Occupational Therapy Student Experiences and Transformations During Fieldwork in Mental Health Settings

The purpose of this study is to better understand the transformative experiences of occupational therapy students during fieldwork. In occupational therapy education, fieldwork provides students with an in-depth experience in the field. Thirty-one students submitted narratives following completion of Level II fieldwork in a mental health setting. Concepts from transformative learning theory guided the analysis. The themes that emerged were: (1) understanding clients with mental illness; (2) understanding occupation and occupational therapy; (3) feeling like a professional; and (4) changing as a person. The results highlight the importance of understanding the transformative process and fieldwork in mental health settings.     

An Integrative Review of School-Based Mental Health Interventions for Elementary Students: Implications for Occupational Therapy

Occupational therapy for children and youth experiencing mental health conditions is often overlooked in current school-based services, as the traditional role within the system is often limited to physical health issues. The purpose of this integrative review is to investigate current psychosocial interventions within school settings to understand the effects of services provided and to determine potential roles for school-based occupational therapists. The findings of this review support occupational therapists in facilitating interventions that target mental health in school settings. Psychotherapy presented the strongest evidence for reducing psychosocial symptoms in school settings.     

The Test–Retest Reliability and Predictive Validity of a Battery of Newly Developed Occupational Performance Assessments

The Canadian Occupational Performance Measure was used as a tool to compare goals for intervention identified by seven clients living in a long-term residential program and diagnosed with schizophrenia, with their goals as identified by the occupational therapist. In-depth interviews were conducted in conjunction with the use of the Canadian Occupational Performance Measure. Data analysis revealed an overarching theme that described the clients' concerns as, “I want to accomplish goals outside of the residence program.” During the analysis, however, the data revealed that the occupational therapist primarily focused her attention on goals to be achieved within the residence program, emphasizing programming and symptom management as each client's priorities for intervention, rather than community involvement. The findings reveal how data from the Canadian Occupational Performance Measure was used to reveal client/therapist disconnect in goal setting and the need to continue to examine client-centered practices in mental health settings.     

An Occupational Therapist's Interdisciplinary Approach to a Geriatric Psychiatry Activity Group: A Case Study

Occupational therapy has long recognized the usefulness of activity groups to promote functional outcomes for clients in mental-health settings. An occupational therapist used an interdisciplinary approach (working with a psychiatric nurse practitioner and a manual arts therapist) to conduct a biweekly geriatric psychiatry activity group. A case study is presented to demonstrate the success and longevity of the interdisciplinary activity group. Each clinician contributed unique skills to provide occupation which provided positive outcomes for the clients. Practically, the employing of different disciplines allowed group coverage for each other in times of cost-containment and limited resources.     

The Kawa Model: Therapists' Experiences in Mental Health Practice

This pilot study sought to gather information related to the experience of occupational therapists, using the Kawa Model of practice in a mental health setting. Two therapists utilized the model with one client, each over a six-week period. Through qualitative inquiry, the participants (therapists) revealed that, although initially apprehensive about using a new model, they found that the Kawa Model increased client/therapist interaction and energy levels and challenged them to push the boundaries of therapeutic practice. This research suggests that exploration of new models of practice may be beneficial in terms of facilitating successful partnerships and outcomes with clients in mental health settings.     

Addressing the Mental Health Needs of the Rural Underserved: Findings from a Multiple Case Study of a Behavioral Telehealth Project

Behavioral telehealth is a reasonable solution to the accessibility to mental health care problem that exists in many rural communities. This paper reports the results of a multiple case study of a behavioral telehealth program administered through a marriage and family therapy training program. The results suggest that mental health services can be effectively delivered using existing distance education technology to underserved rural populations. Rural communities have unique barriers to accessing mental health care, some of which can be overcome through the distance delivery of services and some of which cannot. In order to effectively deliver treatment, accommodations to the technology must be made by both therapist and client.     

Principles of Occupational Therapy Group Outcome Assessment in Mental Health

In today's penurious health care climate, occupational therapists must scrutinize their practice and substantiate their interventions in order to remain viable service providers. This article proposes a method of occupational therapy outcomes assessment in mental health care that is rooted in client-centered functional outcomes. Since little consensus exists on which instruments are most effective, this article begins with an outline of broadly accepted principles for assessment of patient outcomes in mental health. Next, we describe a practical method for selecting outcomes measures in interdisciplinary settings. Finally, we offer pragmatic solutions to address barriers to outcome assessment.     

Current and Future Education and Practice

SUMMARY

This article describes a national study conducted by the American Occupational Therapy Association Mental Health Special Interest Section to assess the adequacy of mental health content and fieldwork experiences in occupational therapy educational programs preparing graduates for current and future mental health practice. The results of the study indicate that occupational therapists, especially those who practice in mental health settings, must become more “business-oriented.” This orientation includes educating occupational therapy students about reimbursement issues, legal and political systems, marketing strategies, and advocacy roles. Other recommendations are discussed as possible ways to prepare future practitioners more effectively for roles in community-based settings.     

Reviving Nostalgia for an Era of Practice: An Illustration of the Therapeutic Use of Projective Methods/Media in Occupational Therapy

Projective methods have long had their roots in psychosocial occupational therapy and they remain valuable to the profession. In this article, the author hopes to reawaken interest for an era of practice that was strongly influenced by psychoanalytic theories. She critiques the conceptual models that inform their use in mental health and argues the importance of having a sound theoretical stance in light of the profession’s unique value in this area. She articulates the methods’ clinical utility and relevance to occupational therapy practice and recovery-oriented care. Using a clinical illustration, she demonstrates the potency of the unfolding process between therapist, client and activity.     

The Role of the Occupational Therapist as a Community Consultant

Concern for health development has been in the forefront of occupational therapy practice and training for many years. However, consultation in this area to community agencies and grass roots programs is a relatively new endeavor for occupational therapists. This article describes community consultation in a demonstration project emphasizing the concept of preventive mental health. Steps in establishing the consultation role are discussed using the theoretical constructs of systems consultation. Discussion of the educational objectives for field training in community mental health, community experience during the field training, and the supervisory and communication networks essential to such a program are presented as a model in developing the role of the occupational therapist as a community consultant.     

The Provision of Assistive Technology by Occupational Therapists Who Practice in Mental Health

The purpose of this study is to determine what assistive technology devices occupational therapists working in mental health settings use with their clients. Based on the literature, the authors expected that no tech and low tech assistive technology solutions are being used with clients in these settings even though high technology options are available for people with mental illness who have co-existing cognitive disabilities. The findings of the study reveal that indeed no tech and low tech interventions are most often used. Implications for professional development educational programs and further research are suggested.     

The Resilience of Clergywomen?: Gender and the Relationship between Occupational Distress and Mental Health among Congregational Leaders

Religious leaders face unique vocational challenges that place their mental health at risk. As the clergy as a profession has traditionally been male-dominated, clergywoman experience greater occupational stress than their clergymen colleagues, putting their mental health at additional risk. However, past research offers varied evidence on the gendered nature of clergy health, suggesting that clergywomen may be especially resilient to some difficulties of clergy work. Using panel data from the Clergy Health Initiative, a sample of United Methodist pastors from 2010 to 2021, this study examines clergy-specific occupational stress and its gendered relationship with depression. I find that, while clergywomen experience higher levels of occupational stress, the relationship between occupational stress and depression is weaker for clergywomen as compared to clergymen. This study thus offers a new perspective on the gendered nature of the pastorate: that clergywomen may be able to more effectively cope with vocational difficulties than clergymen.     

A Qualitative Study Exploring the Causes of Boredom for Men with a Psychosis in a Forensic Setting

Boredom is a problem in forensic mental health settings and is believed to increase levels of violence and be detrimental to health and recovery. There were 8 men in a forensic unit, all diagnosed with a psychotic disorder, that were interviewed regarding their experiences of boredom. A thematic analysis was used to identify emergent themes. These included: Mental health and motivation; Restrictive environment; Responsibilities; and Nothing to do. These findings provide a greater understanding of factors which may contribute to boredom within forensic settings and can guide occupational therapy interventions to address them.     

Fieldwork Journal at F.E.G.S.

SUMMARY

The challenge of working with the mentally ill population on the first Level I fieldwork exposure is often experienced in a setting where the on-site supervisor is a therapist from another discipline. Many skilled mental health professionals can offer a rich learning experience and assist students in mastering generic clinical skills in relating to and understanding the psychiatric population. Occupational therapy students bring to this clinical relationship the opportunity to demonstrate the effectiveness of occupational therapy interventions through group work, and individual evaluation and treatment, which benefits both the clients and the larger program. This article recounts the journal of a Level I student's journey through a setting that provided a receptive environment for fostering growth in the process of becoming truly comfortable and effective in the skills and roles of an occupational therapist in a mental health environment.     

Occupational Therapists' Perception of the Tree Theme Method™ as an Intervention in Psychosocial Occupational Therapy

This study investigated how occupational therapists experience utilization of the Tree Theme Method, an intervention based on creative activities and life-story telling and making. The Tree Theme Method is comprised of five sessions in which the therapist asks the client to paint symbolic trees, with specific themes representing their present life situation, childhood, adolescence, adulthood, and the future. Nine occupational therapists in mental health care were asked about their experiences when using the Tree Theme Method. The informants formed two focus groups and each group was interviewed twice. Qualitative content analysis was used to identify five categories including: (1) therapeutic frames, (2) therapist requirements, (3) client requirements, (4) the therapeutic relationship, and (5) the Tree Theme Method as a multi-dimensional process. Overall the informants were satisfied with the intervention with some variation as to therapists' perception about the helpfulness of the tool. The Tree Theme Method was experienced as a structured method of starting a therapeutic process and initiating a therapist–client relationship. The therapeutic attitude, self-knowledge, and expert knowledge seemed to be important prerequisites for the therapists when using the Tree Theme Method intervention.     

Occupational Therapy Interventions in Mental Health: A Literature Review in Search of Evidence

A growing body of literature sheds light on occupational therapy (OT) interventions and outcomes in adult mental health. Although this research has not developed to the point where a systematic review is warranted, a synthesis of these findings is needed. This article provides an overview of OT interventions in adult mental health and their documented outcomes. Fifty peer-reviewed intervention studies targeting adults with mental illness were reviewed. Seven categories of interventions emerged: employment/education; psychoeducation; creative occupations/activity; time use/occupational balance; skills/habit development; group/family approaches; and animal-assisted therapy. Further research involving rigorous designs is needed to establish a solid evidence base for OT interventions in adult mental health.     

Employers' Perceptions of Occupational Therapy in Community Mental Health

ABSTRACT

This paper explores the nature of occupational therapy practice from the perspective of community mental health agency directors currently employing occupational therapists. Directors were interviewed using a semi-structured format. Retrospective content analysis produced a systematic detailed summary of six major and eight minor themes separating into process themes or how the occupational therapist practised, and content themes, or what the occupational therapist practised. The process themes included a holistic approach, client centredness, and a practical, outcome oriented focus. The content themes included the use of activity, focus on individual functioning, and specific vocational and living skill training. In addition, some directors identified inadequacies including insufficient medical background and the need for education in community practice. Themes were compared against two additional data sources; expert occupational therapists and current literature in occupational therapy in mental health. There was agreement on the major themes. Implications of these results are discussed.     

Community Organization and Planning Consultation

This paper focuses upon the role of the occupational therapist as a health agent with resultant responsibilities for participation in health planning and preventative program development. Included is a discussion of community problem solving methods, an overview of community organization, and principles of preventative intervention. A community-wide assessment methodology upon which to base planning decisions is presented. The principles of prevention, community assessment, and occupational therapy program development are emphasized through a discussion of a mental health model which evolved in a military community.     

Perinatal Posttraumatic Stress Disorder: Implications for Occupational Therapy in Early Intervention Practice

The purpose of this article is to present literature regarding perinatal posttraumatic stress disorder and to describe the implications of research findings for occupational therapy screening and treatment in early intervention practice. Changes in legislation regarding early intervention practice and family centered care are presented as a rationale for including maternal mental health screening as a standard practice in the field of early intervention. A case study illustrates symptoms of perinatal posttraumatic stress disorder and the effect on maternal-infant co-occupational engagement. The Model of Human Occupation is used to guide clinical reasoning about potential occupational therapy interventions.