Occupational therapy\u27s link to vocational reeducation, 1910-1925.

The development of occupational therapy is rooted in early 20th century medical reform. During the early 1910s, several members of the medical profession, human service workers, and the larger American society were increasingly disturbed by medical practices that did not consider the individual\u27s personal experience of disability. Occupational therapy was developed, in part, out of this desire to provide persons with treatment that helped them to function in their communities despite their disability. Early occupational therapy leaders envisioned the fledgling profession as a societal service capable of assisting persons with disabilities to return to both work and community life. Vocational reeducation was initially considered to be an integral component of occupational therapy in the years from 1910 to 1920. However, the profession\u27s early link to vocational reduction was challenged by vocational technical trainers during World War I. To prevent occupational therapy from being subsumed by vocational technical training, the early occupational therapy leaders implemented several strategies: adoption of physician prescription for all occupational therapy services, delivery of occupational therapy services primarily within hospital settings, and dissociation from vocational reeducation services. Reasons accounting for why the early occupational therapy leaders abandoned their initial commitment to vocational reeducation are explored. Suggestions about how this decision has affected present-day practice are also offered

Effectiveness of a Multimodal Mindfulness Program for Student Health Care Professionals: A Randomized Controlled Trial

Background: The effectiveness of a multimodal mindfulness program incorporating traditional and nontraditional forms of active and nonactive meditation practices with a sample of occupational and physical therapy students was assessed in this study. Method: Thirty-six participants were randomly assigned to an intervention or control group. The 8-week mindfulness program consisted of one weekly 40-min in-person group session and four weekly 10-min online guided meditations. Pre and postintervention measures included the Perceived Stress Scale (PSS), Student Stress Management Scale (SSMS), mindfulness activity log, open-ended qualitative questionnaire, GPA, and counseling visit frequency. Results: Statistically significant differences, with large effect sizes, were found between intervention and control group PSS (Z=-4.291, pd=-1.84) and SSMS (Z=-3.330, pd=-1.27) postintervention scores. Statistically significant differences, with large effect sizes, were found between intervention group pre and postmindfulness activity ratings for each week and all weeks combined (Z=-12.599, pd=1.29). Qualitative data revealed eight themes including greater sleep quality, energy levels, self-compassion, and life-work balance. No statistically significant differences were found between intervention and control group counseling visit frequency and GPA. Conclusion: As this is preliminary data about a novel intervention with a small student sample, effectiveness of this intervention should be further explored in a replication study

The Role of Occupational Therapy in Functional Literacy

In this Opinions in the Profession article we aim to uniquely articulate the distinct value of and need for functional literacy development in the clients we serve. Functional literacy, as coined in this article, is the ability to interpret common written materials needed to effectively carry out basic daily life skills and participate in meaningful occupations and social roles. We propose three specific strategies through which occupational therapists, across practice settings, developmental stages, and populations, can assume active roles in literacy support as it is embedded in occupation: literacy (a) as a form of occupational justice promotion; (b) as an approach to health facilitation, well-being, and adaptive capacity; and (c) as a means to strengthen social connectedness. As the emerging practice area of functional literacy grows, intervention guidelines will need to be established and assessed for effectiveness with specific populations. We urge occupational therapists to begin to consider functional literacy in all client assessment and intervention services

Student level II fieldwork failure: strategies for intervention.

OBJECTIVE: This report describes how common student communicative and behavioral characteristics that appear to predict the existence of potential problems during Level II fieldwork were identified in order to develop and implement preventative interventions during the academic curriculum at New York University (NYU). RECORD REVIEW: A record review of NYU professional-level occupational therapy students from 1986 to 1995 was completed to identify common factors among students who performed well academically but failed clinical fieldwork. Eight communicative and behavioral characteristics were identified: (a) rigidity of thinking, (b) discomfort with the ambiguity that accompanies clinical reasoning, (c) lack of psychological insight, (d) difficulty interpreting feedback, (e) externalization of responsibility, (f) difficulty learning from mistakes, (g) discomfort with the physical handling of patients, and (h) dependence on external measures for self-esteem. INTERVENTION: On the basis of the identified characteristics, five intervention strategies were adopted: (a) academic seminars that address professional behavior and interpersonal skills, (b) faculty feedback to students regarding problematic behaviors, (c) clinician and senior student counseling with identified students, (d) student remediation programs consisting of community service, and (e) student learning contracts based on specific behavioral objectives. These strategies were administered before Level II fieldwork to 10 students in the 1996 class who exhibited the characteristics indicative of potential fieldwork failure. OUTCOME: Of the 10 students in the 1996 class, 7 passed fieldwork without further difficulty, two failed fieldwork midterm assessments but went on to achieve passing final evaluations, and one failed the final fieldwork assessment but passed an additional third fieldwork experience. The class of 1996, which was the first to receive formal intervention designed to decrease fieldwork failure, demonstrated lower fieldwork failure rates than did all other classes in the past 10 years

Effectiveness of a Metacognitive Shopping Intervention for Adults with Intellectual Disability Secondary to Down Syndrome

Background: The purpose of this study was to examine the effects of a metacognitive strategy-training intervention on the shopping performance of adults with intellectual disability secondary to Down syndrome. Method: A single subject ABA design across six participants was employed and included a 2-week baseline data collection period, followed by an 8-week intervention phase, and a 2-week follow-up data collection period 1 month after intervention end. Time, frequency, and level of assistance required by the participants to demonstrate targeted shopping skills were measured during baseline, intervention, and follow-up probe phases. Results: As a group, the participants experienced statistically significant improvements in time (x2 = 144.25, px2 = 38.00, px2 = 207.08, pZ = -8.50, pd = 0.92), frequency (Z = -4.07, pd = -2.60), and level of assistance (Z = -9.39, pd = -2.44). Results calculated for individual participant performance mirrored group results. Conclusion: The findings of this study suggest that the intervention effectively improved the participants’ shopping performance. Further research is warranted

A Scoping Review of Self-Awareness Instruments for Acquired Brain Injury

Background: Self-awareness and insight are critical functions required to maintain safe and optimal participation in all daily life activities in a variety of environmental contexts. In the past two decades, occupational therapists have developed several psychometrically sound assessments designed to identify self-awareness and insight deficits in patients with neurological disorders. This scoping review identifies and evaluates key properties of such assessments to inform clinical practice. Method: Multiple electronic databases were searched using the key search terms of “self-awareness” and “self-awareness assessment,” and “insight” and “insight assessment.” Included studies were original primary sources from the peer-reviewed journals. Results: Nine assessments met the inclusion criteria: Assessment of Awareness of Disability, Awareness Interview, Awareness Questionnaire, Insight Interview, Patient Competency Rating Scale, Patient Competency Rating Scale for Neuro-Rehabilitation, Patient Distress Scale, Self-Awareness of Deficits Interview, and Self-Regulation Skills Interview. Each assessment is reviewed in detail regarding its purpose, administration time, format, type of awareness assessed, psychometric properties, and advantages and disadvantages. Conclusions: Although all nine assessments are psychometrically sound, some may hold more usefulness for occupational therapists depending on a variety of factors, including patient cognitive level and activity tolerance and clinical setting and time constraints

Development and Psychometric Properties of the Emotional Intelligence Admission Essay Scale

The purpose was to describe the development and psychometric properties of the Emotional Intelligence Admission Essay scale. The authors developed an admission essay question and rating scale designed to provide information about applicants’ emotional intelligence (EI). Content validity, convergent validity, interrater reliability, and internal consistency were established. The scale was also examined to determine if it could discriminate between students with and without professional behavior problems in the academic and fieldwork settings. Content validity was found to be high by a panel of three experts in EI (content validity index = 1.0). Convergent validity with the Assessing Emotions Scale was moderate (r = .46, p \u3c .02). Interrater reliability between two trained faculty raters was high (ICC = .91, p \u3c .000). Internal consistency of the scale was high with a Cronbach’s alpha of .95. This version of the scale was not able to discriminate between students with and without professional behavior problems. The moderate to strong psychometric properties suggest that the EI Admission Essay Scale has the ability to provide information about applicants’ EI. The wording of the essay question must be modified to better instruct applicants to address interpersonal conflict

A Bibliometric Analysis of Peer-Reviewed Journal Publications by British Occupational Therapy Authors

Background: A bibliometric analysis was completed of the peer-reviewed literature from 1991 to 2015 written by British occupational therapy authors that was indexed in the Science Citation Index-Expanded (SCI-Expanded) or Social Sciences Citation Index (SSCI) databases. Methods: “Occupational therapy” and “occupational therapist” were used as keywords to search journal articles’ publication title, abstract, author details, keywords, and KeyWords Plus. One of the authors had to be identified as a qualified occupational therapist with a British affiliation. Results: From 1991 to 2015, 680 journal articles were published by British occupational therapy authors. The top three journals in which authors published were the British Journal of Occupational Therapy, Clinical Rehabilitation, and Disability and Rehabilitation. The five institutions that generated the largest number of occupational therapy articles were the University of Nottingham, Brunel University London, University of Southampton, Queen Margaret University, and the University of East Anglia. British authors often collaborated in the writing of manuscripts with other authors from Australia, the United States, Canada, and Sweden. Conclusion: The quantity of occupational therapy peer-reviewed literature written by British authors has increased over the last 2 decades. British authors have made and continue to make noteworthy contributions to the profession’s body of refereed knowledge at the national and international levels

The Role of Occupational Therapy in Functional Literacy

In this Opinions in the Profession article we aim to uniquely articulate the distinct value of and need for functional literacy development in the clients we serve. Functional literacy, as coined in this article, is the ability to interpret common written materials needed to effectively carry out basic daily life skills and participate in meaningful occupations and social roles. We propose three specific strategies through which occupational therapists, across practice settings, developmental stages, and populations, can assume active roles in literacy support as it is embedded in occupation: literacy (a) as a form of occupational justice promotion; (b) as an approach to health facilitation, well-being, and adaptive capacity; and (c) as a means to strengthen social connectedness. As the emerging practice area of functional literacy grows, intervention guidelines will need to be established and assessed for effectiveness with specific populations. We urge occupational therapists to begin to consider functional literacy in all client assessment and intervention services