Effectiveness of everyday occupations for changing client behaviors in a community living arrangement

This study examined the effect of three occupations-based interventions for reducing the frequency of dysfunctional behaviors (disruptive vocalizations, distraction of others, withdrawal from appropriate social interactions) in two women with dual (i.e., developmental, psychiatric) conditions. Additionally, the duration of time spent appropriately engaged was examined.

A single-subject, multiple baseline, across-subjects design, with two dually diagnosed residents in a Community Living Arrangement (CLA), was used to evaluate change in four behaviors under three alternating conditions. Condition 1 was CLA (morning and evening combined) compared with the school and sheltered workshop, Condition 2 was CLA morning, and Condition 3 was CLA evening. Intervention consisted of engagement in everyday occupations associated with the school-workshop and CLA settings as well as a positive reinforcement program.

Using occupations-based interventions and a behavior modification program, 5 of 6 behaviors improved significantly in the school-and-workshop setting compared to the CLA, under Condition 1. Under Condition 2, the morning occupations-based intervention in conjunction with positive reinforcement for active participation significantly improved 4 of 6 behaviors for the two residents. Similarly, under Condition 3--the evening occupations-based intervention--4 of the 6 targeted behaviors improved significantly.

The use of everyday occupations as interventions, in conjunction with positive reinforcement for active participation, was effective for decreasing dysfunctional behaviors and increasing functional behaviors in two women with dual conditions who resided in a CLA.