Occupational Therapy and Public Safety Personnel: Return to Work Practices and Experiences.
Megan Edgelow, Ana Petrovic, Clare Gaherty and 1 others
PMID 38146163WHAT IT FOUND
Occupational therapists working with injured first responders report feeling pressured to document exposure therapy and return-to-work goals even when inappropriate.
Stigma and poor communication with insurers block progress. Therapists build rapport by using clients' language and dark humour.
Key findings
01Therapists reported internal pressure from managers to list exposure therapy and return-to-work as goals, even when they did not think it matched the client's current readiness.
02Stigma and difficulty navigating the insurance system were the most frequently reported barriers to return-to-work, while good communication with insurers and employers acted as facilitators.
03Therapists described using dark humour and the client's own language as critical tools to build rapport and demonstrate understanding of the workplace culture.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study reports no patient outcomes, so it cannot say whether these practices help people return to work successfully. The chart review was limited to two specific companies and 31 records, so it may not reflect all Ontario practices. The survey used convenience sampling with no way to calculate a response rate, meaning the 49 respondents may not represent all therapists working with this group. Most respondents were early in their careers, so the findings may reflect a novice perspective rather than established expert practice. The data collection overlapped with the COVID-19 pandemic, which therapists identified as a major barrier, potentially skewing the results regarding service delivery and restrictions.
Declared interests
The study was supported by the Canadian Occupational Therapy Foundation and the Ontario Society of Occupational Therapists.
The easy way to misread this
Do not read the high frequency of exposure therapy and cognitive behavioural therapy in the charts as evidence that these are the most effective treatments for this group. The study reports no outcomes, and therapists explicitly stated they sometimes felt pressured to list these goals even when they believed them inappropriate for the client's current state.