Supporting self-determination in mental health recovery: Strategies employed by occupational therapists

IF 1.6 4区医学 Q2 REHABILITATION

Australian Occupational Therapy Journal Pub Date : 2023-10-20 DOI:10.1111/1440-1630.12913

Jasmine Fawor, Nicola Hancock, Justin Newton Scanlan, Debra Ellen Hamilton

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Abstract

Introduction

Self-determination is a core component of mental health recovery and a predictor of positive outcomes. The literature calls for occupational therapists to lead practice change to greater recovery-orientation, including facilitating people's self-determination. However, systemic challenges thwart translation of policy into practice and therapists report a lack of confidence in implementing recovery-oriented principles. This study aimed to understand the strategies that mental health occupational therapists employ to support people's self-determination.

Methods

Data were collected through an international on-line questionnaire principally comprising two open-ended questions designed to elicit deep reflective personal accounts. Participants were asked about an experience in which they supported a person's self-determination and the factors that either facilitated or hindered this experience. Qualitative data were analysed using inductive thematic analysis, guided by constant comparative methods.

Findings

Thirty-four therapists, predominantly from Australia (n = 30), participated. Therapists described supporting self-determination as a multifaceted process that involved: (1) working on myself, (2) working with the person, and (3) working with others. They emphasised that the combined use of various strategies across these three areas of work was important to support people's self-determination. Further, awareness of and addressing issues of power in their practice was key.

Conclusion

This study supports the translation of recovery-oriented principles into practice by revealing the nuanced strategies implemented by occupational therapists striving to support self-determination. Participants employed diverse strategies to empower people to take the ‘driver's seat’ in their mental health recovery journey. Insights from this study will support other occupational therapists to actualise recovery-oriented principles and better support self-determination in their practice. To effectively implement self-determination strategies, therapists must reflect on and address existing power differentials within mental health services, particularly between themselves and the people they support.

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支持心理健康恢复中的自决：职业治疗师采用的策略。

引言：自决是心理健康恢复的核心组成部分，也是积极结果的预测因素。文献呼吁职业治疗师将实践转变为更大的康复导向，包括促进人们的自决。然而，系统性挑战阻碍了政策转化为实践，治疗师报告说，他们对实施以康复为导向的原则缺乏信心。本研究旨在了解心理健康职业治疗师为支持人们的自我决定而采用的策略。方法：通过国际在线问卷收集数据，主要包括两个开放式问题，旨在引发深刻反思的个人账户。参与者被问及他们支持一个人自决的经历，以及促进或阻碍这种经历的因素。定性数据采用归纳专题分析法进行分析，并采用持续的比较方法。研究结果：34名治疗师，主要来自澳大利亚（n = 30），参与。治疗师将支持自决描述为一个多方面的过程，包括：（1）锻炼自己，（2）与他人合作，以及（3）与他人一起工作。他们强调，在这三个工作领域综合使用各种战略对支持人民自决至关重要。此外，在他们的实践中认识和解决权力问题是关键。结论：本研究通过揭示职业治疗师为支持自决而实施的微妙策略，支持将以康复为导向的原则转化为实践。参与者采用了不同的策略，让人们在心理健康恢复之旅中占据“驾驶座”。这项研究的见解将支持其他职业治疗师实现以康复为导向的原则，并在实践中更好地支持自决。为了有效实施自决策略，治疗师必须反思和解决心理健康服务中现有的权力差异，特别是他们自己和他们支持的人之间的权力差异。

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来源期刊

Australian Occupational Therapy Journal 医学-康复医学

CiteScore

2.80

自引率

16.70%

发文量

审稿时长

6-12 weeks

期刊介绍： The Australian Occupational Therapy Journal is a leading international peer reviewed publication presenting influential, high quality innovative scholarship and research relevant to occupational therapy. The aim of the journal is to be a leader in the dissemination of scholarship and evidence to substantiate, influence and shape policy and occupational therapy practice locally and globally. The journal publishes empirical studies, theoretical papers, and reviews. Preference will be given to manuscripts that have a sound theoretical basis, methodological rigour with sufficient scope and scale to make important new contributions to the occupational therapy body of knowledge. AOTJ does not publish protocols for any study design The journal will consider multidisciplinary or interprofessional studies that include occupational therapy, occupational therapists or occupational therapy students, so long as ‘key points’ highlight the specific implications for occupational therapy, occupational therapists and/or occupational therapy students and/or consumers.