Reviewing the Theory and Practice of Occupational Therapy in Mental Health Rehabilitation

TLDR

Evidence‑based supported employment for people with schizophrenia is a paradigm shift that is two to three times more effective than traditional vocational rehabilitation, emphasizing individualized intensive support coordinated with optimal mental‑health care. The article urges occupational therapists to critically revise their theory and practice to facilitate evidence‑based supported employment for schizophrenia and related psychotic disorders, outlining strategies for adaptation and revitalization.

Abstract

The delineation of evidence-based practices in supported employment for people with schizophrenia now represents a paradigm shift in the theory and practice of mental health rehabilitation. The principles and methods of traditional vocational rehabilitation and traditional mental health rehabilitation are giving way to evidence-based practices in supported employment, which are consistently proving two to three times more effective at producing competitive employment outcomes. These practices include close coordination with optimal forms of mental health treatment and care and highly individualised forms of intensive supported employment. There is a focus on the vocational services being provided, whereas the traditional and currently prevailing approach follows a more gradual and stepwise process with less of an individual focus, and where individual characteristics are considered important predictors of vocational rehabilitation success. This paradigm shift now challenges occupational therapists working in mental health rehabilitation to revise their theory and practice critically in order to support the implementation of evidence-based practices in supported employment for people with schizophrenia and related psychotic disorders. This article discusses how occupational therapists can adapt to this paradigm shift and revitalise their theory and practice in mental health rehabilitation.