OTs consider habits as specific, automatic behaviors that may support - or hinder - occupational performance. The key to habits is that they are automatic so that we don't even really think about these behaviors when we do them. Examples may include the way we brush out teeth, the order in which we get dressed, how we groom our hair, or the way we place our keys in the same place upon arriving home (well - I have hear some people do that!).
What purpose do habits serve? In OT terms, effective habits enable us increase the efficiency of our occupational performance because the behaviors are automatic. For instance, how long would our morning self-care routine be if we actually had to stop and think about performing each step of brushing our teeth, getting dressed, or grooming our hair? It would take us HOURS to get ready - everyday!! But because our habits enable us to do large portions of our daily tasks efficiently, our occupational performance is improved.
But what happens when an injury or illness occurs and we are no longer able to utilize our existing habits? As OTs we work with clients to find new ways to do things, or adapt an activity, but do we use the term "habits" when working together?
Wallenbert and Jonsson (2005) published a fascinating study on the challenges people with stoke encountered in developing new habits to support their occupational performance. They discovered the participants in their study were often reluctant to utilize the adaptive strategies they learned through OT, or develop new habits, as this would be an acknowledgment that they would not continue to progress. It was as if they resisted developing new habits, they could remain in a "waiting" period to see if things improved. For me, reading the words of the study participants, made me think of our OT process in such a different way.
So, do you specifically address habits with your clients?
References
Wallenbert, I., & Jonsson, H. (2005). Waiting to get better: A dilemma regarding habits in daily occupations after stroke. American Journal of Occupational Therapy, 59, 218–224.
Hi
ReplyDeleteThe only way I can think about having explicitly utilised habits was when working with clients with Parkinson's. Often when we are working with a client with reduced mobility we might break down the activity of getting up from a chair or bed by saying things like shuffle your bottom forwards, nose over toes or chin over knees (whatever is accepted at the moment), arms back etc. However because of the cognitive processing difficulties with Parkinson's actually this makes it too complicated and it is better to kick in to automatic habits, so simply saying do you want to get up to prompt them into standing, are you thirsty to prompt them to drink. I also remember that because it is natural for people to roll onto their side to get up from the bed a side bed lever was often thought to be more effective than the more expensive under the pillow or mattress bed elevators.
Personally one way habits don't help my occupations when I am driving, I frequently end up going a different way to that which I want to because my habit of taking a certain route comes in.
Thanks