Abstract
A pilot for integrating OT into a Department of Corrections Community Supervision Center was implemented. This pilot sought to use OT assessment and intervention for justice-involved individuals to address skill building, increase problem solving, and further explore the needs and barriers to re-entry, including maintenance of supervision to prevent recidivism. This pilot highlighted a gap in life skills training for this population and this program's impact.
Primary Author and Speaker: Ariana Gonzalez
Additional Authors and Speakers: Megan Davis, Emily Gralinski, Stephanie Monforte,and Jacqueline Strausser
A community-based participatory pilot for integrating occupational therapy into a Department of Corrections Community Supervision Center was implemented. Mental illness, substance use and TBI are higher in incarcerated individuals as compared to the general population and this can lead to impairments in cognition which impacts overall functioning and ability to learn new skills thus presenting barriers to successful transition to the community. To reduce recidivism, especially those due to technical violations, justice-involved individuals need to possess the cognitive skills and abilities to follow rules of supervision and avoid violations. This pilot sought to use occupational therapy assessment and interventions to address the behavioral, cognitive and mental health needs of this population by addressing skill-building, increasing problem-solving and further exploring the needs and barriers to reentry including maintenance of supervision. A purposive same of 5 previously incarcerated males residing in the Community Supervision Center, ages 21-47, were recruited for participation in this study. These participants were seen 1:1 for occupational therapy assessment and intervention 1-2x a week over a period of 16 weeks in and outside of the Community Supervision Center. Additionally, the occupational therapist ran leisure and structured groups in and outside of the Community Supervision Center. Pre and post-test data were collected using the following measures: a demographic survey, five standardized Patient-Reported Outcomes Measurement Information System (PROMIS) assessments: PROMIS -43 Profile v2.0, PROMIS Bank v2. -Social Isolation, PROMIS Self Efficacy for Managing Daily Activities v1.0, PROMIS Self Efficacy for Managing Emotions-short form 4a and PROMIS General Self Efficacy- short form 4a, the Vulnerability Index-Service Prioritization Decision Assistance Tool, and the Activity Card Sort: Including use of Covert Occupation. Participants also completed a 5-question exit interview. Additionally, seven Department of Corrections staff members were interviewed post-pilot to gather perspectives on the effectiveness and feasibility of this program. Significant positive changes in PROMIS scores for self-efficacy, self-efficacy for managing emotions, anxiety, and sleep disturbances with moderate positive changes in reduced feelings of social isolation were seen in individuals after participating in this study. VI-SPDAT scores indicated housing insecurity with this sample. Various reported reasons for barriers to participation in intended or desired activities included cognitive difficulties including focus, attention, memory and learning. This sample demonstrated difficulty setting attainable goals, difficulty with other cognitive tasks such as organization and attention and lacked life skills required for successful reentry; all skills that this program addressed. Based on participant and staff qualitative data, this program is not only feasible but has potential to expand further based on the needs. This pilot program highlighted the high demand as well as the program's fit to meet that demand for occupational therapy for previously incarcerated individuals. This pilot revealed a gap in life skills training for this population and this program's impact in engagement in meaningful occupation leading participants to change their old and ineffective habits which surprised staff members who had worked with the same individuals for years without promising change. These life skills are extraordinarily essential for the population's successful reentry to the community, maintained sobriety and prevention of recidivism.
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