Choice Making in Group and
Individual Activity
(activity analysis, affective function, freedom of choice, group activity
therapy, occupational therapy)
Alexis D. Henry
A guiding premise of occupational
therapy practice is that it IS beneficial
to allow clients freedom of choice zn
selecting and participating in acl1Vlties. This study exammed subyects' affective responses to having or lacking
freedom of choice 1.n completing an
activity and explored how those responses might differ when subjects did
the activity in individual as opposed
to group settings. Forty female undergraduate and graduate students paTtlcipated in an Q1'igami activity undeT
four different expeTimental conditions: a) individual-choice; b) zndlvidual-no choice; c) group-choice;
and d) group-no chOlce. Afterward,
each subject rated how she felt about
herself while participating in the activity by using Osgood's semantic di{
ferential designed to elicit Tesponses
zn terms of three affective factors:
evaluation, power, and activity. Data
analysis revealed an interaction between the two independent variables
on the power factor such that subjects
who were not per'mitted choice responded significantly differently from
those who were permitted choice only
in the group setting. Implications
of this finding for occupational
therapy practice are discussed.
David L. Nelson
Linda W. Duncombe
urposeful activity and activity
groups have been identified
by Mosey (I) as legitimate tools of
the profession of occupational
the ra py. Occu pational thera pis ts
believe that activities require and
promote physical, intellectual, and
emotional abilities, and they use
acti vities in treatment with the belief that purposeful, meaningful
activity can influence the state of
health of an individual (2, 3). Additionally, activity groups are
thought to provide an opportunity
to accomplish goals not emphasized in individual treatment (4,5).
By its nature, the occupational
therapy treatment process is collaborative and requires active involvement on the part of the panent.
In order to use activities therapeutically, therapists must understand and appreciate the properties and characteristics of activities,
and their impact on individuals.
The process of examining an activity to distinguish its component
parts is known as activity analysis
(I). Mosey (1), Fidler (6), Cynkin
(2), and Gillette (7) all identify an
ongoing need for occupational
therapists to engage in systematic
analysis of activities in order to use
them appropriately to meet treatment goals.
Only a limited number of
studies have used a systematic,
quantitative, and replicable approach to activity analysis. I n an
attempt to determine the ability of
occupational therapists to define
and measure "levels" of activity,
Allard (8) presented a rating scale
that incorporated a range of seven
specific qualities frequently used
to describe activities. She administered the scale to both occupational therapists and an teachers,
and she found a higher degree of
interrater reliability among the
therapists in comparison to the
teachers. Fox and Jirgal (9) reported on the efforts of the clinical
council of the Wisconsin schools of
occupational therapy to define se-
AleXIS D. Henry, M.S, OTR, is a
Service Occupational Therapist,
McLean Hospital, Belmont, Massachusetts, 02178.
David L. Nelson, Ph.D., OTR, is Asszstant Professor of Occupational
Therapy, Sargent College of Allied
Health Professwns, Boston University, Boston, Massachusetts, 02215.
Linda W. Duncombe, M.S., OTR, is
Assistant Clinical Professor of Occupational Therapy, Sargent College of
Allied Health Professions, Boston
University, Boston, Massachusetts,
02215.
The Amencan Journal of Occupatwnal Therapy
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245
lected properties of occupational
therapy activities and to develop a
guide for the gradation of activities. They found a high degree of
agreement (W = .80 or better)
among 18 occupational therapists
rating 10 activities on both physical and psychological characteristics.
In 1959, Smith et al. (10) attempted to identify the psychological attributes of craft activities.
They developed a 20-item polar
adjective rating scale based on Osgood's semantic differential, and
they asked th ree grou ps of 12 patients each and one group of occupational therapists to rate nine
commonly used craft activities.
Their results indicated that different craft activities elicit clearly distinguishable affective responses, in addition to demonstrating that the psychological
meaning of activities can be quantified and measured. A 1982 study
by Nelson et al. (II) built on the
work of Smith et al. (10) and extended the use of the semantic differential in analyzing the psychological characteristics of activities.
However, whereas Smith et al.
examined affective responses to
names of activities, this study was
concerned with subjects' affective
responses to participation in activities. Fifty-nine beginning occupational therapy students participated in four activities and immediately afterward rated the activity
using Osgood's 12-scale, shortform semantic differential. The
results indicated that the four activities elicited significantly different affective responses on the
evaluation, power, and activity factors of affective meaning.
When analyzing the affective responses that an individual has to
participating in an activity, therapists must consider the differences
246
between participating in a freelychoosen activity as opposed to a
therapist-directed one. Freedom
of choice in activities is an idea that
has been advocated by several theorists in the field (12-14). Yerxa
(12) argued that allowing patients
to engage in self-directed activity
is necessary to achieve occupational therapy's ultimate goal: the
patient functioning in the environment with self-actualization.
Burke (13) suggested that the occupational therapy treatment process be one in which individuals
are encouraged to explore, tryout,
and define what they want. Kielhofner et al. (14) also identified
freedom of choice in activities as
an important aspect of the treatment process. By allowing patients
to identify and pursue their own
choices, therapists can take advantage of the patients' natural urge
toward mastery of the environment and thus help them to develop a sense of personal causation.
In their descriptions of treatment programs for a variety of
psychiatric patients, Bobis et al.
(15), Shannon and Snortum (16),
and Steele (17) have all identified
beneficial effects from allowing
patients some freedom in choosing
activities. Howe (18) and Kuenstler (19) both described activitybased treatment groups for psychiatric patients in outpatient settings. Each author identified the
benefits that patients derived from
participating in a group where
participation in the decisionmaking process was encouraged,
and taking responsibility for
choices was expected.
Only two studies by occupational therapists have attempted to
address the impact of choice in a
systematic way. In 1953, Taber et
al. (20) investigated the effects of
participation in a free-choice as
opposed to a directed activity on
the total adjustment of psychiatric
patients. The results indicated that
patients who participated in the
free-choice activity showed greater
progress toward "normal behavior" than did patients in the directed activity. A study by Niswander and Hyde (21) examined
what activities patients chose, the
needs they expressed in choosing
them, and whether allowing patients to make their own choices
was beneficial. Based on the data
collected on 60 female patients,
the authors concluded that permitting the patient to choose the
activity produced more sustained
interest, a higher quality of work,
and less dependence on the thera pist for approval.
I n addition to considering the
differences between choice and no
choice in activity analysis, therapists must also consider the differences between group activities and
individual activities. Zajonc's (22)
theory of social facilitation postulates that the behavior of an individual is always influenced by the
presence of others. Mosey (1)
identified activity groups as providing opportunities for the constructive use of the nonhuman environment. She proposed that the
shared need to master the nonhuman environment often assists
patients in developing a sense of
commonality with each other.
Howe (18) and Kuenstler (19) also
noted the potentially supportive
nature of groups, which can help
reduce a patient's sense of isolation. In 1969, Werner et al. (4)
studied the differences between
group-centered and individual
treatment programs. They found
that group-centered programs
prod uced significant increases in
social contact and interdepen-
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dence among group members.
Nelson et al. (5) noted that participation in group activities increased socialization, developed a
feeling of belonging among members, increased awareness of
others and the opportunity to exchange ideas, and increased selfconfidence.
Research Problem
The following questions were investigated: I) How will subjects respond to having choice in activity
as opposed to not having choice in
terms of their feelings about themselves, and 2) Will those responses
differ when subjects participate in
the activity in a group setting as
opposed to engaging in the activity
alone?
The semantic differential, which
was first presented by Charles Osgood (23) in 1952 as a means of
measuring the affective meaning
of concepts, was used in this stud y
to make subjects' affective responses operational. Osgood identified three factors of affective
meaning that he believed had the
most universal significance: evaluation, power, and activity (24).
Evaluation relates to a person's
positive or negative feelings about
something. Power relates to a person's feelings of the magnitude of
effect something potentially has
on its environment. Activity relates
to a person's feelings about the degree of movement or volatility associated with something (II).
Based on the literature reviewed, it was hypothesized that a
choice by group interaction would
occur such that subjects who were
given no choice in completing the
activity and did the activity in a
group setting would have a significantly different (lower) response
in terms of the power factor of affective meaning.
Methods
Subjects. The subjects in this study
were drawn from the undergraduate and graduate student population of Sargent College of Allied
Health Professions at Boston U niversity and included students in
the occupational therapy, physical
therapy, and rehabilitation counseling programs. Forty-four female volunteers were randomly assigned to one of four groups, and
the groups were randomly assigned to one of four experimental
conditions: a) individual-choice, b)
individual-no choice, c) groupchoice, and d) group-no choice.
Two subjects in the group-choice
condition withdrew before beginning the experiment, and, therefore, two were dropped from the
group-no choice condition. This
left a total of 40 subjects: II subjects in each individual condition
(groups I and 2) and 9 subjects in
each group condition (groups 3
and 4). The distribution and mean
age of subjects in each experimental condition is shown in Table I.
Instrument. The semantic differential used in this study consisted
of the 12 scales recommended by
Osgood for English usage (25).
Subjects were asked to assign a
rating on a 7-point (from 0-6) scale
for each of the 12 scales (see
Figure I). Four of the 12 scales are
identified with each factor, and
each set of four scales are added
to arrive at an "evaluation" score,
a "power" score, and an "activity"
score for each subject. The possible source on anyone factor
ranges from 0 to 24.
Procedure. Origami, the ancient
Japanese paper-folding craft, was
chosen as the activity in which all
subjects would participate. Origami was chosen because a single
design can be completed quickly
and because the activity allows for
a variety of choices to be made by
a participant. During the activity,
Table 1
Curricula and Ages of Subjects in Each Group as Randomly Assigned (OT
pational therapy, PT = physical therapy, RC = rehabilitation counseling)
=
occu-
Age
Curriculum
Group
Mean
SO
2290
3.14
2336
4.54
21.11
2.51
22.55
3.80
Group #1
OT 5
Individual-choice
PT 4
RC 2
Group #2
OT 5
Individual-no choice
PT 4
RC 2
Group #3
OT 5
Group-choice
PT 3
RC 1
Group #4
OT 4
Group-no choice
PT 4
RC 1
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247
Figure 1
Short·form semantic differential (footnoted in terms of Osgood's three factors of affective meaning)
awful
nice"
fast C
slow
quiet
noisyc
sour
sweet"
powerful b
powerless
youngC
old
good"
bad
weak
strong b
alive c
dead
deepb
shallow
big
b
little
helpful"
unhelpful
a Positive responses on the evaluation factor
b
Positive responses on the power factor
CPositive responses on the activity factor
subjects in the choice conditions
could choose to do up to five different origami designs using
paper of various colors and sizes.
Each subject in group I, the individual-choice condition, participated in the activity alone. The
principal investigator was present
in the room, but did not sit near
the subject or directly observe the
activity. Each subject was provided
with all needed materials, including a written instruction form
describing the activity and explaining what to do, written directions for five different origami designs, and a supply of origami
paper in a wide variety of colors
and in three different sizes. Subjects were informed by the written
instructions that they could do as
many or as few of the designs as
they wished, but they were asked
to do at least one. They were allotted 45 minutes for the activity.
They were given no additional instructions or assistance by the investigator. At the end of 45 min248
utes, subjects were asked to rate
how they felt about themselves while
participating in the activity using the
semantic differential. Again, subjects were provided with a written
form describing how to complete
the semantic differential. When
each subject had completed the
scales, all finished origami designs
and the rating form were collected
by the investigator.
Subjects in group 2, the individual-no choice condition, also
participated in the activity alone
with the investigator present. As
with grou pI, su bjects were provided with all materials needed including written instruction forms,
directions for origami foldings,
and origami paper. Subjects in
group 2, however, were given neither a choice of which origami designs they did nor a choice of the
color or size of paper used. Instead, each subject in group 2 was
directed, via the written instruction form, to make exactly the same
origami designs as one of the sub-
jects in group I had chosen to do.
Thus, yoked pairs of subjects participated in exactly the same activity. When these subjects had
been allotted 45 minutes to complete the activity, they were asked
to respond to the semantic differential in the same manner as subjects in grou pl. All origami designs and the rating form were collected by the investigator.
Data collection on subjects in
group 3, the group-choice condition, and in group 4, the group-no
choice condition, followed the
same format as described for
groups I and 2 respectively, with
the exception that subjects in these
two conditions participated in the
activity in group settings. Thus,
each subject in group 4 was assigned to make exactly the same
origami designs as a subject in
group 3 had chosen to do, again
creating yoked pairs of subjects.
Subjects in the group conditions
were given no direction from the
investigator to influence the
amount or kind of interaction they
could have with each other, and
interaction among group members was ignored by the investigator. Therefore, subjects in the
group conditions were free to help
each other with designs or to comment on each other's designs if
they so chose. These subjects were
asked to respond to the semantic
differential scales in the manner
previously described.
Results
Analysis of the data revealed insignificant correlations on the dependent variables between the yoked
pairs of subjects. Therefore, twoway (group x choice) analysis of
variance was used to measure the
effects of the four different experimental conditions on the evaluation, power, and activity factors of
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affective meaning. The analysis revealed no significant main effects
of interactions on either the evaluation factor or the activity factor.
However, a significant interaction
between the two independent variables was found on the power
factor of affective meaning,
F(1,36) = 4.83, P < .05, indicating
that the subjects in the group-no
choice condition (group 4) experienced themselves as significantly
less powerful than other subjects
(see Table 2).
A subsequent F test for simple
effects confirmed that there was a
significant difference between the
group-choice condition (group 3)
and the group-no choice condition
(group 4) on the power factor of
affective meaning, F(1,16) = 4.81,
P < .05, but that there was no significant difference between the individual-choice condition (group
1) and the individual-no choice
condition (grou p 2) on the power
factor, F(l,20) = .49, P > .05 (see
Figure 2).
Table 2
Mean Scores of the 4 Groups on the 3 Factors of Affective Meaning (total n
Individual
Mean
=
40)
Group
SO
Mean
SO
Evaluation Factor
Choice
13.8
4.9
11.8
5.4
No choice
13.3
3.9
11.1
9.1
Power Factor'
Choice
11.1
2.9
131
3.5
No choice
12.0
3.1
9.4
36
10.6
2.1
10.7
43
99
1.8
10.7
3.9
Activity Factor
Choice
No choice
• Interaction between Choice vs. No choice and Individual vs. Group significant at
the .05 level
Figure 2
Mean ratings of how subjects felt about themselves in terms of the affective factor of
power after choice or not having choice in individual or group situations
Choice
No Choice
Power Score
24
22
20
18
16
Discussion
Perhaps the primary implication
of the results of this study is that
individuals' awareness of their
power or lack of power in a given
situation is influenced by environmental factors (such as the presence or absence of others). In this
study, the power factor measured
how much of an effect subjects
perceived themselves to have on
the environment while participating in the origami activity. Subjects who were not permitted
choices in completing the activity
perceived themselves as less powerful only when they participated
in the activity in the presence of
others in the same situation. Wicklund (26) proposed that the presence of others is one thing that can
increase an individual's self-aware-
14
12
- -- -
10
--
8
6
4
2
o
Individual
Situation
ness, and Scheier and Carver (27)
found that heightened self-awareness increased an individual's responsiveness to transient affective
states. For subjects in the groupno choice condition, the presence
of others was an environmental
Group
Situation
factor that heightened self-awareness and caused a transient affective state-powerlessness-to become more salient. The presence
of others was, in effect, a feedback
mechanism that provided additional information to subjects
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249
about their power. Subjects who
lacked freedom of choice, but participated in the activity alone did
not have this environmental factor
(i.e., others in the same situation)
to influence their perceptions of
their freedom to make choices.
This finding has important implications for occupational therapy
theory. The literature suggests
that having a sense of self as a
competent actor within the environment is partly dependent on
autonomous functioning with
freedom to make choices and that
allowing patients to make choices
during treatment helps to develop
a sense of competency (13, 14).
The results of this study indicate
that allowing or not allowing
freedom of choice can affect an
individual's self-perception as
having or not having power. Therapists need to be aware, however,
that environmental factors also influence how powerful individuals
perceive themselves to be. In the
Model oj Human Occupation (28), an
individual's sense of personal causation-the image of the self as
potentially powerful or powerless
in interactions with the environment-is the guiding force that
influences how and when an individual chooses to enact occupational behavior. Kielhofner et al.
argue that therapists must structure the environment to enhance
the patient's sense of personal causation (14). To enhance personal
causation, the treatment process
should involve not only allowing
patients to have freedom of choice
whenever possible, but should also
include a feedback mechanism
that makes a patient's power in a
given situation more salient. This
study suggests that group treatment may be one mechanism that
provides such feedback.
The lack of significant differ-
250
ences on the evaluation and activity factors also merits discussion.
The evaluation factor measured
how positively or negatively subjects felt about themselves while
participating in a time-limited activity in an isolated situation. The
mean score across all 4 groups was
a 12.6 on a scale of 0-24, revealing
a "neutral" response on this factor.
The results suggest that choice or
lack of it in an isolated situation
does not influence how much individuals like themselves. Even
those subjects who did feel less
powerful than other subjects did
not like themselves less than other
subjects. Perhaps how positively or
negatively persons regard themselves is a more deep-seated
feeling that is related to their sense
of self-esteem and is therefore not
easily influenced by isolated situations. It seems logical that individuals can feel that they are not very
powerful in a situation that they
know is time limited and still continue to like themselves despite the
temporary lack of power.
The activity factor measured the
degree of movement that subjects
perceived in each experimental situation. Origami is a highly structured activity involving small, deliberate movements and requiring
a high degree of concentration
and attention to detail. No significant differences were found
among the four groups on the activity factor. Even though subjects
in both group conditions were observed to interact spontaneously
with each other and, at times, to
assist each other with the designs,
the results indicate that doing origami with others did not appear
to cause subjects to perceive themselves as more active than those
subjects who did the activity alone.
This may suggest that there are
some characteristics of activities
that are relatively stable and not
influenced by environmental factors.
These findings indicate the usefulness of the semantic differential
in making subtle distinctions in its
measurement of affective responses to participation in activities, and they lend support to the
statement of ~elson et al. (11) that
the semantic differential can be an
effective tool for occupational
therapists to use when attempting
to identify the affective dimensions of activities. It appears increasingly likely that this sophisticated, yet easy-to-administer instrument will be useful in future
research in occupational therapy
and the analysis of activities.
Conclusion
Occu pational therapists have long
advocated allowing patients freedom of choice in activities. The
primary goal of this study was to
analyze the impact that allowing or
denying freedom of choice might
have on an individual, specifically
in terms of affective responses.
Further research might examine
the following questions:
1) How does affective response
to freedom of choice in activities
vary across populations with regard to differences in age, sex, or
clinical diagnosis?
2) How do subjects respond to
having or not having freedom of
choice in different types of activities?
3) Are there other environmental factors that might influence individuals' perceptions of
their freedom of choice?
4) How might freedom of choice
in activities affect other areas of
human behavior, for example,
learning or social interaction?
5) Does allowing freedom of
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choice facilitate change during
treatment?
7.
Acknowledgments
This article is based in part on
Alexis Henry's thesis conducted in
partial fulfillment of the Master of
Science degree at Sargent College
of Allied Health Professions,
Boston University, Boston, Massachusetts.
8.
9.
10.
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