ORIGINAL RESEARCH article
Front. Rehabil. Sci.
Sec. Interventions for Rehabilitation
International Health Professional Perspectives of using the Cognitive Orientation to daily Occupational Performance Approach in routine practice
Provisionally accepted
- 1Bone and Joint Health, Queen Mary University of London, London, United Kingdom
- 2The Royal London Hospital and Tower Hamlets Community Children’s Therapy Services, Barts Health NHS Trust, London, United Kingdom
- 3Occupational Therapy Department, Mercy University Hospital,, Cork, Ireland
- 4School of Allied Health, Faculty of Health Sciences, Australian Catholic University - North Sydney Campus, North Sydney, Australia
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Background: The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach is an evidence-based intervention that utilizes a problem-solving approach to achieve client-chosen goals. Training is available to support professionals in learning and using the approach effectively. Therapists' perspectives of using the approach in practice post training has not been reported. Methods: Perspectives of CO-OP trained health professionals were gathered using an international online survey. Closed and Likert scale questions were analyzed using descriptive statistics, and free-text responses were coded using content analysis. Results: The dataset compiled responses from 181 participants across 6 continents. CO-OP training was perceived positively, reporting it prepared them well for using CO-OP. However, 66% would like further support to use the approach. Of the recommended 10 individual sessions, only 1/3 of participants provided the recommended dosage. Despite the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) being prescribed outcome measures in CO-OP, only 63% of respondents used the COPM and 23% the PQRS. Conclusion: Education and training are important to implement evidence-based interventions, but do not always lead to delivering the approach with fidelity. Future research should focus on how to support CO-OP implementation with fidelity, including process evaluation to understand clinical contexts and evaluate its effectiveness when delivered by clinicians.
Keywords: Cognitive Orientation to daily Occupational Performance1, Meta-Cognition3, routine practice5, strategy use2, survey4
Received: 13 Sep 2025; Accepted: 05 Feb 2026.
Copyright: © 2026 Gimeno, Swanton and Froude. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hortensia Gimeno
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