Occupational Therapy: How Effective Do Consumers Think It Is?
van der Haas, Marianne C., Horwood, Claire N., New Zealand Journal of Occupational Therapy
Objective: The purpose of this pilot study was to examine a specific role negotiated by occupational therapists in a community mental health team.
Method: A programme evaluation approach was used to gather feedback on consumers' perception of the effectiveness of occupational therapy. Consumers experience was examined and organised into themes.
Results: Despite a low response rate, feedback suggests occupational therapy intervention was perceived to be effective in improving occupational satisfaction. Feedback in relation to culture and spirituality raised questions about the incorporation of these into practice.
Conclusion: Occupational therapists' professional skills and knowledge are an important asset in recovery focused teams and should not be lost in generic roles.
Consumer satisfaction, occupational outcomes, occupational therapy
Van der Haas, M. & Horwood, C. Occupational therapy: How effective do consumers think it is? New Zealand Journal of Occupational Therapy, 53(1), 10-16
In 1998 the Continuing Care Team (CCT) North was a community based mental health team for Waitemata District Health Board (DHB), one of the three DHBs providing mental health services in the Auckland region. The team was composed of a psychiatric consultant, five psychiatric nurses, two social workers and two occupational therapists. Clients were adults aged 18 to 65, living in the community on Auckland's North Shore. These adults, who had a primary diagnosis of schizophrenia or bi-polar disorder, had high support needs and required pro-active mental health workers to build therapeutic relationships and provide follow up services. The Recovery Model (Anthony, 1993; Jacobson & Greenley, 2001) which was introduced to CCT North in the 1990's was embraced by occupational therapists in the team because the proposed beliefs and assumptions for fostering recovery are closely aligned to the philosophy of occupational therapy (Rebeiro Gruhl, 2005).
At the time mental health clients, who wanted to be known as mental health consumers, were advocating to have more input in their health care (Donabedian, as cited in Stallard, 1996). Likewise, Waitemata DHB were committed to reducing inequalities in health outcomes (Waitemata District Health Board, 2003) and planned to actively incorporate the principles of the Treaty of Waitangi into policy and practice. They also wanted consumers involved in all aspects of planning, funding, provision and evaluation of services to reflect their mission statement: "To be judged by consumers as innovators of best possible mental health service" (Waitemata Health, 1998 p. 1).
Community Support Worker services established in the mid 1990s had challenged the roles of CCT North team members. It was a timely opportunity for occupational therapists in that team to evaluate their role. Trends in New Zealand and Australia represented the role of occupational therapists in mental health as largely generic rather than specific (Lloyd, King, & McKenna, 2004; Lloyd, McWha, & King, 2003). Alternatively, occupational therapists in the CCT North had argued against these trends because they felt that allocation of staff time often favoured the treatment paradigm thus constraining their focus on enabling occupation (Krupa, Radloff-Gabriel, Whippey, & Kirsh, 2002). Consequently they had negotiated a strong discipline specific role and were now keen to gain consumer feedback of their service. They wanted to determine:
1. How effective consumers believed the occupational therapy service was in enabling them to lead meaningful and satisfying lives.
2. How improved performance in self care, productivity and leisure impacted on their overall health and well-being.
Literature shows that there is an increased demand for evidence based practice and accountability (Stanton, Kramer, & Thompson-Franson, 1997; Canadian Association of Occupational Therapists (CAOT), 1997). …