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How do we know we do what it says on the tin? Ensuring adherence to a person centered approach within Occupational Therapy Mental Health Services in Higher Education.
Abstract
Current Irish mental health policy demands a shift towards person centred service delivery. Occupational therapy is well placed to implement and develop services in line with this policy as it has person centred care at the core of its theoretical constructs. This study examines the use of person centred models in an occupational therapy service for students with mental health disabilities in higher education that is, the Person Environment Occupation (PEO) and Recovery models. As documentation offers the best insight into the integration of theory to practice, the aim of this study was to examine if documentation adhered to its theoretical underpinnings. Thus 195 Electronic case files were reviewed and 47 in a re-assessment process. Results demonstrated adherence to the recovery model was an area of strength for the service as was alignment to international best practice standards. However, recording of goals and interventions in line with the PEO model was lacking. Following a period on consultation with senior therapists and the clinical director changes were made to further embed the models into the documentation processes. Following this consultation re-assessment demonstrated greater adherence to person centred models in all interactions with the students with mental health disabilities. This research demonstrates that it is necessary not only to examine ones practice but to develop context specific tools to ensure person centred care signifying integration of theory to practice.
Keywords
References
McGrath, T. (2015). Health, mental health and wellbeing: occupation-centred perspectives in the Irish context. Irish Journal of Occupational Therapy 43, 29-34
Department of Health, (DoH). (2006). A Vision for Change: Report of the Expert Group on Mental Health Policy. Dublin Stationary Office: Dublin.
Department of Health, (DoH). (2013). Healthy Ireland: a framework for improved health and wellbeing 2013-2025. Dublin: Department of Health.
Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P. & Letts, L. (1996). The person-environment-occupation model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy 63, 9-23.
Christiansen, C.H., Baum, C.M. & Bass-Haugen, J. (2014). Occupational Therapy: Performance, Participation, and Well-Being, (4th edn). Thorofare, NJ: SLACK Incorporated.
Reed, K. (2015). Occupational Therapy Concepts in the Person-Occupation-Environment-Performance Model: Their Origin and Historical Use in the Occupational Therapy Literature. In: Occupational Therapy: Performance, Participation, and Well-Being, (4th edn). Christiansen, C.H., Baum, C.M. & Bass-Haugen, J. (eds). Thorofare NJ: SLACK Incorporated.
Nolan, C. (2011). The Development and Piloting of the ‘Trinity student Profile’: A Self- Report measure for Students Experiencing Mental Health Problems. PhD. Dissertation Trinity College, Dublin.
Brown, C. & Stoffel, V.C. (2010). Occupational Therapy in Mental Health: A Vision for Participation.Philadelphia, PA: F.A. Davis.
Quinn, S., Gleeson, C. & Nolan, C. (2014). An Occupational Therapy Support Service for University Students With Asperger's Syndrome (AS). Occupational Therapy in Mental Health, 30 (2) 109-125.
Wong, S. & Fisher, G. (2015). Comparing and Using Occupation-Focused Models. Occupational Therapy in Health Care 29 (3) 297-315.
Joosten, A. (2015). Contemporary occupational therapy: Our occupational therapy models are essential to occupation centred practice. Australian Occupational Therapy Journal 62 (3) 219-222.
Anthony, W.A. (1993). Recovery from Mental Illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal 16 (4) 11-23.
Deegan, P.E. (1998). Recovery: The Lived experience of rehabilitation. Psychosocial Rehabilitation Journal 11 (4) 11-19.
Le Boutillier, C., Leamy, M., Bird, V.J., Davidson, L., Williams, J. & Slade, M. (2011). What Does Recovery Mean in Practice? A Qualitative Analysis of International Recovery-Oriented Practice Guidance. Psychiatric Services 62 (12) 1470-1476.
Williams, J., Leamy, M., Bird, V., Harding, C., Larsen, J., Boutillier, C., Oades, L. & Slade, M. (2012). Measures of the recovery orientation of mental health services: systematic review. Social Psychiatry and Psychiatric Epidemiology 47 (11) 1827-1835.
Carrick, H., Purcell, R. & Byrne, M. (2013). Embracing performance measurement in mental health services. Irish Journal of Psychological Medicine 30, 209-219.
Hammel, K. (2015). Client-centred occupational therapy: the importance of critical perspectives. Scandinavian Journal of Occupational Therapy 22, 237-243.
Bowie, P., Bradley, N. & Rushmer, R. (2012). Clinical audit and quality improvement - time for a rethink? Journal of Evaluation in Clinical Practice 18, 42-48.
National Institute for Clinical Excellence, UK. (2002). Principles for best practice in clinical audit. London: Radcliffe Publishing.
Bart, O., Avrech Bar, M., Rsendbery, L., Hamudot, V. & Jarus, T. (2011). Development and Validation of Documentation of Occupational Therapy Session during Intervention. Research in Developmental Disabilities 32, 719-726.
Lou J. & Durando P (2008). Asking clinical questions and searching for the evidence. In: Evidence based rehabilitation: a guide to practice. Law, M. & MacDermind, J. (eds.), 2nd edn. Thorofare, NJ: SLACK Incorporated.
Health Service Executive. (2013). A Practical Guide to Clinical Audit. Available from: http://www.hse.ie/eng/about/Who/qualityandpatientsafety/Clinical_Audit/clauditfilespdfs/practicalguideclaudit2013.pdf
British Association of Occupational Therapists/College of Occupational Therapists. (2011). Professional Standards for Occupational Therapy Practice - Practice and process - standards. Retrieved May 30, 2014, from: http://www.cot.co.uk/sites/default/files/general/public/4-Practice-process.pdf
Mental Health Commission. (2008). A Recovery Approach within the Irish Mental Health Services. A Framework for Development. Dublin: Mental Health Commission.
Slade, M. (2010). Measuring recovery in Mental Health Services. Israel Journal of Psychiatry & Related Sciences 47 (3) 206-212.
Indecon. (2010). Accountability in the delivery of a vision for change - a performance assessment framework for mental health services. Available at: (http://amnesty.ie/reports/accountability-delivery-vision-change-performanceassessment-framework-mental-health-service).
Baars, I., Evers, S.M., Arntz, A. & van Merode, G.G. (2010). Performance measurement in mental health care: present situation and future possibilities. International Journal of Health Planning and Management 25 (3) 198-214.
Moran, V., O’Connor, S. & Borowitz, M. (2013). International approaches to measuring the quality of mental health care. Epidemiology and Psychiatric Sciences 22 (1) 3-7.
Muligan, S. & Arthanat, S. (2014). An Examination of Occupation-Based, Client-Centered, Evidence-Based Occupational Therapy Practices in New Hampshire. OTJR: Occupation, Participation and Health 34 (2) 106-116.
Tolan, S., Fox, J. & Gallagher, A. (2014). Knowledge and attitudes of Irish occupational therapists towards recovery. Irish Journal of Occupational Therapy 42 (1) 22-29.
Spaniol, L., Wewiorski, N., Gagne, C. & Anthony, W. (2002). The process of recovery from schizophrenia. International Journal of Psychiatry 14, 327-336.
Turpin, M. & Iwama, M.K. (2011). Using occupational therapy models in practice: A field guide. Edinburgh: Churchill Livingstone.
Schindler, V. (2010). A Client-Centred, Occupation-Based Occupational Therapy Programme for Adults with Psychiatric Diagnoses. Occupational Therapy International 17, 105-112.
Gustafsson, L., Molineux, M. & Bennett, S. (2014). Contemporary occupational therapy practice: The challenge of being evidence-based and philosophically congruent. Australian Occupational Therapy Journal 61, 121-123.
Hitch, D., Pepin, G. & Stagnitti, K. (2014). The Integrating Theory, Evidence and Action (ITEA) Method: A Procedure for Helping Practitioners Translate Theory and Research into Action. British Journal of Occupational Therapy 77 (12) 592-600.
Rouleau, S., Dion, K. & Korner-Bitensky, N. (2015). Assessment practices of Canadian occupational therapists working with adults with mental disorders. Canadian Journal of Occupational Therapy 82 (3) 181-193.
DOI: http://dx.doi.org/10.5750/ejpch.v4i2.1079
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