Geriatrics cognitive assessment and resource engagement day: Piloting an interdisciplinary outpatient cognitive care model.

Background. Psychotherapy encompasses a range of evidence-based mental health interventions adopted by healthcare providers, including occupational therapists. Advocacy for public funding and regulation of psychotherapy requires critical reflections on occupation-based approaches within this changing landscape. Purpose. To explore the perspectives and practices of Canadian occupational therapists regarding psychotherapy. Method. An online survey of Canadian therapists providing mental health services (n = 487) was conducted, followed by 8 regional focus groups (n = 63) to explore perspectives in more depth. Analysis of the survey and focus group data identified key trends in practice patterns and beliefs. Findings. There was variation in the extent to which psychotherapy was adopted, but trends in the types of approaches and perceived competence in foundational skills. Tensions were noted in the extent to which psychotherapy was linked to occupational therapy (OT) practice. Most felt that occupational therapy offered a unique occupation-based approach, but practice was shaped by differences in the regulatory context, and recognition of their role. Implications. Lack of clarity regarding the definition of psychotherapy, provincial differences in regulation, and limited external awareness of our role speaks to the need for national conversations, research and guidelines regarding occupation-based psychotherapy.

Background. Return to driving following acquired brain injury enhances participation in community-based occupations, yet may be difficult to achieve and not without risk. Evidence supports on-road driving remediation to achieve functional fitness to drive post-acquired brain injury. Purpose. To determine if skills acquired through on-road driving remediation are maintained. Method. Secondary analysis of randomized controlled trial findings compared functional fitness to drive status and driving performance as rated by on-road occupational therapy driver assessment post-intervention and six-month follow-up. Findings. Of 25 participants with acquired brain injury (26-65 years), 95% of the 19 deemed functionally fit and 50% of the six deemed not functionally fit to drive retained that status at follow-up. Four changed status, with most (n = 3) shifting from not fit to fit. No significant change in functional fitness to drive status or driving performance observed at follow-up (p = .625). Being fit to drive at follow-up was significantly associated with competent observation, awareness, speed control, planning, judgement, and self-navigation. Conclusions. Following on-road driving remediation devised by an occupational therapist with advanced training in driver assessment and delivered by a qualified driving instructor, skills were maintained six-month follow-up post-acquired brain injury.

Background: Research in occupational therapy that engages both the perspectives of therapists and service users from the Somali community in the United Kingdom is limited. While occupational therapy is acknowledging its Eurocentric foundations, efforts are underway to adapt its models of practice to better suit cross-cultural contexts. Aim: To explore occupational therapists’ experiences in working cross-culturally with Somali service users. Methodology: A participatory research approach was used. Six virtual online World Cafés were conducted, with a total of 120 therapists participating. Data were analysed using template analysis. Findings: Three key themes emerged: (1) Accessing occupational therapy – highlighting the need to reach people and effectively communicate occupational therapy’s role, (2) cultural relevance of occupational therapy – highlighting the need for culturally congruent interventions and (3) from cultural (in)competence to cultural humility – highlighting the importance of diverse occupational therapy teams and the need to develop confidence in culturally humble practice. Conclusion: Occupational therapists must critically examine their use of language, terminology, identity and professional culture, as these elements may inadvertently hinder equitable access for diverse populations. This paper calls for continuous efforts to make occupational therapy practices more inclusive and accessible.

Introduction: The Assessment of Client’s Enablement (ACE) was developed to help occupational therapists address perceived differences with clients. However, its clinical utility in promoting collaboration has not been empirically studied. Method: This qualitative descriptive study involved semi-structured interviews with experienced occupational therapists who had used ACE in clinical practice. Transcribed data were analysed using the Steps for Coding and Theorization (SCAT) method. Results: Seven occupational therapists participated. ACE was perceived to facilitate mutual understanding and dialogue by making differences in perceptions of therapists and clients more visible. Three central themes were identified: (1) clinical characteristics and uses of ACE, including ease of integration into practice, provision of visual feedback and use as a complementary tool; (2) observed changes in both clients and therapists, including increased client insight, more active engagement and enhanced professional reflection; and (3) the promotion of collaborative processes, such as shared goal setting, improved communication and trust building. Participants emphasised the importance of appropriate timing and sensitivity to client characteristics to ensure ACE was used effectively and ethically. Conclusion: This study provides preliminary insight into how ACE may support collaboration in occupational therapy.

ABSTRACT Vicki Husband (b.1970) is an Occupational Therapist who qualified in 1999 and has spent the majority of her career working in community rehabilitation. Husband is also a poet and her second collection of poetry, Glasgoscopy is centred on her role as a health professional in the North West health sector of Glasgow, where she has worked for over twenty years. In this article, Husband explores geographical themes of space, place, time, distance and scale in relation to Glasgoscopy, as well as reflecting on the creative process of writing the book: development of the book’s structure and themes and choice of poetic forms.

Older adults with subjective cognitive decline (SCD) experience emotional distress and report challenges or withdrawal from activities that support health and well-being. This qualitative descriptive study explored participation challenges of older adults with SCD, and their determinants. Data were collected through focus groups with 15 occupational therapists (OTs) working with older adults with SCD in community-based clinical settings, and analysed using deductive content analysis. OTs identified two key participation challenges: limited participation in healthy lifestyle activities, and negative occupational experiences (e.g., reduced enjoyment and diminished sense of competence). Personal determinants were subtle (yet normal) cognitive changes, ineffective strategy use, and limited knowledge about cognition and factors influencing it. Motivational determinants were adverse emotions and negative self-perceptions. Environmental determinants were insufficient social support and internalized age-related stigma. Future intervention for older adults with SCD should focus on supporting occupational experience and participation by addressing knowledge, skills, beliefs, and emotional regulation.

National cross-sectional survey. Hospitals delivering orthopaedic and trauma services across all levels of care and ownership categories in Tanzania. Licensed orthopaedic and trauma surgeons practising in Tanzania served as key informants for their respective hospitals. A total of 171 surgeons provided data on 92 unique hospitals nationwide. Primary outcomes included orthopaedic departmental structural capacity, availability of multidisciplinary specialist support, external support mechanisms and in-hospital orthopaedic training activities. A response rate of 77.7% yielded data on 92 hospitals delivering orthopaedic and trauma services nationwide. Structural capacity varied widely, with only 19.6% of hospitals reporting more than 50 orthopaedic beds, 43.5% relying on a single orthopaedic surgeon, and 47.8% operating with one or two functional theatres. Access to specialist support was limited, with vascular trauma surgeons available in 9.8% of hospitals and plastic and reconstructive surgeons in 8.7%. Intensivists were available in 41.3% of facilities and anaesthesiologists in 57.6%, while physiotherapists were present in 90.2% of hospitals but occupational therapists in only 28.3%. External dependence was common, with 41.3% of hospitals relying on donated implants and 29.3% participating in outreach programmes. In-hospital orthopaedic training opportunities were limited, with seminars or workshops available in 25.0% of hospitals. Across domains, higher-tier hospitals demonstrated significantly greater structural capacity and specialist availability. Orthopaedic and trauma services in Tanzania are available across multiple levels of the health system but are characterised by inequitable workforce distribution, limited capacity at lower-tier hospitals and substantial reliance on external assistance. Integrated strategies linking infrastructure development, multidisciplinary workforce expansion, sustainable procurement and decentralised training are essential to strengthen the organisation and resilience of orthopaedic and trauma services nationwide.

Innovative, inclusive and resource-efficient screening and intervention methods are essential to address motor skill impairment among preschool children and prevent long-term consequences. This study explores the feasibility of implementing a unique motor skill program for preschool children in low-resource rural areas of South Africa, addressing the heightened risk of motor skill impairment in this demographic. Employing a quantitative pre-post quasi-experimental design with convenience sampling, the research involved assessing children using the second edition of the Movement Assessment Battery for Children (MABC-2) to evaluate their motor skills. Key objectives included assessing the program's recruitment, consent, attrition, adherence, and attendance rates, alongside determining its effect on motor skills. Children who scored less than the 5th percentile of the MABC-2 total score were included in the study and schools were randomly assigned to an intervention and control group. The Hopscotch program was facilitated by an occupational therapist over 8 weeks. Two weekly group sessions focused on gross and fine motor skills through obstacle courses, ball games and craft activities. All participants in the groups were re-assessed following the intervention. The control group received the same intervention following the post-assessment. Quantitative attendance checklists were analyzed to determine consent, assent, attrition and attendance rates. The feasibility of the MABC-2 as a data collection instrument and outcome measure was reported according to test completion rate and cost. The initial effect of the program was determined through analysis of the pre-and post-intervention MABC-2 scores using descriptive statistics while independent samples t-test were used to determine statistically significance of between-group differences. The minimal important difference (MID) for MABC-2 scores was considered to determine the clinical significance of the results. The results revealed a high consent rate (98.08%) and a 0% attrition rate, with significant attendance at program sessions (93.75%). While independent samples t-tests indicated no statistically significant differences in motor skill improvements between the intervention and control groups, analysis considering the MID demonstrated clinically significant improvements in overall motor skill proficiency and balance for the experimental group. The cost of the MABC-2 exceeded the planned budget and amounted to 77% of the total study cost. The duration for testing was one school morning for each pre- and post-test when done by five researchers. The study highlights the feasibility of conducting intervention research in low-resource settings. It notes the challenges of using the MABC-2 due to its cost and time requirements and reports on the initial effect of the program on the motor skills of the participants. Statistical significance of positive results was affected by the small sample size; however, the MID was useful in indicating clinical significance of progress made in general motor skill proficiency and balance. The feasibility study provides valuable insights to effectively plan and conduct a research project and implement a school-based motor skill intervention program in a low-resource area.

Objectives Extending healthy life expectancy represents a critical public health priority in Japan. Achieving this goal requires Community Comprehensive Support Center (CCSC) staff to develop competencies in building and managing community-based integrated care systems that promote mutual resident support. This study aimed to identify training challenges and future needs related to community development among CCSC staff nationwide.Methods Focus group interviews (FGIs) were conducted with CCSC staff. Verbatim transcripts underwent thematic analysis to extract and categorize staff-identified training needs.Results Twenty-four staff members (mean age: 44.6 years; seven public health nurses, eight care managers, six social workers, one occupational therapist, one physical therapist, one nurse) from five CCSCs (two directly managed, three commissioned) participated in the study. Analysis of the FGI transcripts yielded 132 codes organized into five categories: (1) fostering resident independence, mutual support relationships, and community acceptance to establish integrated care systems; (2) advancing community activities using the Plan-Do-Check-Act (PDCA) cycle; (3) developing skills to secure community resources and engage in continuous self-improvement; (4) enhancing skills to support individuals with complex, challenging problems; and (5) promoting inclusive society by addressing regional disparities.Conclusion CCSC staff require enhanced skills in fostering resident independence and mutual support to reduce regional disparities and promote social inclusion. Findings emphasize the need for practical, on-the-job training methods, including case studies, to strengthen data-driven PDCA implementation and improve ethical decision-making in complex cases. Developing and implementing targeted training programs is essential to address identified needs and effectively advance community-based integrated care systems.

Background: Home health care plays a vital role in post-acute recovery and chronic disease management in the United States, yet clinician retention remains a critical challenge. Nurses and rehabilitation clinicians, including physical therapists (PT), occupational therapists (OT), and speech-language pathologists (SLP) form the foundation of interdisciplinary home health teams. Despite their interdependence, little is known about discipline-specific satisfaction trends within home-based practice. Purpose: This study examined and compared job satisfaction among nursing and rehabilitation clinicians working in home health across 5 domains: scheduling, travel, work environment, documentation, and overall job satisfaction. Methods: An online survey was distributed through national professional organizations and social media platforms between March 11 and April 15, 2025. A total of 372 responses were analyzed, including 71 from nursing and 301 from rehabilitation clinicians. Descriptive statistics from Likert-scale ratings along with Mann-Whitney U test were used to identify discipline-specific differences. Results: A statistically significant difference was observed in the work environment category ( P = .007), with rehabilitation clinicians reporting higher satisfaction compared to nursing with this aspect of home health. Scheduling ( P = .299), travel ( P = .666), documentation ( P = .850), and overall job satisfaction ( P = .524) did not significantly differ between groups. Documentation was the lowest-rated domain for both disciplines, with only one-third of clinicians expressing satisfaction. Conclusion: The work environment appears to be a key differentiator of satisfaction between nursing and rehabilitation clinicians in home health, with nurses reporting significantly lower satisfaction in this domain. Widespread dissatisfaction with documentation highlights a critical need for system-level reforms. Tailoring workforce support strategies to discipline-specific needs, particularly addressing environmental stressors for nurses and documentation burden for all clinicians, may enhance retention, team cohesion, and quality of care.

Introduction: Sustainable development in occupational therapy is primarily implemented through the integration and adaptation of sustainable occupations in occupational therapy practice. However, occupational therapy through the lens of sustainability remains underexplored. Objective: To explore the insights of Greek occupational therapists regarding sustainability in their practice. Method: A cross-sectional descriptive study was conducted using an electronic questionnaire distributed to 105 Greek occupational therapists. Results: Findings indicate that the majority of Greek occupational therapists (91%, n = 95) acknowledge the importance of sustainable occupations in everyday life. However, only a small percentage (12%, n = 13) of participants have received training in sustainable development practices. Most participants reported engaging in practices related to sustainability, including frequent use of reusable materials (71%, n = 74), recycling (27%, n = 28), sourcing from local communities (40%, n = 42), and adopting eco-friendly products (50%, n = 52). Conclusion: This exploratory study highlights a substantial training gap regarding sustainability in occupational therapy. These findings suggest the need to integrate sustainability-focused content into occupational therapy curricula and continuing professional education as a priority.

To establish French recommendations for the management of people living with hand osteoarthritis (OA) on behalf of the French Society of Rheumatology (SFR) and of the French Society of Physical and Rehabilitation Medicine (SOFMER). A systematic review of the literature, including systematic reviews, meta-analyses, and randomized controlled trials on pharmacological and non-pharmacological treatments, was conducted from inception until November 24, 2023. Based on this review and expert consensus, a multidisciplinary group of 25 healthcare professionals-including rheumatologists, physical and rehabilitation medicine physicians, hand surgeons, general practitioner, geriatrician, occupational therapists, physiotherapists, and patients-formulated the recommendations. Each statement was assigned a level of evidence, a grade of recommendation, and a level of agreement based on EULAR standardized procedures for recommendations. The group established four general principles and 11 specific recommendations. The general principles emphasize treatment objectives, individualized management, patient education, and a multimodal approach combining non-pharmacological and pharmacological therapies. Four specific recommendations address non-pharmacological strategies, including exercise, ergonomic advice, assistive devices, orthoses and heat applications. The group advises against the use of electromagnetic waves, laser therapy, acupuncture, or kinesiotaping. Seven specific recommendations cover pharmacological treatments, advocating for topical and oral NSAIDs, acetaminophen, chondroitin sulfate for symptom relief, low-dose oral corticosteroids for inflammatory flares, and intra-articular steroid injections for inflammatory painful interphalangeal OA. Given the current data, the group advises against the use of conventional synthetic or biological disease-modifying anti-rheumatic drugs (DMARDs). These recommendations provide a structured approach for the management of people living with hand OA in France, aligning with national healthcare practices and patient needs.

School-based health centres (SBHCs) aim to improve access to care, especially among socially vulnerable children. Interprofessional SBHCs are emerging, though their evaluations remain limited. We evaluated an interprofessional SBHC in a low-income community. The evaluation of the SBHCs was guided by the RE-AIM framework. The multimethods design included (i) a document analysis and (ii) a retrospective chart review of SBHC patients from September 2021 to May 2024. The SBHC team comprised of paediatricians, a dietitian, occupational therapist, speech language pathologist, and a nurse working alongside school staff and community providers. After 98 clinic half-days, 760 appointments were scheduled across 153 patients, with a nonattendance rate of 12%. Care needs extended beyond preventative medicine for 80% of children, with mental health conditions being the most common diagnoses. This evaluation demonstrates that interprofessional SBHCs are feasible and offer a scalable model for addressing the complex health needs of socially vulnerable children.

We sought consumers' views about Better Access, which funds sessions of care with eligible providers via the Medicare Benefits Schedule (MBS). We surveyed a stratified random sample of consumers who saw a clinical psychologist, psychologist, social worker or occupational therapist (OT) via Better Access during 2021. The survey focussed on consumers' experiences with receiving treatment through Better Access, and the outcomes of this treatment. Survey data were linked to MBS claims data for consenting participants. In total, 2013 individuals completed the survey; linked MBS data were available for 1317 (65.4%). The majority (85.2%) were satisfied with their care, although they raised some issues, particularly around affordability. When asked to rate their mental health before and after treatment, 91.9% indicated it had significantly improved. Overall, 77.5% attributed this improvement to treatment by the mental health professional. For the full sample, baseline self-rated mental health was predictive of improvement, as was the number of sessions. For the sub-sample with linked data, these factors also predicted improvement, as did whether they paid a co-payment. In general, consumers who use Better Access appear to appreciate the programme and benefit from the care it provides. However, affordability remains an issue.

Exploring the characteristics and experiences of US and Canadian hand therapists with thumb pain.

Better Access is a major Australian Government mental health initiative that provides rebates to people experiencing mental health problems so they can access psychological services at reduced or no cost. Currently, GPs, psychiatrists, clinical psychologists, psychologists, social workers, and occupational therapists provide referrals and/or treatment services under Better Access. This study sought to consult a broad range of stakeholders and identify their collective view on future reform priorities for Better Access. Consultations followed a three-phase process. In Phase 1, participants completed a brief online survey to identify priority topics. In Phase 2, participants took part in an online forum where they discussed and refined topic summary statements. In Phase 3, participants rated agreement with a revised set of statements and ranked topics in a second online survey. Ninety stakeholders participated. Collective views emphasised the need to enhance access through improving affordability for consumers and increasing workforce capacity, particularly in rural/remote areas. Participants also identified a need to review the scope and rules of the programme to better accommodate the increasing use of Better Access by people with more complex mental health needs. Views varied on the best mechanisms to address these issues. Collective views emerged on key areas for reform for Better Access. While there were varying views on the best way to address these priority areas, stakeholders concurred that the programme's capacity needed to be expanded to meet the increasing levels of community demand for mental health care.

Australia's Better Access initiative enables people with mental disorders to be referred for treatment and management through a range of providers. The costs to consumers are offset by Medicare rebates. We examined eligible providers' and referrers' views and experiences with Better Access. An anonymous online survey was completed by 2386 participants: 572 clinical psychologists, 1140 psychologists, 398 social workers, 104 occupational therapists, 45 general practitioners and 126 psychiatrists. The survey included questions about processes, outcomes, barriers and facilitators associated with Better Access. Most survey participants (54-99% depending on professional group) had provided Better Access services in 2021. The majority believed Better Access enables them to deliver care that is appropriate, tailored to consumers' needs and achieves good outcomes. However, there were concerns that consumers who require more intensive or linked-up care might not receive adequate care through Better Access. Many providers, particularly allied health professionals, did not have the capacity to take on new consumers, leading to long waiting lists and delayed treatment. High out-of-pocket costs (a flow-on effect of inadequate rebates) were seen as discouraging engagement by consumers on low incomes. Good communication between referrers and providers was seen as a key facilitator of Better Access care, but complicated referral and review processes were identified as impeding communication and disrupting continuity of care for consumers. Providers and referrers agreed that Better Access achieves good outcomes for consumers. Strategies to address workforce capacity and affordability for consumers, and to streamline referral and review processes are needed.

Compensation-Based Intervention to Improve Activities of Daily Living in Individuals with Stroke: Randomized Controlled Pilot Study.

Development of lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other gender and sexual minority (LGBTQIA+) identities and a disability identity is critical for positive mental health outcomes for LGBTQIA+ autistic individuals. To understand identity development and evaluate the resonance of support among a large sample of LGBTQIA+ autistic adults. A sequential mixed-methods, participatory approach. Data collection for both phases occurred remotely. LGBTQIA+ autistic adults completed the qualitative phase and the survey (Ns = 57 and 107, respectively). Phase 1, the qualitative phase, included semistructured interviews and focus groups based on queer, crip, and intersectionality theories. Questions related to identity exploration and development. Themes regarding barriers and supports were used to develop a survey, used in Phase 2, to collect quantitative data to confirm the resonance of the findings. Participants described exposure, personal research, trial and error, and individuals external to the LGBTQIA+ and autistic communities as contributing to their evolving identities. If these contributing factors were positive, people described experiencing narrative gain, whereby they felt a sense of relief and pride over their identities, and if they were negative participants reported going through a journey toward self-acceptance. Occupational therapy practitioners can support LGBTQIA+ autistic adults in the identity development process by fostering connections with other LGBTQIA+ autistic individuals, providing accessible sexual health education supporting personal research and providing accessible resources, offering opportunities to explore identities through creative means, and creating supportive environments and safe spaces for self-exploration. Plain-Language Summary: Identity development is the process of understanding who you are. Occupational therapy practitioners can help support positive identity development for LGBTQIA+ autistic clients. In Phase 1 of the study, we talked to 57 LGBTQIA+ autistic people and asked them how they learned they were LGBTQIA+ and autistic. We used what we learned from those people to create survey questions, and we asked another 107 LGBTQIA+ autistic people whether the findings from our conversations in Phase 1 resonated with them as well. LGBTQIA+ autistic participants reported that they found it helpful to be exposed to people with diverse LGBTQIA+ and autistic identities; to be connected with articles, blogs, and people online who held diverse LGBTQIA+ and autistic identities; and to trial different identities. They also said it was helpful if people who were not LGBTQIA+ or autistic were supportive during this process. When people had more help, they had better acceptance of themselves. When people had less help, they said they had to learn to accept themselves. Positionality Statement: In this article, we use the term LGBTQIA+ (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other gender and sexual minority identities) to refer to a spectrum of marginalized sexual orientations (e.g., lesbian, gay, bisexual, asexual), gender identities (e.g., transgender, nonbinary, agender), and biological variations in sex characteristics (e.g., intersex). We recognize that these identities are distinct but often interrelated, and unless otherwise specified we use LGBTQIA+ inclusively to reflect participants' self-identification. The first author is a White, straight, cisgender female with a history of generalized anxiety disorder. The second author is a mixed-race, queer, cisgender woman who is multiply neurodivergent, including autism, attention deficit hyperactivity disorder, and posttraumatic stress disorder. The third author is a White, queer, nonbinary autistic person. The fourth author is a White, straight, cisgender female. The research team has varied experience and expertise in conducting research. The first author has a PhD and is a licensed occupational therapist, the second author has worked for many years in research laboratories as a research assistant and coordinator and is a licensed occupational therapist, the third author has a background in quantitative designs and statistical analyses and has worked as a research assistant, and the fourth author worked as a research assistant while in graduate school and is a licensed occupational therapist.