Occupational Therapy’s Role in the Criminal Justice System: A Scoping Review

PURPOSE: This study provides a descriptive analysis of the occupational therapy (OT) literature examining OT roles and practices within the criminal justice system to support the growth of OT practice with this population.

RATIONALE: Two-thirds of prisoners released are rearrested within 3 yr postrelease (National Institute of Justice, 2010). Prisoners present a myriad of occupational performance problems. Occupational deprivation in the correctional environment leads to further abandonment of participation in natural occupations (White, Grass, Hamilton, & Rogers, 2013). OT practitioners have the capacity to address the needs of persons within the criminal justice system, but the profession has been slow to address these needs (Muñoz, Sitterly, & Moreton, 2016; White, Grass, Hamilton, & Rogers, 2013). Entry into this area of practice may be limited by the lack of published guidelines defining OT’s role. Guidelines specific to OT practice in secure mental health settings in the United Kingdom are currently the only related OT practice guidelines in the world.

DESIGN: This scoping review included quantitative counts tracking the number and source of relevant literature and qualitative interpretive categorization of the relevant literature. Eight databases were included: CINAHL, PubMed, OTDBase, Scopus, Sociological Abstracts, the Cochrane Database of Systematic Reviews, the Campbell Collaboration, and the Physiotherapy Evidence Database. We reviewed reference lists, searched the gray literature, and examined textbooks or chapters in textbooks on OT practice in criminal justice. Literature published 1986–2016 was targeted. Systematic searches were conducted of all sources listed above using consistent search terms and established scoping protocols (Arksey & O’Malley, 2005; Levac, Colquhoun, & O’Brien, 2010). Selected sources were initially categorized as research and nonresearch articles. Subsequently, code–recode processes allowed the researchers to develop subcategories that were internally consistent and homogenous while remaining clearly different in focus from other existing or emerging subcategories.

RESULTS: One hundred sources for analysis were identified. Preliminary analyses allowed us to organize the literature in descriptive categories. Existing literature includes articles that address assessment, share program descriptions, or argue for an OT role in criminal justice settings. A small subset of articles specifically address training opportunities for OT students. The research literature is small, but occupational therapists and occupational scientists have explored multiple aspects of occupational functioning such as independent community living, sensory and emotional regulation, gender-specific issues, activities of daily living, occupational and vocational role functioning, time use and management, and social participation.

CONCLUSION: There is a clear progression in the sophistication of the scholarship over the past three decades. Literature in the late 1980s and 1990s was more likely to emphasize the need for occupational therapy in the criminal justice systems, to provide arguments that tied OT’s role to the philosophical tenets of our profession, or to provide descriptions of practice or pilot programs that lacked systematic measurement of outcomes. More recently, some attempts have been made to survey occupational therapists in the United Kingdom, Canada, and the United States.

IMPACT STATEMENT: Occupational therapy in the criminal justice system remains an emerging practice arena. This poster shares the results of a scoping review and a draft set of competencies that may inform the development of practice guidelines for OT in criminal justice settings. Scoping reviews may not fit neatly into traditional research reporting formats. The closest American Occupational Therapy Association research priority is “development and transitions for individuals and families”; an overwhelming problem in criminal justice is recidivism, and an occupational perspective on community reentry and transition from criminal to productive occupations is sorely needed in our society.

References

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8, 19–32. https://doi.org/10.1080/1364557032000119616

Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5, 69. https://doi.org/10.1186/1748-5908-5-69

Muñoz, J. P., Sitterly, A., & Moreton, E. (2016). The scope of practice of occupational therapy in U.S. criminal justice settings. Occupational Therapy International, 23, 241–254. https://doi.org/10.1002/oti.1427

National Institute of Justice (2010). Recidivism. Retrieved from http://www.nij.gov/topics/corrections/recidivism/Pages/welcome.aspx

White, J., Grass, C. D., Hamilton, T. B., & Rogers, S. (2013). Occupational therapy in criminal justice. In E. Cara & A. MacRae (Eds.), Psychosocial occupational therapy: An evolving practice (pp. 715–773). Clifton Park, NJ: Delmar Cengage Learning.