Using Practice-Based Inquiry to Enact Occupation-Centered, Justice-Oriented Practice in an Acute Mental Health Setting.

IMPORTANCE: Occupational therapy practitioners working in mental health settings in the United States are faced with challenges and barriers to implementing justice-oriented, occupation-centered practice. Research situated in the practice context with practitioners as coresearchers may provide an avenue for changing practice. OBJECTIVE: To describe the reconceptualization and redesign of occupational therapy services by a community of occupational therapy practitioners in an acute mental health setting in the United States. DESIGN: Practice-based inquiry, a form of practitioner-generated action research with a community of practice scholars (CoPS), guided the redesign of practice. SETTING: Acute mental health service in a large teaching hospital system. PARTICIPANTS: Nine occupational therapists comprised a CoPS and served as coresearchers and participants in the study. DATA COLLECTION AND ANALYSIS: Practitioner scholars' experiences of daily practice captured in individual reflections and collective research discussions were the source of data. Data collection, analysis, and action was an iterative process. Coresearchers coded and categorized findings and then developed themes reflecting changes enacted in practice. FINDINGS: The data analysis resulted in two themes characterizing how the CoPS reconceptualized and redesigned practice to reflect their commitment to occupation-centered and justice-focused occupational therapy: (1) occupational opportunities through direct services and (2) occupational opportunities through system-level change. CONCLUSIONS AND RELEVANCE: For this CoPS, engaging in a practice-based inquiry facilitated a reconceptualization of their practice and widened their occupational lens, thus strengthening their identity as occupational therapists. Given the barriers to demonstrating occupational therapy's unique contribution to mental health practice, this research provides a valuable tool for practitioners. What This Article Adds: Occupational therapy practitioners who engage in context-specific, action-oriented research experience a transformative process that empowers them to address barriers often encountered in mental health practice and enact occupation-centered and justice-focused practice.

Duke Scholars

Author MaryBeth Gallagher Orthopaedic Surgery, Occupational Therapy