What if therapy focused on how clients think, not just what they do?

The Cognitive Orientation to Daily Occupational Performance (CO-OP) approach is a client-centred model used in occupational therapy to support people in achieving everyday tasks through cognitive strategy use. Rather than focusing on fixing, CO-OP emphasises learning, problem-solving, and skill acquisition. Using guided discovery and motor learning principles, people select their own goals and learn to “goal, plan, do, and check” their performance. This process develops their thinking skills, including how to monitor their performance and problem-solve. This helps develop strategies that can be applied to new challenges, promoting greater independence. Therapists support learning by guiding people to discover their own solutions, making the approach effective across a wide range of conditions. CO-OP can be applied to everyday living skills, such as learning to ride a bike, tying hair, handwriting, or buttoning clothes.

I had the opportunity to support a 7-year-old participant who was eager to learn how to tie his shoelaces. With the excitement of starting Aus Kick and using his new footy boots, he was motivated to learn this skill and engage in sessions.

We approached the task using CO-OP principles. We broke shoelace tying down into smaller, manageable steps and worked through each stage at his pace. We used the Goal-Plan-Do-Check (GPDC) framework. Rather than simply showing him what to do, he was encouraged to think through the process, ask questions, and develop his own strategies. The approach was task-focused, supported memory and maintained attention. Some principles of guided discovery included:

Ask, don’t tell: For example, “How could we hold the laces?”

Coach, don’t adjust: Asking questions when needing support, e.g. “What happened to the laces?” or “How can we fix that?”

Naming the strategy: For example, “I like how you used words such as ‘across, under, pull’ to help you remember the steps to tie a knot.”

By embedding problem-solving into the learning experience, we were not only working on motor skills but also helping him build confidence and independence.

The GPDC framework is a four-step strategy that supports people to outline a specific outcome, create a plan, carry out the plan and evaluate their own success.
Initially developed to address motor-based performance difficulties in children with Developmental Coordination Disorder (DCD), the CO-OP approach has since been adapted for use across multiple clinical populations, including individuals with acquired brain injury (ABI), cerebral palsy, autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), stroke, and other developmental or neurological conditions.

The core objectives of the CO-OP approach include:

1. Skill Acquisition: Supporting people to learn and master targeted functional tasks.
2. Generalisation of Skills: Enabling the application of learned strategies to everyday life activities.
3. Cognitive Strategy Use: Encouraging the development of problem-solving techniques.
4. Transfer of Learning: Promoting the ability to apply learned strategies to new tasks and environments.

Research demonstrates that CO-OP not only improves task performance but also has secondary benefits, including increased participation in daily activities, enhanced motor control, improved cognitive functions such as self-regulation and cognitive flexibility, and heightened self-efficacy. The evidence highlights its effectiveness and adaptability across a range of populations and clinical settings. Therapists continuously assess client progress and adjust guidance to ensure that strategies are effectively learned and goals are achieved.

The CO-OP approach is particularly effective in helping individuals overcome barriers to performing meaningful daily activities, whether physical, cognitive, or social in nature. By identifying performance breakdowns, individuals learn to apply self-directed cognitive strategies such as self-talk, goal setting, and problem-solving to navigate challenges.

Therapists work as facilitators, supporting people through guided discovery. This process highlights where the task is breaking down, supports the person to explore solutions, reflect on outcomes, and refine strategies in a way that works for their thinking. This collaborative process leads to a range of benefits:

• Greater understanding of tasks and sequencing.
• Improved memory and ability to recall steps.
• Greater attention, focus, and self-regulation during activities.
• Increased confidence, motivation, and engagement in everyday tasks.
• Development of transferable skills applicable to a broad range of tasks and contexts.

The CO-OP approach empowers people to take an active role in their own learning. It promotes independence and supports improvements in functional performance across the lifespan. Its combination of structured guidance, client-centred goal setting, and cognitive strategy training makes it one of the most effective and well-researched approaches in occupational therapy practice.