Abstract
The study was conducted to understand the current practice of outpatient behavioral-health OT. A self-developed, internet-based survey was distributed to OT practitioners known to the researchers, followed by snowball sampling. Findings indicate a lack of evidence-based practice in regard to assessments and the OT process. Development of this practice area would aid in community reintegration and the management of chronic behavioral health conditions.
Primary Author and Speaker: Kimberly Hutchinson
Additional Authors and Speakers: Rachael Fox
Contributing Authors: Andrea Meador, Theresa Nelson, Jason Wright, Kelly Machnik
Current research regarding outpatient behavioral health and the role of occupational therapy is limited. While occupational therapists have been involved with mental health-related interventions in inpatient settings for decades, there is often a missing link in services fr clients as they transition from inpatient to outpatient care. Upon discharge from an inpatient facility, clients are typically referred to community group therapy, which tends to provide undifferentiated interventions for various behavioral health conditions rather than focusing on individual disorders (Rouse & Hitch, 2014). Consequently, clients experience limited options to assist with their individualized life stabilization and participation in everyday occupational tasks. Upon review of the literature, researchers believed that individualized occupational therapy services could assist with community re-integration following inpatient discharge. The following study was conducted with the purpose of discovering how behavioral health occupational therapy in the U.S. is currently practiced in outpatient settings and what barriers to practice exist.
Researchers developed a 23 question internet-based survey, which was reviewed by five behavioral health professionals to ensure face validity. The survey was distributed via email hyperlink to 63 individuals. These included individuals known to the researchers as behavioral health occupational therapy practitioners as well as those serving as SIS Mental Health Chairpersons with public email addresses. Snowball sampling was employed and potential respondents were asked to forward the hyperlink to other professionals known to them who might qualify to participate. The survey was also distributed via social media. Inclusion criteria included occupational therapists and occupational therapy assistants who currently or previously worked with any population in an outpatient behavioral health setting. The data collection period lasted four weeks. Upon completion, data were analyzed using descriptive statistics.
Forty-eight responses were received; seven were excluded based on inclusion criteria. Thirty-nine respondents were occupational therapists and two were COTAs. Most common referral sources were following inpatient hospitalization and other outpatient service providers, which supports the researchers' presumption that outpatient behavioral health OT services can assist clients with community re-integration. Assessments and interventions used in practice were numerous and reflected the lack of published literature to support evidence-based practice in this setting. Most common barriers to practice were reporting as billing difficulties, lack of referrals, and lack of recognized need or acceptance by other disciplines.
In conclusion, occupational therapy practice in outpatient behavioral health settings vary according to practitioner indicating a lack of science driven, evidence-based practice in regards to assessments and the OT process in this setting. Development of this practice area would aid in the transition from inpatient psychiatric care to community living and the management of chronic behavioral health conditions.
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