Date Presented 04/13/21
This scoping review analyzed OT practice in justice-based systems as depicted in 140 sources appearing in publications between 1943 and 2019. This analysis may inform students, practitioners, and researchers and support efforts to define a distinct role for OTs in justice-based systems. Results may help define competencies or practice guidelines and inform the development of practices, programs, and research addressing the needs of individuals involved in the criminal justice system.
Primary Author and Speaker: Jaime P. Muñoz
Additional Authors and Speakers: Mimi Stroud, Suzanne Walter, Courtney Stonesifer, Yk Liao, and Samantha Marrah
PURPOSE: This study provides an analysis of OT practice in justice-based systems. U.S. criminal justice policies have resulted in millions of people incarcerated, on probation or on parole from prisons, jails and juvenile detention centers (1,2). Individuals involved in the criminal justice system can experience occupational deprivation and an erosion of social and economic self-sufficiency (1,3). These individuals present a myriad of occupational performance challenges that OTs have the capacity to address, but the profession has been slow to demonstrate the distinct value of OT in justice settings (3). A comprehensive review of OT efforts in these settings may inform development of practice.
DESIGN: Arksey and O’Malley’s (4) discussion of structured review frameworks informed the design of this scoping review. The review included quantitative counts tracking the number/source of relevant literature and qualitative, interpretive categorization of the relevant OT literature between 1943-2019.
METHOD: Key terms and controlled vocabulary related to OT, criminal justice settings and populations guided our search of CINAHL, PubMed, SCOPUS, OTDBASE, and OTSearch resulting in 1047 results that when de-duplicated, left 674 sources. Sources were entered into Covidence software to support an iterative analysis. A source was included in the final analysis if it was related to both OT and criminal justice. Initially titles and abstracts were screened. If a result clearly did not meet the criteria, it was excluded; otherwise, it was included in the 2nd phase of screening. In this phase, the full-text document was located and included in or excluded from the final analysis based on its adherence to the criteria. Documents were tagged within Covidence to identify patterns for later analysis. In each stage, decisions of a 3rd investigator resolved all discrepant ratings.
RESULTS: Sources included in the final analysis totaled 140 and were nearly equally distributed as studies/non-studies. The majority were published in or about OT practice outside the U.S., predominately the U.K, Sweden and Canada. The majority of studies were completed in forensic MH settings, while sources defined as non-studies tended to reflect a broader array of justice-based settings including juvenile detention centers, jails, prisons, and community corrections. The primary foci of studies was exploration of evaluation processes, intervention outcomes or perspectives of practitioners or consumers on OT practice in these settings. The most significant category of non- study sources were descriptions of specific interventions, settings, or OT programs developed for this population. Some of these reported general outcomes, but didn’t systematically assess program outcomes. A clear majority of all sources addressed practice in secure, forensic MH settings and/or interventions that focused on vocational, social interaction, leisure, educational and time management skill development.
CONCLUSION: Descriptions of practice in secure MH facilities outside the U.S. dominates this literature. There is considerable diversity in assessment, intervention and OT program design. A specific focus on addressing the needs of women is nearly non-existent in the literature. The OT’s role in community-based practice is poorly represented in the literature. Diversity in approach may reflect the overall lack of practice guidelines.
IMPACT: OT in the justice-based systems is an emerging practice arena. This review may inform students, practitioners and researchers and support efforts to build a consistent role for OT’s in justice-based systems. OTs may use these results to to draft a set of competencies or practice guidelines for OTs working in U.S. criminal justice settings.
References
1. Beckett, K. (2018). The politics, promise and peril of criminal justice reform in the context of mass incarceration. Annual Review of Criminology, 1, 1, 235-259. https://doi.org/10.1146/annurev- criminol-032317-092458
2. Kaeble, D. (2018). Probation and parole in the United States, 2016. U.S. Department of Justice. Office of Justice Programs, Bureau of Justice Statistics. April 2018 NCJ251148. Retrieved from https://www.bjs.gov/content/pub/pdf/ppus16.pdf#page=15
3. 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, 3, 241-254. https://doi.org/10.1002/oti.1427
4. Arkey, H. & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8, 1, 19-32. https://doi.org/10.1080/1364557032000119616
