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.     

Psychosocial Occupational Therapy Interventions for Substance-Use Disorders: A Narrative Review

The review was conducted to explore psychosocial interventions for adults with substance-use disorders. A refined literature focus was placed on articles published by occupational therapists, or articles published by an allied health professional, that discussed occupational therapy performing the intervention. Ten articles met inclusion criteria, all focusing on aspects of life skills training. Study results support the professions’ ability to enhance functional independence and occupational performance for individuals recovering from substance use. Further, a more controlled investigation is warranted to further define occupational therapy’s scope within substance-use disorder treatment.     

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.     

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.     

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.     

Pre-Admission Factors Influencing Practice Area Preference in Occupational Therapy

ABSTRACT

The percentage of graduates choosing to practice in mental health has declined in recent years. This study examined pre-admission practice area preference of 219 applicants to an undergraduate occupational therapy program. Results indicated that applicants were most influenced by prior experience: 99.6% were exposed to physical disabilities occupational therapy and 82.5% were exposed to mental illness practice area. Forty-eight percent, however, expressed a preference for physical disabilities while only 11 % preferred to work in the field of mental health. University recruiters may need to actively seek out students with a strong preference for mental health. Longitudinal studies to track factors affecting change of practice area preference throughout the educational process are also necessary.     

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.     

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.     

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.     

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.     

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.     

Psychosocial Characteristics of Student Veterans with Service-Related Disabilities: Implications for Further Research and Occupational Therapy Involvement

The purpose of this study was to assess how post-9/11 university student veterans differ from nonveteran university students on four mental health indicators. In comparison to a demographically matched sample of nonveteran students, it was found that veterans in this study had significantly higher levels of depression and post-traumatic stress symptomatology and non-significantly lower levels of engagement in meaningful activities and meaning in life. This non-experimental study indicates that mental health differences between student veterans and their nonveteran peers do exist, and argues for the inclusion of occupational therapy services for student veterans.     

A Client-Centered Model of Instructional Design for Psychoeducation Interventions in Occupational Therapy

Occupational therapists often use psychoeducational interventions in mental health settings. Recent systematic reviews have validated the efficacy of this approach, but the occupational therapy literature on the instructional design process is scarce. In this article the author reviews factors relevant to the instructional design of psychoeducation and then proposes a client-centered instructional design model that considers the client's capacity for engagement, the instructional context/environment, and the learning content demands in the selection of appropriate instructional approaches. The design process is illustrated in four vignettes using behavioral, acquisitional, cognitive, and constructivist approaches.     

Predictors of General Self-Efficacy and Self-Esteem in Occupational Therapy Students: A Cross-Sectional Study

A national survey reported college students showed higher risk of mental health problems than the general population. Using self-efficacy and self-esteem as indicators of mental health, this study explores sociodemographic, relational, educational, and work factors associated with these outcomes. A sample of 148 occupational therapy students in Norway participated, and data were analyzed with multiple linear regression. Factors associated with positive self-efficacy and self-esteem were higher general satisfaction with the education program, amount of time spent on self-study, and being male. Implications are attention toward female students' self-perceptions, improving the learning environment, and encouraging students to do more self-study.     

The Prevalence of Burnout in Occupational Therapists

Burnout is a stress which may affect an health all health professionals. In this paper its process, causes and characteristics in various health professions are outlined. A survey of burnout in Australian occupational therapists was conducted. The results show that occupational therapists working in the psychosocial area have significantly more burnout on the measure of frequency of feelings of personal accomplishment than do those working in paediatric or physical rehabilitation areas. These feelings are related to specific differences in job characteristics. Implications for prevention of burnout are discussed.     

Occupational Therapy in the Rehabilitation of the Patient with Anorexia Nervosa

The first part of this paper develops an ecological and rehabilitative stance for the occupational therapist in relation to the anorexic patient. Maximizing the individual's level of psychosocial functioning is regarded as the primary aim of treatment. A model for approaching the anorexic patient is described which examines environmental factors, and the importance of assessment and follow up. The cognitive behavioral approach is discussed and suggestions are made for adapting it to the occupational therapist's orientation towards practical activity. In the second part of the paper concrete suggestions for therapy are made.     

Three Views of Artful Practice in Psychosocial Occupational Therapy

This qualitative study explored artfulness in the psychosocial practice of three occupational therapists through in-depth observation and interviews. Analysis focused on the therapist-client relationship, activity use, self-reflection, and the change process. Each therapist established an interpersonal connection while offering meaningful, engaging activities. In addition, each brought a distinct and unique personal view to treatment. Findings suggest that the art of practice in occupational therapy is constructed by the therapist's integrated balance of substance, form, and vision to achieve a coherent whole, which positively influences the personal views of substance, form, and vision in clients.