Experiences and perceptions of facilitators of The WORKS

"The Best of Both Worlds": Experiences of young people attending groups co-facilitated by peer workers and clinicians in a youth mental health service

AIM

Groups facilitated by peer workers have been shown to be effective in improving recovery-related outcomes in adult populations. However, limited research has explored the involvement of peer workers in groups in youth mental health services. This qualitative study aimed to explore young people's experiences of participating in groups co-facilitated by youth peer workers and clinicians.

METHODS

Semi-structured interviews were conducted with 13 young people aged 15-25 years who had attended groups conducted in-person and online at a tertiary youth mental health service. Young people were receiving individual support through the service for a range of mental health concerns. Groups were conducted by two clinicians and a youth peer worker who had used the same service and had undergone training in Intentional Peer Support®. An inductive approach using open, process, in vivo and pattern coding was used to identify key themes. Concept mapping was used to explore the relationships between them.

RESULTS

Nine overarching themes were identified that highlighted the unique and complementary contributions of youth peer worker and clinician roles. The sharing of lived experience by youth peer workers facilitated young people's engagement in group discussions, hope for the future, and sense of belonging, whereas clinical input created a sense of safety, structure and purpose.

CONCLUSIONS

These findings support the value of a co-facilitation model in improving the engagement and recovery outcomes for young people experiencing mental health challenges.

The Pathways to Participation (P2P) Program: A Pilot Outcomes Study

Research has consistently found that people with mental illness (known as consumers) experience lower levels of participation in meaningful activities, which can limit their opportunities for recovery support. The aim of this study was to describe the outcomes of participation in a group program designed to address all stages of activity participation, known as Pathways to Participation (P2P). A descriptive longitudinal design was utilized, collecting data at three time points. Outcomes were measured by the Camberwell Assessment of Need Short Appraisal (CANSAS), Recovery Assessment Scale-Domains and Stages (RAS-DS), Behavior and Symptom Identification Scale (BASIS-24), Living in the Community Questionnaire (LCQ), and time-use diaries. All data were analyzed using descriptive statistics and Chi-square analyses. A total of 17 consumers completed baseline data, 11 contributed post-program data, and 8 provided follow-up data. Most were female (63.64%) and had been living with mental illness for 11.50 (±7.74) years on average. Reductions in unmet needs and improvements in self-rated recovery scores were reported, but no changes were identified in either time use or psychosocial health. The findings indicate that the P2P program may enable consumers to achieve positive activity and participation outcomes as part of their personal recovery.

Occupational identity in occupational therapy: A concept analysis

BACKGROUND

The concept of occupational identity has become an important focus within occupational science and occupational therapy, drawing both recognition and inquiry. Even if the concept is highly relevant for understanding the occupational nature of human beings, ambiguity regarding the identification and application of occupational identity exists.

AIM

This analysis aimed to clarify the concept of occupational identity by examining its current use and application within occupational therapy.

MATERIALS AND METHODS

Walker and Avant's method for concept analysis was utilized to clarify the concept of occupational identity.

RESULTS

Analysis resulted in three distinct categories of use: occupational identity construction, occupational identity discrepancy and occupational identity disruption, described contextually in terms of the self being, the self being and doing, and the self being and doing with others.

CONCLUSIONS

Findings validated the significant connection between occupation and identity through doing, being and future becoming. Also uncovered were considerable connections to belonging.

SIGNIFICANCE

Occupational identity encompassed complex connections comprising both individual and collective components. Personally meaningful expression and connection were of particular significance to occupational identity as discrepancies or disruption of meaningful connections had negative implications for occupational engagement.

Longitudinal evaluation of a knowledge translation role in occupational therapy

BACKGROUND

In 2014, a large metropolitan mental health service in Australia developed a senior role (Lead Research Occupational Therapist) to address an identified need for greater research and knowledge translation, and associated capacity building. The aim of this study was to evaluate the impact, in the first 2.5 years, of this role across a range of variables.

METHODS

Multiple methods were used to gather a comprehensive range of data. Workforce surveys were completed both online and in hard copy in early 2014 (n = 42) and late 2016 (n = 44). Research key performance indicators (academic, research production and cultural) were also identified for measurement over time. The data from these surveys were analysed using descriptive and inductive analysis, and also with social network analysis.

RESULTS

This role has demonstrated positive outcomes across a range of variables. There was a medium effect on the quantity of participation in quality assurance and knowledge translation activities by the workforce. Most knowledge translation behaviours were occurring regularly, although several were absent. An improving trend in attitudes towards evidence-based practice was recorded, and perceptions of the knowledge translation role were generally positive. The Lead Research Occupational Therapist moved from the periphery to the centre of the evidence based practice social network. Improved awareness of other clinicians deploying evidence based practice was observed, and the frequency of interaction between clinicians increased. The role has met all key performance indicators, across the academic, research production and cultural domains.

CONCLUSIONS

The shift in focus of this role from research to knowledge translation has produced tangible outcomes for the occupational therapy workforce. These achievements have had a positive impact on the sustainability of the role, which will be continued for at least another two years. An ongoing challenge is to directly measure the impact of this role on outcomes for people with mental illness and their carers.