Canadian Occupation Performance Measure (COPM) has been widely used for client-centred practice as an outcome measure, reporting on client’s self-perception on performance and satisfaction level. The use of COPM in community based intervention has shown clinically significant improvements in outcome scores for various populations, including elderly (Larsen & Carlsson, 2012), clients with post-traumatic brain injury (Doig, Fleming, Kuipers, & Cornwell, 2010) as well as clients with psychiatric diagnoses (Schindler, 2010).
Benefits of COPM
The use of COPM encourages collaboration between therapists and clients to set client-centred therapy goals, increasing client’s motivation to achieve these goals. In addition, COPM allowed therapists to feel a sense of achievement as therapists have a formal structured approach to understand client’s perception and expectations, working towards the goals together (Larsen & Carlsson, 2012). COPM can also be used with a therapist-directed approach for clients who are unable to identify their problem areas or set goals (Doig et al., 2010).
Limitations of COPM
Some limitations of COPM has been noted. Firstly, therapists found it challenging to identify occupational performance issues instead of occupational components. Some therapists also found it hard to engage clients with low motivation in COPM assessment. Future clinical utility of COPMA study done by Larsen and Carlsson (2012) showed that therapists found it hard to administer COPM on clients with cognitive or psychiatric problems. However, results from Doig et al. (2010) showed that COPM scores of clients with post traumatic brain injury matches the
Scale (GAS) in terms of direction of score improvements, giving both subjective and objective scores for the same set of goals. This give a more accurate depiction of client’s improvement instead of only relying on COPM scores where it may not reflect client’s actual improvement in functional status. In these cases, therapists can use both GAS and COPM scores in collaboration, determining client’s true performance level as well as ascertaining client’s perception of their own ability.
Furthermore, it has been noted that GAS can be used to help break down broad COPM goals into smaller, more specific goals to work on with clients, allowing clients to achieve success step by step. Both Larsen and Carlsson (2012) and Schindler (2010) studies had a prior training period for therapists and students administering COPM. This training period includes familiarising them with the administration of COPM scale as well as understanding the theories behind this scale. In addition, they were also given some time to trial administering the COPM scale, where they could feedback to the trainers on the difficulties faced and obtain ways to solve these problems.
This ensured that the COPM scores obtained were reliable, as seen in the study by Larsen and Carlsson (2012) where no difference in COPM scores were found between those administered by occupational therapists and that of physiotherapists, where physiotherapists had no prior knowledge and usage of COPM and the underlying theories compared to the occupational therapists. This indicates the effectiveness of the training period prior to administration of COPM, helping to increase interrater reliability as well as validity of COPM scores obtained.