Forensic Occupational Therapy in Canada: The Current State of Practice

Abstract

Although occupational therapists have been practicing in forensic settings for many years, there is a paucity of literature regarding the nature of this practice in Canada. The purpose of this study was to describe the practices of Canadian occupational therapists in forensic mental health. An online survey was designed based on the Canadian Practice Process Framework. Following purposive and snowball sampling, responses were analysed with descriptive statistics and content analysis. Twenty-seven clinicians responded (56% response rate). Respondents indicated commonalities in workplaces, client caseloads and practice challenges. The outstanding need in Canada to demonstrate client outcomes through the use of evaluation instruments reflects those practice gaps identified internationally. Education, advocacy and research are critical areas for the development of Canadian forensic occupational therapy. Although findings heavily reflect one provincial context and may not be generalizable to nonhospital settings, a number of priority areas were identified. Future efforts should clarify the role of forensic occupational therapy to stakeholders, and validate their contributions through research that evaluates intervention efficacy and meaningful outcomes. Copyright © 2016 John Wiley & Sons, Ltd.

The Scope of Practice of Occupational Therapy in U.S. Criminal Justice Settings

“…These figures are roughly the same as those reported by Cronin‐Davis and Spybey (). Chui () reported a 4.4 mean years of experience for the Canadian practitioners in her study while Duncan et al () reported a mean of 4.1 years. The point here is that within the U.S. and internationally there are talented, experienced practitioners who are and can continue to lead the professions' development in this arena of practice and who may be called upon to mentor one another and new practitioners.…”

“…Four international studies have specifically defined the demographics of practitioners in criminal justice systems and each collected and reported demographic variables differently. Chui () surveyed 27 practitioners in Canada, and in the U.K., Flood (); Duncan et al () and Cronin‐Davis and Spybey () surveyed 86, 60 and 81 practitioners respectively. All four of these studies reported the overwhelming majority of their respondents worked within secure mental health forensic settings.…”

“…Others that have examined the use of occupational therapy practice models within the criminal justice literature have also reported that the MOHO is the most frequently cited practice model (O'Connell and Farnworth, ; Bennett and Manners, 2012) and the only existing set of occupational therapy practice guidelines in secure forensic settings used the MOHO components of volition, habituation, performance and environment to organize the their practice guideline recommendations (College of Occupational Therapists, ). In contrast, Chui () reported that practitioners working in the Canadian criminal justice setting were overwhelmingly using a practice model and almost always used the Canadian Model of Occupational Performance and Engagement (CMOP‐E). It is important to note that the CMOP, PEO models and the MOHO are compatible, share similar theoretical assumptions and are all models that make an effort to consider a broad array of factors that influence a person's occupational functioning in environmental context.…”

Occupational Therapy in Forensic Settings

“…The main challenge is the context because of the complexity of the rules affecting the freedom of the offender and the occupational opportunities [7]. The heterogeneous client population is another challenging condition with in the context.…”

“…The forensic population is growing all over the world and brings challenges with this growing population [5][6][7][8]. These challenges can depend on the person, environment and/or activity.…”