Implementation Intentions for Self-Selected Occupational Therapy Goals: Two Case Reports

Objective: We evaluated the feasibility of an intervention combining metacognitive strategy instruction (MSI) with training in implementation intentions for adults with mild traumatic brain injury (mTBI). Implementation intentions are written premade decision statements specifying when, where, and how goal behaviors are to be enacted.

Method: Two participants with mTBI received a six-session intervention that included setting a daily implementation intention for an occupational therapy goal. A scoring rubric was used to evaluate the quality of implementation intentions; goal achievement was measured using the Canadian Occupational Performance Measure (COPM) and goal attainment scaling.

Results: All implementation intentions received perfect quality scores, suggesting participants learned to correctly craft implementation intentions. Improvements in COPM self-ratings exceeded minimal detectable change values; goal attainment levels indicated better-than-expected goal achievement.

Conclusion: An intervention combining MSI and implementation intention training appears to be feasible. As an adjunct to MSI, implementation intentions may contribute to clients' ability to achieve their own occupational performance goals. Further study is needed.