Group Interventions in a Community Mental Health Setting: A Mixed-Methods Study Exploring Volition

The use of group interventions in OT practice has been recorded for over 100 years, especially with clients in psychiatric settings (Patterson et al., 2017; Pigott et al., 2021). To reinforce the longstanding use of groups and the unique training of occupational therapy practitioners in facilitating groups, AOTA (2014) explicitly included group interventions as a distinct type of OT intervention in the updated Occupational Therapy Practice Framework (Cahill, Egan, & Bazyk, 2020). Research related to OT group interventions, however, remains lacking. Preliminary and recent studies suggest that personal interests and perceived value that the group will support skill building or translate to activities beyond the group session are most important to clients (Lund et al., 2019). Nevertheless, gaps in knowledge continue to exist about clients’ experiences of occupational therapy groups and the nature of activities that are best suited for group interventions (Patterson et al., 2017; Pigott et al., 2021). The Volitional Questionnaire (VQ) is a MOHO-based assessment designed to gather observational information about a person’s motivation for participating in an activity and a general sense of satisfaction (de las Heras, Geist, Kielhofner, & Li, 2007). It has been used in previous studies involving group interventions to explore clients’ experiences during occupational therapy groups (Reid & Hirji, 2003). This mixed methods study borrowed on the work of other studies by using the VQ and a qualitative focus group to more fully explore the clients’ experiences of occupational therapy groups delivered at a community-based supportive housing program.

PURPOSE: The purpose of this poster presentation is to present qualitative and quantitative data on the effects of participating in occupational therapy group sessions on volitional behavior and experiences.

DESIGN: A repeated measure, mixed-method study design was conducted. Participants (n = 5) were recruited from a local permanent supportive housing program for individuals living with a chronic mental illness. They completed 14 different activity groups (recreation (5), crafts (6), and psychoeducation (3)) over a 3-week period. Volitional behaviors during each group were scored by a rater familiar with the VQ. At the conclusion of the three weeks, participants engaged in a focus group designed to explore their experiences of the group activities. This study was approved by the University’s IRB.

RESULTS: An ANOVA statistical variance test was performed to determine whether if at least one group’s mean was statistically significantly different from the whole group’s. A post-hoc Tukey test was then performed to identify which of the three groups accounted for the statistically significant differences. Volitional data were strong for all three types of activity groups. However, findings suggested a statistically significant volitional difference between crafts and recreation groups when compared to psychoeducational groups (p < 0.01). Researchers used the constant comparative method (Miles & Huberman, 1994) along with Saldana’s (2013) three recommended rounds of coding (open, axial, and selective) to identify two themes: (1) the groups were enjoyable and (2) the people (not the activities) were most memorable.

CONCLUSION: This study confirms the volitional power of occupation-based group interventions for this group of individuals living with chronic mental illness. Additionally, the findings reiterate the critical value of therapeutic use of self when providing occupation-based interventions.

References

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1),S1–S48. doi: 10.5014/ajot.2014.682006

Argentzell, E., Leufstadius, C., Tjörnstrand, C., & Eklund, M. (2019). Joining, belonging, and re-valuing: a process of meaning-making through group participation in a mental health lifestyle intervention. Scandinavian Journal of Occupational Therapy, 26(1), 55–68. doi: 10.1321/14DD0-1630.12x1

Patterson, F., Fleming, J., Doig, S., & Griffin, I. (2019). Participant evaluation of an inpatient occupational therapy groups programme in brain injury rehabilitation. Australian Occupational Therapy Journal, 64, 408–418. doi: 10.1111/1440-1630.12392

Pigott, A., Patterson, F., Prescott, S., Doig, E., & Fleming, J. (2021). Exploring the patient perspectives of student-resourced service delivery of rehabilitation groups: A qualitative study. Australian Occupational Therapy Journal, 69, 140–150. doi: 10.1111/1440-1630.12776