Abstract
As OT practitioners work less with individuals with serious mental illness, educational programs are placing students in nontraditional fieldwork settings to fulfill accreditation psychosocial competencies. This study compares how traditional versus nontraditional psychosocial fieldwork placements impact students' attitudes toward working with this population.
Primary Author and Speaker: Tiffany Benaroya
Research has demonstrated that occupational therapy services can positively impact individuals with mental health diagnoses (Ikiugu, Nissen, Bellar, Maassen, & Van Peursem, 2017). Yet, the presence of occupational therapy practitioners in traditional mental health settings has dissipated over the years (Hulse, Cash, & Simons, 2000). With the continued increase in occupational therapy programs opening and the issue in finding placements in traditional mental health settings, academic fieldwork coordinators are at times completing these psychosocial fieldworks in alternative settings such as with individuals with developmental disabilities and brain injury programs (Kautzmann, 1995). While schools are responsible to ensure that these ‘non-traditional' settings support students' learning of objectives regarding psychosocial factors per accreditation standards, it is unclear how comparable these settings are in addressing students' attitudes and competencies in working with individuals with serious mental illness (SMI). OTA students' attitudes were assessed prior to and then following a fieldwork experience in either a ‘traditional' or ‘non-traditional' psychosocial setting—traditional meaning the student worked with individuals whose primary diagnosis was a SMI. SMI is most often defined as including schizophrenia-spectrum disorders, bipolar disorders, as well as major depressive disorders (Jaffe, n.d.) and is how it is defined for the purposes of this study. A one-way between-groups multivariate analysis of variance was performed to investigate differences in field placement location (working with SMI n = 8, non-SMI placement n = 12). Four dependent variables were used: The Knowledge Test of Mental Illness change values between pre and post, the Attribution Questionnaire-9 change values between pre and post, the Mental Illness Clinician’s Attitudes change values between pre and post, and the Student Confidence Questionnaire (SCQ) change values between pre and post. The independent variable was placement type. There were not statistically significant differences between students working with persons with SMI and students not working with persons with SMI. The SCQ was nearing significance (p = .057). Scores improved between pre and post testing suggesting an improvement in stigmatizing attitudes. A list of qualitative open-ended questions were asked to assess students' expectations, concerns, and experiences working with people with SMI. Themes were generated. Pre-test findings demonstrated a lack of knowledge and some stigmatizing attitudes towards individuals with SMI whilst post-test results showed improved communication and feelings of competency working with this population. A majority reported that they would be willing to work with individuals with SMI following their fieldwork experience. Findings suggest that OTA students' psychosocial fieldwork experiences supported the development of comparable competencies and attitudes towards individuals with SMI despite being assigned to a ‘traditional' versus ‘non-traditional' setting. It is proposed that given appropriately set up objectives and guidance that either student assignment will support student interest and comfort in this area of practice. Further, this may allow for more flexibility in psychosocial fieldwork placements moving forward. However, given the small sample size, further study is warranted.
Hulse, J.E., Cash, S.H., Simons, D.F. (2000). A longitudinal study of factors influencing occupational therapy students’ practice preference from pre-admission through job selection. Occupational Therapy in Mental Health, 16, 53-76.
Ikiugu, M.N., Nissen, R.M., Bellar, C., Maassen, A., & Van Peursem, K. (2017). Centennial topics – Clinical effectiveness of occupational therapy in mental health: A meta-analysis. American Journal of occupational Therapy, 71, 7105100020. https://doi.org/10.5014/ajot.2017.024588
Jaffe, D.J. (n.d.). What is “serious mental illness” and what is it not? Retrieved from https://mentalillnesspolicy.org/serious-mental-illness-not/
Kautzmann, L.N. (1995). Alternatives to psychosocial fieldwork: Part of the solution or part of the problem? American Journal of Occupational Therapy, 49, 266-268.