Meaningfulness in Day Centers for People With Psychiatric Disabilities: Gender and Empowerment Aspects

This study investigated the experience of meaningfulness in occupations at day centers among people with psychiatric disabilities from an empowerment and gender perspective. One hundred eight participants, from eight day centers in Sweden, completed instruments measuring experienced meaning, empowerment, psychosocial functioning, and socio-demographic factors. Mixed methods were used, combining statistical analyses and content analysis. Gender differences were found concerning principal occupations performed. These confirmed traditional gender roles. The experience of meaning in day center occupations, particularly the domain of meaning pertaining to personal development, was significantly associated with empowerment. These results may be used in the future development of day centers.     

A Role for Occupational Therapy in Foster Care

The purpose of this publication is threefold. First, it is an attempt to document the need for occupational therapy services within the foster care population. Second, it describes methods that can be used by occupational therapists to provide appropriate interventions to people affected by foster care. And third, it highlights the need for and identifies specific assessments that can be used to evaluate individuals affected by foster care and to measure the effectiveness of occupational therapy services delivered to foster care agencies.     

Occupational Therapy Services to Promote Occupational Performance,Performance Satisfaction,and Quality of Life in University Freshmen: A Pilot Study

Mental health impacts success for many university students. Occupational therapists can intervene during the transition to university to promote mental health. A 5-week, occupation-based group was provided to a group of freshmen university students to encourage short-term improvements in occupational performance (OP), performance satisfaction (PS), and quality of life (QOL). Statistically significant results were obtained for OP and PS (p < 0.05). However, no significant results were obtained when assessing QOL (p > 0.05). Further research, including long term follow-up, about the impact of occupation-based groups with transitioning freshmen is recommended.     

The Evidence Base for Occupational Therapy in Mental Health: More Systematic Reviews Are Needed

To shape its work, the Research Centre for Occupation & Mental Health is interested in research priorities. Systematic reviews develop an overview of the research available about an intervention, which can provide evidence to underpin practice. They also however, identify gaps in the knowledge base and so are useful for research-prioritization exercises. A rigorous literature search identified only four systematic reviews about occupational therapy in mental health, which suggests that more are needed to underpin practice. This article also explains a six-stage process for conducting a systematic review that can be used by occupational therapists in mental health.     

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.     

A Little Goes a Long Way: The Impact of Distal Social Support on Community Integration and Recovery of Individuals with Psychiatric Disabilities

Although an extensive body of literature highlights the important role of social support for individuals with psychiatric disabilities, definitions of support tend to be restricted—focusing on intimate relationships such as friend and family networks and ignoring the role of casual relationships existing naturally in the community. This mixed-methods study of 300 consumers of mental health services in the Southeastern US aims to better understand the impact of community supports, termed distal supports, on community integration and recovery from mental illness. Qualitative content analysis, tests of group mean differences, and hierarchical linear regression analyses revealed the following: (1) participants primarily reported receiving tangible support (e.g., free medication/discounted goods) from distal supports rather than emotional support (e.g., displays of warmth/affection) or informational support (e.g., provision of advice); (2) women and older participants reported more distal supports than men or younger participants; and (3) distal supports played a unique role in predicting community integration and recovery even after accounting for the influence of traditional support networks. Results highlight the importance of considering diverse types of social support in naturally occurring settings when designing treatment plans and interventions aimed at encouraging community participation and adaptive functioning for individuals with psychiatric disabilities.     

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.     

Long-Term Follow-Up of an Occupation-Based Group Addressing Occupational Performance and Satisfaction in University Freshmen

The long-term impact of a 5-week, occupation-based intervention to address the life transition of university students into young adulthood is presented here. Study participants showed statistically significant gains from baseline to long-term follow-up in both occupational performance and performance satisfaction. In post hoc analyses, occupational performance maintained a level of significance. During a time of rapid change, occupation-based interventions have the potential to provide transitioning university freshmen students the skills that they need for a successful transition into a university. Changes in the structure, timing, and focus of the intervention and studies using more diverse and larger samples are warranted.     

Community-Based Theater and Adults with Psychiatric Disabilities: Social Activism,Performance and Community Engagement

The present study is an in‐depth qualitative inquiry with an established theater troupe composed of adults living with psychiatric disabilities known as The Stars of Light. A grounded theory methodology is used to describe dimensions of social activism and characteristics of theater as a medium of engagement at the individual, setting/troupe, and community levels of analysis. Analysis of a broad scope of interview data, performance content, community contacts, and historical data from the troupe’s 19‐year history led to the identification of eight emergent theoretical concepts formulated from 17 supporting associated themes. The theoretical concepts characterize the impacts of community‐based theater in the lives of participants, and theater troupe processes that contribute to community education and positive social change for adults living with psychiatric disabilities. Advantages, limitations, and future directions for research and action in community‐based theater settings are discussed within the context of present research findings.     

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.     

Occupational Therapy Shared Decision Making in Adolescent Mental Health

Shared decision making (SDM) shares values of client-centered practice; however, a few studies exist that explore experiences of occupational therapists (OTs) working in adolescent mental health. This study aims to better understand SDM in adolescent mental health using the Canadian Model of Client-Centered Enablement. A qualitative study included interviews (n = 6) and analysis using an inductive approach. The role of the OT, client factors, therapeutic relationship, and nature of the decision were identified as influencing the process and outcome of SDM. The study helps better understand SDM in practice, the need for specialized education for OTs and has identified future research areas.     

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.     

Exploring Mindfulness With Occupational Therapists Practicing in Mental Health Contexts

Mindfulness, defined as “a purposeful, non-anxious, reflective presence,” (Epstein, 2003a Epstein, R. M., 2003a. Mindful practice in action (I): Technical competence, evidence-based medicine, and relationship-centered care, Families, Systems, &; Health 21 (1) (2003a), pp. 1–9.[Crossref] , [Google Scholar], p. 1) has been identified as a potentially key practice skill of effective health care practitioners working in mental-health settings. The purpose of this mixed-methods study was to explore the cultivation and use of mindfulness in the clinical practice and everyday lives of occupational therapists who practice in mental health. Results revealed that mindfulness is perceived as being an important clinical quality, which enhances therapist well-being and effectiveness, and contributes to improved client outcomes. Relevance to occupational therapy practice philosophies and directions for future research are discussed.     

A Natural Approach in Mental Health Practice: Occupational Adaptation Revealed

A single case study of the stories told by one occupational therapist about her clients in mental health settings is presented in this article. Qualitative analysis revealed key concepts of the role of the occupational therapist as defined by occupational adaptation theory, along with unique perspectives of occupational therapy in mental health settings. The outcome of this study is a demonstration of the unique insight occupational therapy brings to addressing client recovery in mental health settings, specifically from an occupational adaptation perspective. This insight should enlighten others as to the necessity of skilled occupational therapy in mental health settings.     

Bows and ribbons,tape and twine: Wrapping the wraparound process for children with multi-system needs

The wraparound process for children with multi-system needs is one of the most innovative and popular reform efforts in children's services. Nonetheless, the articles in this special issue are indicative of a service reform process that is still maturing and evolving. In this commentary, three key questions regarding the wraparound process are posed: (a) What is wraparound? (b) What is the current state of research regarding wraparound services? and (c) What are the implications for the future? It is argued that the future of wraparound depends at least in part on: (a) carefully defining the wraparound process, including how to best integrate the process with reforms based on the principles of a comprehensive system of care; and (b) making a strong commitment at all levels to the process of cumulative knowledge, of building and creating innovative research and program efforts over time, one upon the other. It is concluded that a failure to invest in careful definition, refinement, implementation, and research on the wraparound process consitutes a failure to invest in children and families with multi-system needs.     

Uncovering the Value and Meaning of a Horticulture Therapy Program for Clients at a Long-Term Adult Inpatient Psychiatric Facility

This qualitative study investigated the value and meaning of the Greenhouse Program and its impact on recovery goals of residents with severe and persistent mental illness at an adult, long-term psychiatric facility. Eight participants and two occupational therapists were interviewed. Findings revealed two main themes, relating to the essence of the program and personal growth of the participants, supplemented by six sub-themes. The findings suggest that initiatives, such as the Greenhouse Program, are an appropriate intervention that occupational therapy professionals can use in adult inpatient psychiatric facilities.     

Social Class Differences and Occupational Stress

This paper examines the findings of a large community-wide survey on occupational stress. Data were collected on a random sample of the general population within the North East of England. A total of 2345 people returned completed questionnaires, which represented all socioeconomic groups. The bivariate results revealed that job satisfaction is significantly greater among the higher socioeconomic groups, but no differences were found in mental and physical (psychosomatic) health among the various socioeconomic groups. The results from a multiple regression analysis provided evidence that the issue of control is significant in predicting greater job satisfaction among all social classes, but not for mental or physical well being.