Experiences Of Occupational Therapists Research Articles

Occupational therapists’ experiences of photo-supported conversations – An intervention in primary health care

Background The health-promoting intervention BeWell™, which includes photo-supported conversations, is intended for people with stress-related illnesses. Its focus is on improving the individual’s health and well-being by addressing what contributes to well-being from the patient’s own perspective. There is no current knowledge of the experiences of occupational therapists of using BeWell™ in primary health care. It is thus important to gain knowledge of their experiences of using this intervention as part of investigating its feasibility. Aim To describe the occupational therapists’ experiences of photo-supported conversations about well-being (BeWell™) with patients diagnosed with stress-related illnesses. Material and methods Six occupational therapists, working in primary health care, who had conducted the photo-supported conversations about well-being (BeWell™), were interviewed individually, and one focus group discussion was also conducted. Systematic text condensation was used as the analysis method. Results Three main themes with two to three subgroups in each were identified; Discovering well-being through images, Enhancing patient’s own efforts towards well-being, and Contributing to one’s own well-being. Conclusions and significance The results provide important knowledge for the continued research work with BeWell™ by investigating how the users of the intervention experienced it.

The experiences of occupational therapists supporting children with self-regulation needs: A qualitative descriptive study.

Occupational therapists support children with self-regulation needs to engage in meaningful occupations at home, school, and in the community. However, little is known about how Australian practitioners perceive their role working with children with self-regulation needs in the Australian healthcare context. Therefore, we explored the contemporary practice experiences of Australian occupational therapists working with children 4-12 years referred for self-regulation support, to better understand elements constituting efficacious service delivery to enhance occupational engagement. A qualitative descriptive design, underpinned by constructivism and relativism, was implemented to address the research aim. Occupational therapists were recruited online to participate in audio-recorded focus groups and interviews. The audio recordings were anonymised, transcribed verbatim, and analysed through reflexive thematic analysis. No consumers were involved in the study design or analysis. Four themes were generated, encapsulating the experience of 13 occupational therapists working with children with self-regulation needs: (1) navigating the complexities of self-regulation, (2) intervening to support the child and surrounding systems, (3) bringing the occupational therapy perspective to the self-regulation puzzle, and (4) working within an evolving practice context. Themes 1-3 describe specific processes that all occurred within the context of Theme 4. Overall, participants detailed successful practice to support children with self-regulation needs to participate in meaningful occupations that required person-centredness, collaboration, coaching, and adaptability of therapists responding to different stakeholder demands. Self-regulation is a complex area of practice, and occupational therapists have a key role in supporting occupational engagement by balancing the child's needs with those of family, other stakeholders, and funding bodies. Findings support occupational therapists and decision-makers advocating for the unique role of occupational therapy in supporting self-regulation in childhood as part of a collaborative, multi-disciplinary approach. Specific consideration must also be given to ways that current funding schemes in Australia enable occupational therapy services for children with self-regulation needs. Controlling emotions and behaviours is sometimes called 'self-regulation'. Some children find this hard and need help from an occupational therapist, who knows a lot about the body and the systems within it. A lot of occupational therapists in Australia help children with their self-regulation. There is not much known about how these therapists see their role in working with these children. We wanted to understand what it is like for occupational therapists who help children, between 4 and 12 years old, with their self-regulation. We interviewed 13 occupational therapists from across Australia and analysed what they said. The data showed four main points: (1) understanding the challenges of self-regulation, (2) helping the child and their environment, (3) using an occupational therapy approach to solve self-regulation issues, and (4) working in a changing practice environment. The therapists described how important it is to focus on the child, work together with many people like caregivers and teachers, and being flexible. They talked about how they balance the needs of the child, family, and funding bodies, which could sometimes be tricky. The study shows the things that therapists are doing when working with children who need help with their self-regulation and the things that therapists find hard working in this space. The results of the study can be used by people who advocate for services that help children and by people who make decisions about Australia's healthcare. One way the study can be used is to think about how current funding schemes do or do not allow different people and professions to work together to support children's self-regulation. Even though there were some limitations, such as a low response rate due to the stress of the COVID-19 pandemic, we did interview therapists from different parts of Australia who work in different settings to each other.

The experience of occupational therapists and physiotherapists using a prototype, evidence-informed online knowledge translation resource to learn about patient-defined, personally-meaningful chronic pain rehabilitation

Purpose Chronic pain is a complex biopsychosocial experience, and rehabilitation helps people to manage pain, and restore valued life roles. Evidence suggests that more positive outcomes occur when clients perceive their rehabilitation to be meaningful. People with chronic pain describe rehabilitation as personally-meaningful when they develop a genuine connection with a credible therapist who they see as a guiding partner, and when rehabilitation holds personal value, is self-defined, and relevant to their sense of self-identity. This paper presents a qualitative study of therapists’ experience using an e-learning package on patient-defined, personally-meaningful rehabilitation. Methods A qualitative descriptive design was used to explore rehabilitation therapists’ experience of a prototype evidence-informed, online resource developed on the basis of eLearning and web-design principles. Semi-structured interviews and focus groups were conducted with a purposive sample of occupational therapists and physiotherapists, and inductive coding and thematic analysis of transcripts was completed. Findings Twenty-four therapists (12 occupational therapists, 12 physiotherapists) participated, representing a mix of gender and experience (early career; experienced; and specialist). Four themes and 12 sub-themes emerged from the analysis. The resource delivered a positive user experience, which added (translational) value to enhance learning, and participants were highly positive about the future potential of the resource to translate chronic pain rehabilitation research for early career, experienced, and specialist rehabilitation therapists. Conclusion Results suggest that the disparate learning needs of rehabilitation therapists from diverse professional backgrounds and experience, may be addressed through the one resource. Participant feedback provides evidence that the resource fits with current models of learning and behaviour change. This study demonstrates the importance of basing online resources on eLearning and web-design principles to translate complex biopsychosocial chronic pain rehabilitation research for rehabilitation therapists.

Occupational Therapists’ Experiences in Providing Training to Caregivers of Hospitalized Older Adults: A Way Forward for Occupational Therapy Practice

Aims This study explores the experiences of occupational therapists in training caregivers of hospitalized older adults, with the aim of identifying strategies to enhance this practice. Methods Six occupational therapists participated. Results Two major themes were generated: (1) challenges in providing training to caregivers and (2) ways to improve caregiver training services. Seven sub-themes were also identified. The findings highlighted several challenges regarding the provision of training to caregivers that need to be taken into consideration by occupational therapists, as well as valuable suggestions regarding the need for effective guidelines, appropriate content, and the utilization of technology to support occupational therapists in the provision of quality caregiver training services Conclusions Integrating healthcare professionals’ experiences is vital for improving services, recognizing the need for ­caregiver-centric approaches, emphasizing communication improvement within healthcare teams, and advocating for deeper insights into older adults’ needs, while highlighting the importance of technology integration in caregiver training.

Evaluating the Experiences of Occupational Therapists and Children Using the SensoGrip Pressure-Sensitive Pen in a Handwriting Intervention: Multimethods Study.

The acquisition of handwriting skills is essential for a child's academic success, self-confidence, and general school performance. Nevertheless, an estimated 5% to 27% of children face handwriting challenges, where the ability to modulate pressure on the pencil and lead on the paper is a key motor component. We aimed to investigate the experience with and usability of the SensoGrip system, a pressure-measuring pen system with personalized real-time feedback about pressure modulation, in a clinical setting with children and occupational therapists (OTs). A multimethods study was conducted, incorporating qualitative interviews and questionnaires with children, user diaries, focus group discussions, and a usability questionnaire with OTs, along with a questionnaire for parents. The study involved OTs (n=8), children with handwriting difficulties (n=16), and their parents (n=16), each of whom used the SensoGrip system in up to 5 therapy sessions. OTs reported that the SensoGrip system helped to focus the child's awareness on handwriting pressure and to measure it objectively. The system received high acceptance and usability ratings from the OTs-usefulness: median score of 4 out of 7; ease of use and ease of learning: median score of 6 out of 7; and satisfaction: median score of 6 out of 7. Participants appreciated that it fosters pressure awareness and motivation to draw and write. The SensoGrip pressure-sensing system with real-time feedback is a promising tool for pediatric occupational therapy. It supports children with handwriting difficulties to adjust their pressure application during the task. In the future, controlled quantitative trials are warranted to further examine the system's impact.

“Experiences of Occupational Therapists with the Every Student Succeeds Act”

ABSTRACT In the United States, school occupational therapists serve as related service providers under the Individuals with Disabilities Education Act and specialized instructional support personnel (SISP) for all students under the Every Student Succeeds Act (ESSA). Since ESSA was enacted in 2015, there has been limited research on school occupational therapists’ understanding and application of their professional expertise to support all students. Given the gap in research, this study focused on facilitators and barriers to school occupational therapy practitioners’ participation in Connecticut public school settings. A convenience sample identified five school occupational therapists. Participation involved engagement in a 6-week program, including 10-minute asynchronous learning activities and 30-minute synchronous virtual meetings. Methods included a pre/post-intervention survey, a weekly questionnaire, and a thematic analysis of recordings. Findings indicated that program course content and activities led to improved insight on ESSA. The program revealed the following themes: there are benefits in ESSA involvement, further education on ESSA is warranted, engagement in ESSA occurs more than realized, and barriers may not be as significant as initially perceived. Qualitative findings identified themes for school occupational therapists to increase their participation in ESSA.

Occupational Therapy and Public Safety Personnel: Return to Work Practices and Experiences.

Background. Public safety personnel (PSP) are frequently exposed to psychological trauma through their work. Evidence shows that worker's compensation claims for work-related psychological injuries are on the rise for PSP. Occupational therapists increasingly provide return to work (RTW) services for this population. Purpose. To explore the therapeutic practices and personal experiences of occupational therapists working with PSP who have work-related psychological injuries. Method. This mixed methods descriptive study included a chart review of available occupational therapy client records from 2016 to 2020 for PSP with work-related psychological injuries from two Ontario companies. Additionally, a web-based self-report survey for Ontario occupational therapists providing RTW services to this same population was available from November 1, 2021 to June 1, 2022. Findings. The chart review included 31 client records and the online survey was completed by 49 Ontario occupational therapists. Therapists commonly provided services in clients' homes, workplaces, and communities, and focused on functional activities. The evidence base drawn on by therapists was not always occupation-based. Barriers to RTW included challenges with interprofessional collaboration, stigma, and the COVID-19 pandemic. Implications. Occupational therapists are commonly working with PSP with work-related psychological injuries and have the opportunity to contribute to the evidence base for occupational approaches to RTW.

Ethical Challenges Experienced by Older Adults with Cognitive Impairments in the Continuum of Health and Social Services: Examples Drawn From the Professional Experiences of Occupational Therapists

According to the World Health Organization (WHO) [1], 47.5 million people worldwide were affected by major neurocognitive disorder, characterized by symptoms that impact cognitive function. More specifically, in Canada, in 2018, there were approximately 452,000 individuals over the age of 65 diagnosed with major neurocognitive disorder [2],

A Qualitative Study on Occupational Therapists’ Experiences with Gun Owners and Victims of Gun-Related Violence

With the widespread access to firearms and an increasing prevalence of gun violence, examining the experiences of occupational therapists in dealing with gun owners and gun violence victims is warranted. Sixteen semi-structured interviews were conducted with occupational therapy practitioners with experience working with this population in the United States. Using thematic analysis, three main themes emerged: psychological and emotional dimensions, occupational safety and management, and daily functioning. The findings of this study provide insights into the strategies used by therapists in this context.

뇌졸중 환자 대상 작업치료 계획 설정 경험에 관한 연구

This study aimed to investigate the treatment planning experience of occupational therapists for stroke patients through a survey. Stroke patients receiving occupational therapy and their therapists were surveyed in this study; a questionnaire on general information about the occupational therapists, diagnostic information of the patient under treatment, and treatment planning experience was distributed among the study participants. Data on stroke patients, including their sex, age, paretic side, cause of stroke, and onset period, were collected through the occupational therapists in charge of these patients. Completed questionnaires were retrieved, and the questionnaire results were coded and analyzed. SPSS Statistics 26.0 was used for all statistical analyses, including descriptive statistics and frequency. In total, 81 stroke patients were undergoing occupational therapy, of which 39 (48.1%) had right hemiplegia and 42 (51.9%) had left hemiplegia. The mean treatment duration was 12.84 months. Further, 19 male (23.5%) and 62 female (76.5%) therapists were included in this study, and their average treatment experience was 4.84±3.75 years. Forty-eight (59.3%) patients responded that the standard for setting treatment goals was determined according to the coordinated opinion of the therapist, patient, and guardian, and the patient's functional and independence level was the most important factor when planning a treatment program. Responses accounted for the most with 33 (40.7%). Thirty-five (43.2%) therapists responded that the occupational therapy intervention used a top-down approach, and 46 (56.8%) responded that a bottom-up approach was used. This study is meaningful as it investigated the treatment planning experience of occupational therapists and confirmed the factors influencing it.

Occupational therapists’ Perspectives of Using Telehealth for Youth with Autism Amidst the COVID-19 Pandemic in the UK: A Pilot Qualitative Study

ABSTRACT The COVID-19 national emergency led to a surging demand for telehealth expansion within pediatric occupational therapy. Despite the growing literature on telehealth as a response to COVID-19, few studies explore the use of telehealth for children and young people with autism spectrum disorder (ASD). This pilot study aimed to understand the experiences of occupational therapists adapting to a virtual delivery service model amidst COVID-19 to support youth with ASD. The researchers used a qualitative research design. Semi-structured, video-based interviews were used to collect data. Interviews were analyzed using thematic analysis. This study included 3 UK registered occupational therapists. Four themes emerged from the data: 1. “Telehealth is Reducing Social Anxiety” 2. “Parents End Up Becoming Your Therapy Assistants” 3. “Nothing Will Replace Face to Face for Assessments” 4. “You Definitely Have to Be More Creative.” The themes report that telehealth can reduce social anxiety, increase skill transferability, and improve family involvement. Participants indicated that shorter sessions, movement-based interventions, planning and adapting to home-based resources were strategies that overcame the limitations of virtual therapy. The findings contrast with some previous research that found that telehealth may inhibit engagement and may strain the therapeutic rapport. This study supports existing literature that telehealth can enhance engagement, family involvement and generalization of skills. Findings from this study support the use of telehealth to deliver occupational therapy services for children and young people with ASD, but it is recommended that telehealth should not be a one size fits all service delivery model. Further larger-scale research is needed to confirm the study findings and to explore the family and young person’s perspectives of using telehealth.

Experiences of the Occupational Therapists During the COVID-19 Pandemic: A Scoping Review.

Occupational therapy has been impacted by the worldwide COVID-19 pandemic and has transitioned from a traditional face-to-face therapy method to an online one. In the wake of the pandemic, occupational therapist faced the challenge of providing online services to people with disabilities. The review aimed to identify and synthesize the best available evidence on the experience of occupational therapists in psychiatric rehabilitation settings during the COVID-19 pandemic. Additionally, the challenges posed by changes in the mode of training were examined. Electronic database search included PubMed, PsycINFO, PsycNET, Cochrane Library, Ovid, MEDLINE, CINAHL, SAGE Journals, Elsevier Science Direct, Springer, Wiley Online Library, JAMA Psychiatry, and Society E-Journals. Inclusion criteria were studies describing the experience of the occupational therapists during the COVID-19 pandemic in psychiatric rehabilitation settings. A systematic search identified 8 studies included quantitative, qualitative and mixed methodology conducted between 2020 and 2022. The findings from the reviewed articles revealed that the complexities and challenges faced by occupational therapists during the COVID-19 pandemic were professional, personal, and organizational; innovative practices were implemented in the psychiatric settings. The review findings expressed both positive (accepting a new mode of training, time saving) and negative experiences (problems with interaction & internet) perceived by the rehabilitation professionals. Enhancing the training of occupational therapists will help in easing the access and know-how of using telerehabilitation services for patients and coping with COVID-19-like situations in the future.

Moral Distress in the Time of COVID-19: Occupational Therapists’ Perspectives

The conditions of COVID-19 have caused moral distress in healthcare workers. Occupational therapists have had to adapt to these unknown times to best treat their clients. The purpose of this study was to explore the experience of moral distress in occupational therapists during the time of COVID-19. Eighteen occupational therapists were included who worked in a variety of settings. Investigators conducted semi-structured interviews to explore experience with moral distress (distress felt when confronting an ethical problem) during the time of COVID-19. The data were analyzed using a hermeneutical phenomenological approach to generate themes regarding the experience of moral distress. Investigators identified themes of occupational therapists’ experiences during the COVID-19 pandemic. These themes included: Experiences of moral distress, capturing participants’ encounters with morally distressing issues; effects of moral distress, exploring the impact of COVID-19 experiences on participants’ well-being and quality of life; and managing moral distress, addressing ways in which occupational therapists tried to mitigate moral distress throughout the pandemic. This study brings awareness to the experience of occupational therapists during the pandemic and explores implications for preparing occupational therapists for future occurrences of moral distress.

Experiences of occupational therapy clinicians on the assessment and evaluation of adult handgrip strength

Introduction: Handgrip strength (HGS) is commonly measured to assess hand function, however, little is known about how and why occupational therapists assess and interpret HGS. This study aimed to explore the experiences of occupational therapists who work with HGS. Additionally, the study explored what biological and functional factors occupational therapists believe influence adult HGS. Method: A qualitative study design utilising purposive sampling identified occupational therapy clinicians within Queensland, Australia who assess HGS. Data were collected from 19 participants using a semi-structured interview process. The interviews were transcribed verbatim and analysed using thematic analysis. Results: Variations of the American Society of Hand Therapists HGS testing procedure were used by the participants based on experience. When evaluating HGS, comparison to normative data was not always completed or seen to be valuable. Biological and functional factors such as height, hand length, occupation and lifestyle factors were considered to influence HGS. Conclusion: The results of this study provide insight into the various ways occupational therapists assess and evaluate HGS according to experience and practice context. These variations in assessment and evaluation of HGS along with the influence of an individual’s biological and functional factors need to be considered when interpreting HGS results.

Cultural competence in occupational therapy to reduce health disparities: a systematic literature review

Background/Aims Despite agreement about the relationship between cultural competence and health equality, there is a lack of clear guidance within occupational therapy about what it means to be culturally competent and how it can be achieved. This literature review aims to critically appraise qualitative research to explore occupational therapists' experience of working cross culturally. By comparing these experiences, this review aims to identify ways in which occupational therapists individually, and occupational therapy as a profession, can increase the efficacy of the interventions they provide within cross-cultural situations, so all clients can be supported to achieve equal health outcomes. Methods The following databases were searched between 2010 and 2020: ASSIA (Applied Social Science Index), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, Medline Pubmed. The resultant papers were appraised using the Critical Appraisal Skills Programme checklist and thematic analysis was used to identify three themes. Results The six papers included in this review present the experiences of occupational therapists and occupational therapy students working in cross-cultural situations in the UK, Canada, South Africa, USA, Australia and Ireland. Three major themes emerged that explore the relationship between client-centred practice and cultural competence, theory–practice links, and strategies and barriers to working in a culturally competent way. Conclusions Cultural competence is strongly aligned with some of the core principles of occupational therapy: occupational justice and occupational identity. However, theoretical knowledge and confidence among occupational therapists in this area is lacking, implying that their impact could be greater if there was a more concrete definition of cultural competence and standardised guidelines for practice. Further research is needed to build on the strategies and overcome barriers, so that occupational therapists can fulfil the professional obligation they have to work effectively with all populations.

Bridging the Gap between Clinical Service and Academic Education of Hand-Splinting Practice: Perspectives and Experiences of Thai Occupational Therapists.

A gap in knowledge about current splinting practice exists between the educational program and clinical service. To bridge this gap, we investigated the perspectives and experiences of Thai occupational therapists regarding contemporary hand splinting practices in clinical use. A mixed-method study was designed. An explanatory sequential mixed methods design was used. In the first quantitative phase, a survey questionnaire was mailed to occupational therapists. The questions were regarding contemporary hand splinting practices in clinical use at seven hospitals in the capital city of Bangkok and outskirt areas. In the second phase, semi-structured interviews were completed to explore expert occupational therapists’ perspectives on practice in the same hospital settings. Transcripts were analyzed using thematic analysis. The results showed that most conditions receiving splints were nerve injuries, orthopedics, and stroke, which represented the service frequency of splint types: functional resting (100%), cock-up (93.3%), and thumb spica splints (80%). Bone and joint deformity prevention ranked first with muscle contracture prevention being ranked second, and the third-ranked was maintaining range of motion. Three themes emerged from the interviews: starting with the patient condition; effective function and value; knowledge and experiential skills. Perspectives and experiences of occupational therapists in splinting practice contribute to education based on the reality of practice. Integrated numerical and textual data of professional skills and knowledge in actual splinting practice can be reflected through splints and orthoses program revisions to meet future learning outcomes.

Continuing Professional Development in Response to COVID-19: Knowledge Mobilization for Occupational Therapy and Physiotherapy via a Curated Web Site.

Once the COVID-19 pandemic was declared, clinicians were redeployed to prepare for increased hospitalizations. This disruption necessitated rapid continuing professional development (CPD) resources for health care providers. This mixed-method study explored the experiences of occupational therapists and physiotherapists who accessed a CPD Web site that provided educational resources related to the pandemic to refresh their clinical knowledge and skills. Faculty from the Michener Institute of Education at the University Health Network and University of Toronto along with 60 collaborators created a Web site to support the need for rapid CPD. An occupational therapist and physiotherapist advisory group informed the evolving design of the occupational therapy and physiotherapy content. In the occupational therapy profession 535 users created an account between April and November 2020 (236 practicing, 283 students, and 16 did not specify) and in the physiotherapy profession 829 created an account (532 practicing, 278 students and 19 did not specify). Each user viewed an average of 53 Web pages. Three themes emerged: (1)To prepare for practice changes, clinicians value a single repository of information; (2) Web site features can either facilitate or hinder access to the needed information; and (3) Participants described diverse learning needs. The Web site design features assisted participants in preparing for redeployment and patient care. Features to encourage self-directed learning, such as the grouping of relevant topics and self-check quizzes, can enhance the user experience.

Occupational Therapists' Experience of Using Home Adaptation and Assistive Products as Interventions for Older Individuals and Persons with Disabilities in Thailand

As Thailand becomes an aged society it is important to promote advancements in geriatric medicine to provide the best care for older individuals. The right assistive facilities and household mobility equipment are essential for everyday activities. The use of home adaptations and assistive products can maximize the quality of life for older individuals and make life more convenient for those with disabilities. This study aimed to investigate the experience of occupational therapists, using home adaptations and assistive products. An individual interview was conducted with eight occupational therapists who worked at regional hospitals and centers of excellence throughout Thailand using a qualitative study. The results were interpreted through thematic analysis. Five main themes emerged: (1) empowering independent living at home, (2) accident prevention and safety, (3) family financial constraints and barriers, (4) availability and accessibility of products, and (5) matching products with clients’ capabilities and needs. Based on an occupational therapy approach, this study examines Thailand's needs for home adaptations and assistive products, as well as barriers to accessing those products and services. Through a contribution to knowledge and information based on occupational therapists' experience, the laws and regulations regarding home adaptations and assistive products for people with disabilities can be improved. Additionally, the interdisciplinary team and authorities involved in this issue should also collaborate to formulate guidelines for home adaptations and assistive products for older individuals and persons with disabilities in the future.

Accessible design features and home modifications to improve physical housing accessibility: A mixed-methods survey of occupational therapists

BackgroundDespite the number of older people and people with disabilities increasing in Australia, it is unclear which housing design features are needed to support physical housing accessibility for people with and without disabilities across the lifespan. ObjectiveThis study drew upon the experience of occupational therapists to investigate accessible housing design features and home modifications to support aging in place and discharge from hospital to home. MethodsA cross-sectional online survey exploring housing design features and home modifications was completed by 144 Australian occupational therapists over six weeks in 2021. Descriptive quantitative and qualitative data analyses were used. ResultsFor both aging in place and hospital discharge, the most important housing design features included step-free access to the dwelling, large step-free showers, and bathroom and bedroom space on the ground floor. Qualitative findings also highlighted the importance of preparing for home modifications, such as reinforcing bathroom walls to support the post-build installation of grab rails. The most frequently needed modifications were for bathroom features, while structural changes to the dwelling were the most time-intensive modifications, requiring more than six weeks to be completed. ConclusionsExternal access to the home and internal access to bedroom and bathroom facilities can support aging in place and hospital discharge and mitigate the need for costly and time-intensive home modifications. While this study was conducted in Australia, the findings have relevance outside of this context, and are important for ensuring equitable accessibility for people with and without disabilities across the lifespan.

An Occupation-Based Clinic Makeover: Perceptions and Experiences of Occupational Therapists

Background: Researchers sought to discover the experiences of occupational therapists transitioning from existing clinical practice to exclusively occupation-based approaches.