Comparing narrative-informed occupational therapy in adult outpatient mental health to treatment as usual: A quasi-experimental feasibility study with preliminary treatment outcomes.
Sally Wasmuth, Victoria G Wilburn, Jay A Hamm and 1 others
PMID 34744219WHAT IT FOUND
Adding narrative-informed occupational therapy to standard mental health care was feasible with high attendance.
Therapist-rated participation improved, but client-reported recovery did not change more than standard care alone.
Key findings
01Intervention clients attended an average of 8.54 sessions, and the no-show rate was 14%, which was better than the clinic's overall rate.
02Therapist-rated occupational participation (OCAIRS) improved significantly over 12 weeks, with six domains responding to the dose of therapy.
03Client-reported recovery (RAS) showed no significant improvement over time in the intervention group, and no significant difference in change compared to the treatment-as-usual group.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Small sample size (n=27) limits the generalizability and statistical power of the findings. The study design was quasi-experimental with non-randomized groups, introducing potential selection bias. The OCAIRS was administered only to the intervention group, preventing direct comparison of occupational participation outcomes between groups. Data collection for the RAS in the comparison group at week 12 was incomplete due to poor client follow-up. The treating occupational therapist collected outcome data for the intervention group, which may introduce observer bias.
Declared interests
The authors declared no conflicts of interest. The study was not funded by a commercial entity.
The easy way to misread this
Do not conclude that narrative-informed occupational therapy improves client-reported recovery. While therapist-rated participation scores improved, the primary client-reported measure of recovery showed no significant change over time and no significant difference compared to treatment as usual.