Defining an Occupational Therapy Intervention for People with Psychosis

Abstract

The purpose of the study was to define occupational therapy in its entirety for people with psychotic conditions in community settings, in order to produce an intervention schedule for piloting in a randomised controlled trial. Initially, a draft schedule was designed using Creek's (2003) definition of occupational therapy as a complex intervention and other literature regarding psychosis. Consensus methods provided a systematic and transparent process for refining the schedule: the Delphi method was used with 20 local mental health occupational therapists followed by a modified nominal group technique with occupational therapists attending a national conference. This paper focuses on the process of gaining consensus and the practice-related issues that arose. The results identified 82 components that detailed occupational therapy actions under 11 stages. The preferred approach was client centred, with models of practice, goals and actions chosen collaboratively with the individual client. Occupational therapy was defined as separate to care management but incorporated some generic tasks. The discussion of this study's implications includes setting a finite length of intervention; barriers to practice; the importance of activity analysis and doing activities together with clients; and how defining practice may help to clarify the role of the occupational therapist in multidisciplinary team work.