Table 5.
Session description | Debriefing of preceding Action Plan (“Test yourself on all the tasks you have chosen for outside-of-training practice over the past weeks since the beginning of your ASAP training and assess your confidence for doing all these tasks under the most demanding of circumstances. Assess your confidence in being able to manage your strengthening, skill development, and community participation needs in the future.”): |
T: “What do you feel are your accomplishments? Do you think you have improved?” | |
P: “I am so excited, for the first time I tried to carry 2 full garbage cans to the road and I did it! I helped my father-in-law get dressed, tied his shoes for him. I tried to shoot hoops using the backboard as the external target—was able to shoot and get 3 baskets out of 7 attempts. Moved farther away from the hoop to make it harder. Did yard work, like to paint and do yard work.” | |
P: “I went bowling with my wife and was able to lift a 6-lb bowling ball and played 2 games. My shoulder was sore so I took a hot shower and did some stretching exercises, feels better.” | |
Determination of tasks and sequence of activities for the session’s practice: painting wall/baseboards, dribbling basketball, carrying 2 bags of groceries | |
Self-efficacy rating for the priority task: 10/10 | |
Task performance and dialogue | T: “What do you want to do today?” |
P: “Finish the paint job.” | |
[TASK PERFORMANCE: Finished trimming the baseboards and painting the wall. Cleaned-up workspace. Endurance measured for progress-—40 min recorded for activity task completion, with 1 break for 1.30 min. The participant reports fatigue after painting.] | |
P: “I know if I can paint with my affected hand, I will be able to work. Being able to paint with my left hand is a real confidence builder.” | |
T: “You have done a terrific job. Thanks so much for all your hard work.” | |
P: “I feel better and better, shoulder feels looser.” | |
Elements/comments | P demonstrated self-management and health protective behavior |
P directed the session and T supported the autonomous behavior by limiting questions and dialogue with the participant. T was a “coach” during the sessions with the P | |
Task-oriented training integrated with self-direction, self-regulation, and self-efficacy produced behavioral changes in the P, with indications of transfer to real-world activities | |
P and T celebrated the accomplishments to drive self-confidence higher | |
Principles 1–8 incorporated |
Abbreviations: ASAP, Accelerated Skill Acquisition Program; P, participant; T, therapist.