Forensic: Application

OT Role Fulfillment 

The application of OT with forensic populations can be done through a variety of roles and approaches. Below are some examples and ideas to help you envision just a few of the possibilities.  


Advocate

  • Compose articles or create educational materials and submit to OT magazines, journals, or websites
  • Share/disperse resources on social media platforms to expand the understanding, implementation, and support for OT in forensic settings
  • Include the topic of forensic OT on your personal blog or podcast

Educator

  • Include information on OT's role with forensic populations in OT curriculum
  • Volunteer to be a clinical instructor to students
  • Mentor/network with other OTs to share experiences and expand knowledge in the field

Entrepreneur

  • Create and sell a toolkit for OT practitioners with resources regarding the treatment of individuals within a forensic setting
  • Create and sell an educational phone/tablet application for OT's
  • Write and sell a book on the homeless population and OT application

Leader / Administrator

  • Become a leader with AOTA or state association who focuses on matters related to forensic populations
  • Present at national, state, or local conferences on the unique needs of the forensic population
  • Mentor other OT's starting out with the forensic population

Policy Developer

  • Propose/support policies that support OT as a standard of care for incarcerated peoples, people participating in residential treatment centers, and other forensic settings

Researcher

  • Conduct/participate in research on the occupational needs of individuals within forensic settings
  • Conduct/participate in research to identify current practices amongst forensic OTs throughout the nation
  • Conduct/participate in  research to measure the effectiveness of OT services on forensic OT populations
  • The Royal College of Occupational Therapist (2017, p. 64-65) has made the following recommendations for future research: 
  1. "The impact and outcomes of integrating recovery principles into secure care delivery."
  2. "Determining the validity and reliability of assessments for specific use in secure settings." 
  3. "The effectiveness and specific contribution of occupational therapy interventions determined using pre- and post-outcome measures, ideally with both control and intervention groups." 
  4. "The impact of the environment on time use, occupational performance and quality of life using robust measures." 
  5. "The use of occupational therapy models in forensic mental health, e.g. the Model of Human Occupation, the KAWA model, Creative Ability Model, PEOP (Person, Environment, Occupation, Performance), the Canadian Model of Occupational Performance and Engagement and the Individual Placement and Support Model." 
  6. "Impact of occupation, and evidence for protective factors, in relation to the risk of violence and recidivism."
  7. "Impact of patient transitions from different levels of security, including step-down and step-up." 
  8. "Meeting the specific occupational needs of people with learning disabilities in the secure setting." 
  9. "The effect of past, present and future occupational risk factors, such as alienation, deprivation and disruption." 
  10. "Comparing the effectiveness and impact of forensic occupational therapy risk assessment and multidisciplinary risk assessment." 
  11. "Occupational therapists' use of occupation focused practice in secure hospitals" 
  12. "The role of occupational therapy for patients in seclusion or those being cared for in longer-term segregation."
  13. "Preparation for community living including vocational activities/work. • Impact of the social environment in addition to the occupational environment. 
  14. "Gender-specific occupational needs of women in secure settings."
  15. "The occupational implications of the positive behaviour support (PBS) model of care and its contribution to the management of challenging behaviour in secure settings."
  16. "The applicability of the CORE-OM as a potential patient-reported outcome measure (PROM) in secure settings."
  17. "Empowerment of patients to understand the association of activity and recovery goals."
  18. "Habituation/institutionalisation and how this can be overcome."
  19. "What role occupational therapists play in creating a safe community within hospitals that reflect the wider community."
  20. "Preparation for discharge that empowers patients to survive in community"

Consultant

  • Lead groups at a forensic setting to address topics such as coping, health and wellness, stress management, vocational readiness, educational pursuits, transitions, etc.
  • Consult organization's that currently serve these populations to help them better meet the population's needs
  • Consult an organization's staff that currently serve these populations to educate on mental health and wellness to increase understanding and to influence organizational policies
  • See treatment ideas below 

Direct Service Provider

  • Individually evaluate, assess, and address identified areas of need
  • Assist clients with preparing for successful transitions back into the community
  • See treatment ideas below 


Suggested Frameworks & Models

  • Canadian Model of Occupational Performance and Engagement (COMP-E)
  • Creative Ability Model
  • Individual Placement and Support Model
  • KAWA Model
  • Model of Human Occupation (MOHO)
  • Occupational Adaptation Model
  • Person-Environment-Occupation-Performance Model (PEOP)
  • Role Acquisition Model 


Suggested Assessments

  • Adolescent Leisure Interest Profile
  • Adolescent/Adult Sensory Profile
  • Assessment of Communication and Interaction Skills (ACIS)
  • Assessment of Motor and Process Skills (AMPS)
  • Beck Anxiety Inventory (BAI)
  • Beck Depression Inventory (BDIII)
  • Canadian Occupational Performance Measure (COPM)
  • Coping Inventory
  • Empowerment Scale
  • Engagement in meaningful activity survey (EMAS)

  • Essen climate evaluation schema (EssenCES)
  • Functional Assessment Scale
  • Goal Attainment Scaling (GAS)
  • Independent Living Scale
  • Interest Checklist
  • Magazine Picture Collage
  • Mini-Mental State Exam
  • MoCA
  • Model of Human Occupation Screening Tool (MOHOST)
  • Occupational Circumstances Assessment Interview and Rating Scale (OCAIRS-Forensic Mental Health Version)
  • Occupational Performance History Interview (OPHI II)
  • Occupational Questionnaire (OQ)
  • Occupational Self Assessment
  • Occupational Therapy Task Observation Scale
  • Role Checklist (RC)
  • Social and occupational functioning assessment scale (SOFAS)

  • The Model of Human Occupation Screening Tool (MOHOST)
  • Volitional Questionnaire
  • World Health Organisation QOL assessment (WHOQOL Bref)


Treatment Ideas

ADLs and IADLs

  • Acquisition and maintenance of personal devices (hearing aids, glasses, contacts, prosthetics, mobility devices, etc.)
  • Acquisition and management of a bank account
  • Acquisition and utilization of communication and technological devices (cellphones, computers, tablets, adaptive devices, etc.)
  • Acquisition of driver license and car insurance
  • Acquisition of health insurance
  • Acquisition of necessities such as food, clothing, toiletries, etc. (where to go, how to apply for assistance, etc.)
  • Address physical deficits or injuries that impede participation in occupation
  • Available community resources and procedures of utilization (library, public transportation, etc.)
  • Budgeting skills
  • Caregiving information/techniques
  • Current norms for grooming, bathing, dressing 
  • Living space maintenance (current cell, future residency)
  • Medication management
  • Mental health (management of anger, anxiety, depression, stress, PTSD, trauma, other mental illness, etc.)
  • Nutritious meal preparation
  • Paying bills
  • Religious participation
  • Safety awareness and utilization of home appliances (stove, refrigerator, microwave, washing machine, dryer, etc.)
  • Sexual education, family planning
  • Substance abuse cessation
  • Time management

Education

  • Available support resources
  • Enrollment at all levels
  • Identification and utilization of community organizations offering free educational classes 
  • Trade skills
  • Transportation to and from school

Play, Leisure, and Social Participation

  • Engagement in facility social opportunities
  • Explore healthy occupations to replace dark occupations
  • Identify interests in activities 
  • Recreational activities
  • Social-emotional skills
  • Socially appropriate behaviors
  • Substance abuse cessation

Rest and Sleep

  • Education of health benefits
  • Relaxation techniques
  • Sleep hygiene
  • Sleep schedule
  • Time management

Work and Volunteering

  • ADA accommodations
  • Applying for employment
  • Expectations surrounding work ethics
  • Identifying opportunities
  • Identifying skill sets
  • Interview skills (role-playing, identifying strengths, preparation, etc.)
  • Resume development
  • Self-efficacy; Self-esteem
  • Vocational readiness


Podcast: Forensic OT  with 

Dr. Susan Connor

COMING SOON!