Effect of occupation-based self-determination interventions on decision making and risky behaviors in students at risk of emotional behavioral disorders

Students at risk of emotional behavioral disorders (EBD) have difficulties and challenges making decision for independent living. The aim of the current study is to assess effect of occupational therapy and self-determination interventions on decision making and risky behaviors of students at risk of EBD. In a single-blind, randomized, controlled trial, 54 eligible students at risk of EBD were assessed using a computerized version of the Tower of London (TOL) and French decision-making Balloon Analogue Risk Task (BART) task. Participants were allocated randomly into two groups of intervention and control. The intervention groups underwent 1 session per week lasting 90 min for 8 weeks. Data were analyzed using chi-square and analysis of covariance (ANCOVA) using Statistical Package for the Social Sciences version 16. ANCOVA of the TOL items (planning time, total time, execution time, move score) shows a significant difference across both groups for planning time (p < 0.001). By comparing means of "move score" item pre- and post-intervention, it is found that the score of this item increases, but this difference was not statistically significant (mean pre = 26.59 mean post = 29.59 p = 0.06). The results of BART showed that "win number" and "average adjusted inflations/win balloon" had a significant effect on adolescents in the intervention group, but not on the control group. Our findings support self-determination intervention, especially occupation-based self-determination program could have an effect on some cognitive skills. The results suggest that intervention is feasible and shows preliminary efficacy in making better decision, planning and reducing risk-taking behavior.