Depression is characterised by loss of interest in activities and difficulty carrying out everyday tasks. Occupational therapy supports people to participate in the activities they want or need to do; however, there is limited evidence on the perceived effectiveness of occupational therapy for people with depression. The study aims/objectives were to identify service user perspectives on (i) the effectiveness of individualised occupational therapy in enabling improvement in occupational functioning and participation, and (ii) the most effective components of occupational therapy. Semi-structured interviews with community-dwelling adults diagnosed with severe, and predominantly enduring, depression and an identified occupational need, who had received occupational therapy, were analysed thematically. Participants ( n  = 7) were derived from a larger mixed-methods study. Three key themes were identified: Occupational therapy is about doing everyday activities which supports positive change; occupational therapy is client-centred which supports progress; the skills, attributes and characteristics of occupational therapists are important. Compelling narratives of how occupational therapy improves participation were evident, providing detailed information on the perceived effectiveness of occupational therapy. This research supports the evidence base for occupational therapy in mental health by mapping the perceived mechanisms of change, or aspects of occupational therapy participants found most helpful.
A client-centred approach ensures that individuals can express what's most important to them, with therapists providing collaborative support. This study examined factors influencing the quality of collaborative relationships between clients and occupational therapists and explored how the strength of these relationships affects therapy outcomes. A prospective longitudinal observational study was conducted at day care centres across Japan, with participants followed for 1 year. Occupational therapists delivered occupational therapy guided by a client-centred approach. Outcomes, including daily activities and health-related quality of life, were measured before and after the intervention. The Collaborative Relationship Scale (CRS) was used to assess baseline relationship quality. Among 101 participants (aged 47-93 years), CRS scores categorised them into good, neutral, and poor relationship groups. Logistic regression revealed that goal achievement and clients' understanding of occupational therapy were associated with relationship quality. Over 50% of participants in the good relationship group had activities of daily living goals, whereas more than 50% in the poor relationship group had mobility goals. Strong collaborative relationships may positively influence occupational therapy processes and outcomes. These findings highlight the importance of goal setting within occupational therapy guided by a client-centred approach in enhancing therapeutic relationships.
Indexed publications in occupational therapy reflect the field's evolving priorities, practices, and methodologies. They play a central role in advancing research, informing professional practice, and fostering theoretical development. This study explores the historical and methodological evolution of indexed publications in occupational therapy to identify trends, thematic shifts, and methodological progress. A bibliometric analysis was conducted on 10,776 articles published between 1945 and 2022 in 15 occupational therapy journals indexed in the Web of Science database. Articles were systematically screened, and performance indicators, citation patterns, and thematic trends were analyzed. The findings revealed three distinct publication periods: foundational (1945-1989), expansion (1990-2009), and maturity (2010-2022). Thematic priorities evolved over time, shifting from physical rehabilitation to mental health, community-based interventions, and broader inclusion of diverse populations. Methodologically, the field progressed from qualitative reviews and descriptive studies to a greater presence of mixed methods, systematic reviews, and experimental designs, although some limitations in rigor persist. Occupational therapy research has experienced significant growth, thematic diversification, and increasing methodological sophistication. These developments reflect the profession's responsiveness to changing societal needs and clinical contexts. The study highlights the importance of sustaining evidence-based practice, interdisciplinary collaboration, and continued investment in high-quality research to support the evolution of the discipline.
Republic Act No. 11241, the Philippine Occupational Therapy Law of 2018, grants occupational therapists professional recognition and autonomy. However, systemic barriers continue to limit the integration of occupation-based practice (OBP) in hospitals. This study examines institutional challenges occupational therapists face in implementing occupation-based interventions within the Philippine hospital system. An interpretive phenomenological study using semistructured interviews was conducted with hospital-based occupational therapists across various healthcare institutions in the Philippines given 4 years of the law's enactment. Purposive sampling ensured representation of therapists with experience in OBP. Data were analyzed thematically, guided by Bourdieu's theory of practice, to explore how institutional structures influence occupational therapy practice. Findings reveal that hierarchical referral systems and biomedical dominance restrict occupational therapists' autonomy, reinforcing impairment-based rehabilitation over occupation-based interventions. Physician-dependent referral pathways further limit their ability to initiate OBP, restricting interdisciplinary collaboration. Institutional policies, resource constraints, and limited mentorship opportunities exacerbate these challenges. Despite legal recognition, systemic barriers hinder OBP in Philippine hospitals. Addressing these challenges requires structured hospital policies, referral pathway reforms, and professional development programs. Strengthening interdisciplinary collaboration and mentorship can support occupational therapists in advocating for and integrating OBP into hospital rehabilitation services.
Parental education has been highlighted as an effective intervention for children, young people and families. However, no parental education interventions are underpinned by occupational therapy (OT) theory. This study aimed to understand the perspectives of parents/carers of children with neurodevelopmental disorders on the acceptability and design of a parental educational intervention underpinned by OT theory. 23 parents/carers of children aged between 5 and 11 years who had a diagnosis of Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder and/or Developmental Coordination Disorder participated in one of three online 90-minute focus groups. Participants were presented with a draft of the proposed intervention and engaged in a facilitated discussion about the acceptability and feasibility of the intervention. Data were analysed using thematic analysis. Four themes were generated: (1) Parents want to develop skills to support their child, (2) parents also need support, (3) there are barriers to reaching parents and (4) parents need an inclusive environment to promote their learning. Parents/carers acknowledged the benefits of the intervention, highlighting the importance of focusing on supporting parents as well as their children. They also raised potential barriers to participation, which included time and money, and emphasised the importance of designing the group with inclusivity as a central principle.
While occupational therapists (OTs) promote quality of life through meaningful occupation, little attention has been paid to the role that leisure plays in palliative care. This review aims to explore the perceptions of service users and OTs regarding engagement in leisure activities at the end-of-life. 1. Determine the value of leisure activities for older adults living with cancer on the palliative pathway, 2. To identify interventions to promote occupational engagement. A qualitative systematic review was conducted in accordance with the PRISMA Statement. The electronic databases namely ASSIA, AMED, CINAHL, Medline, PsycArticles, and PubMed were searched. Qualitative studies meeting the eligibility criteria were included. Two reviewers independently screened the identified articles. The findings were qualitatively synthesised using thematic analysis. We included seven articles with 405 participants. This review demonstrated that leisure could help people in palliative care maintain a sense of identity and normalcy. Leisure also increased happiness and provided relief from pain. Occupational therapy interventions targeting leisure allowed people to maintain a consistent level of engagement. Further empirical research is required to explore palliative patients' perspectives on leisure and to develop specific occupational therapy interventions that enable OTs to facilitate leisure engagement for people in palliative care. Why we conducted this review: • There is little focus on engaging people in leisure when they experience palliative care and there is a big emphasis on managing symptoms of cancer. • More and more people need palliative care due to the increasing ageing population who live longer with debilitating chronic illness. What did We do: • We systematically identified relevant articles and reviewed the literature from the past 14 years to understand the perspectives of older adults receiving palliative care on participating in leisure. What did we find out: • Older adults living with cancer value leisure activities because leisure gives them a greater sense of control over their lives, helps them to maintain a sense of normalcy, provides relief from pain, and increases feelings of happiness. • Occupational therapists have the skills to enable people to participate in leisure by changing the way an activity is done or changing the environment.
Primary care is a growing area for allied health professionals, including occupational therapists, offering opportunities for early intervention and prevention alongside collaborative, holistic approaches to patient care. The aim of the rapid review was to explore the evidence regarding positioning occupational therapists in this setting. Bibliographic databases (CINAHL, Medline, APA PsycInfo), Google Scholar and websites of relevant organisations were searched. Search parameters were English language and date (2013-2024). The initial inclusion criteria focussed on United Kingdom (UK) research but due to a lack of high-quality evidence, randomised controlled trials from countries outside of the UK were included. Sixteen papers were included in the review. Four papers reported UK research. Interventions included falls prevention, frailty services, lifestyle management programmes, medication adherence, mindfulness and vocational clinics. The evidence supported the positioning of the occupational therapy workforce in primary care particularly in the areas of falls interventions, frailty services and self-management. Where occupational therapists were co-located with primary care professionals, this fostered communication, information sharing and a better understanding of occupational therapy.
Artificial intelligence is playing an increasingly important role in supporting rehabilitation processes, offering benefits for both clients and therapists. This study aimed to explore the potential use of ChatGPT-an AI-powered online chatbot-in occupational therapy using clinical case scenarios and to compare the clinical decision-making approaches of ChatGPT and occupational therapists. This study employed a comparative design to evaluate the clinical decision-making skills of ChatGPT and occupational therapists. A total of 111 occupational therapists and ChatGPT responded to 9 questions related to 3 different cases, including items on models and frames of reference, assessment, and intervention. ChatGPT and occupational therapists demonstrated similar decision-making in one case for models and frames of reference, one case for assessments, and one case for interventions (p > 0.05). However, their decision-making differed in the other two cases (p < 0.05). These findings underscore artificial intelligence's promising yet complex role in occupational therapy, highlighting how occupational therapists integrate multiple factors and individual client needs into their decision-making, in contrast to the algorithm-based reasoning of ChatGPT.
Occupational therapy is an inherently emotional endeavour for both clients and therapists. Despite navigating diverse and challenging work environments, relatively little is known about how occupational therapists are expected to manage and express their emotions in line with job-related emotion norms. The aim of this study was to explore the emotional labour experiences of occupational therapists when interacting with clients. Fourteen qualified occupational therapists (11 female and 3 male) took part in a semi-structured interview about practice-related emotion norms, emotion regulation and emotion performance demands. Data were analysed using reflexive thematic analysis. Two overarching themes captured the complexities of emotional labour when interacting with clients including (1) navigating subjective emotion norms, and, (2) negotiating authentic and inauthentic emotions to nurture the therapeutic relationship. Prioritizing client needs informed how and what emotions were expressed and regardless of the emotional labour strategies adopted, therapists strived for perceptions of sincerity in their relationships with clients. The enactment of emotional labour when interacting with clients is critical to delivering therapy and meeting professional standards. The findings have implications for practitioners (e.g. reflective practice, self-care), managers (e.g. supervision) and organizations (e.g. support structures, education) and point to fruitful avenues for research.
There is a pervading feeling of dissonance within the occupational therapy profession: a sense that occupational therapy, and the work of occupational therapists, is not always recognised. Alongside this, there are examples of occupational therapists whose work is recognised at the highest levels and who are realising Elizabeth Casson's legacy. The social age, which we now live in, provides the means to capitalise on examples such as these, to change this narrative, through social movements and social leadership. By committing to a social movement, a form of collective action that enables occupational therapists to tell their own stories through their own networks, and exercising social leadership, which is not dependent on hierarchy or position, occupational therapists can promote the centrality of occupation in the lives of people. Collective action is contingent on individuals making a commitment to act, even if this requires overcoming any barriers they may experience. Elizabeth Casson's contribution to the profession and the collective wisdom of the Elizabeth Casson lectures provide inspiration for anyone unsure of where to begin.
The World Federation of Occupational Therapists (WFOT) Occupational Narratives Database (OND) project strengths, weaknesses, opportunities, and threats (SWOT) were explored. SWOT thematic analysis of digital stories uploaded on the OND platform was conducted. A total of 761 digital stories were published from over 29 countries and 14 different languages. They highlighted the significance of everyday activities, social participation, adaptation to life circumstances, barriers to participation, and the importance of cultural engagement as emerging key themes. The SWOT analysis identified diversity of digital stories from multiple countries and different languages, provision of experiential learning, and launching global initiatives to raise public awareness about occupations as strengths and opportunities for growth and development. Lack of variety in terms of co-occupations, contextual environments, languages used, lack of submissions from certain countries, lack of sustainable social media representations, and consequently limited growth in digital stories were all indicated as weaknesses and threats. The OND project has helped broaden perspectives and understand the diverse meaning of occupations and value of occupational participation across different settings, age groups, and cultures. It provided rich insights into the ways people engage in meaningful occupations and profiled occupation as the domain of occupational therapists globally.
The ability to manage time and materials effectively is foundational to post-primary students taking control of their education. For many students, organisational skill difficulties serve as a barrier to academic achievement in the high-stakes environment of post-primary education. This study explored Irish post-primary school teachers' perspectives of student organisational difficulties and their experiences of engaging in an occupational therapy led teacher professional learning pathway aimed at building capacity to implement the Getting it Together programme. An exploratory, descriptive methodology was employed. A group survey design was used, with data collected from the same group of teachers at three timepoints in 2021 to capture evolving perceptions. Convenience sampling recruited 21 post-primary teachers. Data were analysed using descriptive statistics and thematic analysis. Four themes emerged: 'Challenges with Organisational Skills Leads to Frustration and Impacts Student Confidence', 'Embedding Organisational strategies into everyday teaching', 'Organisational skills in out-of-school contexts' and 'Facilitators and Barriers to implementing GIT'. These reflected teachers' perspectives of students' organisational skills and their experiences of engaging in an occupational therapy led teacher professional learning pathway. This study provides insights into how school-based occupational therapy can build educators' capacity to implement evidence-informed strategies to support students' organisation.
The aim of this study was to test the reliability and validity of OAS-S to measure occupational adaptation in schizophrenia. We used the Davis technique with 10 expert panellists and administered the scale form to 320 people. Two weeks later, we tested 80 people again. Then, we conducted item analysis to evaluate the internal consistency. We also conducted exploratory and confirmatory factor analysis to examine the structural validity. The content validity index of the scale was found to be 0.895. Exploratory factor analysis showed that the scale consisting of 18 items had a three-factor structure that explained 69.925% of the variance. The model fit indices showed that the measurement model was appropriate (RMSEA = 0.045; GFI = 0.954; AGFI = 0.885; NNFI = 0.935; CFI = 0.946; NFI = 0.964; IFI = 0.973; CMIN/DF = 2.405). The results of the reliability analysis were as follows: Intraclass Correlation Coefficient = 0.995 and Cronbach's alpha = 0.998. The results showed very high and statistically significant correlation coefficients between the first and second administrations (r = 0.992; p < 0.001). The OAS-S is a valid and reliable scale consisting of 18 items and 3 subscales. It consists of person, interaction, and occupational environment subdomains. We recommend further studies to validate the scale and adapt it across cultures.
Work inclusion of people with disabilities (PWD) is a pivotal area of occupational therapy (OT). National and international legislation underlines the rights and duties of PWD concerning workplace inclusion. Despite legal frameworks promoting PWD rights in employment, significant barriers exist. Few studies have explored OT interventions in this context. This research aims to assess the impact of an OT-based job coaching intervention on PWDs' participation and engagement in the Lebanese labor market. Using an ABABA design, the study involved 27 sessions applying job coaching principles within an OT framework. Three employed individuals with disabilities, facing workplace challenges, participated. Baseline data included task execution speed and errors. Occupational participation and engagement were measured using the Model of Human Occupation Screening Tool. OT-based job coaching effectively enhanced PWD's participation and engagement, reducing task errors and execution time, thereby addressing some occupational challenges. Based on the outcomes of this study, integrating job coaching with OT approach may improve job performance for PWD. Future research should replicate these findings on a larger scale to validate their applicability in Lebanon and globally.
The refugee situation in which the Sahrawi people live entails precarious policies, services, and care systems. People with disabilities suffer even more from this situation, seeing their quality of life diminished. To evaluate the personal outcomes related to the quality of life of the students at the special education school in Auserd. The KidsLife and KidsLife TEA questionnaires were administered to the 26 students from the special education center during March 2019. The results obtained from 100% of the participants display percentiles below the minimum values of the scale, with the most positive scores found in the Emotional Well-being domain and the least positive in the Social Inclusion domain. The quality of life of the students at the special education center in Auserd has deteriorated due to the social, environmental, and political factors they face. Furthermore, it is necessary to have tools adapted to the context.
Occupational balance is an important concept in occupational therapy. However, no validated Occupational balance assessments currently exist in Lithuania. This study aimed to examine the psychometric properties of the Lithuanian version of the Occupational Balance Questionnaire 11 (OBQ11-LT). A total of 127 healthy adults completed the OBQ11-LT to evaluate construct validity. Of these, 53 participants were randomly assigned to complete the questionnaire again after 7-10 days to assess test-retest reliability. Construct validity was examined using exploratory and confirmatory factor analyses. Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC) for both total scores and individual items. Internal consistency was assessed with Cronbach's alpha. The model demonstrated acceptable fit (χ²(45) = 719.79, p < 0.001; CFI = 0.933; TLI = 0.909; RMSEA = 0.106). The ICC between test and retest OBQ11-LT total score was 0.924. Total scores showed a significant statistical relationship (p < 0.01), indicating good reliability. Cronbach's alpha for the OBQ11-LT total score was 0.915, indicating acceptable internal consistency. OBQ11-LT demonstrates good reliability and validity for assessing occupational balance in general populations. Its psychometric properties are suitable for practice and research, making it a valuable tool for studying occupational balance in similar contexts and broadening the research areas for Lithuanian occupational therapists.
Alopecia areata (AA) is a chronic condition that causes unpredictable hair loss, often leading to significant psychological distress. While the social and medical implications of AA have been explored, the occupational impact has not been considered. This scoping review aimed to explore the lived experiences of individuals with AA from an occupational perspective. A five-stage methodological framework was followed, with a search conducted across three databases (2003-2023), identifying key terms related to AA and its effects on both children, adults, and older adults. Eleven qualitative studies were selected from an initial 265 results, including 989 participants aged 10-79, mainly from North America and the United Kingdom. Data were analysed thematically, identifying three key themes: (1) Navigating AA through occupations across the lifespan, (2) Occupational Engagement in Self-Care is not Always Pleasurable, and (3) Connecting the meaning of hair and its loss with daily occupations. The review concluded that AA affects various aspects of life, including work, study, self-care, and physical activities. While the condition can be distressing, it sometimes leads to the development of new, meaningful occupations. These findings highlight the potential role of occupational therapists in supporting individuals with AA.
Sleep is fundamental to an individual's health, well-being and quality of life. Poor sleep and sleep disturbances are common for individuals receiving palliative care. Occupational therapists play a crucial role by effectively addressing sleep in this context. However, there has been limited research regarding the role, scope and implementation of sleep management interventions among occupational therapists within palliative care, and the needs that therapists have to support this area of practice. An online cross-sectional survey was conducted among Australian occupational therapists with current or recent experience in palliative care. Qualitative data from open-ended response items were analysed using content analysis. Fifty-one occupational therapists (92.2% female) with an average of 7.6 years of experience working in palliative care completed the online survey. Most participants (88.2%) perceived that sleep was within the scope of the occupational therapy practice in palliative care; however, few participants indicated good/excellent knowledge of sleep or sleep assessment and intervention. Barriers to adequately addressing sleep issues included a lack of therapists' knowledge, limited understanding of the scope by other professionals, workload constraints and limited resources. Occupational therapists may benefit from evidence-based resources and guidelines to address sleep issues in palliative care.
Occupational therapy is evolving rapidly due to technological advances and demographic and sociocultural changes. Recognizing emerging trends is fundamental to developing responsive educational programs, evidence-based practices, and adaptive health policies. This study explores expert perspectives across five themes: (1) Future Technologies, (2) Neuroscience and Biotechnology Integration, (3) Technology-Based Therapy Approaches, (4) Sociocultural and Demographic Impacts, and (5) Innovative Educational Methods. A three-round Delphi study was conducted with 36 occupational therapy professionals. The sample included 12 academicians (mean age (M) = 34.5, 67% female), 12 clinicians (M = 31.2, 75% female), and 12 final-year interns (M = 23.1, 92% female). The mean professional experience was 6.0 years for academicians and 5.8 years for clinicians. Thematic analysis and Kendall's W were used to evaluate consensus. Participants emphasized the importance of integrating virtual reality/augmented reality interventions, artificial intelligence-supported assessments, and telehealth into occupational therapy practice. Neuroplasticity-based interventions and simulation-based learning were highlighted for future competence. Ethical concerns regarding artificial intelligence, as well as cost and digital literacy barriers, were also noted. To meet future challenges, occupational therapists should enhance digital competencies, ensure accessibility, and develop inclusive, culturally responsive practices. Findings inform clinical, educational, and policy strategies in occupational therapy.
The United Kingdom (UK) occupational therapy (OT) workforce faces increasing demand amid demographic transitions and workforce shortages. The Royal College of Occupational Therapists developed a national workforce strategy in 2024, necessitating baseline data to measure progress. A national survey employed adaptive sampling to achieve comprehensive representation of the UK OT workforce, examining demographics, diversity, and practitioner experiences. Two thousand two hundred seventy-seven respondents completed the survey (4.32% of Health and Care Professions Council-registered occupational therapists). Response rates varied by question, with some allowing multiple selections. Sixty-seven percent reported increased service demand, with complex, multiple conditions being the most commonly selected driver (63%). Despite 41% experiencing high stress levels, 57% remained satisfied with their roles. Key retention factors were helping others achieve goals (64%) and direct service user contact (61%). Evidence use favoured service user feedback (71%) over published research (47%) and cost-effectiveness data (13%). Only 6% felt very confident with artificial intelligence technologies, despite 57% seeing potential. Main challenges included understaffing (46%) and system capacity gaps (46%). The workforce demonstrates resilience amid systemic pressures. Priority actions include addressing staffing shortages, enhancing the use of robust evidence to inform practice, building digital confidence, and supporting workforce motivation to help others achieve their goals. Findings provide baseline data with international relevance.