Implementation #1 – Technology PowerPoint
Technology PowerPoint Article 1
Vocational Interventions for Unemployed: Effects on Work Participation and Mental Distress. A Systematic Review
Level of Evidence: Level I
The purpose of this systematic review was to determine the effectiveness of vocational interventions on work participation and mental health for unemployed adults. EMBASE and PsychINFO were two databases searched for studies which focused on work participation and mental health interventions for the unemployed. Six articles were based on five intervention studies. These included two RCTs, one non-randomized controlled trial, and two longitudinal studies with pre and post test measures. Each study utilized group training techniques to promote re-employment and/or improve mental health. These interventions taught individuals job-search skills, maintaining work, personal development, and preparedness. One of the six studies reported the training program to have a significant effect on re-employment. Our technology powerpoint is aimed to be a training technique for individuals to better navigate the internet and learn how to search for jobs (Audhoe et al., 2010).
Technology PowerPoint Article 2
Technology Use among Emerging Adult Homeless in Two U.S. Cities
Level of Evidence: Level IV
Homeless adults are often less likely to engage in services due to higher rates of mental illness and substance abuse disorders. No previous research has been conducted to assess how likely technology use is among homeless adults and whether devices are available to use. This study explored how likely emerging homeless adults are to use technology and identified risk factors that prevent this population from using technology. This study recruited 50 homeless adults from Denver, CO and 50 homeless adults from Los Angeles, CA from shelters, drop-in centers, and street outreach. Researchers completed retrospective interviews with participants to assess frequency of technology use, sites used, and purpose for use. 46% of the sample reported using technology every day, and 93% reported using it weekly. Participants reported using the computer to email, use social networking sites, and search the web. Participants reported the most common places they utilized technology were at specific social service agencies and libraries. Findings suggest that homeless adults are consistent and frequent users of technology, suggesting that technology use is a common practice, regardless of risk factors, among homeless adults (Pollio, 2013).
Implementation #2 – Case Manager Cheat Sheets
Case Manager Cheat Sheet Article 1
Occupational Performance Needs of Young Veterans
Level of Evidence: Level IV
Occupational performance issues were observed for 30 young U.S. veterans (age 20-29) who served in Operation Iraqi Freedom and Operation Enduring Freedom. Of the 1.64 million troops deployed on these operations it is estimated that ⅓ of these veterans will struggle with PTSD, TBI, substance abuse, and/or major depression. Participants completed a variety of screens including the COPM to explore the difficulties experienced in daily life challenges in their 1st year as veterans. 40% of participants screened positive for mild TBI, and 92% reported hazardous drinking habits. Individuals reported that their freedom to participate in and choose activities and occupations was the best thing about returning home, however these choices may be compromised based on screening results. Results from screenings showed that most occupational challenges fell in areas of self-care performance including: driving, sleeping, engagement in relationships, physical health, and school/work performance (Plach & Sells, 2013).
Case Manager Cheat Sheet Article 2
Factors Associated with Persistent Posttraumatic Stress Disorder Among U.S. Military Service Members and Veterans
Level of Evidence: Level IV
This study included 2409 veterans who screened positive for PTSD using the PTSD Checklist – Civilian Version. Almost half of the participants (n=1132) were found to have persistent PTSD (versus remitted PTSD) at the first follow up, and 804 of those screened positive for persistent at the second follow-up. Factors associated with persistent PTSD in the first follow up included old age, high combat exposure, enlisted rank, initial PTS severity, depression, history of physical assault, disability, and somatic symptoms. Sleep deprivation, military separation, and lack of social support were associated with persistent PTSD at the second follow up. Overall, combat experiences were the highest risk factor for PTSD. Comorbid occupational performance conditions which should be incorporated in treatment sessions include sleep disturbances, somatic symptoms, and injury/illness (Armenta et al., 2018).
Implementation #3 – Client Bill of Rights
Client Bill of Rights Article 1
Critical Analysis of a Public Policy: An Occupational Therapist’s Experience With the Patient Bill of Rights
Level of Evidence: Level V
The author of this article states her views on the importance of occupational therapists advocating for public policy on a national level for a patient bill of rights. She points out an instance in history where patients felt a lack of control in their care, limited freedom of speech and limited right for justice. The government affairs division of American Occupational Therapy Association (AOTA) highlighted anti-discrimination and comprehensive services as target areas for policy change – indicating the prevalence of issues in these areas in the care of clients. In our fieldwork setting, advocating for a Client Bill of Rights was important the reasons stated in this article (Lohman, 2003).
Client Bill of Rights Article 2
Critical Analysis of a Public Policy: An Occupational Therapist’s Experience With the Patient Bill of Rights
Level of Evidence: Level IV
This study involved a cross-sectional survey of 125 occupational therapists that was designed to determine the level of knowledge occupational therapists have on patient rights. This four-part survey asked questions about the therapists’ level of education, years of experience, practice area, and knowledge on patient rights. The results of the survey demonstrated occupational therapists have a high level of knowledge of patient rights, regardless of experience and education. This article supports occupational therapists’ role and competence in patient rights (Dehghan et al., 2013).
Implementation #4 – Support Services Resource
Support Group Resources Article 1
The Influence of Social Support on Dyadic Functioning and Mental Health Among Military Personnel During Post-deployment Reintegration
Level of Evidence: Level IV
Individuals returning from combat report high rates of depression, anxiety, and PTSD. The purpose of this study is to examine methods through which social support influences the mental health of veterans. For veterans, social support includes formal support from military leadership and informal support from civilians, family, and friends. Research shows that informal social support is more important in overall functioning. Participants for this cross sectional study were recruited through social media and existing military networks. The survey was then emailed to the 321 participants from all branches of the military via email. Outcome measures included the following: The Multidimensional Scale of Perceived Social Support, Patient Health Questionnaire (depression), PTSD Checklist, Generalized anxiety disorder scale, dyadic adjustment scale. Results found significantly positive effects of social support on dyadic functioning for all sources of support (nonmilitary friends, family, military peers, and military leaders). Overall, greater social support leads to significantly better dyadic functioning. Our support group implementation aims to provide resources for veterans to access social supports in an effort to decrease combat relation social symptoms.
Support Group Resources Article 2
Group-Delivered Cognitive/Exposure Therapy for PTSD in Women Veterans: a Randomized Controlled Trial
Level of Evidence: Level I
The standard treatment for PTSD has been to provide cognitive therapies in an individual format. However, there are many benefits to group treatments such as catharsis, instillation of hope, imparting information, altruism, and corrective emotional experience. Group treatment for PTSD specifically offers validation of traumatic experiences, normalization of trauma responses, and reduction of isolation, and results in high levels of participant satisfaction. The primary aim of this study was to examine the overall efficacy of a 16-week, 3-module group protocol on PTSD severity for women veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Participants for this study consisted of 86 female veterans who were classified as OEF/OIF service members and presented with a current PTSD diagnosis, no active drug or alcohol dependence, one clear trauma memory, and no other involvement in PTSD treatment. 44 members were randomly placed into group treatment, and 42 individuals made up the control group. All participants completed a self-report demographic form, and the CAPS was administered to assess PTSD and was the primary outcome measure used. Participants in the treatment group engaged in a 16-week, 90 minute group treatment sessions with topics on education, trauma narrative writing, development of coping strategies, behavioral training, and guided imagery exposure. Results from this study show that four clinical indicators of PTSD had improved for the treatment group when re-assessed with the CAPS, and measures of quality of life and life functioning also were improved for the treatment group. This study demonstrated the benefits for group treatment to reduce PTSD symptoms for women veterans.
References
Armenta, R. F., Rush, T., LeardMann, C. A., Millegan, J., Cooper, A., Hoge, C. W., … Nieh, C. (2018). Factors associated with persistent posttraumatic stress disorder among U.S. military service members and veterans. BMC Psychiatry, 18(1), 1–12. https://doi.org/10.1186/s12888-018-1590-5
Audhoe, S.S., Hoving, J.L., Sluiter, J. K., & Frings-Dresen, M.H.W. (2010). Vocational interventions for unemployed: effects on work participation and mental distress. A systematic review. Journal of Occupational Rehabilitation, 20(1), 1–13. https://doi.org/10.1007/s10926-009-9223-y
Castillo, D.T., Chee, C.L., Nason, E., Keller, J., Baca, J.C., …. Keane, T.M. (2016). Group-delivered cognitive/exposure therapy for PTSD in women veterans: A randomized controlled trial. Psychological Trauma: Theory, Research, Practice, and Policy, 8(3) 404-412. http://dx.doi.org/10.1037/tra0000111
Cederbaum, J. A., Wilcox, S. L., Sullivan, K., Lucas, C., & Schuyler, A. (2017). The influence of social support on dyadic functioning and mental health among military personnel during postdeployment reintegration. Public Health Reports, 132(1), 85–92. https://doi.org/10.1177/0033354916679984
Dehghan, L., Dalvand, H., Haghgoo, H. A., Hosseini, S. A., & Karimlou, M. (2013). Occupational therapists and patients’ rights: Their level of clinical knowledge. Journal of Medical Ethics and History of Medicine, 6.
Lohman, H. (2003). Critical analysis of a public policy: An occupational therapist’s experience with the Patient Bill of Rights. American Journal of Occupational Therapy, 57(4), 468–472. https://doi.org/10.5014/ajot.57.4.468
Plach, H. L., & Sells, C. H. (2013). Occupational performance needs of young veterans. American Journal of Occupational Therapy, 67(1), 73–81. https://doi.org/10.5014/ajot.2013.003871
Pollio, D., Batey, D., Bender, K., Ferguson, K., Thompson, S. 2013. Technology use among emerging adult homeless in two U.S. cities. National Association of Social Workers, 58(2), 173-175. doi: 10.1093/sw/swt006