. The cognitive-behavioral FOR is integrated in occupational therapy-focused interviews, including use of cognitive behavioral techniques, for anxiety management (e.g., deep breathing exercise), phobia (e.g., systematic desensitization), and chronic fatigue (e.g., graded activity scheduling). Other cognitive behavioral techniques include activity diaries and graded activity scheduling. This FOR can be used in conjunction with an occupation-focused conceptual model such as Model of Human Occupation, to enhance a detailed understanding of clients’ occupational performance and occupational identity needs.
Summarized by
- Macey Cho
Type
- Frame of reference
Population
- Child
- Adolescent
- Adult
- Elderly
Disability
- All
Domain of occupation
- Unspecified
Application Note
It is combined with occupational-focused conceptual model to enhance occupational therapist’s understanding of clients’ occupational performance and needs.
Key Reference
Duncan, E. A. S. (2011). The cognitive behavioural frame of reference. In E. A. S. Duncan (Ed.), Foundations for practice in occupational therapy (5th ed., pp. 153-164). Edinburgh: Churchill Livingstone.
Year Published
- 2011
Primary Developer
- Edward Duncan
Primary Developer Email
- edward.duncan@stir.ac.uk
Related Models
Behavioral Frame of Reference
The behavioral frame of reference (FOR) emphasizes on the use of behavioral modification to shape behaviors, which purports to increase the tendency of adaptive behaviors or to decrease the probability of maladaptive learned behaviors. The key concepts in this FOR include:
- Read more about Behavioral Frame of Reference
Psychoanalytic Frame of Reference
The psychoanalytic frame of reference (FOR) emphasizes on the unconscious aspect of what is done and said, and it is embedded in an occupational therapy relationship model of practice - the Vivaio model (MOVI). The central element of the MOVI is the recognition of constant emotions that exist in the interdependent relationship between the three elements of patient, therapist and ‘doing’.
- Read more about Psychoanalytic Frame of Reference
Model of neuro-occupation, intention, meaning and perception
This model aims to describe the symbiotic relationship between occupation and the brain, as a chaotic, self-organized, and complex system. It assumes that changes in human condition do not follow a linear path. The model views occupational therapy as a complex intervention and a result of dynamic integration of several factors and unpredictable outcomes. The concept of neuro-occupation is complex and holistic, and aims to help occupational therapists to apply the non-linearity principles.
- Read more about Model of neuro-occupation, intention, meaning and perception
Instrumentalism in Occupational Therapy model
This model aims to facilitate occupational therapists in accessing clients’ mind as an instrumental tool for occupational functioning and adaptation to the environment. It consists of three phases across 10 steps.
- Read more about Instrumentalism in Occupational Therapy model
Cognitive Strategy Attributes Framework
This framework aims to guide clinical reasoning with respect to describing, analyzing, and selecting a potential strategy for a client’s unique performance problem. It identifies seven general attributes that can be used to describe and organize cognitive strategies. They are:
- Read more about Cognitive Strategy Attributes Framework
Model Type
Model (conceptual)
Framework
Model (practice)
Theory
Frame of reference
Population
Child
Adolescent
Adult
Disability
Visual perceptual disorder
Attention Deficit Hyperactivity Disorder
Human Immunodeficiency Viruses
Alcohol dependence
Cancer
Hearing impairment
Vision impairment
Musculoskeletal disorders
Autism
Learning disability
Pain
Mental disability
Psychological disorder
Communication disorder
Developmental disability
Neurological disorder
Cognitive disability
Sensory processing disorder
Handwriting difficulty
Physical disability
All
Domain of Occupation
All
ADL
Education
IADL
Leisure
Play
Rest and sleep
Social participation
Work
Unspecified
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