COGNITIVE BEHAVIORAL THERAPY

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy

Man is an open system that can change and develop through interaction with the environment. Behavior is an expression of psychosocial, biological, and environmental factors interacting within the system. Biological factors may predispose someone to a certain disease or dysfunction which may be expressed in the presence of stress. Factors such as family structure, work environment, and culture can contribute to positive or negative experiences from which an individual learns. There is an innate drive within humans for self-efficacy; the ultimate goal is to master one's environment. A person's values, beliefs, and goals determine the behaviors one engages in to accomplish the ultimate goal of environmental mastery.

These values, beliefs, and goals are developed through cognitive processes unique to each individual and are a result of the interplay between previous learning and psychosocial, biological, and environmental factors throughout life. Because each person's cognitive processes are unique, experiences are subjectively interpreted in different ways. People react in context with their desire for environmental mastery and their personal beliefs and values learned throughout life. When considered together, the Model of Human Occupation and Cognitive-Behavioral Therapy frame of reference give an explanation of behavior that includes psychosocial, biological and environmental factors while maintaining the importance of cognition. The purpose of this paper is to review how Cognitive-Behavioral Therapy and the Model of Human Occupation explain behavior, dysfunction, treatment approach, and their relevance to occupational therapy.

Kielhofner and Burke's Model of Human Occupation (MOHO) (1980) believes that humans have an innate drive for exploration and mastery of their respective environments. Man interacts with the environment though engagement in occupation. Occupations are the means through which an individual pursues their goals. Within this model, occupations are defined as complex, organized groups of goal-oriented behaviors (Bruce & Borg, 1993). One's chosen actions and occupations are a meaningful reflection of personal beliefs and goals for environmental mastery. Mastery is the extent to which an individual perceives the result of their behavior as effective, efficient, and satisfying (Stein & Cutler, 1998).

MOHO postulates an open systems theory in regards to human behavior. "An open system is an organized complex of subsystems that are in dynamic interaction. The system is, in turn, in dynamic interaction with its environment. All parts are maintained and transformed through this dynamic interaction" (Kielhofner & Burke, 1980, p. 573). The open system interacts with the environment through a process of input, throughput, output, and feedback. Input is information from the environment; throughput is the processing of input by the internal cognitive structures of a human; output is the mental, physical, and social aspects of behavior; and feedback is information from the environment about the consequences of a behavior (1980).

The open system can be divided into a hierarchical arrangement of three subsystems that are responsible for behavior. The highest level governing over behavior is volition. This is the underlying, energizing component behind behavior responsible for which one will be chosen and initiated. Volition is determined by one's innate drive to master his/her ...