Assessment practices of Canadian occupational therapists working with adults with mental disorders

Background.

Little is known about assessment practices of occupational therapists working with adults with mental disorders.

Purpose.

This study investigates the assessment practices of occupational therapists working with clients experiencing symptoms of schizophrenia or major depressive disorder.

Method.

We conducted a national survey of assessment practices using case vignettes of hypothetical clients.

Findings.

From 343 vignettes completed by 286 respondents, 68.4% included the use of one or more standardized measures during treatment. Measures were rarely repeated. Results showed that the Canadian Occupational Performance Measure was the most frequently used, suggesting a focus on assessing global functioning, while the Assessment of Motor and Process Skills was listed as the most desired assessment tool. Implementing nonstandardized assessments was common.

Implications.

Despite wide variations in occupational therapists’ assessment practices, the use of standardized assessments is prevalent. The low rate of repeated measures (0% to 25.9%) suggests a need to better monitor changes and treatment outcomes.

Profile of cognitive problems in schizophrenia and implications for vocational functioning

AIM

This literature review attempts to profile specific areas of cognition that have shown unique and consistent evidence of dysfunction among people with schizophrenia. In addition, their impact on vocational functioning is illustrated, so as to highlight the importance of managing these cognitive difficulties in vocational rehabilitation.

METHODS

Literature search was carried out on seven key cognitive domains identified by the National Institute of Mental Health in the USA. Their impact on vocational function was also reviewed.

RESULTS

It is found that attention, declarative and working memory, reasoning, problem-solving and social cognition are areas of impairment that have great impact on vocational functioning. Attention and memory problems affect learning of new work tasks. Executive function is particularly crucial in determining supported and open employment outcomes, as executive dysfunction cannot be easily compensated. Lastly, social cognition plays a major role in determining the success of workplace social exchanges.

CONCLUSION

Occupational therapists need to have a good understanding of the profile of cognitive problems among people with schizophrenia, in order to tailor our intervention according to their cognitive strengths and difficulties. Several cognitive remediation strategies and programs have been designed specifically for people with mental illness. Equipping ourselves with skills in conducting such programs will augment our expertise in vocational rehabilitation.