Occupational therapy interventions for recovery
Reviewed by Dr Katrina Bannigan, Director of
RCOMH.
This systematic review is one of three published in the special
issue on the effectiveness of occupational therapy services in
mental health practice published by the American Journal of
Occupational Therapy. The editor’s motivation in compiling the
special issue was an attempt to build the evidence supporting the
occupational therapy profession’s contribution to mental health
practice.
The publication of this paper is timely in that it focuses on
the contribution of occupation- and activity based interventions,
and interventions addressing performance skills and performance
patterns; aspects of the environment; and context, activity
demands, and client factors, in terms of recovery for people with
serious mental illness in community settings. Serious mental
illness was defined as the group of people who experience
schizophrenia, major depression, bipolar disorder, and
schizoaffective disorder. Gibson et al (2011) contest that
“…community integration is the tangible manifestation of the
personal recovery experience because it can be viewed by others and
it allows for concrete measurement. The acquisition and maintenance
of normative life roles serve as an additional manifestation of the
personal recovery experience.” (p248). However, there was not an a
priori agreed measure, which is usually expected in systematic
reviews, but the studies were integrated in narrative review rather
than a meta analysis so the issue of heterogeneity was not an
issue. Gibson et al (2011) observe “Evidence can be found
indirectly, however, by examining the components of recovery”
(p253). This is indicative of the fact that the evidence of
effectiveness of interventions to improve recovery and more
research in the area of recovery is limited. Gibson et al (2011)
make two very important points namely,
- “This type of research is best achieved through the development
of a cooperative network of academic, clinical, and professional
staff to develop, design, and see grant funding for multisite
efficacy studies” (p254), and
- “…it is important that mental health curricula incorporate the
most up-to-date information on best practice” (p254).
Some observations in passing
- The search terms were shaped by a Patient Intervention
Comparison and Outcome (PICO) question. Therefore it should be a
useful worked example, for students at undergraduate and
postgraduate levels, of how the research question is used to shape
a search strategy.
- Two Masters students contributed to this work as part of their
degree. This is an example of how students can use their studies
positively to make a valuable contribution to the evidence
base. To grow the evidence base postgraduate students are
encouraged strongly to engage with faculty members to see how they
can contribute research programmes that will contribute to
developing the evidence for occupation and mental health.
- The data extraction table is published as a supplemental table
(available from the web) which is a bit frustrating when reading
the hard copy. More journals are doing this now because of the
constraints on space in hard copy.
If you would like to read this article the full reference is
Gibson RW, D’Amico M, Jaffe L, Arbesman M (2011) Occupational
therapy interventions for recovery in the areas of community
integration and normative life roles for adults with serious mental
illness: a systematic review. The American Journal of Occupational
Therapy, 65(3), 247-256. Doi:10.5014/ajot.2011.001297