occupational therapy literature review topics

100 Most Influential OT Research Articles

• Post date --> January 4, 2024
• Sticky post

Learn how we review the most influential occupational therapy research. And, see our 2024 list of the most influential OT-related journal articles.

How OT Potential helps you keep up with new research

Approximately 1,000 research articles containing OT are published EACH YEAR. That means roughly 5,000 articles have come out over the past five years!

As busy clinicians, we obviously don’t have time to keep up on all of the evidence. But, we do owe it to our patients to stay on top of the most influential research. 

In our membership community, The OT Potential Club , we find and review the most influential research for you. In our two week rotation, we first share a written review of the research and give you space to discuss it. Then the follow week, we release an episode of the OT Potential Podcast , where we invite an expert guest to help us pull out actionable takeaways. These episodes are AOTA approved courses.

See the process in the video below. You can also sign up for a free trial to see our platform !

See sample journal article reviews and take 2 free CEU courses Sign up for our OT Potential Club free 5-day trial.

How we select OT research to review

Each year to determine the most influential research for us to review we generated a list the 100 most influential OT-related journal articles from the past 5 yeras.

We team up with a research librarian to make this happen. 

For our 2024 list, we searched the Scopus database for articles published from 2019-2023 that had “ occupational therapy ” included in either the title, abstract, or keywords. (By the way, Elsevier’s Scopus is the largest abstract and citation database of peer-reviewed literature.) Then, we ranked the list by the number of times the articles had been cited in other journal articles.

The articles with green check marks have already been discussed in the OT Potential Club , and we will continue to work through this list throughout 2024.

To see research we’ve reviewed from past years’ lists check our article, research in the OT Potential Club .

The 100 most cited OT articles from the past five years

✅ = already reviewed in the ot potential club and featured as ceu course on the ot potential podcast.

• Listen to the podcast: Parkinson Disease Evidence Review with Brandy Archie
• Listen to the podcast: Cerebral Palsy and OT Evidence with Iona Novak
• Listen to the podcast: Rheumatoid Arthritis and OT with Cheryl Crow
• Listen to the podcast: OT and Psoriatic Arthritis with Duana Russell-Thomas
• Spinocerebellar ataxia (2019) Nature Reviews Disease Primers
• Considering the potential for an increase in chronic pain after the COVID-19 pandemic (2020) Pain
•   Occupational Therapy Practice Framework: Domain and Process-Fourth Edition (2020) American Journal of Occupational Therapy
•   American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis (2019) Arthritis Care and Research
• Outpatient Physical, Occupational, and Speech Therapy Synchronous Telemedicine; A Survey Study of Patient Satisfaction with Virtual Visits during the COVID-19 Pandemic (2020) American Journal of Physical Medicine and Rehabilitation
• Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition (2020) Journal of Bone and Mineral Research
• Long-Term Effects of Breast Cancer Surgery, Treatment, and Survivor Care (2019) Journal of Midwifery and Women’s Health
• Cerebral palsy in children: A clinical overview (2020) Translational Pediatrics
• Listen to the podcast: Depression in Neurodegenerative Diseases with Rachel Wiley
• Listen to the podcast: Pediatric OT Evidence Review with Michelle DeJesus
• Pediatric Teleheath: Opportunities Created by the COVID-19 and Suggestions to Sustain Its Use to Support Families of Children with Disabilities (2021) Physical and Occupational Therapy in Pediatrics
• Listen to the podcast: Virtual Reality and OT with Christopher Gaskins
• Benefits of pulmonary rehabilitation in covid-19 – a prospective observational cohort study (2021) ERJ Open Res
• Emerging health challenges for children with physical disabilities and their parents during the COVID-19 pandemic: The ECHO French survey (2021) Annals of Physical and Rehabilitation Medicine
• Cerebral palsy: An overview (2020) American Family Physician
• Complex regional pain syndrome: a narrative review for the practising clinician (2019) British Journal of Anaesthesia
• Social Isolation – The Other COVID-19 Threat in Nursing Homes (2020) JAMA – Journal of the American Medical Association
• Listen to the podcast: CIMT and OT with Catherine Hoyt
• Assessment of Emergency Department and Inpatient Use and Costs in Adult and Pediatric Functional Neurological Disorders (2021) JAMA Neurology
• Canadian guideline for Parkinson disease (2019) CMAJ
• A systematic review of ayres sensory integration intervention for children with autism (2019) Autism Research
• Professional identity: A concept analysis (2020) Nursing Forum
• Sepsis-associated encephalopathy and septic encephalitis (2021) Expert Review of Anti-Infective Therapy
• Diagnosis and management of functional neurological disorder (2022) BMJ
• Listen to the podcast: OT for Spasticity in Adults with Scott Thompson
• Elements virtual rehabilitation improves motor, cognitive, and functional outcomes in adult stroke (2019) Journal of NeuroEngineering and Rehabilitation
• Clinical Neurorestorative Therapeutic Guidelines for Spinal Cord Injury (2020) Journal of Orthopaedic Translation
• Immersive Virtual Reality Mirror Therapy for Upper Limb Recovery after Stroke: A Pilot Study (2019) American Journal of Physical Medicine and Rehabilitation
• Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) Journal of Clinical Medicine
• Developmental delay: Identification and management at primary care level (2019) Singapore Medical Journal
• Occupational therapy consensus recommendations for functional neurological disorder (2020) Journal of Neurology, Neurosurgery and Psychiatry
• One year in review 2019: Systemic sclerosis (2019) Clinical and Experimental Rheumatology
• Personalized medicine for patients with COPD: Where are we? (2019) International Journal of COPD
• Association of Geriatric Comanagement and 90-Day Postoperative Mortality among Patients Aged 75 Years and Older with Cancer (2020) JAMA Network Open
• Immersive Virtual Reality for the Management of Pain in Community-Dwelling Older Adults (2019) OTJR Occupation, Participation and Health
• Nonpharmacological Interventions to Improve Depression, Anxiety, and Quality of Life (QoL) in People With Dementia (2020) Journal of Geriatric Psychiatry and Neurology
• Occupational therapy for people with dementia and their family carers provided at home (2019) BMJ Open
• Decade of progress in motor functional neurological disorder: Continuing the momentum (2021) Journal of Neurology, Neurosurgery and Psychiatry
• Management of Osteogenesis Imperfecta (2020) Frontiers in Endocrinology
• Multiple sclerosis management during the COVID-19 pandemic (2020) Multiple Sclerosis Journal
• Parent perspectives of an occupational therapy telehealth intervention (2019) International Journal of Telerehabilitation
• Breast cancer in adolescent and young adult women under the age of 40 years (2021) JCO oncology practice
• Effects of telerehabilitation in occupational therapy practice: A systematic review (2019) Hong Kong Journal of Occupational Therapy
• Awareness and current knowledge of Parkinson’s disease: a neurodegenerative disorder (2019) International Journal of Neuroscience
• Cognitive reserve and age predict cognitive recovery after mild to severe traumatic brain injury (2019) Journal of Neurotrauma
• Cognitive training for people with mild to moderate dementia (2019) Cochrane Database of Systematic Reviews
• Physical Rehabilitation in Critically Ill Children: A Multicenter Point Prevalence Study in the United States (2020) Critical Care Medicine
• Quality of life and its related factors for adults with autism spectrum disorder (2019) Disability and Rehabilitation
• Extracorporeal Membrane Oxygenation Is a Team Sport: Institutional Survival Benefits of a Formalized ECMO Team (2019) Journal of Cardiothoracic and Vascular Anesthesia
• Motor learning in neurological rehabilitation (2021) Disability and rehabilitation
• Guidelines on the diagnosis and management of the progressive ataxias (2019) Orphanet Journal of Rare Diseases
• Construct validity, test-retest reliability, and the ability to detect change of the Canadian Occupational Performance Measure in a spinal cord injury population (2019) Spinal cord series and cases
• Telerehabilitation During the COVID-19 Pandemic in Outpatient Rehabilitation Settings (2021) Physical Therapy
• Loss in services precedes high school exit for teens with autism spectrum disorder (2019) Autism Research
• Construct validity of a revised version of the Occupational Balance Questionnaire (2020) Scandinavian Journal of Occupational Therapy
• Telehealth for the provision of occupational therapy: Reflections on experiences during the COVID-19 pandemic (2020) International Journal of Telerehabilitation
• Treatment patterns in children with autism in the United States (2019) Autism Research
• Stroke self-management and the role of self-efficacy (2021) Disability and rehabilitation
• Occupational therapy in the promotion of health and well-being (2020) The American Journal of Occupational Therapy
• Toward a theory-based specification of non-pharmacological treatments in aging and dementia (2020) Alzheimer’s & Dementia
• Efficacy of Virtual Reality Combined With Real Instrument Training for Patients With Stroke: A Randomized Controlled Trial (2019) Archives of Physical Medicine and Rehabilitation
• Relationships between job satisfaction, burnout, professional identity and meaningfulness of work activities for occupational therapists working in mental health (2019) Australian Occupational Therapy Journal
• Potential benefits of music playing in stroke upper limb motor rehabilitation (2020) Neuroscience and Biobehavioral Reviews
• Evaluation of pelvis postural systems in spinal cord injury patients: Outcome research (2020) Journal of Spinal Cord Medicine
• A review of interprofessional training wards: Enhancing student learning and patient outcomes (2019) Medical Teacher
• Effects of virtual reality-based planar motion exercises on upper extremity function, range of motion, and health-related quality of life (2019) Journal of neuroengineering and rehabilitation
• What is the threshold dose of upper limb training for children with cerebral palsy to improve function? A systematic review (2020) Australian occupational therapy journal
• Listen to the podcast: OT, Plagiocephaly, and Cognitive Outcomes with Amirra Condelee
• COVID-19 and Cerebrovascular Diseases: A Systematic Review and Perspectives for Stroke Management (2020) Frontiers in Neurology
• The use of augmented reality for rehabilitation after stroke: a narrative review (2020) Disability and rehabilitation. Assistive technology
• Listen to the podcast: Pain and OT with Irvin Eisenberg
• Flexor tendon rehabilitation in the 21st century: A systematic review (2019) Journal of Hand Therapy
• An intervention to reduce neuropsychiatric symptoms and caregiver burden in dementia: Preliminary results from a randomized trial of the tailored activity program–outpatient version (2019) International Journal of Geriatric Psychiatry
• Pharmacological and non-pharmacological therapeutic strategies in difficult-to-treat rheumatoid arthritis: A systematic literature review informing the EULAR recommendations for the management of difficult-to-treat rheumatoid arthritis (2021) RMD open
• Patient satisfaction with telehealth in rural settings: A systematic review (2020) International journal of telerehabilitation
• Physical, occupational, and speech therapy for children with cerebral palsy (2020) Developmental medicine and child neurology
• Enhanced recovery after surgery trends in adult spine surgery: A systematic review (2020) International journal of spine surgery
• Impact of Sarcopenia on Adverse Outcomes after Allogeneic Hematopoietic Cell Transplantation (2019) Journal of the National Cancer Institute
• Optimal Terminology for Services in the United States That Incorporate Horses to Benefit People: A Consensus Document (2021) Journal of alternative and complementary medicine
• Improving the quality of life of people with advanced respiratory disease and severe breathlessness (2019) Breathe
• Comparative efficacy of interventions for reducing symptoms of depression in people with dementia: Systematic review and network meta-analysis (2021) BMJ (Clinical research ed.)
• Listen to the podcast: OT & Smart Home Tech Adoption with Carol Chiang
• Contributing to social transformation through occupation: Experiences from a think tank (2019) Journal of Occupational Science
• Moving from cultural competence to cultural humility in occupational therapy: A paradigm shift (2020) The American journal of occupational therapy
• Virtual reality in neurorehabilitation: An umbrella review of meta-analyses (2021) Journal of clinical medicine
• Recommendations for the Nonpharmacological Treatment of Apathy in Brain Disorders (2020) The American journal of geriatric psychiatry
• Evidence-based practice implementation in stroke rehabilitation: A scoping review of barriers and facilitators (2020) The American journal of occupational therapy
• Treatment of neuropathic pain after peripheral nerve and brachial plexus traumatic injury (2019) Neurology India
• Cultural competency and the reproduction of White supremacy in occupational therapy education (2020) Health Education Journal
• Rural-urban disparities in health care costs and health service utilization following pediatric mild traumatic brain injury (2019) Health services research
• Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 5th Edition (2022) Pain medicine
• Interventions to improve upper limb function for children with bilateral cerebral palsy: a systematic review (2019) Developmental medicine and child neurology
• Re-imagining occupational therapy clients as communities: Presenting the community-centred practice framework (2019) Scandinavian journal of occupational therapy
• Occupational therapy, everyday life and the fabric of life: Theoretical-conceptual contributions for the construction of critical and emancipatory perspectives (2020) Cadernos Brasileiros de Terapia Ocupacional
• Hyperphosphatemic Tumoral Calcinosis: Pathogenesis, Clinical Presentation, and Challenges in Management (2020) Frontiers in Endocrinology
• Early versus delayed mobilization for in-hospital mortality and health-related quality of life among critically ill patients: A systematic review and meta-analysis (2019) Journal of intensive care

Need help accessing these articles?

As you can see, each of the articles in our list is hyperlinked for your convenience—and I’m always surprised by how many research articles are free! However, if you find one that is not free, you can also see if it’s available via your AOTA membership in AJOT or via ProQuest with your NBCOT membership. You can read more about these options in our blog post on where to find OT research .

All that being said, some articles you may simply have to purchase. 

Resources derived from our OT research list

As we spend time exploring this research, we’ll continue to systematically pull information that is helpful for OTs. Check out these other blog posts, which incorporate information we find in our research:

• Helpful List of OT Journals
• List of OT Assessments
• OT Documentation

We hope this list fills you with excitement for occupational therapy—and the research that is driving it. And, we hope you consider joining us in our favorite corner of the internet…the OT Potential Club . 🙂

13 replies on “100 Most Influential OT Research Articles”

Thanks for taking the time to research and share these articles, I live by and truly believe that Team Work Makes a Dream Work! I look forward to our club and please count me in 🙂 One way that I would keep up with the latest and greatest was having mini lunch time discussions with my therapy pals. We would switch off who was responsible to bring in an article and share what we learned but most importantly how we can apply it. I think if more DOR could get behind these groups this would make big impacts in our daily practices. Look forward to your next blog! Aloha <3

Hey Monica!!

I am so excited to hangout with you in the OT Potential Club, and talk about ways to apply new research! I agree that lunch time journal clubs are such a great tool for departments. Hopefully the OT Potential Club will make preparing content for these even easier!

Thank you so much for all your support! (And please send some of your warm weather to those of us in the Midwest!)

As a future OT student, I’m curious if you have any insight into the following question. As I read about advancements in childhood development research, it strikes me that OT’s are often not included in these discussions. For instance, I went to a Brookings Institution panel on "A prescription for play" ( https://www.brookings.edu/blog/education-plus-development/2018/08/21/a-prescription-for-play/ ) and it would have been great to have an OT on the panel since they work "on the ground" with children. As neuroscience continues to break ground on new issues related to childhood development (i.e. the brain and trauma), why aren’t OT’s being included in these discussions? Is it because they are considered practitioners and not researchers?

Hi Laura, You’ve stumbled onto a huge problem here, and it isn’t specific to OT. One often cited study showed that it takes about 17 YEARS for new medical knowledge to be adopted into practice (and even then only a fraction of best practices actually get adopted.) There is clearly a disconnect between academia and practitioners on the ground. To solve the complex challenges of today and the future, we certainly need new tools and bridge builders to help us shorten this gap!

Thanks – this is helpful to know. And I’m glad it’s just a problem with OT, because it had me wondering what the issue was.

*it’s not just

Hi Laura. As Sarah stated, you’ve stumbled upon a huge problem, that I think IS specific to occupational therapy. The medical and research communities (and general community for that matter) remain under-educated about the existence and value of the occupational therapy profession. We very rarely have a seat at the table, as you recognized. Occupational therapy, though being around for over 100 years, continues to be quite insulated. Although this is changing! In my opinion, AOTA has never done an excellent job of marketing us OUTSIDE the occupational therapy community, and thus hasn’t had the skillset to teach us how to market ourselves. This is a challenge I continue to struggle with but am working solidly towards addressing.

A few strategies I use are to always identify myself as an "occupational therapist," instead of an "OT" and I work in the field of "occupational therapy". I also don’t refer to PT in my definition of what occupational therapy is. A third way I do this is to have an elevator pitch of what occupational therapy is ready at all times.

Hope this helps answer your question 🙂

Love, love, love this post and the list!! Ever an inspiration, Sarah!

Ahhh! Thank you! I am consistently inspired by the OT community and can’t wait to hang out with OT practitioners in the OT Potential Club!

I wish there were more exert articles about OT in Mental Health, such a great need for mental health supports now-a-days!

It’s awesome.. Am amazed. I was able to conduct my research problem.

Oh wow! I’m so glad to hear that! What was your research problem?

Thanks for sharing these articles, they are so useful. 🙂

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Occupational Therapy and Rehabilitation Sciences

• Defining the Research Question(s)
• Reference Resources
• Evidence Summaries & Clinical Guidelines
• Health Data & Statistics
• Patient & Consumer Facing Materials
• Images/Streaming Video
• Database Tutorials
• Crafting a Search
• Narrowing / Filtering a Search
• Expanding a Search
• Cited Reference Searching
• Find Grey Literature
• Save Your Searches
• Cite Sources
• Critical Appraisal
• Different Types of Literature Reviews
• Conducting & Reporting Systematic Reviews
• Finding Systematic Reviews
• Tutorials & Tools for Literature Reviews
• Mobile Apps for Health

What are Systematic Reviews? (3 minutes, 24 second YouTube Video)

Systematic Literature Reviews: Steps & Resources

These steps for conducting a systematic literature review are listed below . 

Also see subpages for more information about:

• The different types of literature reviews, including systematic reviews and other evidence synthesis methods
• Tools & Tutorials

Literature Review & Systematic Review Steps

• Develop a Focused Question
• Scope the Literature  (Initial Search)
• Refine & Expand the Search
• Limit the Results
• Download Citations
• Abstract & Analyze
• Create Flow Diagram
• Synthesize & Report Results

1. Develop a Focused   Question 

Consider the PICO Format: Population/Problem, Intervention, Comparison, Outcome

Focus on defining the Population or Problem and Intervention (don't narrow by Comparison or Outcome just yet!)

"What are the effects of the Pilates method for patients with low back pain?"

Tools & Additional Resources:

• PICO Question Help
• Stillwell, Susan B., DNP, RN, CNE; Fineout-Overholt, Ellen, PhD, RN, FNAP, FAAN; Melnyk, Bernadette Mazurek, PhD, RN, CPNP/PMHNP, FNAP, FAAN; Williamson, Kathleen M., PhD, RN Evidence-Based Practice, Step by Step: Asking the Clinical Question, AJN The American Journal of Nursing : March 2010 - Volume 110 - Issue 3 - p 58-61 doi: 10.1097/01.NAJ.0000368959.11129.79

2. Scope the Literature

A "scoping search" investigates the breadth and/or depth of the initial question or may identify a gap in the literature. 

Eligible studies may be located by searching in:

• Background sources (books, point-of-care tools)
• Article databases
• Trial registries
• Grey literature
• Cited references
• Reference lists

When searching, if possible, translate terms to controlled vocabulary of the database. Use text word searching when necessary.

Use Boolean operators to connect search terms:

• Combine separate concepts with AND  (resulting in a narrower search)
• Connecting synonyms with OR  (resulting in an expanded search)

Search:  pilates AND ("low back pain"  OR  backache )

Video Tutorials - Translating PICO Questions into Search Queries

• Translate Your PICO Into a Search in PubMed (YouTube, Carrie Price, 5:11) 
• Translate Your PICO Into a Search in CINAHL (YouTube, Carrie Price, 4:56)

3. Refine & Expand Your Search

Expand your search strategy with synonymous search terms harvested from:

• database thesauri
• reference lists
• relevant studies

Example: 

(pilates OR exercise movement techniques) AND ("low back pain" OR backache* OR sciatica OR lumbago OR spondylosis)

As you develop a final, reproducible strategy for each database, save your strategies in a:

• a personal database account (e.g., MyNCBI for PubMed)
• Log in with your NYU credentials
• Open and "Make a Copy" to create your own tracker for your literature search strategies

4. Limit Your Results

Use database filters to limit your results based on your defined inclusion/exclusion criteria.  In addition to relying on the databases' categorical filters, you may also need to manually screen results.  

• Limit to Article type, e.g.,:  "randomized controlled trial" OR multicenter study
• Limit by publication years, age groups, language, etc.

NOTE: Many databases allow you to filter to "Full Text Only".  This filter is  not recommended . It excludes articles if their full text is not available in that particular database (CINAHL, PubMed, etc), but if the article is relevant, it is important that you are able to read its title and abstract, regardless of 'full text' status. The full text is likely to be accessible through another source (a different database, or Interlibrary Loan).  

• Filters in PubMed
• CINAHL Advanced Searching Tutorial

5. Download Citations

Selected citations and/or entire sets of search results can be downloaded from the database into a citation management tool. If you are conducting a systematic review that will require reporting according to PRISMA standards, a citation manager can help you keep track of the number of articles that came from each database, as well as the number of duplicate records.

In Zotero, you can create a Collection for the combined results set, and sub-collections for the results from each database you search.  You can then use Zotero's 'Duplicate Items" function to find and merge duplicate records.

• Citation Managers - General Guide

6. Abstract and Analyze

• Migrate citations to data collection/extraction tool
• Screen Title/Abstracts for inclusion/exclusion
• Screen and appraise full text for relevance, methods, 
• Resolve disagreements by consensus

Covidence is a web-based tool that enables you to work with a team to screen titles/abstracts and full text for inclusion in your review, as well as extract data from the included studies.

• Covidence Support
• Critical Appraisal Tools
• Data Extraction Tools

7. Create Flow Diagram

The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow diagram is a visual representation of the flow of records through different phases of a systematic review.  It depicts the number of records identified, included and excluded.  It is best used in conjunction with the PRISMA checklist .

Example from: Stotz, S. A., McNealy, K., Begay, R. L., DeSanto, K., Manson, S. M., & Moore, K. R. (2021). Multi-level diabetes prevention and treatment interventions for Native people in the USA and Canada: A scoping review. Current Diabetes Reports, 2 (11), 46. https://doi.org/10.1007/s11892-021-01414-3

• PRISMA Flow Diagram Generator (ShinyApp.io, Haddaway et al. )
• PRISMA Diagram Templates  (Word and PDF)
• Make a copy of the file to fill out the template
• Image can be downloaded as PDF, PNG, JPG, or SVG
• Covidence generates a PRISMA diagram that is automatically updated as records move through the review phases

8. Synthesize & Report Results

There are a number of reporting guideline available to guide the synthesis and reporting of results in systematic literature reviews.

It is common to organize findings in a matrix, also known as a Table of Evidence (ToE).

• Reporting Guidelines for Systematic Reviews
• Download a sample template of a health sciences review matrix  (GoogleSheets)

Steps modified from: 

Cook, D. A., & West, C. P. (2012). Conducting systematic reviews in medical education: a stepwise approach.   Medical Education , 46 (10), 943–952.

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• Next: Different Types of Literature Reviews >>
• Last Updated: May 2, 2024 10:52 AM
• URL: https://guides.nyu.edu/ot

Occupational Therapy

• Key resources
• Journal articles and databases
• Evidence-based practice
• Websites and organisations

What is a literature review?

Books and articles.

• Referencing

A literature review is a critical assessment of the literature pertaining to a particular topic or subject.  It is a 'systematic, explicit, and reproducible method for identifying, evaluating and synthesising the existing body of completed and recorded work produced by researchers, scholars, and practitioners'  Fink, (2005).

What's its purpose?

• justify your research
• provide context for your research
• identify new ways, to interpret and highlight gaps in previous research
• ensure that the research has not been done before
• signpost a way forward for further research
• show where the research fits into the existing literature
• highlight flaws in previous research
• Doing a literature review in nursing, health and social care
• The essential guide to doing a health and social care literature review
• Health sciences literature review made easy: The matrix method
• The literature review: A step-by-step guide for students
• The literature review: Six steps to success
• Systematic approaches to a successful literature review
• Writing a literature review Includes checklists
• Writing an effective literature review
• << Previous: Websites and organisations
• Next: Referencing >>
• Last Updated: May 7, 2024 2:30 PM
• URL: https://guides.library.uq.edu.au/occupational-therapy

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OTJR: Occupational Therapy Journal of Research

Preview this book.

• Description
• Aims and Scope
• Editorial Board
• Abstracting / Indexing
• Submission Guidelines
• Articles from social, psychological, medical and rehabilitation sciences that advance understanding of everyday activities as they influence participation and health
• Original research from occupational therapy that supports evidence based practice to enable participation
• Qualitative and/or mixed methods research from occupational science and other disciplines that provides insight into how humans engage, participate and interact within their cultures and society.  
• Access to current articles, as well as several years of archived content
• Early review of manuscripts online within two months of acceptance
• Access to content in a Journal indexed in MEDLINE/PubMed, CINAHL, and Social Sciences Citation Index

The aim of OTJR is to advance knowledge and science in occupational therapy and related fields, nationally and internationally, through the publication of scholarly literature and research. The journal publishes research that advances the understanding of occupation as it relates to participation and health. The following topics should guide authors seeking to publish in the journal:

• The relationship of occupation to health, well-being and/or quality of life
• The influence of body systems or body function on occupational performance and/or social participation
• The psychometric properties of measures or methodologies that advance understanding of performance, occupation, and participation
• The outcomes or effects of interventions that influence performance, occupation, health, and/or quality of life
• The effectiveness and efficacy of occupation-based interventions
• The influence of the social, built, or natural environments on occupational performance;
• Qualitative or mixed methods research from occupational science and other disciplines that provide insight into how humans engage, participate and interact within their cultures and society.
• Other topics relating to occupational therapy practice that will lead to improving the lives of people as they seek to fully participate in family, work, community and society.
• Clarivate Analytics: Current Contents - Social & Behavioral Sciences
• Clarivate Analytics: Social Sciences Citation Index (SSCI)
• PubMed: MEDLINE

For a Word document version of the author guidelines, please download the Word version attached .

Introduction       Editorial Board       Aims and Scope       Types of Manuscripts       Open Access Publishing Option Manuscript Submission Manuscript Preparation       ORCID       Patient Consent       Research Data Author Guidelines – All Manuscript Types       Formatting       Inclusive Language Guidelines       Cover Letter       Title Page       Key Words       Abstract       Plain Language Summary (PLS)       Main Document       References       Tables & Figures       Funding       Supplemental Materials Review Process Information Artificial Intelligence Author Guidelines for Revisions       On acceptance and publication       OnlineFirst Publication       Access to your published article       Promoting your article       Appealing the publication decision Contributor’s publishing agreement

Introduction OTJR:  Occupational Therapy Journal of Research   is published quarterly by the American Occupational Therapy Foundation, Inc. This peer-reviewed journal offers empirical and review articles to readers interested in advancing the understanding of occupation as it relates to participation and health. The journal invites manuscript submissions that conform to its purpose and scope (see aims and scope below) without regard to the professional affiliation of authors. The journal encourages submissions of original research reports of translational or basic research studies with quantitative, qualitative, or mixed methods designs.

Editorial Board A current listing of members on the Editorial Board can be found at:  https://us.sagepub.com/en-us/nam/otjr-occupation-participation-and-health/journal202285#editorial-board

Aims and Scope The aim of OTJR:  Occupational Therapy Journal of Research   is to advance knowledge and science in occupational therapy, occupational science, and related fields, nationally and internationally, through the publication of scholarly literature and research. The journal publishes research that advances the understanding of occupation as it relates to participation and health.

The following topics may guide authors seeking to publish in the journal:

• The influence of body systems or body function on occupational performance and/or social participation 
• Original research from occupational therapy that supports evidence-based practice to enable participation
• Occupational development in all ages of the lifespan, i.e., the occupation of children, the importance of occupation in maintaining health in aging
• The influence of the social, built, or natural environments on occupational performance
• Qualitative or mixed methods research from occupational science and other disciplines that provide insight into how humans engage, participate, and interact within their cultures and society
• Other topics relating to occupational therapy practice that will lead to improving the lives of people as they seek to fully participate in family, work, community, and society

Types of Manuscripts OTJR:  Occupational Therapy Journal of Research   publishes:

• Full-length original research articles , which include empirical translational or basic research studies with quantitative, qualitative, or mixed methods designs.
• Review articles,  including systematic literature reviews, meta-analyses; evidence-based reviews, integrative reviews, or scoping reviews.
• Brief Reports  that represent a short report of original research that is pilot or exploratory in nature or addresses a discrete research question and lacks broad implications
• Book reviews ,
• Letters to the editor , and
• Forum proceedings that inform and/or advance the science of occupational therapy. Submissions will be determined by invitation from the Editor-in-Chief, or topic proposals may be submitted directly to the Editor-in-Chief for consideration.
• Invited reviews or commentaries, by invitation from the Editor-in-Chief. Topic proposals may be submitted directly to the Editor-in-Chief for consideration.

OTJR does not accept research protocol or occupational therapy education  focused manuscripts.

Open Access Publishing Option OTJR offers optional open access publishing via the Sage Choice program. This allows you to publish your article with a CC-BY license.

Please visit the  Sage Choice website  for additional information, pricing and eligibility for possible discounts or waivers. For more information on open access options and compliance at Sage, including self-author archiving deposits (green open access) visit  Sage Publishing Policies  on our Journal Author Gateway.

Should you wish to submit for Open Access publishing, you may identify your submission as Open Access upon submission.

Manuscript Submission Manuscripts addressing one or more of the above purposes are acceptable for submission. Please read the guidelines below then submit manuscripts to: https://mc.manuscriptcentral.com/otjr .    Manuscripts considered for publication with OTJR:  Occupational Therapy Journal of Research  must be submitted solely to OTJR and must not have been previously published elsewhere.

During the submission process, authors must indicate if they have a financial interest in or serve as a consultant, reviewer, or evaluator for any product or company mentioned in the article. As part of the submission process, authors will be required to warrant that: (1) authors are submitting their original work; (2) authors have ownership rights in the work; and (3) authors have obtained and can supply all necessary permissions for the reproduction of any copyright works not owned by them. Accordingly, authors are submitting the work for first publication in the Journal; it is not being considered for publication elsewhere, and it has not already been published elsewhere.

Authors are responsible for obtaining permission from copyright holders for reproducing any illustrations, tables, figures, or lengthy quotations previously published elsewhere. If academic, hospital, or business affiliations are given or are referred to in the manuscript, it is the responsibility of the author to obtain permission from the proper authorities to use the names of such. All letters of permission should be submitted with the manuscript. If applicable, authors should describe the role of the study sponsor, if any, in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication. If the supporting source had no such involvement, the authors should so state. If applicable, authors must declare whether they had assistance with study design, data collection, data analysis, or manuscript preparation. If the manuscript reports on a registered clinical trial and has been assigned a trial registration number from a public trials registry, authors should provide this information.

Please see the Sage guidelines on prior publication and note that OTJR:  Occupational Therapy Journal of Research  may accept submissions of papers that have been posted on pre-print servers. Please note this in your submission and include the DOI for the pre-print in the designated field in the manuscript submission system. Authors should not post an updated version of their paper on the pre-print server while it is being peer reviewed for possible publication in the journal. If the article is accepted for publication, the author may re-use their work according to the journal's author archiving policy. If the paper is accepted, authors must include a link on the pre-print to the final version of the paper.

Sage Publishing disseminates high-quality research and engaged scholarship globally, and we are committed to diversity and inclusion in publishing. We encourage submissions from a diverse range of authors from across all countries and backgrounds.

Manuscript Preparation ORCID As part of our commitment to ensuring an ethical, transparent and fair peer review process Sage is a supporting member of ORCID, the Open Researcher and Contributor ID . ORCID provides a unique and persistent digital identifier that distinguishes researchers from every other researcher, even those who share the same name, and, through integration in key research workflows such as manuscript and grant submission, supports automated linkages between researchers and their professional activities, ensuring that their work is recognized. 

The collection of ORCID IDs from corresponding authors is now part of the submission process of this journal. If authors already have an ORCID ID, authors will be asked to associate that to the submission during the online submission process. We also strongly encourage all co-authors to link their ORCID ID to their accounts in our online peer review platforms. It takes seconds to do. Click the link when prompted, sign into your ORCID account and our systems are automatically updated. Authors’ ORCID ID will become part of the accepted publication’s metadata, making your work attributable only to the authors. ORCID ID is published with the  accepted article so that fellow researchers reading the article can link to the authors’ ORCID profile and from there link to the authors’ other publications.  

If authors do not already have an ORCID ID please follow this link to create one or visit our ORCID homepage to learn more.

Patient Consent Authors are required to ensure the following guidelines are followed, as recommended by the  International Committee of Medical Journal Editors, Uniform Requirements for Manuscripts Submitted to Biomedical Journals. Patients have a right to privacy that should not be infringed without informed consent. Identifying information, including patients' names, initials, or hospital numbers, should not be published in written descriptions, photographs, and pedigrees unless the information is essential for scientific purposes and the patient (or parent or guardian) gives written informed consent for publication. Informed consent for this purpose requires that a patient who is identifiable be shown the manuscript to be published. 

Identifying details should be omitted if they are not essential. Complete anonymity is difficult to achieve, however, and informed consent should be obtained if there is any doubt. For example, masking the eye region in photographs of patients is inadequate protection of anonymity. If identifying characteristics are altered to protect anonymity, such as in genetic pedigrees, authors should provide assurance that alterations do not distort scientific meaning and editors should so note. When informed consent has been obtained it should be indicated in the submitted article.

Research Data At Sage we are committed to facilitating openness, transparency, and reproducibility of research. Where relevant, The Journal encourages authors to share their research data in a suitable public repository subject to ethical considerations and where data is included, to add a data accessibility statement in their manuscript file. Authors should also follow data citation principles. For more information please visit the Sage Author Gateway , which includes information about Sage’s partnership with the data repository Figshare.

Author Guidelines – All Manuscript Types The following guidelines adhere to Sage and OTJR:  Occupational Therapy Journal of Research’s   Editorial Policies, and must be used prior to, and while developing and submitting a manuscript. When submitting manuscripts, authors will be asked to confirm that they have read these guidelines and that their submission adheres to the guidelines. Manuscripts that do not conform to these guidelines will be returned to the author without review.

Formatting All manuscript submissions must be typed in Times New Roman, with a 12-point font size. The line spacing must be double-spaced throughout the manuscript, including the title page, abstract, main document, references, acknowledgments, figure legends, and tables. Each page should be  numbered sequentially. Each page should have 1-inch margins on all sides, with the right side of the text unjustified.

Authors should submit the manuscripts prepared in accordance with the Publication Manual of the American Psychological Association, 7th edition ( http://www.apastyle.org ). The Journal also adheres to the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (2010) of the International Committee of Medical Journal Editors. Do not use error-prone abbreviations (see www.ismp.org/Tools/errorproneabbreviations.pdf for a complete list).

Reporting Guidelines The relevant EQUATOR Network reporting guidelines should be followed depending on the type of study. The EQUATOR wizard can help you identify the appropriate guideline ( https://www.penelope.ai/equatorwizard ). Below are some examples:

• Randomized trials : All randomized controlled trials should include a completed CONSORT flow chart  as a cited figure and the completed CONSORT checklist as a supplementary file.
• Systematic reviews : Systematic reviews should include a completed PRISMA flow chart as a cited figure and a completed PRISMA checklist as a supplementary file.

Other resources can be found at NLM’s Research Reporting Guidelines and Initiatives .

Inclusive Language Guidelines OTJR: Occupational Therapy Journal of Research   recommends :

• Names of conditions are more specific than categories of conditions or general references, such as "people with disabilities." The language to use for disability is evolving. The important part is to maintain the integrity of all individuals as human beings.
• Person-first language emphasizes the person, not individual's disabling or chronic condition (e.g., person with paraplegia, people with substance use disorders, people with intellectual disabilities)
• Identity-first language can be used when the disability becomes the focus, which allows the individual to claim the disability and choose their identity rather than permitting others to name it or select terms with negative implications (e.g., blind person, autistic person, amputee)
• It is permissible to use either approach or to mix person-first and identity-first language unless, or until, you know that a group or individual clearly prefers a specific approach.
• Neurodiversity is a term that has been embraced by many advocacy movements by, and on behalf of, affected individuals, such as people with autism spectrum disorders and learning disabilities, because it shows there are natural variations in brain differences.
• Refer to individuals with disabilities as “patients” or “clients” within the context of a health care setting.

OTJR: Occupational Therapy Journal of Research  requests that authors  avoid :

• Avoid “othering” terms, slurs, and excessively negative labels.
• Avoid pictorial metaphorics or negativistic terms that imply restriction (e.g., “wheelchair bound”), excessive and negative labels (e.g., “AIDS victim”), and slurs (e.g., “cripple”).
• Avoid euphemisms that are condescending when describing individuals with disabilities (e.g., “special needs,” “physically challenged,” “handi-capable”).
• Avoid reducing people with disabilities to a list or group of deficiencies.

Cover Letter Every manuscript submission must be accompanied by a cover letter, addressed to the Editor-in-Chief. In the cover letter, please make sure to specify the type of submission (e.g., full-length research article, book review, letter to the editor, or forum proceeding). Include a general description of the submission and its content. For book reviews, include the book under review in the general description. Also, provide a rationale for why the submission will make a substantive contribution to the journal. During the submission process, copy and paste, and upload the cover letter into the designated section.

Title Page Every manuscript submission must include a Title Page, uploaded as a separate file. During the submission process, select “Title Page” from the file designation pull-down menu. The Title Page should include the following:

• Manuscript title : The title should be a maximum 12 words without any abbreviations.
• Authors:  All contributing authors should be listed on the title page with their professional designations and affiliations. Papers should only be submitted for consideration once consent is given by all contributing authors. Those submitting papers should carefully check that all those whose work contributed to the paper are acknowledged as contributing authors. The list of authors should include all those who can legitimately claim authorship. This is all those who: (i) made a substantial contribution to the concept and design, acquisition of data or analysis and interpretation of data, (ii) drafted the article or revised it critically for important intellectual content, (iii) approved the version to be published. Please refer to the ICMJE Authorship guidelines .
• Corresponding author:  Include the mailing and email address of only the corresponding author.
• Acknowledgements section:  For the purposes of anonymous peer review, include acknowledgements grant/contract support, and information concerning previous presentation of the material at symposia or conferences in an "Acknowledgements" section of the title page, and not in the main manuscript submission. Once a decision has been reached regarding publication, this section will appear in the manuscript prior to the references. All contributors who do not meet the criteria for authorship should be listed in the "Acknowledgements" section. Examples of those who might be acknowledged include a person who provided purely technical help, writing assistance, or a department chair who provided only general support. Authors should disclose whether they had any writing assistance and identif ythe entity that paid for this assistance.
• Declaration of conflicting interests section:  The policy of OTJR: Occupational Therapy Journal of Research  requires a declaration of conflicting interests from all authors enabling a statement to be carried within the paginated pages of all published articles. Please include any declaration in a "Conflict of Interests" section on the title page. If no declaration is made, the following will be printed under this heading in your article: "None declared." Alternatively, you may wish to state that "The Author(s) delcare(s) that there is no conflict of interest." When making a declaration the disclosure information must be specific and include any financial relationship that all authors of the article have with any sponsoring organization, editorial, publisher, and the for-profit interests the organization represents, and with any for-profit product discussed or implied in the text of the article. Any commercial or financial involvements that might represent an appearance of a conflict of interest need to be additionally disclosed in a covering letter accompanying your article to assist the Editor in evaluating whether sufficient disclosure has been made within the Declaration of Conflicting Interests provided in the article. For more information, please visit the Sage Journal Author Gateway .
• Research ethics section and patient consent:  For all submissions, on the title page please include the full name of the Institutional Review Board and an Ethics Committee reference number. In the methods section of the manuscript please include appropriate anonymous information only. All other manuscript files should be devoid of author information (example: name, institution, city) to facilitate the anonymous peer review process. When reporting studies involving human subjects, authors must indicate whether the procedures followed were in accordance with the ethical standards of relevant institutional or national bodies and consistent with the revised (2000) Helsinki Declaration and typescripts must include a statement that the research protocol was approved by the appropriate ethical committee. All papers reporting animal and human studies must report approval, or a letter stating the study was exempt, obtained from the local Ethics Review Board or Institutional Review Board (or the equivalent for countries other than the US and Canada). Also, the manuscript must report whether appropriate informed consent procedures were used; that all subjects were informed of the study's risks and benefits, that their participation was voluntary, and that their identity would not be disclosed. Authors must also confirm appropriate handling of confidentiality and data security.
• Trials:  If you are submitting a trial and it has been registered, please include this full information on the title page. Please also include the anonymized information in the methods section of the paper. In line with the Declaration of Helsinki 1975, revised Hong Kong 1989, we encourage authors to register their clinical trials (at  http://clinicaltrials.gov  or other suitable databases identified by the ICMJE,  http://www.icmje.org/publishing_10register.html ).
• For book reviews:  The title page should include the following information about the book in reference format using APA 7th edition: Author Last Name, Author name. (YEAR).  Book title.  Place of publication: Publisher, Date of publication.

Key Words When submitting the manuscript in ScholarOne, authors must select three identifying key words from the available options. The keywords should reflect the manuscripts content area and/or methodology. Key words do not need to be listed on the manuscript files or title page.

Abstract Articles should include an abstract that clearly and concisely summarizes the manuscript. The abstract should be written in one paragraph and contain the following headings: rationale OR background, objectives, methodology, results OR findings, and implications OR conclusion. Abstracts should be no more than 150 words, which is inclusive of required headings. During the submission process, copy and paste the abstract into the designated section.

Plain Language Summary (PLS)

Please include a PLS with your submission. The PLS should contain a plain language title of up to 50 words and a summary of up to 300 words. The PLS should provide an engaging and understandable summary of the research, avoiding technical jargon, and clearly reflect the findings, merits, and limitations of the research using non-technical language. PLS must be suitable for a broad range of non-researchers that may benefit from this knowledge translation, such as: clinicians, service users and/or family members, policy makers, or members of the media.

The PLS publishes directly below the scientific abstract and are open access making it available online for anyone to read. Peer review of the PLS will be conducted following our PLS reviewer guidelines . When submitting, authors should enter their plain language title and plain language summary into the box provided in the submission system. The PLS does not need to be provided in the manuscript text or as a separate file. Manuscripts without a PLS, or a PLS which is a direct copy of the scientific abstract, will be returned. If the article type does not require an abstract and therefore does not require a PLS please enter “N/A” in each box.

If you need professional help writing your Plain Language Summary, please visit our Author Services portal.

Requirements for Anonymous Peer Review - All Submissions In order to facilitate this double-anonymous peer review, authors are required to submit:

• A  version of the manuscript  which has had any information that compromises the anonymity of the author(s) removed or anonymized. This version  will be sent  to the peer reviewers.
• A  separate title page  which includes any removed or anonymized material. This  will not be sent  to the peer reviewers.

Main Document Word Limit per Submission Type Word limits for manuscript submissions, and whether references are included within the word limits will vary by submission type, as outlined below. Words contained in Tables, Figures, or Supplementary Files are NOT included in the word count.

Original Research Article and Occupational Science Section   Full-length research articles may include data-driven quantitative, qualitative, or mixed-methods designs. When the journal announces a call for a Special Issue, the Special Issue should adhere to the guidelines listed here, in addition to in the information stated in the call for papers.

• Introduction: The introduction should include: a literature review of the topic, clearly defined objectives/hypotheses/aims/research questions, and a rationale for conducting the study. Objectives should identify the specific aim or outcome of the study.
• Methods: The methods section shoudl clearly outline the: study design, setting and location, process of participant selection and eligibility criteria, participant consent, measures/variables/assessments, outcomes, data collection and analyses. Please state whether an ethics or institutional review board approval was obtained; if not, provide a rationale.
• Results: The results section should provide a clear interpretation of the results, consistent with the quantitative, or qualitative, or mixed methodology used.  
• Discussion: The discussion section should: restate the purpose of the study, explore the study findings in comparison to the current literature, address study limitations and strengths. Discussion should include an emphasis on the implications of the research to occupational therapy practice or occupational science.
• Conclusions: The conclusion section should: answer the study’s objectives/hypotheses/aims/research questions, include how the manuscript contributes to the further improvement/ understanding of occupation, participation and/or health, and address how the manuscript contributes to the evidence base of occupational therapy practice and/or the advancement of occupational science.

Brief Reports

A Brief Report is a short report of original research that is typically pilot or exploratory in nature or that addresses a discrete research question and lacks broad implications. The research can be of any design. A brief report may present an update on previously reported work if it includes new data, results, etc. Authors should follow author guidelines for reporting original research to the extent possible, given the established word limit.

Forum Proceedings Foru m Proceedings should include the following:

• Introduction: The introduction should include a literature review of the topic, the history and purpose of the present forum, information on prior forums on this topic (if applicable), the rationale for conducting a forum on this topic (e.g., why this format, why now, and why with these stakeholders), and outline the objectives of the forum. Objectives should identify the specific aim or outcome of the forum.
• Methods: The methods section should outline participants, partners, and organizations, specifically: who convened the forum, and who were the invited participants and/or stakeholders at the forum, and their roles. Descriptive statistics of participant demographics (e.g., discipline area, credentials, levels of expertise, etc.) should be provided if possible. The setting and procedures for the forum should be outlined, specifically: the location, duration, and description of forum agenda and areas of focus; how were panels convened, and by whom; and whether there is an external reference/archive to the forum contents and/or presentations. Please note whether an ethics or institutional review board approval was obtained; if not, provide a rationale. Data evaluation should be outlined, specifically with regards to how participant feedback was obtained, evaluated, and integrated into the outcome of the forum; and how consensus was reached.
• Results: The results section should summarize specific outcome recommendations and the level of consensus for each, as applicable.
• Discussion: Discussion should further explore each outcome/recommendation for future directions and priorities, pertaining to clinical practice, research, public health, and/or policy. Discussion should further situate outcomes in relation to existing evidence or literature when feasible.
• Conclusions: Conclusions should be completed as per the guidelines for full-research article submissions.

Book Reviews Book reviews should provide a brief and clear description of the contents of the book, including scope and structure. Reviews must provide brief information about the author and the background of the book (example: if the book is a result of a PhD dissertation). The review should evaluate the boo k’s strengths and weaknesses, and provide examples of each. Authors may wish to consider the following questions when summarizing the strengths and weaknesses of the book:

• What are important contributions that this book makes?
• What contributions could have been made, but were not made?
• What aspects where missing?
• How does this book stand out when compared to others in the field?
• To which audience(s) will this book be most helpful?

If needed, use quotations to provide an example of the writing style and/or statements that are particularly helpful in illustrating the author(s) points. The review should assess the book’s  place in the field of occupational therapy and/or occupational science, including comments on the potential value and impact of the book.

Letters to the Editor Letters should provide thoughtful scientific criticism, rebuttal, or personal data relating to research articles or commentary published in OTJR: Occupational Therapy Journal of Research . No more than five citations and references can be included. Unless specifically indicated to the contrary, all letters will be assumed to be for publication and will be subject to the same editorial revision policies as other manuscripts.

References Submit References in the main document and format to APA 7th edition style. Please note that references may be included in the word limit , dependent on the type of submission as outlined in the “Word Count” table above. The author must assume responsibility for the accuracy of references. Old citations should relate to the original work in the field, classic work related to the topic, or, in rare cases, the only other relevant work.

Tables & Figures The manuscript submission should have a maximum of five tables and figures, combined. Tables and Figures are NOT counted within the word limit.

Instructions for Tables are as follows:

• Submit Tables in a separate document, with each Table on a new page within a word processing document (e.g., DOCX).
• Tables may be submitted in separate documents as per the preference of the author.
• Format each Table according to APA 7th edition, with proper numbering and a table title.
• Indicate the location of the table in the manuscript with a placeholder (example: <Insert table 1 here>).
• During submission, select “Table” from the file designation pull-down menu.

Instructions for Figures are as follows:

• Submit each Figure in a separate file.
• Submit Figures as digital images with high resolution (at least 300 dpi) in JPEG or TIFF format.
• Submitting images that are embedded into Word or PowerPoint® files are NOT acceptable.
• Figures will be printed in black and white only. Figure legends should not be included in the digital image. Instead, indicate the location of the figure in the manuscript with a placeholder that represents the figure legend (example: <insert figure 1 here>)
•  During submission, select “Figure” from the file designation pull-down menu.

Funding To comply with the guidance for Research Funders, Authors and Publishers issued by the Research Information Network (RIN), OTJR: Occupational Therapy Journal of Research additionally requires all Authors to acknowledge their funding in a consistent fashion under a separate heading . Please visit  Funding Acknowledgement s o n the Sage Journal Author Gateway to confirm the format of the acknowledgment text in the event of funding or state in the acknowledgments section that: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Supplemental Materials Supplemental material is published electronically on the journal website and does not appear in the print version of the journal but is readily accessed from the journal’s table of contents as well as by a hyperlink within the pdf file of the manuscript. In general, supplemental materials may include information that is of value but is not critical for readers to understand the main outcomes of the study and may also include results that enhance or extend the findings.

Reference to supplemental material should be made in the main text of the paper (e.g., Supplemental methods, Supplemental Figure 1, Supplemental Table 2, etc.), and their legends/titles should be labeled in the same way. The files should also be labeled with “supplement" (or "supp," "supplementary," etc.) in the file name. Please select “Supplementary File” from the file designation pull-down menu when uploading these files during the submission process.

Supplemental Materials should be submitted in the format for publication because Supplemental Materials are not type-set or edited by the publisher and are not provided with the page proofs.

Artificial Intelligence

Use of Large Language Models and generative AI tools in writing your submission

Sage recognizes the value of large language models (LLMs) (e.g. ChatGPT) and generative AI as productivity tools that can help authors in preparing their article for submission; to generate initial ideas for a structure, for example, or when summarizing, paraphrasing, language polishing etc. However, it is important to note that all language models have limitations and are unable to replicate human creative and critical thinking. Human intervention with these tools is essential to ensure that content presented is accurate and appropriate to the reader. Sage therefore requires authors to be aware of the limitations of language models and to consider these in any use of LLMs in their submissions:

• Objectivity: Previously published content that contains racist, sexist or other biases can be present in LLM-generated text, and minority viewpoints may not be represented. Use of LLMs has the potential to perpetuate these biases because the information is decontextualized and harder to detect.
• Accuracy: LLMs can ‘hallucinate’ i.e. generate false content, especially when used outside of their domain or when dealing with complex or ambiguous topics. They can generate content that is linguistically but not scientifically plausible, they can get facts wrong, and they have been shown to generate citations that don’t exist. Some LLMs are only trained on content published before a particular date and therefore present an incomplete picture.
• Contextual understanding: LLMs cannot apply human understanding to the context of a piece of text, especially when dealing with idiomatic expressions, sarcasm, humor, or metaphorical language. This can lead to errors or misinterpretations in the generated content.
• Training data: LLMs require a large amount of high-quality training data to achieve optimal performance. However, in some domains or languages, such data may not be readily available, limiting the usefulness of the model.

Guidance for authors

Authors are required to:

• Clearly indicate the use of language models in the manuscript , including which model was used and for what purpose. Please use the methods or acknowledgements section, as appropriate.
• Verify the accuracy, validity, and appropriateness of the content and any citations generated by language models and correct any errors or inconsistencies.
• Provide a list of sources used to generate content and citations, including those generated by language models. Double-check citations to ensure they are accurate, and are properly referenced.
• Be conscious of the potential for plagiarism where the LLM may have reproduced substantial text from other sources. Check the original sources to be sure you are not plagiarizing someone else’s work.
• Acknowledge the limitations of language models in the manuscript , including the potential for bias, errors, and gaps in knowledge.
• Please note that AI bots such as ChatGPT should not be listed as an author on your submission.

We will take appropriate corrective action where we identify published articles with undisclosed use of such tools.

Review Process Information Manuscripts meeting the stated guidelines go through the peer review process common to most respected professional journals. OTJR: Occupational Therapy Journal of Research adheres to a rigorous double-anonymous reviewing policy in which the identity of both the reviewer and author are always concealed from both parties. All manuscripts are reviewed anonymously by a minimum of two reviewers.

In order to facilitate this double-anonymous peer review, authors are required to submit:

• A version of the manuscript  which has had any information that compromises the anonymity of the author(s) removed or anonymised. This version  will  be sent to the peer reviewers.
• A  separate title page  which includes any removed or anonymised material. This  will not  be sent to the peer  reviewers.

The average time to first decision is published annually in the January Editorial. Upon acceptance, authors will receive page proofs to review before the manuscript is published. The corresponding author will receive an electronic complimentary copy of the manuscript, which they can share with their co-authors.

OTJR is committed to delivering high quality, fast peer-review for your paper, and as such has partnered with Publons. Publons is a third-party service that seeks to track, verify and give credit for peer review. Reviewers for OTJR can opt in to Publons in order to claim their reviews or have them automatically verified and added to their reviewer profile. Reviewers claiming credit for their review will be associated with the relevant journal, but the article name, reviewer’s decision and the content of their review is not published on the site. For more information visit the Publons website.

Author Guidelines for Revisions Authors may submit a revised version of their manuscript to the journal if they receive a decision that requests revision and resubmission. Revised manuscript submissions must include at least three documents: (1) cover letter with full information on author information; (2) anonymous response letter to reviewers; and (3) a revised version of the manuscript that cle arly identifies all changes made.

• Cover letter: Submit the cover letter as a separate document. Address the cover letter to the Editor-in-Chief. In the cover letter, state that you are resubmitting the manuscript and that you have addressed all of the reviewers’ comments. The cover letter may be unblended.
• Response letter to reviewers: Submit the Response letter to reviewers as a separate document. This document must be separate from the cover letter. Do not include any identifying information, as the letter will go through peer review. Ensure you clearly address each reviewers’ comments with referral to the changes made in the main document.
• Revised version of the manuscript that highlights all changes made: Submit the Revised version of the manuscript as a separate document. Highlight all changes made; for example, through using track changes, highlighting the text, or using a different font color. Do not include any identifying information, as the revised manuscript will be peer reviewed. Do not submit a clean copy of the revised manuscript. Ensure you adhere to all guidelines listed under Manuscript Preparation (e.g., maximum word count as outlined above, dependent on submission type).

On acceptance and publication Your Sage Production Editor will keep you informed as to your article’s progress throughout the production process. Proofs will be made available to the corresponding author via our editing portal Sage Edit or by email, and corrections should be made directly or notified to us promptly. Authors are reminded to check their proofs carefully to confirm that all author information, including names, affiliations, sequence and contact details are correct, and that Funding and Conflict of Interest statements, if any, are accurate.

OnlineFirst Publication OnlineFirst allows final articles (completed and approved articles awaiting assignment to a future issue) to be published online prior to their inclusion in a journal issue, which significantly reduces the lead time between submission and publication. Visit the Sage Journals help page for more details, including how to cite OnlineFirst articles.

Access to your published article Sage provides authors with online access to their final article.  

Promoting your article Publication is not the end of the process! You can help disseminate your paper and ensure it is as widely read and cited as possible. The Sage Author Gateway has numerous resources to help you promote your work. Visit the Promote Your Article page on the Gateway for tips and advice. In addition, Sage is partnered with Kudos, a free service that allows authors to explain, enrich, share, and measure the impact of their article. Find out how to maximize your article’s impact with Kudos .

Appealing the publication decision Editors have very broad discretion in determining whether an article is an appropriate fit for their journal. Many manuscripts are declined with a very general statement of the rejection decision. These decisions are not eligible for formal appeal unless the author believes the decision to reject the manuscript was based on an error in the review of the article, in which case the author may appeal the decision by providing the Editor with a detailed written description of the error they believe occurred.

If an author believes the decision regarding their manuscript was affected by a publication ethics breach, the author may contact the publisher with a detailed written description of their concern, and information supporting the concern, at [email protected]   This journal is a member of the Committee on Publication Ethics (COPE) . COPE suggests a transparent appeals policy is best practice but please discuss with your editor.  

Contributor’s publishing agreement Before publication, Sage requires the author as the rights holder to sign a Journal Contributor’s Publishing Agreement. Sage’s Journal Contributor’s Publishing Agreement is an exclusive license agreement which means that the author retains copyright in the work but grants Sage the sole and exclusive right and license to publish for the full legal term of copyright. Exceptions may exist where an assignment of copyright is required or preferred by a proprietor other than Sage. In this case copyright in the work will be assigned from the author to the society. For more information please visit our Frequentl y Asked Question s  o n the Sage Journal Author Gateway. 

OTJR: Occupational Therapy Journal of Research   and Sage take issues of copyright infringement, plagiarism or other breaches of best practice in publication very seriously. We seek to protect the rights of our authors and we always investigate claims of plagiarism or misuse of articles published in the journal. Equally, we seek to protect the reputation of the journal against malpractice. Submitted articles may be checked using duplication-checking software. OTJR: Occupational Therapy Journal of Research   editorial staff will subject a certain number of articles, randomly chosen, to Turnitin to scan for plagiarism. Where an article is found to have plagiarized other work or included third-party copyright material without permission or with insufficient acknowledgement, or where authorship of the article is contested, we reserve the right to take action including, but not limited to: publishing an erratum or corrigendum (correction); retracting the article (removing it from the journal); taking up the matter with the head of department or dean of the author’s institution and/or relevant academic bodies or societies; banning the author from publication in the journal or all Sage journals, or appropriate legal action.  

There are no fees payable to submit or publish in this journal.

However, OTJR offers optional open access publishing via the Sage Choice program. This allows you to publish your article with a CC-BY license.

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A scoping review of occupational therapy interventions in the treatment of people with substance use disorders

Irish Journal of Occupational Therapy

ISSN : 2398-8819

Article publication date: 16 November 2021

Issue publication date: 10 December 2021

Diagnosis of substance use disorders and addictive behaviours are growing worldwide. It is timely to examine and collate literature on the nature of occupational therapy intervention in this field, to increase understanding of current practice and inform future directions. The purpose of this paper is to source and synthesise literature on occupational therapy interventions used in the treatment of people experiencing addiction.

Design/methodology/approach

Four databases were searched in August 2019. A total of 597 titles were screened, and 18 studies with varying methods met inclusion criteria. A narrative synthesis of the included literature was arranged into themes to summarise key findings.

Findings were grouped into three themes about occupational therapy provision to people experiencing addiction: single occupation focused intervention; skills training (including sub-themes on daily living skills and vocational skills); and establishing a community-based sober routine.

Research limitations/implications

Further research on this topic should focus on efficacy of treatments and build on current findings to develop more rigorous research with appropriate sample sizes to support evidence-based practice.

Originality/value

This study presents a synthesis of how occupational therapy interventions have been used to treat people experiencing addiction issues. Findings indicate occupational therapy appears to fit well within addiction treatment and assert that occupational therapy is most supportive when interventions go beyond the teaching of skills alone to prioritise occupational engagement and client centred practice.

• Occupational therapy
• Substance use
• Addiction recovery
• Addiction treatment

Ryan, D.A. and Boland, P. (2021), "A scoping review of occupational therapy interventions in the treatment of people with substance use disorders", Irish Journal of Occupational Therapy , Vol. 49 No. 2, pp. 104-114. https://doi.org/10.1108/IJOT-11-2020-0017

Emerald Publishing Limited

Copyright © 2021, Deirdre Anne Ryan and Pauline Boland.

Published in Irish Journal of Occupational Therapy . Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence maybe seen at http://creativecommons.org/licences/by/4.0/legalcode

Introduction

Addiction is a dependence syndrome consisting of behavioural, cognitive and physiological phenomena that develop after repeated substance use ( WHO, 2013 ). These phenomena include a strong desire to engage with the substance or behaviour, difficulties controlling use, persisting with use despite harmful consequences and prioritising addiction-related activities above all others ( WHO, 2013 ). The World Drug Report ( UNODC, 2017 ) estimates there are 255 million illicit drug users globally. WHO (2014) reports more than half of Irish adults could be classed as harmful drinkers, with the National Institute for Health and Care Excellence ( NICE) (2010 , p. 5) defining harmful drinking “as a pattern of alcohol consumption causing health problems directly related to alcohol.” With substance use increasing, health and addiction services face a challenge requiring cross-sectoral innovative approaches.

Occupational therapists are well positioned to support people with substance use disorders, because of their holistic focus and skills in occupational enablement ( Amorelli, 2016 ) and have been part of inpatient addiction treatment as far back as 1952 ( Hossack, 1952 ). Although there are some guides for potential occupational therapy for people experiencing substance use and addictive behaviours ( Lancaster and Chacksfield, 2014 ; Wasmuth et al. , 2014 ), these can be limited by opinion or are descriptions of potential rather than actual clinical interventions.

Previous systematic reviews have not specifically identified the range of interventions carried out exclusively by occupational therapists working with people experiencing substance use or addictive behaviours ( Wasmuth et al. , 2014 ; Rojo-Mota et al. , 2017 ). However, Rojo-Mota et al. (2017) noted an emerging trend that occupation-based interventionists are increasingly recognising the need for effectiveness studies. These studies could support the many occupational therapists who report reduced confidence addressing issues for people with substance use disorders with up-to-date evidence ( Thompson, 2007 ).

The details of how and when occupational therapists work with people experiencing substance use disorders remains unclear, therefore collating and examining the existing evidence should clarify the design and delivery of existing interventions, likely outcomes for clients, their families and supportive services and the sustainability of change in sober occupations over time. A scoping review approach was chosen to guide data collection and analysis as this review design is suited to mapping the data, can be effective at assisting examination of the extent, range and nature of evidence on a topic (Tricco et al. , 2018) as well as summarising findings from a heterogeneous body of knowledge, often necessary to inform healthcare practice models ( Munn et al. , 2018 ). The aim of this scoping review was to explore descriptions of occupational therapy interventions in addiction recovery treatment, synthesise these findings and to present information on interventions currently delivered.

identifying the research question;

identifying relevant studies;

study selection;

charting the data; and

collating, summarising and reporting the results.

Eligibility criteria

Inclusion criteria was that articles described occupational therapy interventions as part of addiction treatment in any setting with adolescents, aged 13 and over, and/or adults and be published in English. We included articles published from 2000 to August 2019 to report on addiction interventions informed by Helbig and McKay’s (2003) framework for addiction from an occupational perspective. Owing to the paucity of intervention descriptions in articles from peer-reviewed journals, and to generate a true representation of what occupational therapists are doing in this practice area, articles from non-peer-reviewed professional magazines were considered, as has occurred in scoping reviews previously ( Paez, 2017 ). Study methodology or study design quality [appraised using the Crow Critical Appraisal Tool (CCAT)] was not used to exclude literature.

Articles were excluded if it was unclear what interventions were facilitated by an occupational therapist; if intervention description was linked only to theory, potential feasibility of an assessment or to smoking cessation programmes.

Search strategy

Databases included CINAHL-Complete, Scopus, PsycINFO and MEDLINE as these covered most peer-reviewed literature in this clinical area. Boolean terms were used to combine terms associated with the population and the topic. Search terms included occupational therapy, occupational therapist, OT, intervention, addiction, substance use/disorder/abuse/misuse, drug abuse/misuse and alcohol abuse/misuse. The reference lists of included articles were searched as were forward citations of key articles.

Selection of sources

The titles and abstracts of all articles were screened independently by both authors (DR and PB) using Rayyan software, who then compared results to agree on included articles.

Data charting process

The full text of each included article was read and data describing occupational therapy interventions were extracted. Data was extracted on the aims of the research/publication, demographics of people with substance use disorders, contexts in which occupational therapists were working, methods used to describe interventions and evaluate treatments and core research/publication findings.

Critical appraisal

The CCAT Form ( Crow, 2013 ) was used to appraise all included articles. Two papers were independently appraised by both authors to calibrate use of this tool. Tricco et al. (2018) identified formal assessment of methodological quality as optional in scoping reviews however, critical appraisal informed understanding of the quality of research generally.

Synthesis of results

Similarities in practice and intervention focus were analysed and grouped thematically. Descriptions of interventions across papers were extracted and examined by DR. The key components of the research question were used to design initial mapping of key concepts of interest, consistent with scoping review methodology ( Arksey and O'Malley, 2005 ) – namely, the outline of intervention design, delivery and intensity (where this information was available) and map-related outcomes for clients, their families and services. Thereafter, DR collated interventions under theme names which best captured the core theme of each paper. These theme categories were reviewed by PB to ensure coherency.

Selection of evidence

A total of 432 citations were identified after removal of duplicates, thereafter 399 were excluded based on title and abstract. A total of 33 full-text articles were assessed and 15 articles were excluded. Figure 1 depicts the screening process followed, based on PRISMA-ScR guidelines (Tricco et al. , 2018).

Characteristics of included articles

Included articles are represented in the extraction document ( Table 1 ). Of the 18 included articles, three were quantitative ( Detweiler et al. , 2015 ; Peloquin and Ciro , 2013a, 2013b ), five were qualitative ( Bell et al. , 2015 ; Godoy-Vieira et al. , 2018 ; Ribeiro et al. , 2019 ; Stevens, 2003 ; Ussher et al. , 2000 ), six were narrative descriptions of interventions ( Gutman, 2006 ; Lakshmanan, 2014 ; Louie, 2012 ; Peloquin, 2010 ; Roush, 2008 ; Tayar, 2004 ) and four used mixed methods ( Boisvert et al. , 2008 ; Cardinale et al. , 2014 ; Darko-Mensah, 2011 ; Wasmuth et al. , 2016 ).

CCAT scores ranged from 6/40 to 35/40 ( Table 2 ), with an average score of 21/40 or 52% of standards met across all articles. Lowest scoring areas were design, sampling, data collection and ethical matters.

Context of occupational therapy intervention

Most research was conducted in the USA ( n = 10) ( Boisvert et al. , 2008 ; Cardinale et al. , 2014 ; Detweiler et al. , 2015 ; Gutman, 2006 ; Peloquin, 2010 ; Peloquin and Ciro , 2013a, 2013b ; Roush, 2008 ; Tayar, 2004 ; Wasmuth et al. , 2016 ) with one each from UK ( Ussher et al., 2000 ), New Zealand ( Stevens, 2003 ), Canada ( Darko-Mensah, 2011 ), Hong Kong ( Louie, 2012 ), India ( Lakshmanan, 2014 ), South Africa ( Bell et al. , 2015 ), Brazil ( Godoy-Vieira et al. , 2018 ) and Portugal ( Ribeiro et al. , 2019 ).

Two studies focused on adolescents ( Bell et al. , 2015 ; Louie, 2012 ), four on women-only ( Cardinale et al. , 2014 ; Peloquin, 2010 ; Peloquin and Ciro , 2013a, 2013b ), with one study each focused on veterans ( Wasmuth et al. , 2016 ) and prison populations ( Tayar, 2004 ).

Single occupation focused intervention;

Skills training (sub-themes) on

daily living skills; and

(vocational skills).

Establishing a community-based sober routine.

Single occupation focused intervention

Four interventions consisted of a single focused occupation ( Cardinale et al. , 2014 ; Detweiler et al. , 2015 ; Ussher et al. , 2000 ; Wasmuth et al. , 2016 ). Detweiler et al. (2015) used horticulture, which was the main intervention. The programme was greeted positively by participants, with reductions in cohort cortisol levels noted post intervention. Planning skills, responsibility and collaboration were built through engagement in garden education, planning and management.

Ussher et al. (2000) promoted fitness orientated physical activity, co-facilitated between an exercise specialist and an occupational therapist who supported engagement in exercise counselling, goal setting and weekly check-in sessions, which aimed to support self-monitoring, a vital skill for maintaining recovery.

Wasmuth et al. (2016) used drama, where participants were involved in the production of a co-facilitated play. The occupational therapist used rehearsals to develop cognitive strategies with participants. Facilitated discussions linked character experiences to the participants’ issues, which was an accessible medium for them to acknowledge the difficult impact of substance use in their lives. The community element provided a safe, supportive space, which facilitated participants who relapsed during rehearsals to return to gain support.

Finally, Cardinale et al. (2014) reported on the “Tree Themed Model,” with five semi-structured group sessions, including progressive relaxation exercises followed by members painting a tree to represent different parts of their life. Participants particularly valued insights gained during the creative process.

Skills training

Many publications reported that occupational therapy is well placed to support the development of skills ( Bell et al. , 2015 ; Peloquin, 2010 ; Ribeiro et al. , 2019 ; Roush, 2008 ; Stevens, 2003 ; Tayar, 2004 ). Skills development interventions fell into two categories: skills for daily life, i.e. activities of daily living (ADLs) including associated supportive skills, and skills required for work roles.

Daily living skills and interventions

A total of 12 publications referred to life skills and personal development as core occupational therapy interventions. Time management and routine planning were common interventions, included in nine publications ( Boisvert et al. , 2008 ; Godoy-Vieira et al. , 2018 ; Gutman, 2006 ; Louie, 2012 ; Ribeiro et al. , 2019 ; Roush, 2008 ; Stevens, 2003 ; Tayar, 2004 ; Ussher et al. , 2000 ). Three papers ( Bell et al. , 2015 ; Peloquin and Ciro , 2013a, 2013b ; Ribeiro et al. , 2019 ) outlined how life skills and personal development were used within inpatient settings. These publications presented individual and group interventions including role playing, communication, assertiveness, relaxation and social skills training. Boisvert et al. (2008) described interventions with community-dwellers, reporting on occupational capacity and interventions focused on ADL development, communication and personal development to support transition to live in a peer-supported community house.

Gutman (2006) supported life skill development in a case study, by drawing on the neurological process of addiction. Gutman linked life skill difficulties, e.g. stress management and reduced motivation, and goal achievement difficulties to the brain’s neurological process of priming, which can lead to relapse. The case study participant was educated on how addiction has changed the brain’s reward system. This learning facilitated the participant to build new supportive lifestyle habits.

Roush (2008) champions role-playing life skills and sobriety skills, advocating for the benefits of a multi-problem viewpoint and that advocated for using occupational profiles to support intervention planning with people experiencing addiction.

Vocational skills, exploration and interventions

Nine studies discussed vocational interventions in addiction treatment, stressing the importance of work in preventing relapse. Seven interventions facilitated vocational exploration including creating Curriculum Vitaes (CVs), supporting job applications and discussing vocational preferences ( Bell et al. , 2015 ; Darko-Mensah, 2011 ; Godoy-Vieira et al. , 2018 ; Louie, 2012 ; Peloquin, 2010 ; Stevens, 2003 ; Tayar, 2004 ). Darko-Mensah’s (2011) programme, “Career 101,” focused solely on vocational exploration, education and work skills. Bell et al. (2015) and Tayar (2004) presented the benefits of vocational training with adolescents and female prison-based populations. Three studies honed in on participant’s work roles ( Lakshmanan, 2014 ; Louie, 2012 ; Stevens, 2003 ). Lakshmanan (2014) and Louie (2012) supported participants to develop a structured recovery through work. Stevens (2003) used work-focused groups where craft projects were created and sold at markets.

Providing a forum to explore productivity and engage in work roles supported participants to discover their potential, enabled identity development outside of addiction and facilitated inclusion, which is often lacking in early recovery ( Darko-Mensah, 2011 ; Godoy-Vieira et al. , 2018 ). Boisvert et al. (2008) reflected value in work roles from a community perspective where participants were facilitated to gradually take on responsibilities, work roles and leadership roles within the community house.

Establishing a community-based sober routine

A participant in Peloquin (2010) summarised this theme by stating long-term success for people with substance use disorders relies on recovering sober and satisfying lives. Roush (2008) recommends that skill learning should be followed by skill consolidation and goal setting. This supports the transfer of skills to the community creation of sober routines. Ribeiro et al. (2019) , Tayar (2004) ; and Ussher et al. (2000) discussed the importance of routine planning and accessing recovery supports in establishing a sober lifestyle. Four studies reported on assertiveness skills ( Bell et al. , 2015 ; Gutman, 2006 ; Lakshmanan, 2014 ; Stevens, 2003 ) with Gutman (2006) and Lakshmanan (2014) moving to apply this skill further to support sobriety via drug/drink refusal skills.

Leisure exploration was central in eight studies ( Bell et al. , 2015 ; Godoy-Vieira et al. , 2018 ; Lakshmanan, 2014 ; Peloquin, 2010 ; Ribeiro et al. , 2019 ; Roush, 2008 ; Stevens, 2003 ; Tayar, 2004 ) to encourage community re-integration and establish non-addiction related routines. Ribeiro et al. (2019) presented that the discovery or rediscovery of meaningful leisure activities developed motivation, vital for the process of change. Ussher et al. (2000) and Wasmuth et al. (2016) discussed how establishing different leisure interests supported self-exploration and role development.

Using occupational therapy to support development of identity went beyond the facilitation of leisure interventions. One of the themes identified in Bell et al. (2015) , “take us out to life,” supports this theory, as participants indicated the occupational therapy intervention enabled planning and confidence in their future sober lives. Gutman (2006) highlights the neurological process of addiction when discussing community engagement, identifying new role development and social integration supports as vital components. Godoy-Vieira et al. (2018) reported that the establishment of a social identity beyond a substance user identity was a key role for occupational therapy. The importance of community identity was highlighted by Boisvert et al. (2008) when the success of their peer support community indicated the importance of community re-integration as beneficial for recovery.

This review has illustrated that occupational therapy interventions related to addiction treatment are sparsely reported and rarely evaluated. Rojo-Mota et al. (2017) summarised that occupational therapy models were capable of explaining addiction from an occupational perspective but stated more research was required with regards to effectiveness. While effectiveness of interventions is not the core focus of this review, but rather what interventions are currently in use in daily clinical practice; indeed, occupational therapy is delivered in multiple ways across varied settings for people with substance use disorders. Illustrating the breadth of work in this area will hopefully increase development of occupational therapy interventions from acute to community-based settings. The increasing clarity on the design of occupational therapy interventions to support recovery for people experiencing addiction is encouraging, though the lack of empirical evidence on effectiveness needs to be addressed.

Most reported interventions were underpinned by development of life skills and supported re-engagement in meaningful routines. These interventions are central to occupational therapy practice to support people to move away from the dysfunctional impact of addictive behaviours. Life skills development were often embedded in existing treatment programmes, where occupational therapists engaged with service-users independently, but also as part of a wider team.

Of note, it is not enough to acquire skills, one also needs skills practice to support recovery. Feedback in Peloquin (2010) reflected that the facilitation of skills practice was the most valuable aspect of occupational therapy intervention. Across studies, people with substance use disorders were enabled to take control of their lives through engagement in occupation ( Tayar, 2004 ; Wasmuth et al. , 2016 ).

Facilitating skills practice and positive occupations supported service-users to make positive changes beyond occupational therapy interventions. Many studies noted this ( Boisvert et al. , 2008 ; Cardinale et al. , 2014 ; Godoy-Vieira et al. , 2018 ; Peloquin and Ciro , 2013a, 2013b ; Ribeiro et al. , 2019 ; Tayar, 2004 ; Wasmuth et al. , 2016 ), but it was particularly prevalent in Ussher et al. (2000) . A “chain reaction” effect occurred when service-users were supported to make one influential positive change, dispersing into other areas of life.

Interestingly, some interventions were not necessarily part of traditional addiction treatment programmes, i.e. those with an abstinence or harm reduction focus. These community intervention examples represented more novel interventions, i.e. exercise, theatre and horticulture. Another unexpected finding was the amount of narrative presentations of interventions present, one paper alone had an explicit research focus.

Finally, other than 10/18 USA-based papers, there was a broad geographical spread representing varied health-care systems and approaches to occupational therapy practice, so results should be interpreted with caution for specific countries and cultures.

Recommendations

Based on our findings, we recommend an increase in research on how occupational therapy is engaging with people with substance use disorders, a call being endorsed by others ( Amorelli, 2016 ; Wasmuth et al. , 2016 ). Some possible areas for priority include exploring the role of occupational therapy interventions to support people experiencing substance use and addictive behaviours within structured treatment programmes. Using qualitative or participatory research methods would be valuable to explore both a clinician and a service-user perspective. The CCAT scores for the studies in this review were mixed. Positively, there was what appears to be a growing quantity of research in this area, indicating recognition of the need for greater quantity and quality of evidence for occupational therapists working in this field. However, the low CCAT scores indicated a need for more high-quality empirical research focused on measuring interventions effectiveness.

The practice recommendations include the assertion that occupational therapy appears to be a good fit within addiction treatment. The included studies support occupational therapists to consider going beyond the teaching of skills alone and to prioritise occupational engagement and client-centred practice to support clients beyond a substance user identity ( Godoy-Vieira et al. , 2018 ). Wasmuth et al. ’s (2015) meta-cognition research identified the addictive process impacts the skill of cognitive mastery. This impairment adversely affects the adoption and carryover of skills. Therapists are advised to remain cognisant of the neurological research on addiction, as well as that emerging from mental health field more generally ( Gutman, 2006 ).

Strengths and limitations

To date no other review has synthesised descriptions of occupational therapy practice within addiction recovery treatment. This scoping review has presented findings which represent the start of a process of assessing the available literature to inform further research in this developing clinical area. Following the protocol for a scoping review facilitated rigorous searching and screening of literature, while using an evidence-based screening tool and completing a double screening in a blinded manner also adds to the rigor of the findings.

A more systematic review was not possible to address this research aim given the heterogeneity of the methods and study populations (Tricco et al. , 2018). While our critical appraisal process is a strength of this paper, to enable as much relevant literature to be included as possible, some non-peer-reviewed papers were identified as lacking in rigour. We are wary of attributing outcomes to occupational therapy intervention that may not have been seen if sample sizes were larger or, in some cases research methods more rigorous. The challenge is now for clinicians to measure relevant outcomes, report on and publish interventions occurring in an ethical, rigorous manner.

This scoping review has outlined literature on occupational therapy interventions when working with people experiencing addiction. Interventions delivered by occupational therapists in addiction treatment are generally well received by clients and supportive to reducing the harm associated with addictive behaviours. Further research focused on interventions used within addiction recovery treatment are required, to provide clearer descriptions of how occupational therapy interventions are delivered used and applied in this clinical area, to increase the and share evidence-based practice.

Key findings

Occupational therapy appears to be a good fit within most addiction treatment settings and that occupational therapy interventions are most supportive when intervention goes beyond the teaching of skills, to prioritise occupational engagement.

More research evidence is required to understand clearly how occupational therapists are engaging with people with substance use disorders and addictive behaviours.

What this study added

This study presents a synthesis of how occupational therapy interventions have been used to treat people experiencing addiction and indicates that service-users report finding occupational therapy supportive and helpful; however, there is currently limited evidence for generalisability of these findings. Further research is required to best understand how to design and tailor occupational therapy within diverse treatment settings.

PRISMA 2009 flow diagram

Extraction table of included articles

Crow critical appraisal tool (CCAT) score of included articles

OT: Occupational therapy

PTSD: Post-traumatic stress disorder

QoL: Quality of life

HT: Horticultural therapy

PEO: Person environment occupation – model of practice used in occupational therapy

SU: Service user

MOHO: Model of human occupation = Model of occupational therapy practice

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World Health Organization ( 2013 ), “ Substance abuse ”, available at: www.who.int/topics/substance_abuse/en/ (assessed 28 March 2019).

World Health Organization ( 2014 ), ‘Global Status Report on Alcohol and Health 2014’, available at: www.who.int/substance_abuse/publications/alcohol_2014/en/ (accessed 20 November 2018 ).

Acknowledgements

Research ethics : No ethical approval was required for this study.

Conflict of interest : The authors confirm that there is no conflict of interest.

Funding : This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Corresponding author

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Scoping reviews in occupational therapy: the what, why, and how to

Affiliation.

• 1 La Trobe Rural Health School, Faculty of Health Sciences, La Trobe University, Bendigo.
• PMID: 24125011
• DOI: 10.1111/1440-1630.12080

Background/aim: Scoping reviews are a method of identifying, locating, analysing and summarising relevant empirical literature and research findings on a nominated topic. A description of scoping reviews is provided with examples that have been published in the occupational therapy and related literature and outline of the uses of scoping reviews for research and in evidence-based practice.

Methods: Recent occupational therapy literature was searched to identify occupational therapy-related scoping reviews published in the refereed literature and to identify the methodologies used and topics covered.

Results: A limited range of scoping reviews was located and a summary of their results is provided as examples of scoping reviews in the occupational therapy field.

Conclusion: The scoping review methodology is an efficient and effective approach for locating, analysing, summarising and presenting available literature and research findings on a particular topic. In comparison to a systematic review, it does not have the same high level of rigour, however does provide a general overview of the literature using a structured methodology to ensure consistency. The methodology of scoping reviews is effective for researchers where there is limited high level evidence available about a topic that would be required by a systematic review and provides an efficient way of identifying previous research and current knowledge gaps. Although there has been some scoping reviews published, it is predicted that there will be an increase in the future when the use of scoping reviews in occupational therapy is more fully realised and operationalised.

Keywords: literature critique; methodology; scoping review.

© 2013 Occupational Therapy Australia.

• Biomedical Research
• Databases, Bibliographic
• Evidence-Based Practice*
• Occupational Therapy / methods*
• Patient-Centered Care / methods
• Peer Review, Research / methods
• Quality Assurance, Health Care
• Review Literature as Topic*

61 Best Occupational Therapy Research Topics

Occupational therapists help people of all ages to recover and improve their physical, sensory, and cognitive activities. More than half of occupational therapists work in hospitals, while others work in nursing homes, educational facilities, and homes. But what does it take to be an occupational therapist? It would be best to study occupational therapy primarily up to the master’s level . Students are assigned projects as part of their course work through the studies. That is why we have selected the best occupational therapy research topics for your next assignment.

In occupational therapy, students always have trouble handling research projects. If you study occupational therapy and feel like you need help selecting a research topic, do not hesitate to contact us. Our writers go the extra mile and assist you in writing a top-notch research paper.

Do You Need Help in Selecting an Occupational Therapy Research Topic?

When you search “occupational therapy research topics, “it is not easy to trust platforms that offer academic consultation services. However, we offer expert writing services and professional research tips to keep your data confidential when you order from us.

Need help doing your assignment?

Often, occupational therapy students have a large workload which prevents them from doing every task on time. And when you have limited time, it becomes challenging to select a research topic.

We hope the tips below help you in your subsequent research:

1. Select a topic that interests you

When you select a topic that interests you, the research process becomes fun and engaging.  

2. Narrow your topic

If your topic is too broad, it loses focus. Therefore, you should narrow down your scope to cover all the relevant information on the topic.

3. Review your research guidelines

Make sure that the research topic meets the requirements. If some of the guidelines are unclear, you should consult your professor or HelpForHomework to explain . 

4. Read your class notes  and do background research

Reading your notes helps in doing background checks on a topic. Knowing more about your research topic helps you develop a compelling argument for your paper.

5. Consider your audience

You should select a topic that is understandable to your audience. The research depends on your level of education as more comprehensive reports are high in the educational spectrum. Further, by identifying your audience, you can arrange details, tone, and supporting information in an appropriate presentation . 

6. Create questions to evaluate your research topic

After finding a research topic, create questions to evaluate it. For example:

• Is the research feasible?
• How attractive is the research topic?
• What has been researched?
• What is the problem to be solved?
• What is the solution to the problem?
• How is your solution a good one?
• Who is the audience?

Qualities of an Excellent Occasional Therapy Research Topic

As we have recommended, always narrow down to a topic that interests you. After selecting a topic, you should check if it has the following qualities:

Clarity: Your occupational therapy research topic should be straightforward and understandable to your audience.

Complex: Your project topics should not be answerable by yes or no. The topic should be arguable and analytical.

Focused : Once you select a topic, check if it is narrow and focused and answer it thoroughly.

Your final research grade depends on how effective your topic selection is. It would be best if you prepared for your research early. However, if you need help, do not hesitate to contact us. But first, go through the occupational therapy research topics below and tell us what you think.

Hot Occupational Therapy Research Topics

Hot occupational therapy research topics should help you in creating a unique project. Before selecting a topic, you should examine the aspects that are preferable to you and what interests you the most. But it would be best if you did not worry as we have a list of top recommendations to save you .

• Discuss the progress made in a decade in occupational therapy for adults
• Ethics in occupational therapy
• Explain the role of occupational therapy for patients with stroke
• How do diabetic patients benefit from occupational therapy?
• How does culture affect occupational therapy?
• How is occupational therapy important in controlling dementia?
• How is occupational therapy necessary in pain management?
• Is occupational therapy truly occupational?
• Occupational therapy for breast cancer patients
• Occupational therapy in disease prevention
• Role of occupational therapy in disaster preparedness and management
• Role of occupational therapy in functional literacy
• Role of occupational therapy in the management of depression
• Role of occupational therapy in the management of eating disorders
• What is the role of occupational therapy in schools?

Good research topics for occupational therapy

An excellent occupational therapy research topic should be comprehensive and enjoyable to read. When formulating a research topic, you should ensure that you are original, specific, and concrete. We hope you find the best research topic from the list below:

• Benefits of occupational therapy for adult mental health patients
• Between bottom-up and top-down approaches, which method is effective for patients suffering from a stroke?
• Coexistence between teachers and occupational therapists in a school setting
• Discuss the stereotypes in occupational therapy practice
• Evaluate occupational therapy for patients with a brain tumor
• How can occupational therapy be used to prevent human trafficking?
• Interventions used by occupational therapists when treating spinal cord injuries
• Occupational therapy for cancer patients with metastatic disease
• Occupational therapy for inpatient
• Occupational therapy for terminally ill patients
• Occupational therapy in mental health management
• Role of occupational therapy in symptoms control
• The role of occupational therapy for prisoners
• The use of apps in occupational therapy treatment
• What are the therapeutic outcomes of occupational therapy?

Occupational therapy student research topics

It may seem challenging to select the best occupational therapy research topic, so the trick is to narrow down and select one that fascinates you. Always take your time, research a list of topics, and choose the one you can support. Here are some of the topics to consider:

• Critical historical analysis of occupational therapy
• Does occupational therapy affect politics
• Foundations of occupational therapy practice
• Impact of the gender of providing occupational therapy services
• Importance of occupational therapy in school mental health
• Leadership in occupational therapy
• Occupational therapy for children with autism
• Occupational therapy for people who have hip replacement
• Occupational therapy models for families
• Role of occupational therapy for children with sensory modulation disorder
• Role of occupational therapy in managing sleep
• Role of occupational therapy in psychiatry
• Scope of occupational therapy
• Students perception of occupational therapy
• Teacher’s perception towards occupational therapy
• The perspective of sensory integration approach in occupational therapy

Pediatric occupational therapy research topics

Pediatric occupational therapists seek to understand children’s motor skills, cognitive abilities, and social development. The therapists also check factors that may hinder children’s growth or ability to perform certain tasks at a specific age.

While studying pediatric occupational therapy, students go through a hassle in selecting a research topic. That is why HelpForHomework compiled the best 15 Pediatric occupational therapy research topics for you.

• A profile of your country pediatric occupational therapy
• Competency of a pediatric occupational therapist in the USA
• Correlation between obesity and academic achievement
• Discuss how religion and culture affect decision making in pediatric occupational therapy
• Effects of COVID-19 to outpatient occupational therapy
• How effective are the weighted vests in pediatric occupational therapy?
• How effective is the standing frame to children with cerebral palsy?
• Policies governing pediatric occupational therapy
• Risk factors correlating with musculoskeletal complaints from children
• The role of pediatric occupational therapy to children with osteosarcoma
• Treatment methods of lower limb spasticity in children with cerebral palsy
• Treatment of neonatal jaundice
• Use of video occupational therapy modeling for children
• What is the role of pediatric occupational therapy?
• What is your perspective on occupational-based pediatric therapy?

Need Help With Occupational Therapy Research?

Now that you have an occupational therapy research topic, do you need help in writing? Our support department is on standby to help you get top-quality expert papers. Further, if you need more clarification on project topics, do not hesitate to contact us. We assure you of personalized and professional help whenever you consult us for your assignments. Also check out Physical Therapy Research Topics .

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• Research article
• Open access
• Published: 02 August 2011

Occupational therapy and return to work: a systematic literature review

• Huguette AM Désiron 1 ,
• Angelique de Rijk 2 ,
• Elke Van Hoof 3 , 4 &
• Peter Donceel 1  

BMC Public Health volume  11 , Article number:  615 ( 2011 ) Cite this article

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The primary aim of this review study was to gather evidence on the effectiveness in terms of return to work (RTW) of occupational therapy interventions (OTIs) in rehabilitation patients with non-congenital disorders. A secondary aim was to be able to select the most efficient OTI.

A systematic literature review of peer-reviewed papers was conducted using electronic databases (Cinahl, Cochrane Library, Ebsco, Medline (Pubmed), and PsycInfo). The search focussed on randomised controlled trials and cohort studies published in English from 1980 until September 2010. Scientific validity of the studies was assessed.

Starting from 1532 papers with pertinent titles, six studies met the quality criteria. Results show systematic reviewing of OTIs on RTW was challenging due to varying populations, different outcome measures, and poor descriptions of methodology. There is evidence that OTIs as part of rehabilitation programs, increase RTW rates, although the methodological evidence of most studies is weak.

Conclusions

Analysis of the selected papers indicated that OTIs positively influence RTW; two studies described precisely what the content of their OTI was. In order to identify the added value of OTIs on RTW, studies with well-defined OT intervention protocols are necessary.

Peer Review reports

Restoring the ability to work is a key element in the rehabilitation of adult patients (aged 16-65 years). The primary goal of occupational therapy (OT), as part of the rehabilitation program, is to enable people to participate in the activities of everyday life including the ability to work. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the "occupations' (used in terms of activities, and not only referring to employment) they want to, need to, or are expected to do. OT can involve, in order to reach the therapeutic goals, modifying the occupation itself or the environment [ 1 ]. According to the World Federation of Occupational Therapists (WFOT), the aims of Occupational Therapy (OT) are "... to promote, develop, restore and maintain abilities needed to cope with daily activities to prevent dysfunction. Programs are designed to facilitate maximum use of function to meet demands of the person's working, social, personal and domestic environment... " [ 1 ].

Assisting patients to return to their job is clearly an important part of the therapeutic effort of occupational therapists [ 2 ], the OT process is based on initial and repeated assessments in individual patients. Assessment includes the use of standardized procedures, interviews, observations in a variety of settings and consultation with significant people in the person's life. Functionality, the ability to perform activities in daily life, leisure and work and the possibility to participate in all aspects of life (including work) are part of the OT assessments. The results of these recurrent assessments form the basis of the therapeutic program plan, with inclusion of both short- and long-term aims of treatment. This plan must be relevant to the person's developmental stage, habits, roles, life-style preferences and the person's environment.

OT interventions, being part of the therapeutic plan, are designed to facilitate performance of everyday tasks and adaptation of settings in which the person works, lives and socializes. Interventions are directed towards developing, improving, and restoring daily living skills, work readiness, work performance, play skills, leisure capacities and enhancing educational performance skills (objectives) [ 3 ]. Re-assessments in different phases of the rehabilitation process are used to check results, and (re-)direct therapeutic goals.

Following Holmes [ 4 ], rehabilitation must focus on identifying and overcoming the health, personal/psychological, and social/occupational obstacles to recovery and (return to) work from this point of view, vocational rehabilitation reflects a wide variety of interventions, including meaningful occupations through voluntary work, sheltered work, supported employment and open employment opportunities. As a therapeutic intervention, return to work includes also patients who are assisted by their (occupational) therapists to regain access to the (premorbid) type of work.

From that point of view, vocational rehabilitation is one of the methods that can be put to use by OT on behalf of reaching the patients goals when RTW and/or regaining productivity (in a more large meaning) is at stake. In practice, vocational rehabilitation is realized through a partnership between the patient and all the rehab-team members, including OT. Especially for patients who suffer from symptoms that not only endanger their (labour-) participation while the rehabilitation process is on-going, but who risk being disabled on longer terms (because of permanent limitation of chronic problems), OT is assumed to be a relevant part of the whole rehabilitation program [ 5 ].

Since no evidence was found on behalf of breast-cancer survivors (specific population in which the researchers at first took interest), it was decided to enlarge the focus on RTW and OT for all patients confronted with long term effects of diagnose/treatment, including problems on RTW.

In the lecture of Whyte [ 6 ], held at the 57th John Stanley Coulter memorial lecture, the author stated that much discussion has been going on, on the need to enhance evidence base supporting rehabilitation practice. Within the professional group of occupational therapists, both researchers and practitioners indicate that - like Whyte points out in the conclusions of his lecture- they need to acknowledge that empirical work alone will not develop the science of rehabilitation. Therefore, attempting to add to the work that Whyte, Lee and others advocate, this review centralizes current evidence with regard to the added value of OT for patients aiming at return to work, regardless of the categories of patients to who this intervention was provided (RTW).

For different groups of patients, the importance of RTW is increasing both for personal and societal reasons [ 7 ]. Early RTW programs represent a bridge towards employment for an injured worker. Wright argued that OT practitioners are ideally suited to guide that transition [ 8 ]. Evolution in the medical treatment of different pathologies (e.g. cancer, AIDS) initiated evolutions in rehabilitation programs offered to patients. As part of the multidisciplinary rehabilitation effort, OT focuses on restoring activity and participation (including labour participation). Restoring and/or maintaining activities and participation of clients in different dimensions of life (self-maintenance, productivity and leisure) [ 9 ] is the main goal for occupational therapy interventions (OTIs). Occupational therapists should deliver evidence-based services in order to ensure quality in the input of OT within the whole rehabilitation program. Evidence supporting the effectiveness of OTIs in terms of RTW is particularly useful, as it can be used to develop specific programs targeting RTW.

Primary goal of this review was to assess the effect of OTIs on RTW and if effects are found, to describe what OT aspects contribute to the effects. Secondary aim was to select the most efficient OTI for an intervention to promote RTW. Subsequently, this review focussed on the following questions:

What are the effects of OTIs in vocational rehabilitation on RTW?

What aspects of ot contribute to these effects.

Evidence-based information not only will stimulate professionals in rehabilitation teams to optimize the quality of services these professionals provide (and more specifically the work of occupational therapists). It will also support the quality of patient outcomes in terms of preventing loss of income, decreasing the number of sick-leave days, and increasing quality of life [ 10 ].

Five electronic databases (Cinahl, Cochrane Library, Ebsco, Medline (Pubmed), and PsycInfo) were used to search for pertinent articles published between 1980 and September 2010. The patient population/problem (P), intervention (I), comparison (C), and outcome (O), or PICO technique, was used to find relevant information and to formulate relevant questions that best match the capabilities of database search engines. Using the PICO elements as guideline, focus of this review could be rigorously maintained on patients suffering from an injury or illness that causes temporary incapacity to work and on patients participating in rehabilitation programs including OT.

Identification of studies

Figure 1 shows the selection process of articles for full-text analysis (n = 26). Inclusion criteria were:

Search strategy . *: Criteria used to exclude selected studies. • Studies in which the term "occupational therapy" did not occur in title and/or abstract. • studies that did not contain "occupational therapy" and "return to work" in the title, abstract and/or key-words. • Studies in the field of "occupational medicine/occupational rehabilitation" that discussed return to work (RTW) but did not mention occupational therapy (OT). **: Exclusion-criteria: • No correct reference information mentioned (no authors name indicated, lists of articles from congress books,...). • Doubles (studies that appeared in multiple electronic sources). ***: After screening with PICO items, reviews and descriptive studies were excluded but intervention studies were included. ****: studies excluded after analysing the full text (role of OT in RTW process), excluding those studies that did not explicitly mention OT as a part of the multidisciplinary rehabilitation programme.

The studies had to be either randomised controlled trials (RCTs) or cohort studies and written in English;

The participants had to be patients of working age (18-65 years) that had participated in a rehabilitation program;

The OTI had to be a part of a multidisciplinary rehabilitation program aiming at RTW, regardless of the patient population the intervention was provided for.;

The interventions examined had to be RTW multidisciplinary rehabilitation programs that included OT (i.e. the therapeutic efforts had to be part of a defined program whose specific goal was to help patients re-enter or remain in the work force);

The outcome measures had to measure work-related outcomes such as RTW, sick leave, or employment status;

Studies were published between 1980 till September 2010.

Vocational rehabilitation studies that did not explicitly describe or mention OT involvement were excluded (see Figure 1 ).

A preliminary pilot study used to determine how to direct the literature search, showed that OT was often part of multidisciplinary teamwork or program described under "vocational rehabilitation". Therefore, "vocational rehabilitation" was added to the search terms "occupational therapy" and "return to work" (see Figure 1 ).

By screening the titles, abstracts, and keywords for the terms "occupational therapy" and "return to work" potential studies were identified. Studies published in German [ 11 – 13 ] were also included. Additionally, using the names of researchers authoring relevant studies, a "snowball search" was used by screening the reference lists of selected articles for pertinent references. Additional research material suggested by OT experts was screened too.

Data extraction

Data extraction from the included papers was performed by one researcher (H.D.) and checked for accuracy by the other authors. Disagreement in data extraction was resolved by consensus. As the structure and content of the OT programs remained vague, except for the study of Lambeek et al., the authors were invited by e-mail between October and December 2010 to provide more information. From 3 studies additional information was provided [ 14 – 16 ].

Quality assessment

Quality assessment was performed by evaluating methodological quality of the studies [ 17 – 19 ]. Internal validity, study methodology, and external validity were assessed.

Internal validity

The criteria used to check internal validity were the quality of the sampling, the quality of randomisation and experimenter blinding, sufficient number of participants for statistical evidence, and description of confounders and bias. Three levels of scoring were used: (A) when the number of participants was sufficient to produce reasonably acceptable statistical power, randomisation was carried out carefully for RCTs (including blinding) and it was described whether (and in which way) confounders and bias were taken into account; (B) when all criteria were met as far as practically possible, but some compromises were necessary or when a description of how confounders and bias were treated was lacking; (C) all other cases.

Methodological quality

Criteria used for the methodological evaluation were appropriateness of data analysis, loss-to-follow-up/selective loss-to-follow-up, intention-to-treat analysis/per protocol analysis, and compliance. Three levels of scoring were used: (A) when all of these criteria were described in the article and treated appropriately; (B) when appropriate data analysis was carried out and some but not all of the criteria were described in the article or some comments could be made on the methodological approach; (C) when appropriate data analysis was carried out, but the methodology was not described or was poorly described.

External validity

Criteria used to evaluate external validity were whether the conclusions were applicable to situations in other geographic areas, importance (quantitative) of the populations for which the conclusions are likely to be applicable, and scope of generalizability (non-specificity of the sample). Three levels of scoring were used: (A) RCT studies that were likely to be applicable to large populations and likely to be geographically independent; (B) cohort studies that were likely to be generalizable and/or that examined somewhat specific populations; (C) studies that examined very specific populations (e.g. traumatic brain injury in military personnel on duty).

Evidence was gathered about the effect of OTIs in vocational rehabilitation on RTW by analysing peer-reviewed papers on OTIs that focussed on RTW. The search focussed on RCT and cohort studies, initially obtaining 1532 titles of potentially pertinent papers (see Figure 1 ). For the 251 articles that met the inclusion criteria, abstracts were analysed for the explicit use of OT as a part of the rehabilitation interventions aiming at RTW. Of these articles, 26 were selected for further full-text review. These papers were subjected to further analysis using the inclusion criteria mentioned. This review focussed on studies that specifically and explicitly focussed on OT as part of a multidisciplinary rehabilitation program. This strict inclusion criterion did lead to finally withhold six studies.

Studies selected

Six papers [ 14 – 16 , 20 – 22 ] finally met the quality criteria. These six studies included 899 patients older than 18 years (active age) that participated in rehabilitation programs aimed at RTW. All studies included patients - suffering from differing problems - who had jobs at the time of the research project in which they participated and patients were supported by social security system and/or private insurances. The patients were evaluated after the program (1 week to 42 months after discharge). Three of the studies were RCTs; the remaining three were cohort studies. Methodological characteristics and quality are presented in Table 1 .

One of the selected studies was of high quality (A score) for all the items. Two selected studies showed good internal validity (score B), and 3 showed moderate internal validity (score C). Four studies were of moderate methodological quality (score C), and only two studies--Vanderploeg et al. [ 16 ] and Lambeek [ 14 ] --were of high quality (score A). Three studies--Jousset et al. [ 20 ], Schene et al. [ 15 ] and Lambeek et al. [ 14 ] and Vanderploeg et al. [ 16 ] did have limited external validity (score C) because they focussed on very specific target groups. Potential bias from selecting patients in insurance-paid programs was recognised by Vanderploeg et al.[ 16 ]and Lambeek et al. [ 14 ], but not specifically mentioned by the other studies.

Although all studies in this review focussed on RTW and the role of OT in that process, analysis showed many differences which hindered comparison of the studies and their results. All studies showed an effect on RTW in a program in which OT is involved, although large heterogeneity is found. Studies differed in type of intervention, patient type involved, operational definition of the notion RTW and in follow-up period.

Outcome measures and definition of return to work

All of the selected studies denoted RTW as an outcome measure but their definition of RTW and what RTW involves varied widely (Table 2 ).

Concluding whether a given intervention has (successful) effects regarding its goal (RTW) depends on the definition of "successful RTW" (see table 2 ). In the studies reviewed here, both the definition of successful RTW, which ranged from part-time to full-time employment, and the time of follow-up, which ranged from 1 week to 42 months, differed substantially. In the study of Joy et al. [ 21 ], successful RTW was measured in terms of the percentage of RTW compared to the situation before participants entered the program. Although the other selected studies also compared different forms of treatment including OT, they did not demonstrate precisely how each professional discipline contributed to RTW.

All OTIs affected RTW. Jousset et al. [ 20 ] found significantly lower mean numbers of self-reported sick-leave days in the functional restoration group who took part in OT. Joy et al. [ 21 ] suggested that multidisciplinary programs (including OT) such as work-hardening and functional restoration may be of benefit in helping the patients identify and resolve issues that often contribute to disability exaggeration leading to greater RTW success independent of any changes in a patient's overall pain level. This parallels the findings of Lambeek et al. [ 14 ], who also concluded that disability decreased although improvement of pain did not differ between both groups. Schene et al. [ 15 ] found that adding OT to the usual treatment increased and accelerated work resumption of people suffering from depression. OT, however, did not accelerate recovery from depression. Results of the work of Sullivan et al. [ 22 ] revealed that a risk-factor-targeted intervention administered by physical therapists and occupational therapists can have a meaningful impact on RTW following whiplash injuries. The impact of their program was most pronounced for the subgroup of subjects who scored in the risk range on all psychosocial variables targeted by the program. Vanderploeg et al. [ 16 ] added (measured by in-person evaluations and structured telephone interviews at 1 year after the programs) the amount of help that the participating patients with traumatic brain injury received and details on any vocational activity over the year since completing the study protocol to their RTW measure. Their study found no difference in RTW between patients that received cognitive didactic and those who received functional experiential approaches during traumatic brain injury rehabilitation.

Effects of OTIs in rehabilitation programs regarding RTW are recognisable, but large differences in settings, design, in- and exclusion criteria, disciplines concerned in the study-programs, and in outcomes made it difficult to determine the extent to which OT contributions to these interventions affected RTW (see table 3 ). The different OTIs, integrated in the multidisciplinary intervention are:

• Jousset et al. mention "work simulation" as part of the Functional Restoration Program but do not specify what exactly the content of that part of the program was, in which settings it was performed or what the specific approach of the occupational therapist was [ 20 ].

• Lambeek et al. [ 14 ] mention the contribution of occupational therapists in the description of the study, but in the specifications of different types of therapeutic services, provided in primary and secondary care, the description "occupational therapist" is not used. Nevertheless, the additional description of the protocol of the "integrated care " used in the study, point outs very clearly in what way occupational therapy was used. The main part of the work of the occupational therapist included in the study of Lambeek et al. [ 14 ] is to provide a workplace intervention. Being a member of the multidisciplinary team, the OT takes part in gathering patient information. In the additional report [ 23 ], a detailed OT protocol is included and supported by an "occupational therapist flow chart", thus indicating the OTI time-span. Every four weeks (telephone) conferences with the clinical occupational physician, physical therapist and medical specialist need to take place. The protocol mentions the issues that need to be discussed and the timeframe for the OTI.

• The content of a therapeutic program item like "work hardening" is mentioned in the work of Joy et al., but is not clear what the therapeutic actions are, what type of approach is used, what activities are performed [ 21 ].

• The program of Schene et al. [ 15 ] provides three individuals visits in the last phase. The information, separately published in the intervention protocol, clarifies precisely the content of the program [ 24 ].

• The OT part of the program of Sullivan et al contains "increasing activity involvement" but it is not specified in the study-report what precisely the therapeutic actions of the occupational therapist were [ 22 ].

• Vanderploeg et al. [ 16 ] mention that the OT was part of the multi-disciplinary team, but do not give further details on the content of the input of OT. The additionally provided information [ 25 ] gives more specific information on the research protocol, however, no specification of the precise content of the occupational therapy part of the program was indicated [ 25 ]. The protocol clarifies how the whole team had to collaborate but does not offer a detailed description of the specific actions of each discipline involved.

Whether OT had a meaningful role in the outcome of the different programs, is not only a result of the OT contribution itself, but also of the composition of the services offered by the multidisciplinary team concerned in the program (see tables 3 and 4 ).

Remarkable in the selected studies was the mixture of terms used to describe multidisciplinary teams. The disciplines concerned in "multidisciplinary rehabilitation" across the six studies show that a great variety of disciplines is involved in RTW programs. Moreover, many of the authors failed to differentiate between occupational therapy, physiotherapy, and physical therapy. Lambeek et al. [ 14 ] however, describe precisely the contribution of each discipline in the multidisciplinary team, including a flow chart of the process in which each of those team members was involved in the integrated care protocol.

Recognizing the role that OT plays in the overall therapeutic effort (by using the WFOT definition of the profession [ 1 ]), is not obvious, but for experienced OT's nevertheless very well recognisable in the papers by Jousset [ 20 ], Joy, Sullivan [ 22 ] and Vanderploeg [ 16 , 25 ]. This finding supports the statement of Lee and Kielhofner that specific evidence of OTIs is lacking.

Schene et al.'s [ 15 ] conclusions show that a holistic approach (e.g. psychosocial intervention combined with physical therapy) is useful for preventing loss of capacities (and thereby loss of the ability to work). Moreover, Sullivan et al. [ 22 ] suggested that a holistic approach can increase successful RTW by 25%. Vanderploeg et al. [ 16 , 25 ] determined the contribution of OT (cognitive-didactic versus functional-experiential approaches) during different stages of the therapeutic process. Referring to the definition of OT used in this review, the cognitive-didactic approach can be considered as the OTI in the Vanderploeg et al. study [ 16 ]. Although they did not find significant differences after one year of rehabilitation, they found that participants in the cognitive-didactic program showed better post-treatment cognitive performance.

The primary aim of this systematic review was to identity the effectiveness in terms of Return to Work (RTW) of Occupational Therapy Interventions (OTIs) in rehabilitation patients with non-congenital disorders. In general, findings show results in favour of using OT in a multidisciplinary rehabilitation when targeting RTW. The effect of OT, measured at follow-up in terms of the number of sick-leave days or in terms of employment status, showed good results.

A great deal of the literature (1027 of 1532 articles) fitted the search terms but did not examine interventions that specifically and explicitly included OT. The selected literature (1532 preliminary results) contained a lot of descriptive studies, qualitative research and reviews. Therefore, using a strict set of inclusion criteria, the search was focussed on RCTs or cohort studies, leaving descriptive literature aside. As a result, this review is based on six studies and reveals that better RTW results are achieved when rehabilitation focuses on functionality using OT, as already suggested by the WFOT and confirming the reasoning of Wright.

Since a large variety of interventions, with different patient-populations were performed by the occupational therapists of these programs used in the studies, it was difficult to compare - and thereby generalise - the results of these studies. In order to do so, both uniform terminology and specific, detailed descriptions of the therapeutic content of the OTIs would be needed. This supports the statement of Lee and Kielhofner [ 2 ], as they point out the lack of well-described definitions in the field of OT research. Research efforts indicate that performing or simulating patients' "work activity" during rehabilitation can be very valuable in assisting them to restore their labour-participation [ 26 – 28 ]. Therefore, it would be very beneficial for constructing "good practice" to determine in further research efforts exactly what sort of interventions an OT program needs to implement in order to be as successful as possible, as provided in the work of Lambeek et al. [ 23 ] and Schene et al. [ 15 ].

Schene et al. [ 15 ] demonstrated that, in comparison to a psychosocial intervention alone, adding OT increases RTW for people suffering from major depression. Results of Lambeek et al. [ 23 ] tend to support this statement regarding RTW for patients suffering from low back pain. Jousset et al. [ 20 ] showed a decreased number of sick-leave days in workers with low-back injuries.

There are thus indications that OT is a key element in the therapeutic program. Nevertheless, the scientific evidence on which these OTIs would be based, can only - to ensure solid evidence - be retrieved from two studies. In literature, occupational therapists report many challenges in adopting and implementing evidence-based principles to practice. According to Lee and Kielhofner, research indicates that current OT practice is still not strongly grounded in theory, occupation and evidence [ 2 ]. They state that, although occupational therapists provide a range of work-related interventions, specific evidence related to OT in the area of vocational rehabilitation remains somewhat limited [ 2 ].

Lee and Kielhofner found that published works tend to focus on issues of scholarship rather than implications for practice, thereby often limiting the practical implementation of the findings into OT practice. Nevertheless, Lee and Kielhofner also state that experiences (of some authors of projects in which occupational therapists are involved) indicate that simultaneous consideration of theory and evidence is advantageous to achieve occupation-focuses best practice [ 2 ].

Simultaneous addition of other interventions on the other hand, such as care management and physical therapy (graded activity) [ 18 ], clog the precise effect of the OTI. In their report, Lambeek et al. [ 14 , 23 ] do not comment on a possible cross-over or a mutual re-enforcing effect of components of the integrated care program as effected by respectively the clinical occupational physician, the physical therapy and the OT. They do, however, in the discussion part of their report, regret the fact that the study design was not suitable for assessing the effectiveness of the individual components of the integrated care intervention (integrated care management, workplace intervention, and graded activity). In this study the randomization compared usual care to a workplace intervention, in which the medical team was enlarged by the employer, aiming at identifying the barriers and coming up with solutions. Average patient contact for providers was the same for the occupational medicine physician and the occupational therapist with approximately 17 sessions with the physical therapist. Clearly, an unambiguous identification of the OTI was not possible. The study indicates the fact that OT can/does have a role to play when RTW is at stake. Lambeek et al. [ 14 ] presume that a factorial design, and additional qualitative research focussing on the experience of healthcare professionals and patients, could give more insight into the effective components of the intervention.

In the protocol used in Schene et al. [ 15 ], the authors specify the socio-economical context in which the intervention took place. Referring to the Dutch legislation and the care that can be provided within that legal framework, de Vries and Schene [ 24 ] clarify how "care as usual" needs to be understood; this information was lacking in other studies.

In occupational therapy literature, different authors have been mentioning the importance of "work" as a life-domain that cannot be neglected by the therapeutic programs offered by occupational therapists [ 29 – 34 ]. Gibson and Strong [ 35 ] stated that occupational therapists can play a major role in work rehabilitation for RTW by assessing and rehabilitating workers with a disability injury. Kinébanian & Le Granze indicate that Lee and Kielhofner [ 2 ] described and synthesised evidence about work-related OTIs the Model of Human Occupation (MOHO) [ 36 ]. MOHO-based work programs have been shown to have positive impact in improving vocational outcomes for a broad range of clients, including persons with chronic illness [ 2 , 7 , 9 , 12 , 13 , 37 , 37 – 40 ]. Studies included in the work of Lee and Kielhofner [ 2 ] point to the need for further research to more fully examine the effectiveness of programmes involving different diagnostic groups.

The authors of this review agree with Lee and Kielhofner [ 2 ] that occupational therapists should put more effort in clearly documenting the specific therapeutic actions they deliver in the RTW process, as provided by Schene et al. [ 24 ] and Lambeek et al. [ 14 , 23 ]. Therapeutic actions such as work hardening, work simulation, preparation for work reintegration, contacting the place of work, starting work in individual sessions, exploration of work problems, support and evaluation of work resumption need to be described more precisely in order to document the specific content of OT actions and to be able to repeat these actions. When efforts of occupational therapists are described and taken into a precise protocol, taking the work of Schene et al. and Lambeek et al. as inspiration [ 14 , 15 , 23 ], comparison is facilitated.

As occupational therapists try to restore the abilities of their patients during the rehabilitation process, they need well-constructed evidence pertinent to the unique situations they may encounter. This supports both the occupational therapist and the patient to construct a therapeutic pathway that fits the unique and individual reality of the patient.

By pointing out both the base evidence for "good practice" and the need to construct valid and reliable OTIs, this review sheds light on how occupational therapists need to work in order to develop adequate therapeutic answers for patients' needs. As this systematic review is set up as a part of a research project, aiming on a RCT on OT and RTW, we also try to assist in overcoming the indicated shortcomings. Far too long, OT's have focused on practice "in the field", without publishing practical- or research results on their work. As - following the evolution the input of the WFOT - in more and more countries, not only bachelor-level research is done, but OT's are participating in research on master of PhD level, one can expect that more research (both qualitative and quantitative) will be published.

In the systematic search we carried out, the aim was to identify studies in which OT was involved, trying to find indication for further research. Except for the study of Vanderploeg et al. [ 16 ] no other publication could be found in which OT was separately measurable. This indicates the need for a (relatively young) profession like OT to clarify the effects that OTI can have in strengthening the work of the team and delivering benefit for patients on specific issues (function, activity and participation) in lives domains like self-care, leisure and productivity.

Using uniform terminology will clarify the existing confusion that stems from the use of different terms and content (e.g., occupational therapy versus physical therapy; return to work versus work resumption versus job re-entry). Eliminating this confusion can help caregivers and patients to get a clear notice of what service they can claim when an occupational therapist is included and what results they may expect when an OTI. Finally, in order to clarify and construct evidence supporting the value of OT in restoring labour participation for rehabilitation patients, much research still needs to be done.

The goal of this systematic review was to analyse the effectiveness in terms of Return to Work (RTW) of Occupational Therapy Interventions (OTIs), in order to construct evidence for OTIs programs providing RTW assistance for rehabilitation patients. Descriptive literature and information from experienced practitioners in the field of OT reveal that occupational therapists are increasingly involved in assisting patients in restoring their workability. This systematic review provides sufficient evidence that rehabilitation programs that included OTIs do contribute to RTW, but it is not clear yet what the effective ingredients are, except for work place interventions [ 14 ]. Only six studies met the inclusion criteria and varied regarding population, outcome measure, or had weak descriptions of the methodology used. Thus, a univocal indication of "good practice" of an OTI aiming at RTW is lacking. Even though, the results of this review contribute to clarifying what steps need to be taken to construct the evidence needed and, even more, can stimulate occupational therapists and researchers in their efforts to continue the work that needs to be done.

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Acknowledgements

The authors wish to thank Gary Kielhofner and Renee Taylor for their stimulating support for this paper. We also thank C. Kuiper for delivering additional material for this review and researchers of Maastricht University (Department of Social Medicine, Faculty of Health, Medicine and Life Sciences) for their feedback.

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All authors were involved in the process of setting up the strategy for this study. PD supervised the study. HD carried out the research work itself, the other authors screened retrieved papers on in- and exclusion criteria and they also appraised the quality of the retrieved studies. The draft of the manuscript was supervised by PD, AdR & EvH.

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Désiron, H.A., de Rijk, A., Van Hoof, E. et al. Occupational therapy and return to work: a systematic literature review. BMC Public Health 11 , 615 (2011). https://doi.org/10.1186/1471-2458-11-615

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Olfson M , Cosgrove CM , Wall MM , Blanco C. Alcohol-Related Deaths of US Health Care Workers. JAMA Netw Open. 2024;7(5):e2410248. doi:10.1001/jamanetworkopen.2024.10248

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Alcohol-Related Deaths of US Health Care Workers

• 1 Department of Psychiatry, College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York, New York
• 2 Census Bureau, Mortality Research Group, Suitland, Maryland
• 3 Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Rockville, Maryland

Despite an increase in alcohol-related deaths in the US over the last 2 decades, 1 , 2 little is known about alcohol-related mortality risks among physicians 3 and other health care workers. Compared with non–health care workers, health care workers have increased drug overdose death risks. 4 An occupational liability to substance use or to risks of painful injuries and access to controlled substances may explain these findings. Only the first hypothesis would contribute to an increased risk of alcohol-related mortality. We estimated risks for alcohol-related deaths among US health care workers compared with non–health care workers.

This cross-sectional study was deemed exempt from review and the need for informed consent by the institutional review board of the New York State Psychiatric Institute owing to the use of only deidentified data. We followed the STROBE reporting guideline.

The 2008 American Community Survey (ACS) was a cross-sectional, nationally representative survey of approximately 2.9 million addresses with a 97.9% response rate. Data were linked to National Death Index records from 2008 to 2019. 5 After excluding unemployed individuals and those younger than 26 years, the cohort included 1 838 000 individuals. Alcohol-related underlying or contributing causes of death were identified (eTable 1 in Supplement 1 ). Health care workers included (1) registered nurses, (2) support workers, (3) technicians, 4) social and behavioral workers, (5) other diagnosing or treating clinicians (eg, dentists), and (6) physicians (eTable 2 in Supplement 1 ). Event time was from ACS administration to alcohol-related death, death from other causes, or December 31, 2019, whichever came first, with follow-up between 11 and 12 years for participants still living.

Analyses were performed in SAS, version 9.4 (SAS Institute Inc). Unadjusted and age- and sex-standardized alcohol-related death rates per 100 000 person-years with 95% CIs were calculated (2-sided P  < .05 indicated statistical significance). Cox proportional hazards regression models estimated alcohol-related death hazard ratios for the 6 health care groups adjusted for age, sex, race and ethnicity, marital status, educational level, and income. Race and ethnicity were included as covariates given known disparities in alcohol-related deaths among US racial and ethnic groups. We applied ACS weights. 6

The median age of the overall cohort was 44 (IQR, 35-53) years; 47.7% were female and 52.3% were male. Group sociodemographic characteristics are presented in Table 1 . Unadjusted alcohol-related death rates per 100 000 person-years were significantly lower for each health care worker group than for non–health care workers. Following age and sex standardization, only physicians (4.2) and other diagnosing or treating clinicians (11.6) had significantly lower alcohol-related death rates than non–health care workers (18.1). Controlling for the other sociodemographic characteristics, alcohol-related mortality hazards did not significantly differ between each health care worker group and non–health care workers ( Table 2 ).

Compared with non–health care workers, health care workers, especially physicians, had lower crude alcohol-related death rates. Following sociodemographic adjustment, however, significant group differences were no longer observed.

When viewed in relation to elevated drug overdose death rates for some health care worker groups, 2 the alcohol-related mortality results suggest health care workers do not have a general underlying liability to substance-related deaths. Specific occupational factors, such as access to controlled medications, may pose drug overdose risks that do not extend to alcohol-related deaths. However, alcohol-related mortality represents an extreme end point and alcohol-related morbidity remains a common problem. Study limitations include termination of mortality data before the COVID-19 pandemic, misclassification of alcohol-related cause of death in death records, 1 absence of key alcohol-related risk factors such as personal or family history of alcohol use, and an inability to measure occupational transitions during the 11-year follow-up.

The risks of alcohol-related deaths among health care workers did not exceed those of non–health care workers. However, this finding does not diminish the importance of improving management of alcohol-related problems among health care workers. Future research should compare problematic alcohol use among health care worker groups during the COVID-19 and post–COVID-19 periods.

Accepted for Publication: March 7, 2024.

Published: May 8, 2024. doi:10.1001/jamanetworkopen.2024.10248

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Olfson M et al. JAMA Network Open .

Corresponding Author: Mark Olfson, MD, MPH, Psychiatry & Epidemiology, Columbia University, 1051 Riverside Dr, New York, NY 10032 ( [email protected] ).

Author Contributions: Ms Cosgrove had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Olfson, Wall, Blanco.

Acquisition, analysis, or interpretation of data: Olfson, Cosgrove, Blanco.

Drafting of the manuscript: Olfson, Wall.

Critical review of the manuscript for important intellectual content: Olfson, Cosgrove, Blanco.

Statistical analysis: Cosgrove, Wall.

Administrative, technical, or material support: Olfson, Cosgrove.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by interagency agreements of National Heart, Lung, and Blood Institute and National Institute on Aging with the US Census Bureau.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: Any opinions and conclusions expressed herein are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute, the National Institute on Drug Abuse, or the US Census Bureau.

Data Sharing Statement: See Supplement 2 .

Additional Information: The Census Bureau has ensured appropriate access and use of confidential data and has reviewed these results for disclosure avoidance protection (Project 7532119: CBDRB-FY23-CES004-029 and CBDRB-FY23-CES004-031).

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