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Sammells E, Logan A, Sheppard L. Participant Outcomes and Facilitator Experiences Following a Community Living Skills Program for Adult Mental Health Consumers. Community Ment Health J 2023; 59:428-438. [PMID: 36074286 PMCID: PMC9981707 DOI: 10.1007/s10597-022-01020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/25/2022]
Abstract
Outcomes from participating in a six-week small-group living skills program, periodically implemented over two years with twelve adult mental health consumers, are reported as a case study. Occupational therapy and recovery-oriented approaches underpinned the development and implementation of the program thus it was important that outcome measures aligned with these perspectives. Data were gathered pre and post program using the Canadian Occupational Performance Measure (COPM) and the Life Skills Profile-16 (LSP-16) in each iteration of the program. Two occupational therapy program facilitators were interviewed about their experience of running the program and using these measurement tools. COPM occupational performance (p = 0.001) and COPM satisfaction (p = 0.004) scores indicated significant change at post-program whereas the LSP-16 total and subscale scores did not (p = 0.132 for total scores). Facilitator insights into the experience of implementing the living skills program and the perceived alignment of the COPM and LSP-16 with recovery-oriented practice are reported.
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Affiliation(s)
- Eliza Sammells
- Occupational Therapist, BOccThy (HONS), Australian Catholic University, Melbourne, Australia
| | - Alexandra Logan
- Occupational Therapy Senior Lecturer, School of Allied Health, Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Loretta Sheppard
- Occupational Therapy, Deputy Head, School of Allied Health, Australian Catholic University, Melbourne, Australia.
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Lindström M. Development of the Everyday Life Rehabilitation model for persons with long-term and complex mental health needs: Preliminary process findings on usefulness and implementation aspects in sheltered and supported housing facilities. Front Psychiatry 2022; 13:954068. [PMID: 36051549 PMCID: PMC9424656 DOI: 10.3389/fpsyt.2022.954068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED This paper describes the initial phases of the design and development of the Everyday Life Rehabilitation (ELR) intervention, and it presents preliminary findings on usefulness and implementation aspects derived from an ongoing larger trial exploring the effect, cost-effectiveness, and usefulness of ELR. ELR is a model designed to meet the absence of meaningful activities and challenges with integrated, activity- and recovery-oriented rehabilitation in sheltered and supported housing facilities for persons with extensive psychiatric disabilities. The aim of the present study was to examine early experiences of implementing the ELR model from the perspectives of managers, housing staff, and occupational therapists. The paper will sum up preliminary findings based on process data included in an internal pilot prior to a full-scale pragmatic clustered RCT. Four Swedish municipalities with 19 housing facility units were involved and provided process data for the study. Thematic analysis were applied. The informants perceived the methodology to be well suited to the target group and context and to contribute to positive changes in participants' lives. The web-based training was also experienced as relevant and easily accessible to staff, as well as elements of collegial learning and feedback. However, they reported that their municipalities lacked basic conditions for making the whole concept work in such a short time. The ELR is overall perceived as useful, but experiences also make complex difficulties visible regarding integrated, coordinated rehabilitation and organizational readiness. Based on findings, a recommendation on basic prerequisites will be added to the ELR guidance for leadership and management. CLINICAL TRIAL REGISTRATION [ClinicalTrials.gov, 24 September 2021], identifier [NCT05056415].
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Affiliation(s)
- Maria Lindström
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Rocamora-Montenegro M, Compañ-Gabucio LM, Garcia de la Hera M. Occupational therapy interventions for adults with severe mental illness: a scoping review. BMJ Open 2021; 11:e047467. [PMID: 34716157 PMCID: PMC8559113 DOI: 10.1136/bmjopen-2020-047467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To identify the occupational therapy (OT) interventions in adults with severe mental illness (SMI) most investigated in intervention studies and to describe their characteristics. DESIGN Scoping review. DATA SOURCES On 17 January 2020, we searched the following electronic databases: MEDLINE, Scopus, Web of Science and EMBASE. We also performed a manual search of TESEO doctoral thesis database and of the journals indexed in the first quartile of OT according to the SCImago Journal Rank. We updated our search on 10 March 2021, performing a complementary search on ProQuest database and repeating the search in all sources. The terms included in the search strategy were: schizophrenia, schizotypal personality, delusional, schizoaffective, psychotic, bipolar, major depression, obsessive-compulsive, severe mental, OT and intervention. STUDY SELECTION The study screening was peer-reviewed. Inclusion criteria were: (1) OT intervention studies in SMI: experimental, randomised, non-randomised and pilot/exploratory studies; (2) adult population with SMI: schizophrenia, schizotypal personality disorder, delusional disorder, obsessive-compulsive disorder, schizoaffective disorder, psychotic disorder, bipolar disorder, major depressive disorder; (3) OT identified as a discipline involved in the intervention; (4) English or Spanish language and (5) studies with full text available. RESULTS Thirty-five studies met the inclusion criteria. OT interventions were classified in psychosocial, psychoeducational, cognitive and exercise interventions. The most used OT intervention was psychosocial intervention. CONCLUSION Psychosocial intervention was the most investigated OT intervention in SMI, followed by psychoeducational, cognitive and exercise interventions. These interventions are usually group interventions in patients with schizophrenia, performed by a multidisciplinary team (in which an occupational therapist collaborates), with 2-3 weekly 60 min sessions and a duration of 3-6 months.
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Affiliation(s)
- María Rocamora-Montenegro
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
| | - Laura-María Compañ-Gabucio
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Comunidad Valenciana, Spain
| | - Manuela Garcia de la Hera
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Comunidad Valenciana, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Badu E, O’Brien AP, Mitchell R. An Integrative Review of Recovery Services to Improve the Lives of Adults Living with Severe Mental Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168873. [PMID: 34444622 PMCID: PMC8393579 DOI: 10.3390/ijerph18168873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/02/2022]
Abstract
There is an increasing call for recovery-oriented services but few reviews have been undertaken regarding such interventions. This review aims to synthesize evidence on recovery services to improve the lives of adults living with severe mental illness. An integrative review methodology was used. We searched published literature from seven databases: Medline, EMBASE, PsycINFO, CINAHL, Google Scholar, Web of Science, and Scopus. Mixed-methods synthesis was used to analyse the data. Out of 40 included papers, 62.5% (25/40) used quantitative data, 32.5% used qualitative and 5% (2/40) used mixed methods. The participants in the included papers were mostly adults with schizophrenia and schizoaffective disorder. This review identified three recovery-oriented services—integrated recovery services, individual placement services and recovery narrative photovoice and art making. The recovery-oriented services are effective in areas such as medication and treatment adherence, improving functionality, symptoms reduction, physical health and social behaviour, self-efficacy, economic empowerment, social inclusion and household integration. We conclude that mental health professionals are encouraged to implement the identified recovery services to improve the recovery goals of consumers.
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Affiliation(s)
- Eric Badu
- School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
- Correspondence: ; Tel.: +61-452414632
| | - Anthony Paul O’Brien
- Faculty of Health, Southern Cross University, East Lismore, NSW 2480, Australia;
| | - Rebecca Mitchell
- Faculty of Business and Economics, Macquarie University, Macquarie Park, NSW 2109, Australia;
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Inman J, Bannigan K, Akhurst J. Occupational therapy and psychosis: POINTER feasibility study for a pragmatic clinical trial. Br J Occup Ther 2021. [DOI: 10.1177/03080226211000257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The dearth of clinical trials of individualised occupational therapy with people with a diagnosis of psychosis limits the evidence base globally for occupational therapy practice. This study evaluated the feasibility of conducting a pragmatic clinical trial. Method Mixed methods design using a pragmatic perspective; two-centre, one-group pretest-posttest study, at six months. POINTER Occupational Intervention Specification captured routine individualised occupational therapy. Process evaluation included recruitment, retention, intervention delivery, fidelity, adherence and outcome measurement. The primary outcome was participation in activities of everyday life, measured by Time Use Survey, Participation Scale and Utrecht Scale for Evaluation of Rehabilitation-Participation. The Canadian Occupational Performance Measure measured self-reported experience of and satisfaction with occupational performance. The Short Form-36v2 Health Survey measured health-related quality of life, a secondary outcome. Participants’ experiences were explored using a questionnaire. Intervention providers’ perspectives were investigated via the POINTER occupational intervention log and focus groups. Results Recruitment was (20/36) and drop-out 20% (4/20). Fidelity was 77%, and adherence was good; POINTER had validity and utility. Outcome measurement was acceptable to participants, indicating increased participation in activities of everyday life. Conclusion A larger clinical trial is merited; recruitment processes need further exploration, and outcome measurement needs refining.
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Affiliation(s)
- Joanne Inman
- Faculty of Health & Social Care, Edge Hill University, Ormskirk, UK
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Kirsh B, Martin L, Hultqvist J, Eklund M. Occupational Therapy Interventions in Mental Health: A Literature Review in Search of Evidence. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/0164212x.2019.1588832] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Lori Martin
- University of Toronto, Toronto, Ontario, Canada
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Holmqvist KL, Holmefur M. The ADL taxonomy for persons with mental disorders - adaptation and evaluation. Scand J Occup Ther 2018; 26:524-534. [PMID: 29720019 DOI: 10.1080/11038128.2018.1469667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND There is a lack of occupation-focused instruments to assess Activities of Daily Living (ADL) that are intended for persons with mental disorders. The ADL Taxonomy is an instrument that is widely-used within clinical practice for persons with physical impairment. The aim of this study was to adapt the ADL Taxonomy for persons with mental disorders and evaluate its validity. METHODS An expert group of Occupational Therapists (OTs) from psychiatric care adapted the ADL Taxonomy to fit the client group, including creating three new items. OTs in psychiatric care collected client data and evaluated the instrument for usability. Rasch analysis was used to evaluate the contruct validity of 16 activities separately. RESULTS The OTs collected 123 assessments from clients with various mental disorders. Ten activities had excellent, and four had acceptable, psychometric properties with regard to item and person fit and unidimensionality. The activity managing the day/time gave complex results and would benefit from further development. The OTs found the test version intelligible, relevant and easy to use. CONCLUSIONS The ADL Taxonomy for persons with mental disorders has 16 activities with three to six actions each, and is now ready for clinical use.
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Affiliation(s)
- Kajsa Lidström Holmqvist
- a University Health Care Research Center, Faculty of Medicine and Health , Örebro University , Örebro , Sweden
| | - Marie Holmefur
- b School of Health Sciences, Faculty of Medicine and Health , Örebro University , Örebro , Sweden
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Gutman SA, Brown T. A Bibliometric Analysis of the Quantitative Mental Health Literature in Occupational Therapy. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/0164212x.2017.1413479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sharon A. Gutman
- Professor, Rehabilitation and Regenerative Medicine, Columbia University Medical Center, Programs in Occupational Therapy, New York, NY
| | - Ted Brown
- Associate Professor, Faculty of Medicine, Nursing, and Health Sciences, Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University – Peninsula Campus, Frankston, VIC, Australia
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Wisenthal A, Krupa T, Kirsh BH, Lysaght R. Cognitive work hardening for return to work following depression: An intervention study: Le réentraînement cognitif au travail pour favoriser le retour au travail à la suite d'une dépression : étude d'intervention. The Canadian Journal of Occupational Therapy 2018; 85:21-32. [PMID: 29334790 DOI: 10.1177/0008417417733275] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Work absences due to depression are prevalent; however, few interventions exist to address the return-to-work challenges following a depressive episode. PURPOSE This mixed-methods study aimed to (a) evaluate the effectiveness of cognitive work hardening in preparing people with depression to return to work and (b) identify key elements of the intervention. METHOD A single group ( n = 21) pretest-posttest study design was used incorporating self-report measures (Work Ability Index, Multidimensional Assessment of Fatigue, Beck Depression Inventory II) with interviews at intervention completion and at 3-month follow-up. Descriptive statistics, paired-samples t test, and content analysis were used to analyze the data. FINDINGS Work ability, fatigue, and depression severity significantly improved postintervention. Participants identified structure, work simulations, realism of simulated work environment, support, and education as key intervention elements. IMPLICATIONS Findings underscore an occupationally focused return-to-work intervention for people recovering from depression with potential for wider adoption and future research.
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Abstract
PURPOSE OF REVIEW Life expectancy of people with severe mental illness is considerably shortened and their risk for cardiovascular and metabolic disorders is increased. They spend more time in solitary and less time in structured activities than the general population.Engagement in healthy patterns of activity, including active, meaningful participation in the community can, therefore, be critical to recovery from severe mental illness. Occupational therapy is a profession that focuses on time use, activity patterns and occupational engagement, and the links to health and well-being. In this study, we review research evidence regarding approaches to occupational engagement, including behavioural activation, time use, and activity promotion. We also will review studies that specifically evaluate the impact of occupational therapy interventions. RECENT FINDINGS There is a growing body of evidence regarding the value of interventions addressing occupational engagement of individuals with severe mental illness, including a range of activation strategies and approaches. There is a need, however, for documentation of theoretically informed approaches that are supported by fidelity measures to ensure standardization. SUMMARY Larger-scale studies are needed, including consistent outcome measures to document engagement and changes in activity patterns as well as health-related outcomes. High-quality randomized clinical trials are important to establish effectiveness. As occupational therapy interventions are complex and embedded within a range of multidisciplinary approaches, new models of pragmatic trials within the naturalistic context of psychiatric rehabilitation are also needed.
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Cairns A, Kavanagh D, Dark F, McPhail SM. Setting measurable goals with young people: Qualitative feedback from the Goal Attainment Scale in youth mental health. Br J Occup Ther 2015. [DOI: 10.1177/0308022614562584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Measuring occupational performance is an essential part of clinical practice; however, there is little research on service user perceptions of measures. The aim of this investigation was to explore the acceptability and utility of one occupational performance outcome measure, Goal Attainment Scaling, with young people (12–25 years old) seeking psychological help. Method Semi-structured interviews were conducted with ten young people seeking help from a youth mental health clinic. Interviews were audio taped and a field diary kept. Interviews were transcribed verbatim and analysed using content analysis. Results were verified by member checking. Results All participants were able to engage in using Goal Attainment Scaling to set goals for therapy, and reported the process to be useful. The participants identified the physical location and ownership of the scale was important to help motivate them to work on their goals. Conclusion Young help-seekers see Goal Attainment Scaling as an acceptable tool to facilitate the establishment of functional goals. Young service users were particularly keen to maintain control over the physical location of completed forms.
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Lindström M, Sjöström S, Lindberg M. Stories of rediscovering agency: home-based occupational therapy for people with severe psychiatric disability. QUALITATIVE HEALTH RESEARCH 2013; 23:728-740. [PMID: 23515296 DOI: 10.1177/1049732313482047] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
As part of a larger study, we offered Everyday Life Rehabilitation (ELR) as a model for integrated occupational therapy in sheltered or supported housing facilities, to enable meaningful daily occupations for people with psychiatric disabilities. Our aim with this study was to understand how participants made sense of their occupational transformations in the context of their everyday life and life history. We carried out qualitative interviews and field observations with 16 participants with psychosis-related disorders. We used narrative analysis and disclosed stories of "rediscovering agency," referring to occupational and identity transformations. A parallel outcome study has shown positive results for participants, and by using narrative inquiry we contribute with a deeper understanding of the meaning making of their transformations and mechanisms of the intervention; i.e., hope, extended value of reaching goals, reentering the majority world, transparency of process, and attunement to the individual. The findings support the use of the ELR intervention.
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Affiliation(s)
- Maria Lindström
- Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden
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