York St John University
   
 
The Bridge
 
     
 
June 2009
 
   
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Bridging the gap between research and practice

 

Welcome to the latest edition of the Research Centre for Occupation & Mental Health’s e-bulletin, The Bridge. 

 

This edition is a little bit different because Dr Wendy Bryant, from Brunel University, has provided the highlights from the American Association of Occupational Therapists conference for people interested in occupation and mental health research.

 
2009 Annual conference of AOTA (American Occupational Therapy Association), Houston, Texas, April 23rd – 26th 2009
There are many assumptions about the differences between occupational therapy in the USA and the UK, and going to the AOTA conference is a great opportunity to reflect on those assumptions. I was one of 3000 people at this conference including many occupational therapists and students from all over the US. This short summary focuses on two presentations: the first is fascinating because of its very scientific focus linked with occupation.
Houston, we have a problem: Occupation and space research
Helen Cohen, an occupational therapist and vestibular physiologist based in the National Space Biomedical Research Institute (http://www.nsbri.org/) works in collaboration with the scientists to study adaptive behaviour and functional performance in zero-gravity environments. She gave examples of how altering positioning can promote functioning (http://www.bcm.edu/oto/faculty/hc.html). The two other speakers were scientists focused on the physiological impact of microgravity: occupation is key to judging the significance of this impact. While physiology might seem remote from mental health issues, it was good to see the importance of occupation for grounding intricate scientific research.
Evidence-based literature reviews
AOTA has commissioned literature reviews into occupation and serious mental illness to provide evidence for practice, as occupational therapy in the USA in mental health is not well established. Studies which were at level 3 or above on the hierarchy of evidence were included, so all qualitative evidence was ignored. There was one review on education and work, and the other on community reintegration. Both teams involved librarians to conduct the database searching and students to conduct the reviews for their Masters degrees.

There was strong evidence for Individual Placement Support and “manual driven interventions” in activities of daily living, social skills combined with work rehab and cognitive training combined with work rehab. For community reintegration, 34 studies were directly supportive of OT, 3 supportive of OT-related work and 6 inconclusive. One particular difficulty was how OT was defined for the purpose of comparison with other interventions, and the absence of long-term follow-up.

Here in the UK we have so much to offer our US colleagues and this presentation highlighted the importance of publishing our work for international audiences.

Other highlights
There was a very interesting workshop on models of health promotion and two recommended resources, one on models and the other a new OT textbook:

http://www.cancer.gov/PDF/481f5d53-63df-41bc-bfaf-5aa48ee1da4d/TAAG3.pdf

http://www.fadavis.com/online_store/catalog/catalog_detail.cfm?publication_id=2041

The Eleanor Clarke Slagle lecture examined the founding vision for OT in the USA and would be worth reading when it comes out in the American Journal, especially for insights into occupational science, social reform, habit training and activity analysis. What I particularly enjoyed was hearing about the very different priorities of the Founders, who fostered the different strands of OT we have today.
There is a new edition of the Occupational Therapy Practice Framework (available in the American Journal) which has greater emphasis on population approaches and is really useful for thinking about structures for research into occupational therapy. Again it can be found in the American Journal and there is a Table explaining the changes for those familiary with the first verion.
Winnie Dunn explained how her work on sensory processing could apply to well populations, using her book “Living Sensationally” which is a very accessible text.

http://www.jkp.com/catalogue/book.php/isbn/9781843108719

Her work really emphasises individual differences, especially around tolerance of sensory input. There was also a poster investigating differences in sensory processing for people with eating disorders which was fascinating. Winnie’s work is supported by standardised measures and solid science, so again offers an excellent resource for research.

Dr Wendy Bryant
Lecturer, Brunel Univeristy

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