Department of Occupational Therapy Works
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Item History of Professional Occupational Therapy Education at Indiana University, 1924-2022(2022) Fisher, Thomas F.; Fess, Elaine Ewing; Laurencelle, Patricia; Nathan, Carol D.; Hamant, CelestineDuring its over one hundred year history as a profession, Occupational Therapy (OT) has provided leadership in teaching, research and civic engagement pertaining to the health of the citizens of Indiana, the region and the nation. Indiana University began its OT program in 1957, forty years after the profession was founded. It was the first established program in the state.Item Considerations for Occupational Therapists in Developing Community-Level Interventions for Youth with High Adverse Childhood Experiences (ACEs)(Western Michigan University, 2022) Wilburn, Victoria G.; Huber, Megan E; Senter, Denise; Stoll, Hannah B.; Occupational Therapy, School of Health and Human SciencesDrug misuse likely contributes to the over 30,000 children in foster care and to the 24.2% of children who have experienced two or more adverse childhood experiences (ACEs). Twenty-five percent of children are living in poverty, with nearly half of those living in single-parent households. Among the national guidelines to preventing ACEs are connecting youth with positive activities and providing family relationship enhancement opportunities. We believe the profession of occupational therapy can help contribute to the mental and behavioral health care workforce in a greater capacity than is currently used. Many children are not afforded the opportunity to engage in novel leisure pursuits that are essential for positive mental health function and well-being. Occupational therapists can assist in creating a culture of health and equity for youth by harnessing the power of play and leisure to promote self-healing communities.Item A Mixed-method Analysis of Community-Engaged Theatre Illuminates Black Women’s Experiences of Racism and Addresses Healthcare Inequities by Targeting Provider Bias(Sage, 2020) Wasmuth, Sally; Pritchard, Kevin; Milton, Cierra; Smith, Emily; Occupational Therapy, School of Health and Human SciencesTheatre has been a powerful means of eliciting social change. This paper describes methods and outcomes of a theatre project to reduce healthcare inequities experienced by Black women. We conducted narrative interviews with a convenience sample of Black women and conducted thematic analysis of interview transcripts to learn about their experiences of healthcare and to inform development of a professional theatrical production. To assess the impact of the performance on the audience, we used a single post-test concurrent mixed-methods design using a self-created Likert-type survey that included space for open-ended responses. Ten Black women completed narrative interviews. Thematic analysis revealed 5 main themes: being ignored, being accused, being talked-down to, fearing harm, and being hurt. Narratives were used to create a script that centered on these themes, and that was professionally produced and performed. Audience members (n = 113, 25% healthcare providers) produced a mean total post-test score of 19.28 (agree/strongly agree) on a 25-point survey with 2 items scoring in the 2 to 3 range (disagree/not sure). Thematic analysis data revealed the extent to which Black women experienced discrimination in multiple settings. Quantitative survey data suggested audience members conceptually understood and were aware of inequity, but open-ended responses revealed this information was new for some, and prior knowledge for others. The audience reported planning to change personal behaviors that may contribute to inequity. Participants were unsure if they had contributed to inequity in the past. The performance stimulated conversation about implicit bias and discrimination and encouraged audience members to examine their contributions to the problem. Future pre-post studies are needed to better assess the impact of the performance. Theatre has the potential to illuminate the extent and nature of discrimination in healthcare and society, and to foster conversations that allow audience members to consider their own potential contributions to discrimination.Item Adverse Childhood Experiences and Mental Health Conditions Among Multiracial Adolescents(Taylor & Francis, 2021) Weller, Bridget E.; Conrad, Joseph K.; Wilburn, Victoria G.; Ramamonjiarivelo, Jo; Gladden, Jessica; Occupational Therapy, School of Health and Human SciencesThe relationships between adverse childhood experiences (ACEs) and mental health conditions have received much attention in the literature. A particularly well-documented type of ACE is household dysfunction. However, compared to monoracial youth, little is known about the relationship between this type of ACE and mental health outcomes among multiracial adolescents. Objective The objective of this study was to verify the factor structure of the household dysfunction type of ACE using data from the National Survey of Children’s Health (NSCH), and then examine whether household dysfunction (measured as a latent construct) was associated with mental health conditions among multiracial adolescents. Design We used cross-sectional data collected in 2016 from caregivers who completed the NSCH and analyzed data from a subpopulation of adolescents (12–17) who reported more than one race (n = 1,231). Mplus 8.4 was used to conduct confirmatory factor analysis and probit models from a structural equation modeling framework. Results Results from this study indicated that the household dysfunction type of ACE, as a latent construct, had good model fit and was significantly associated with depression [standardized coefficient [B] = .50, 95% confidence interval [CI] .36, .65], anxiety [B = .61, 95% CI .48, .73], behavior problems [B = .58, 95% CI .44, .72], and ADHD [B = .54, 95% CI .38, .69] for multiracial adolescents. Conclusions Household dysfunction may result in adolescents being separated (physically or emotionally) from their caregivers, which may hinder adolescents’ ability to establish or maintain one of the most important relationships needed to promote racial/ethnic identity development and mental health. Implications for advancements in theory and NSCH are presented.Item Utilizing Student Consultation to Promote Incorporation of Occupational Therapy in a Pediatric Behavioral Health Unit(Eastern Kentucky University, 2020) Wilburn, Victoria; Stoll, Hannah; Fodstad, Jill; Chase, Anthony; Douglas, Christina; Occupational Therapy, School of Health and Human SciencesThis advanced graduate elective was designed for second year Master of Occupational Therapy students to provide opportunities for students to act as consultants of the profession and collaborators within the community utilizing community engaged learning methods. This elective helped to detail components of evidence-based practice, primary needs of integration, and future opportunities within an urban pediatric behavioral health unit. The practice area of mental health was chosen specifically as the collaborating site due to the decline of occupational therapist recognition as qualified mental and behavioral health providers. This lack of recognition may limit reimbursement and funding, and decrease employment opportunities, both detriments to practice. However, within the last decade there has been a resurgence in establishing the profession’s roots within mental and behavioral health practice. Several key pieces of federal legislation have recognized occupational therapists' expertise and have cited the profession in several mental and behavioral health initiatives. Many states are seeking recognition of occupational therapists as qualified behavioral health providers (QBHP) or qualified mental health providers (QMHP) and this elective provided the opportunity for didactic instruction to intersect with advocacy and education while producing a rich learning experiences for all involved.Item Intersections of occupational participation and borderline personality disorder: A grounded theory approach(Taylor and Francis, 2020-01) Wasmuth, Sally; Mokol, Emily; Szymaszek, Karolina; Gaerke, Kyra-Jo; Manspeaker, Trevor; Lysaker, Paul; Tommasi, Marco; Occupational Therapy, School of Health and Human SciencesBorderline personality disorder (BPD) is characterized by intense emotions, self-harm, unstable self-image, and risky behaviors, which impede wellness and interfere with occupational participation. However, literature on occupational participation of people with BPD is scarce and has mostly focused on women. This study explores and elucidates intersections of occupational participation and BPD in a sample of mostly male veterans in order to identify potential ways occupational therapists and other health professionals can support wellbeing for this population. Grounded theory analysis was conducted on data collected using the Indiana Psychiatric Illness Interview (IPII), a semi-structured interview designed to elicit illness personal narratives. Analysis yielded three main themes—influencing environment, internal experience, and occupation—and several subthemes including being abused, arising problems, feeling neglected, feeling victimized, escape, self-segregating, positive change, participating/engaging, and substance abuse. Occupations both influenced and were influenced by the environment and internal experiences. Environments appeared to influence internal experience, but internal experiences did not influence environments directly. Rather, internal experiences impacted a person’s occupations which, in turn, impacted their environments. Participants’ occupational lives revealed, as expected, several subthemes depicting negative and/or isolating experiences. However, participants’ occupations directly impacted both their environmental contexts and internal experiences, suggesting occupational performance may be a powerful mechanism of change for this population. Findings offer promise that occupational therapists could facilitate health-promoting occupational participation which, in turn, may result in more positive and health-promoting environments and internal experiences.Item Comparing Narrative-Informed Occupational Therapy in Adult Outpatient Mental Health to Treatment as Usual: A Quasi-Experimental Feasibility Study with Preliminary Treatment Outcomes(Taylor & Francis, 2021) Wasmuth, Sally; Wilburn, Victoria G.; Hamm, Jay A.; Chase, Anthony; Occupational Therapy, School of Health and Human SciencesThis paper describes implementation of narrative-informed occupation-based service delivery in outpatient community mental health that addresses (1) the need for outcome data on occupational therapy in this setting, (2) an ongoing mental health provider shortage, and (3) a need for innovative approaches to supporting mental health. We found a significant improvement from baseline to post-intervention in occupational participation. Dose of occupational therapy was significantly related to improvements in roles, habits, values, long-term goals, social environment, and readiness for change. This study supports future, larger effectiveness studies of narrative-informed occupation-based intervention delivered by occupational therapists in outpatient community mental health.Item Utilizing Student Consultation to Promote Incorporation of Occupational Therapy in a Pediatric Behavioral Health Unit Occupational Therapy in a Pediatric Behavioral Health Unit(Journal of Occupational Therapy Education, 2020) Wilburn, Victoria G.; Stoll, Hannah B.; Fodstad, Jill C.; Chase, Anthony; Douglas, Christina M.This advanced graduate elective was designed for second year Master of Occupational Therapy students to provide opportunities for students to act as consultants of the profession and collaborators within the community utilizing community engaged learning methods. This elective helped to detail components of evidence-based practice, primary needs of integration, and future opportunities within an urban pediatric behavioral health unit. The practice area of mental health was chosen specifically as the collaborating site due to the decline of occupational therapist recognition as qualified mental and behavioral health providers. This lack of recognition may limit reimbursement and funding, and decrease employment opportunities, both detriments to practice. However, within the last decade there has been a resurgence in establishing the profession’s roots within mental and behavioral health practice. Several key pieces of federal legislation have recognized occupational therapists' expertise and have cited the profession in several mental and behavioral health initiatives. Many states are seeking recognition of occupational therapists as qualified behavioral health providers (QBHP) or qualified mental health providers (QMHP) and this elective provided the opportunity for didactic instruction to intersect with advocacy and education while producing a rich learning experiences for all involved.Item Using expansive framing to enhance personal relevancy and engagement in science(The Hoosier Science Teacher, 2018) Radloff, Jeffrey; Chase, AnthonyItem Assessment institute insights: A report of the STEM education track of the 2017 Assessment Institute(Assessment Update, 2018) Chase, Anthony