Growth Mindsets: Their Implications in Pediatric Occupational Therapy
by Katherine J. Collmer, M.Ed., OTR/L
What is the element in therapy that transforms a goal from one focused upon performance to that which targets learning? What facet of our service approach drives motivation and addresses or prevents the client’s sense of “learned helplessness?” At what point do we, as therapists, influence the mindset of our clients and facilitate their growth in rehabilitation?
These questions lie at the foundation of our own growth as a profession as the health care reform initiatives align with our long-held principles of client-centered treatment. But, just as we are beginning to understand that the medical community is catching up to our perspective, we are equally becoming aware that a client-centered practice framework can produce outcomes that reflect the “shift toward value-based-reimbursement” and “challenge(s) occupational practitioners to demonstrate their unique contributions” (1) to healthcare. In turn, the quality of a framework that stresses the importance of individuality, holism, and a sense of self and one that values the development of both the individual and a client-therapist relationship is contingent in part on the (client’s) experience of care and his perspective of his involvement in the process. Toward that end, research and discussions have been directed toward the development of a “working alliance” and a stable relationship that foster a positive rapport with our clients and serves as a means for active participation in their service plans. (2)
Active participation implies motivation. And motivation suggests a belief that one can succeed in his attempts to learn and grow and to achieve his personal potential. Our ability to motivate our clients demands a certain awareness of the ways in which people are motivated and how their responses to failures can provoke either a helpless response or the determination to master new things and conquer challenges. Carol Dweck, author of Mindset: The New Psychology of Success, conducted research to uncover the factors that motivate and direct a learner’s pattern of success or failure. She concluded that children who were guided toward persisting in the face of challenges and encouraged to believe that failures were due to their lack of trying versus a lack of ability developed “mastery-oriented patterns.” (3) Their “attributions” toward success and failure reflected their judgments about the causes of events and behavior, as well as the recognition of the consequences of those attributions, and drove them to strive for learning versus performance. There is an important difference between performance-oriented and learning-focused goals. Dweck noted that performance goals focus upon demonstrating the ability to do something while learning-focused goals encourages the increase of ability. The difference lies in one being static and fixed and the other dynamic and malleable. The success of client-centered therapy relies upon the participant believing that he has the ability to increase his ability. It is based upon a growth mindset.
Fostering a Growth Mindset in a Therapeutic Environment
Mindset is defined as “a fixed mental attitude or disposition that predetermines a person’s responses to and interpretations of situations.” It is a frame-of-mind, a perspective, and a set of behaviorisms that become an inclination or a habit. According to the prominent dictionaries, a habit is a recurrent and often unconscious behavior that is acquired through frequent repetition and becomes an established disposition of the mind or character. Therefore, habits can be developed as well as broken. Fostering a growth mindset in our pediatric therapy sessions is a viable and applicable target in a client-centered service delivery model. The same assumptions about success relative to a child’s level of academic achievement can be applied to a pediatric client’s success toward therapy goals. A research team reviewed the literature that studied the “noncognitive factors” involved in student learning. These included both their Academic Behaviors, such as going to class, completing homework, active classroom engagement, and studying, and their levels of Academic Perseverance, labeled as tenacity or stick-to-it-ness. They both were determined to be indicators of how likely a child was to continue to pursue academic goals despite challenges. (4) The results of the review suggested that “one of the best levers for increasing students’ perseverance and improving their academic behaviors (was) by supporting the development of Academic Mindsets.”
- Belonging to a learning community. Our therapy sessions revolve around learning (or unlearning) habits and behaviors that will enhance a child’s opportunity for success. Our willingness to build a rapport that fosters trust and develops into a working alliance that encourages communication, and in the end becomes a stable relationship that incorporates the child’s opinions and ideas into the rehabilitation process, encourages a sense of belonging in the therapy environment. (2)
- Belief in the likelihood of success. Studies have shown that self-efficacy was a strong determinant of success among similar-ability students. A child’s sense of his ability to succeed is “malleable” and can be influenced by feedback on performance and ability, as well as the provision of training and assistance with setting goals. (4) The core components of client-centered care (respect, collaboration, communication, support, and inclusion) and the part that hope and self-perception play in an occupational practice (1) foster the building of self-efficacy. It is our role as occupational therapists to help our clients to “celebrate” their willingness to take risks, to allow themselves to fail, and to learn from those failures. (5)
- Belief that abilities and intelligence can grow with effort. Carol Dweck considers students with a growth mindset to believe that “the brain is like a muscle” that gets stronger with use. (6, qtd in 4) They are motivated by mastery and enjoy challenging themselves with new ideas and learning opportunities. (4) It is our role as therapy practitioners to provide the “just-right challenges” that will build brain muscle and encourage our clients to believe that they can learn and grow despite their personal challenges.
- Belief in a sense of meaning and value surrounding the work. As we continue to interpret and make meaning of our experiences, our brains are looking for connections in order to process new information and ideas. (4) Tasks and information that do not represent meaning nor constitute any value to our clients will fall short of the mark and limit their potential for success. Purposeful activities are planned and directed tasks that are key to planning an occupational therapy program, while meaningful activities are those that achieve the program goals through an intrinsic motivation for the patient. (7) It is our role as therapists to offer our clients activities that are both purposeful and meaningful and that will bring them back to therapy to build the sense of belonging and self-efficacy that results from a mastery mindset.
Fostering a learning mindset in therapy begins with the principles laid out in the client-centered approach to our occupational practice that build rapport, a working alliance, and a stable relationship, no matter the age of client.
atherine J. Collmer, M.Ed., OTR/L, is a pediatric occupational therapist who specializes in the assessment and remediation of handwriting skills. In her current book, Handwriting Development Assessment and Remediation: A Practice Model for Occupational Therapists, she shares a comprehensive guide and consistent tool for addressing handwriting development needs. She can be contacted via her website, Handwriting With Katherine.Pixabay and their use should include the link attached to their photographs. Disclaimer: The information shared on the Handwriting With Katherine website, blog, Facebook page, Twitter page, Pinterest page; in the Universal Publishing Handwriting Teachers’ Guides; on any guest blog posts or any other social media is for general informational purposes only and should not be relied upon as a substitute for sound professional medical advice or evaluation and care from your physician/medical team or any other qualified health care providers. Therefore, the author of these links/posts take no responsibility for any liability, loss, or risk taken by individuals as a result of applying the ideas or resources.
- Mroz, Tracy M., Jennifer S. Pitonyak, Donald Fogelberg, and Natalie E. Leland. “Client Centeredness and Health Reform: Key Issues for Occupational Therapy.” Am J Occup Ther American Journal of Occupational Therapy 69.5 (2015): 1-8. Web. 3 Oct. 2015.
- Collmer, Katherine J., M.Ed., OTR/L. “Client-centered Practice in Pediatrics.” Handwriting Is Fun! Blog. Handwriting With Katherine, 29 Sept. 2015. Web. 3 Oct. 2015. <http://blog.handwritingwithkatherine.com/client-centered-practice-in-pediatrics/>.
- Krakovsky, Marina. “The Effort Effect.” Stanford Magazine. Stanford University, Mar.-Apr. 2007. Web. 03 Oct. 2015. <http://alumni.stanford.edu/get/page/magazine/article/?article_id=32124>.
- Farrington, Camille A. “Academic Mindsets as a Critical Component of Deeper Learning.” Hewlett Foundation News. William and Flora Hewlett Foundation, n.d. Web. 03 Oct. 2015. <http://www.hewlett.org/library/grantee-publication/academic-mindsets-critical-component-deeper-learning>.
- Schwartz, Katrina. “What’s Your Learning Disposition? How to Foster Students’ Mindsets.” MindShift. KQED News, 25 Mar. 2014. Web. 03 Oct. 2015. <http://ww2.kqed.org/mindshift/2014/03/25/whats-your-learning-disposition-how-to-foster-students-mindsets/>.
- Dweck, Carol S. Mindset: The New Psychology of Success. S.l.: Random House, 2008. Print.
- Senior, Rob. “Better, Faster, Stronger.” Better, Faster, Stronger. Advance Healthcare Network, 28 Sept. 2010. Web. 03 Oct. 2015. <http://occupational-therapy.advanceweb.com/Archives/Article-Archives/Better-Faster-Stronger.aspx>.