OCCUPATIONAL THERAPY FOR PEOPLE WITH A DIAGNOSIS OF PSYCHOSIS; INTERVENTION SPECIFICATION

Background: Occupational therapy has been defined as a complex intervention (Creek 2003). More effectiveness studies are needed in occupational therapy generally (Bannigan et al. 2008) and mental health specifically (COT... [ view full abstract ]

Background: Occupational therapy has been defined as a complex intervention (Creek 2003). More effectiveness studies are needed in occupational therapy generally (Bannigan et al. 2008) and mental health specifically (COT 2006). Randomised controlled trials (RCTs) have been perfected largely through drug trials, whereas occupational therapy typically involves greater complexities (Nelson and Mathiowetz 2004) making effectiveness studies very challenging. Frameworks and guidance for designing and evaluating complex interventions to improve health have advanced (Richards and Hallberg 2015). This paper describes the method used to create an occupational therapy intervention specification and details of the specification itself.
Method: The Medical Research Council (2008) guidance was applied and a task analysis of occupational therapy with people with a diagnosis of psychosis was carried out (Gitlin 2013). This was scrutinised by the POINTER study steering group, academics and clinicians; some amendments were made. The validity and applicability of the occupational therapy intervention specification is currently being explored in a feasibility study for a pragmatic RCT.
Results: The occupational therapy intervention specification is described; outlining the theory base, therapy goals, objectives, activities and the hypothesized outcomes.
Conclusion: As a complex intervention, approaches to test occupational therapy’s efficacy in a research setting is a priority for the profession. This intervention specification will be used in a larger pragmatic RCT to test the efficacy of occupational therapy with people with a diagnosis of psychosis, living in the community.
Application to Practice: The use of the intervention specification to support best practice and research will be discussed.