Evidence Based Practice Symposium - McMaster University

provisional OT services at Trellis within the past two years.
Procedure: Face-to-face semi-structured interviews over a twoweek
period in March of 2012. Semi-structured interviews
were audiotaped in order to generate denaturalized verbatim
transcripts of the interviews for data analysis. Data Analysis:
Through an inductive approach, each transcript was coded
independently, line by line manually, by two investigators. A
book of codes was devised through discussions among
investigators to ensure consistency. Upon completion of coding
each transcript, the four investigators came together to cluster
codes into categories and finally into themes.
Results/Discussion
Six major themes emerged from the data related to the
participants’ experiences of engagement in OT services. The
first three themes related to the participants’ direct experiences
with OT services: increasing self-awareness through the use of
the COPM; the value of groups as a medium for doing; and
doing as a function of self, support and situation. The final
three themes related to the impact of OT on recovery at large:
occupation as an invaluable tool for recovery; putting recovery
into perspective; and occupational goals as a source of
motivation.
The core concepts of PSR were mirrored in the OT
services provided. Firstly, the use of the COPM elicited
specific goals that the participants wanted to work on.
Secondly, through the ‘Goal Setting and Doing’ group, they
were provided with the skills necessary to break down goals
into manageable steps. Lastly, working on these goals with the
student occupational therapist proved to be a valuable
environmental support as this was tailored to each individual’s
stage in recovery. The COPM enabled the participants to
evaluate their participation in the occupations of everyday
living, which is an ideal fit with the expertise of occupational
therapists. This places occupational therapists in a well-suited
role to navigate this process.
Finally, research indicates that individuals with a SMI
find engagement in meaningful activities to be a transformative
and healing process (3).This was echoed by the majority of
participants in our study. Seven out of eight participants were
very passionate about advocating for occupation as a seminal
part of their lives and contributor to recovery.
Recommendations
The following are provisional recommendations based on the
study’s findings as well as participants’ suggestions:
� Trial OT services within the Adult Services Program at
Trellis for one year.
� Evaluate the impact of the one-year trial OT services.
� Investigate the impact of OT services from the perspective
of Trellis case managers.
Study Limitations
� Views expressed by the participants may not reflect all
service users as only 8 out of 20 clients participated.
� The time each participant spent with the occupational
therapist varied from one visit to numerous weeks, which
may have impacted the experiences the participants had
with OT services.
� Not all individuals who interacted with an occupational
therapist attended the group for various reasons, which led
to limited data surrounding the experience of the groups.
Future Directions
This study aimed to investigate the potential impact of
provisional OT services within the Adult Services Program at
Trellis in order to provide preliminary recommendations to the
agency. Results highlighted the positive impact of OT services
for the participants of the study. Engaging in OT services led
participants to shift their focus away from their mental illness,
towards participation in day-to-day activities. Despite this shift,
participation in these activities was found to be a difficult
process that often needed formal ongoing support. Therefore,
the main provisional recommendation that emerged was to trial
OT services within the Adult Services Program for one year.
This recommendation seeks to address the limited exposure
and improve the continuity of OT services provided. This study
has contributed to the profession by supporting the literature to
advocate for the OT role within a PSR framework, ICM teams
and the mental health system at large. This study exemplifies
how the unique skill set and scope of practice of OT can
enhance one’s recovery and participation in everyday living.
The addition of OT services to Trellis will promote
interdisciplinary collaboration, effective use of resources, and
continuity of care to the valued clients it serves. Future
research should seek to evaluate this trial service via the use of
COPM, as well as investigate the impact of OT services from
the perspective of Trellis case managers.
References
1. Krupa, T., Fossey, E., Anothony, W. A., Brown, C., & Pitts, D. B.
(2009). Doing daily life: How occupational therapy can inform
psychiatric rehabilitation practice. Psychiatric Rehabilitation Journal,
32, 155-161.
2. Pitts, D. B. (2009). Introduction to special section on occupational
therapy. Psychiatric Rehabilitation Journal, 32, 151-154.
3. Mee, J., & Sumsion, T. (2001). Mental health clients confirm the
motivating power of occupation. British Journal of Occupational
Therapy, 64, 121-128.
4. Kirsh, B. & Cockburn, L. (2009). The Canadian Occupational
Performance Measure: A tool for recovery-based practice. Psychiatric
Rehabilitation Journal, 32, 171-176.
5. Chesworth, C., Duffy, R., Hodnett, J., & Knight, A. (2002). Measuring
clinical effectiveness in mental health: Is the Canadian Occupational
Performance an appropriate Measure? British Journal of Occupational
Therapy, 65, 30-34.
6. Law M, Baptiste M, Carswell A, McColl M, Polatajko H, Pollock N.
(2005). The Canadian Occupational Performance Measure (COPM;
4th ed.). Ottawa: CAOT Publications, ACE.
7. Schaedle, R., McGrew, J. H., Bond, G. R., & Epstein, I. (2002). A
comparison of experts' perspectives on assertive community treatment
and intensive case management. Psychiatric Services, 53, 207-210.