Psychometric Evaluation of the Occupation-Centered Intervention Assessment (OCIA) in Mental Health Practice

PURPOSE: The purpose of this study was to determine the clinical utility and validity of the Occupation-Centered Intervention Assessment (OCIA) for occupational therapy practitioners in mental health settings. The American Occupational Therapy Association’s (AOTA) philosophical base encourages practitioners to use occupations during the intervention process (2017). However, there a disconnect between the philosophical assumptions and practice in mental health settings despite the guidance from the AOTA philosophical base and models of practice. The OCIA is a tool for practitioners to reflect on, identify, and strategize occupation-centered intervention implementation. The OCIA can fill this theory-practice gap by increasing awareness and use of occupation-centered interventions in practice.

DESIGN: Utilizing a broad qualitative approach, the researchers recruited expert occupational therapy practitioners using purposive sampling. Inclusion criteria included nationally registered and state licensed practitioners with at least three years clinical practice in a mental health setting or authorship in the journal, Occupational Therapy in Mental Health. Specifically, an attempt to recruit both mental health practitioners and researchers was deemed important to gain a variety of expertise and perspectives regarding mental health practice.

METHOD: All participants participated in an online OCIA training and completed a semi-structured interview to provide in-depth responses regarding the clinical utility and validity of the OCIA in mental health practice. The researchers recorded all interviews, transcribed the interviews verbatim, and employed thematic analysis, allowing themes to emerge from the data. The analytical process included familiarization of the data through transcription of interviews, identification of a thematic framework, then indexing, mapping and interpretation which lead to several final encompassing themes (Braun & Clarke, 2006). Trustworthiness was established through reflexivity, an audit trail, member checks, and researcher triangulation.

RESULTS: Five themes emerged from the data, which included: usefulness in clinical practice, suitable environments for tool use, educational use for students and healthcare professionals, recommendations for training module revisions, and continua modifications.The results indicated the OCIA would be clinically useful and valid for use in mental health settings with minor tool and training revisions.

CONCLUSION: Practitioners agreed that occupation-centered therapeutic intervention improves patient outcomes and suggested training videos could better demonstrate types of therapy that frequently occur in mental health settings and verbiage should be more relevant to populations served at mental health settings. With minor revisions, the OCIA may help guide practitioners through self-reflection and therefore increase the use of such interventions in mental health practice settings. Further clinical research is recommended to understand utility and validity in additional occupational therapy practice settings, such as pediatrics and community practice, and to better understand the tool’s potential as an educative resource for students completing both didactic coursework and experiential learning.The OCIA provides practitioners in mental health settings with a tool to guide occupation-centered practice. This study will advance practitioner understanding of the use of occupation-centered interventions within mental health settings and guide reflection for implementing such strategies. The OCIA has the power to provide practitioners with a way to strategize and immediately implement occupation-centered interventions within mental health practice settings.

References

American Occupational Therapy Association. (2017). Philosophical base of occupational therapy. American Journal of Occupational Therapy, 71(Suppl. 2), 7112410045. doi:10.5014/ajot.2017.716S06

Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. doi:10.1191/1478088706qp063oa