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Preparing	
  OccupaBonal	
  Therapy	
  Students	
  to	
  Address	
  Clients’	
  Mental	
  Health	
  Needs	
  Through	
  
PromoBon,	
  PrevenBon	
  &	
  IntervenBon	
  in	
  School-­‐Based	
  PracBce	
  
Cindy	
  DeRuiter,	
  OTD,	
  OTR/L;	
  Andrea	
  Bilics,	
  PhD,	
  OTR/L,	
  FAOTA	
  
University	
  of	
  Illinois	
  at	
  Chicago,	
  Worcester	
  State	
  University	
  
Cindy	
  DeRuiter,	
  OTD,	
  OTR/L	
  
University	
  of	
  Illinois	
  at	
  Chicago	
  
Email:	
  cderuit2@uic.edu	
  
	
  
	
  
Contact	
  
1.	
  AccreditaAon	
  Council	
  for	
  OccupaAonal	
  Therapy	
  EducaAon	
  [ACOTE]	
  (2014).	
  Standards	
  and	
  	
  
Interpre,ve	
  Guide.	
  Retrieved	
  from	
  hnp://www.aota.org/-­‐/media/Corporate/Files/EducaAonCareers/Accredit/Standards/2011-­‐Standards-­‐and-­‐InterpreAve-­‐Guide-­‐August-­‐2013.pdf	
  
2.	
  Bazyk,	
  S.	
  (Ed.).	
  (2011).	
  Mental	
  health	
  promo,on,	
  preven,on,	
  and	
  interven,on	
  with	
  children	
  and	
  
youth:	
  A	
  guiding	
  framework	
  for	
  occupa,onal	
  therapy.	
  Bethesda,	
  MD:	
  AOTA	
  Press.	
  
3.	
  Milliken,	
  B.E.,	
  Goodman,	
  G.,	
  Bazyk,	
  S.,	
  &	
  Flinn,	
  S.	
  (2007).	
  Establishing	
  a	
  case	
  for	
  	
  
occupaAonal	
  therapy	
  in	
  meeAng	
  the	
  needs	
  of	
  children	
  with	
  grief	
  issues	
  in	
  school-­‐based	
  seongs.	
  Occupa,onal	
  Therapy	
  in	
  Mental	
  Health,	
  23(7),	
  75-­‐100.	
  
4.	
  Brandenburger-­‐Shasby,	
  S.	
  (2005).	
  School-­‐based	
  pracAce:	
  Acquiring	
  the	
  knowledge	
  and	
  skills.	
  	
  
American	
  Journal	
  of	
  Occupa,onal	
  Therapy,	
  59,	
  88–96.	
  
5.	
  Nielsen,	
  S.K.	
  &	
  Hektner,	
  J.M.	
  (2014).	
  Understanding	
  the	
  psychosocial	
  knowledge	
  and	
  aotudes	
  	
  
of	
  school-­‐based	
  occupaAonal	
  therapists.	
  Journal	
  of	
  Occupa,onal	
  Therapy,	
  Schools,	
  &	
  Early	
  Interven,on,	
  7,	
  136-­‐150.	
  
6.	
  Beck,	
  A.J.,	
  Barnes,	
  K.J.,	
  Vogel,	
  K.A.,	
  &	
  Grice,	
  K.O.	
  (2006).	
  The	
  dilemma	
  of	
  psychosocial	
  	
  
occupaAonal	
  therapy	
  in	
  public	
  schools.	
  Occupa,onal	
  Therapy	
  in	
  Mental	
  Health,	
  22,	
  1-­‐17.	
  
7.	
  American	
  OccupaAonal	
  Therapy	
  AssociaAon	
  [AOTA]	
  (2014).	
  Broader	
  Scope	
  in	
  Schools	
  	
  
(Emerging	
  Niche).	
  Retrieved	
  from	
  hnp://www.aota.org/PracAce/Children-­‐Youth/Emerging-­‐Niche/Broader-­‐Scope-­‐in-­‐Schools.aspx	
  
8.	
  American	
  OccupaAonal	
  Therapy	
  AssociaAon	
  [AOTA]	
  (2009).	
  Blueprint	
  for	
  Entry-­‐Level	
  	
  
Educa,on.	
  Retrieved	
  from	
  hnps://www.aota.org/-­‐/media/Corporate/Files/EducaAonCareers/Educators/Blueprint_FINAL.pdf	
  
	
  
References	
  
Directors	
  of	
  Entry-­‐level	
  occupaAonal	
  therapy	
  programs	
  were	
  asked	
  how	
  their	
  program	
  
prepares	
  occupaAonal	
  therapy	
  students	
  to	
  become	
  competent	
  mental	
  health	
  pracAAoners	
  in	
  
schools.	
  Trends	
  from	
  survey	
  results	
  are	
  reported	
  and	
  used	
  to	
  idenAfy	
  strategies	
  to	
  develop	
  
occupaAonal	
  therapy	
  students’	
  capacity	
  to	
  address	
  their	
  clients’	
  mental	
  health	
  needs	
  in	
  
schools.	
  
Abstract	
  
Phase	
  1	
  
Of	
  169	
  potenAal	
  respondents	
  from	
  the	
  AOTA	
  Program	
  Directors’	
  listserv,	
  19	
  responded	
  to	
  the	
  
survey	
  by	
  answering	
  the	
  iniAal	
  consent	
  quesAon,	
  though	
  only	
  14	
  completed	
  the	
  survey.	
  	
  All	
  
parAcipants	
  noted	
  that	
  their	
  programs	
  required	
  coursework	
  addressing	
  occupaAonal	
  
therapy’s	
  role	
  in	
  schools;	
  given	
  a	
  5-­‐point	
  Likert	
  scale,	
  50%	
  of	
  parAcipants	
  “strongly	
  agreed”	
  
that	
  their	
  program	
  prepares	
  OT	
  students	
  to	
  be	
  effecAve	
  school-­‐based	
  pracAAoners,	
  while	
  
50%	
  selected	
  “agree”.	
  	
  
	
  
When	
  asked	
  whether	
  their	
  program	
  prepares	
  students	
  to	
  address	
  mental	
  health	
  concerns	
  of	
  
clients	
  in	
  school-­‐based	
  pracAce,	
  14%	
  strongly	
  agreed,	
  64%	
  agreed,	
  and	
  21%	
  provided	
  a	
  
neutral	
  response.	
  Programs	
  were	
  most	
  frequently	
  addressing	
  mental	
  health	
  from	
  	
  an	
  
intervenAon	
  standpoint	
  (43%),	
  followed	
  by	
  mental	
  health	
  promoAon	
  (36%)	
  and	
  intervenAon	
  
for	
  mental	
  health	
  issues	
  (21%).	
  The	
  majority	
  of	
  parAcipants	
  (57%)	
  agreed	
  that	
  their	
  program	
  
prepares	
  students	
  to	
  advocate	
  for	
  their	
  role	
  as	
  mental	
  health	
  pracAAoners	
  in	
  schools,	
  while	
  
21%	
  strongly	
  agreed	
  and	
  21%	
  provided	
  a	
  neutral	
  response.	
  	
  
	
  
QualitaAve	
  data	
  from	
  Phase	
  1	
  was	
  coded	
  and	
  the	
  following	
  themes	
  were	
  idenAfied:	
  
•  Programs	
  are	
  sufficiently	
  addressing	
  OT’s	
  role	
  in	
  school-­‐based	
  mental	
  health–	
  no	
  
need	
  to	
  improve	
  
•  Mental	
  health	
  in	
  school	
  seongs	
  is	
  a	
  weak	
  link	
  in	
  OT	
  educaAon	
  
•  ParAcipants	
  idenAfied	
  a	
  need	
  for	
  more	
  instrucAon	
  in	
  pediatric	
  mental	
  health	
  
•  ParAcipants	
  idenAfied	
  a	
  need	
  to	
  shiG	
  paradigms	
  for	
  OTs	
  to	
  recognize	
  their	
  own	
  role	
  
as	
  mental	
  health	
  pracAAoners	
  in	
  schools	
  
•  Time	
  and	
  volume	
  of	
  content	
  were	
  idenAfied	
  as	
  perpetual	
  barriers.	
  
•  ParAcipants	
  recognized	
  the	
  need	
  for	
  exploratory	
  work	
  in	
  this	
  area	
  
Phase	
  2	
  
Of	
  18	
  randomly	
  selected	
  programs,	
  6	
  program	
  directors	
  responded	
  to	
  the	
  survey.	
  None	
  
provided	
  learning	
  arAfacts	
  for	
  coursework	
  in	
  their	
  program.	
  
QualitaAve	
  data	
  from	
  Phase	
  2	
  was	
  coded	
  and	
  the	
  following	
  themes	
  were	
  idenAfied:	
  
•  Programs	
  embed	
  minimal	
  mental	
  health	
  content	
  into	
  pediatric	
  courses	
  
•  Emerging	
  topics	
  in	
  school-­‐based	
  mental	
  health	
  (bullying,	
  trauma	
  care)	
  may	
  be	
  
addressed	
  via	
  inter-­‐professional	
  educaAon	
  
•  ParAcipants	
  idenAfied	
  psychosocial	
  fieldwork	
  placements	
  as	
  integral	
  to	
  learning	
  in	
  
this	
  area	
  
•  Results	
  from	
  phase	
  2	
  corroborated	
  phase	
  1	
  results	
  
IntroducBon	
  
This	
  study	
  was	
  conducted	
  in	
  two	
  phases:	
  the	
  first	
  phase	
  uAlized	
  a	
  mixed	
  methods	
  design	
  
consisAng	
  of	
  quanAtaAve	
  survey	
  data	
  from	
  program	
  directors,	
  as	
  well	
  as	
  qualitaAve	
  
responses	
  to	
  structured	
  survey	
  quesAons.	
  A	
  convenience	
  sample	
  was	
  recruited	
  via	
  an	
  email	
  
to	
  the	
  AOTA	
  Program	
  Directors’	
  listserv.	
  
	
  
	
  In	
  the	
  second	
  phase,	
  a	
  random	
  sample	
  of	
  accredited	
  entry-­‐level	
  programs,	
  straAfied	
  by	
  
Carnegie	
  ClassificaAon	
  of	
  program,	
  were	
  selected	
  for	
  survey	
  and	
  review	
  of	
  descripAve	
  data	
  
gathered	
  from	
  available	
  learning	
  arAfacts	
  (e.g.	
  syllabi,	
  presentaAons,	
  and	
  assignments).	
  The	
  
authors	
  aimed	
  to	
  sample	
  10%	
  of	
  all	
  entry	
  level	
  programs	
  in	
  the	
  U.S.;	
  however,	
  due	
  to	
  low	
  
response	
  rate,	
  only	
  4%	
  of	
  programs	
  in	
  the	
  United	
  States	
  were	
  sampled.	
  
Methods	
  
OccupaAonal	
  Therapy	
  programs	
  address	
  the	
  role	
  of	
  school-­‐based	
  occupaAonal	
  therapists	
  but	
  
provide	
  limited	
  didacAc	
  and	
  experienAal	
  learning	
  opportuniAes	
  addressing	
  OT’s	
  role	
  in	
  
mental	
  health	
  promoAon,	
  mental	
  illness	
  prevenAon	
  and	
  intervenAon.	
  Self-­‐assessment	
  data	
  
from	
  program	
  directors	
  reveals	
  that	
  most	
  feel	
  they	
  are	
  adequately	
  addressing	
  mental	
  health	
  
in	
  school	
  based	
  pracAce;	
  yet	
  few	
  were	
  able	
  to	
  provide	
  concrete	
  examples	
  of	
  learning	
  
opportuniAes	
  (lectures,	
  assignments,	
  projects)	
  addressing	
  OT’s	
  role	
  as	
  mental	
  health	
  
pracAAoners	
  in	
  schools	
  and	
  nearly	
  all	
  cited	
  a	
  need	
  to	
  expand	
  educaAon	
  opportuniAes	
  in	
  this	
  
area.	
  
	
  
Program	
  directors	
  cited	
  school-­‐based	
  mental	
  health	
  as	
  a	
  criAcal	
  role	
  for	
  occupaAonal	
  therapy	
  
and	
  pointed	
  to	
  a	
  need	
  for	
  further	
  research	
  and	
  learning	
  opportuniAes	
  in	
  this	
  area.	
  	
  
ParAcipants	
  expressed	
  a	
  desire	
  to	
  add	
  inter-­‐professional	
  educaAon	
  opportuniAes	
  in	
  school-­‐
based	
  mental	
  health,	
  develop	
  further	
  didacAc	
  coursework	
  specific	
  to	
  school-­‐based	
  pracAce	
  
and	
  pediatric	
  mental	
  health,	
  and	
  expand	
  upon	
  psychosocial	
  fieldwork	
  opportuniAes	
  in	
  
schools.	
  Further,	
  program	
  directors	
  felt	
  a	
  responsibility	
  to	
  help	
  OT	
  students	
  shiG	
  their	
  
paradigms	
  on	
  school-­‐based	
  pracAce,	
  i.e.	
  helping	
  students	
  understand	
  the	
  varied	
  roles	
  of	
  OT	
  
in	
  schools	
  beyond	
  sensorimotor	
  concerns.	
  IdenAfied	
  barriers	
  included	
  linle	
  Ame	
  to	
  address	
  
this	
  topic,	
  limited	
  experAse	
  of	
  faculty	
  members	
  in	
  school-­‐based	
  mental	
  health,	
  and	
  a	
  high	
  
volume	
  of	
  other	
  topics	
  to	
  address	
  to	
  meet	
  pracAce	
  standards.	
  
Discussion	
  
•  School-­‐based	
  mental	
  health	
  conAnues	
  to	
  be	
  a	
  criAcal	
  emerging	
  pracAce	
  area	
  in	
  
occupaAonal	
  therapy.	
  
•  Program	
  directors	
  noted	
  an	
  increased	
  need	
  for	
  mental	
  health	
  training	
  for	
  school-­‐based	
  
pracAAoners	
  
•  OT	
  educators	
  must	
  embed	
  mental	
  health	
  content	
  into	
  pediatric	
  and	
  school	
  based	
  training.	
  
•  Programs	
  must	
  highlight	
  the	
  systemic	
  role	
  of	
  occupaAonal	
  therapists	
  as	
  providers	
  of	
  
mental	
  health	
  promoAon	
  and	
  illness	
  prevenAon	
  services,	
  in	
  addiAon	
  to	
  the	
  individual	
  
intervenAon	
  level.	
  
•  OT	
  educators	
  must	
  prepare	
  students	
  to	
  arAculate	
  OT’s	
  disAnct	
  value	
  as	
  mental	
  health	
  
providers	
  in	
  schools.	
  
ImplicaBons	
  for	
  OT	
  EducaBon	
  
Mental	
  health	
  promoAon,	
  mental	
  illness	
  prevenAon,	
  and	
  intervenAon	
  are	
  criAcal	
  emerging	
  
areas	
  for	
  occupaAonal	
  therapy	
  pracAce	
  in	
  school	
  seongs1.	
  According	
  to	
  research	
  by	
  pediatric	
  
mental	
  health	
  experts	
  in	
  the	
  field,	
  school	
  based	
  occupaAonal	
  therapy	
  pracAAoners	
  in	
  the	
  U.S.	
  
are	
  not	
  consistently	
  and	
  effecAvely	
  addressing	
  the	
  mental	
  health	
  needs	
  of	
  children	
  in	
  today’s	
  
school	
  systems2,	
  3.	
  	
  
	
  
	
  
Entry-­‐level	
  OT	
  pracAAoners	
  working	
  in	
  schools	
  report	
  not	
  feeling	
  prepared	
  to	
  pracAce	
  in	
  an	
  
educaAonal	
  seong,	
  and	
  feel	
  ill-­‐equipped	
  to	
  intervene	
  with	
  children	
  who	
  have	
  mental	
  health	
  
difficulAes4,5	
  .	
  Findings	
  from	
  this	
  and	
  other	
  studies	
  suggest	
  that	
  OT	
  pracAAoners	
  possess	
  
pediatric	
  psychosocial	
  knowledge	
  but	
  struggle	
  to	
  integrate	
  this	
  knowledge	
  into	
  pracAce6.	
  	
  
	
  
Both	
  the	
  American	
  OccupaAonal	
  Therapy	
  AssociaAon	
  (AOTA)	
  Curriculum	
  Blueprint	
  and	
  the	
  
AccreditaAon	
  Council	
  for	
  OccupaAonal	
  Therapy	
  EducaAon	
  (ACOTE)	
  Standards	
  point	
  to	
  mental	
  
health	
  promoAon,	
  mental	
  illness	
  prevenAon,	
  and	
  intervenAon	
  as	
  priority	
  areas	
  for	
  
occupaAonal	
  therapy	
  educaAon7,	
  8;	
  yet	
  there	
  is	
  neither	
  a	
  specific	
  AOTA	
  requirement	
  nor	
  an	
  
ACOTE	
  standard	
  for	
  what	
  an	
  entry	
  level	
  school-­‐based	
  therapist	
  should	
  know	
  before	
  entering	
  
the	
  field.	
  ACOTE	
  standards	
  provide	
  each	
  academic	
  insAtuAon	
  the	
  freedom	
  to	
  design	
  program	
  
content	
  to	
  align	
  with	
  the	
  insAtuAon’s	
  mission	
  and	
  values;	
  therefore,	
  the	
  amount	
  of	
  school-­‐
based	
  and	
  mental	
  health	
  content	
  included	
  in	
  each	
  program’s	
  curriculum	
  may	
  vary.	
  	
  
	
  
Program	
  directors	
  of	
  entry-­‐level	
  Master’s	
  occupaAonal	
  therapy	
  programs	
  in	
  the	
  United	
  States	
  
were	
  surveyed	
  regarding	
  how	
  their	
  program	
  prepares	
  OT	
  students	
  to	
  become	
  competent	
  
mental	
  health	
  pracAAoners	
  in	
  school	
  seongs.	
  
Results	
  
Chart	
  1.	
  Program	
  directors’	
  percepAons	
  of	
  their	
  schools	
  preparaAon	
  of	
  OT	
  students.	
  
Andrea	
  Bilics,	
  PhD,	
  OTR/L,	
  FAOTA	
  
Worcester	
  State	
  University	
  
Email:	
  abilics@worcester.edu	
  
	
  
	
  
Do	
  not	
  copy	
  without	
  permission.	
  
Research	
  QuesBon 	
  	
  
To	
  what	
  extent	
  do	
  entry-­‐level	
  Master’s	
  occupaAonal	
  therapy	
  programs	
  prepare	
  students	
  to	
  
become	
  entry-­‐level	
  pracAAoners	
  in	
  school	
  seongs,	
  with	
  specific	
  regard	
  to	
  therapists’	
  ability	
  
to	
  address	
  mental	
  health	
  concerns	
  in	
  school	
  seongs?	
  
0	
   2	
   4	
   6	
   8	
   10	
   12	
   14	
   16	
  
My	
  program	
  prepares	
  students	
  to	
  
arAculate	
  mental	
  health	
  role	
  of	
  OT	
  
in	
  schools	
  
My	
  program	
  prepares	
  students	
  to	
  
address	
  mental	
  health	
  in	
  schools	
  
My	
  program	
  prepares	
  students	
  for	
  
school	
  based	
  pracAce	
  
Neutral	
  
Agree	
  
Strongly	
  Agree	
  
ParBcipants	
  
For	
  both	
  phases	
  of	
  the	
  study,	
  parAcipants	
  were	
  program	
  directors	
  of	
  ACOTE-­‐accredited	
  
professional	
  (i.e.	
  Master’s)	
  level	
  occupaAonal	
  therapy	
  educaAon	
  programs	
  in	
  the	
  United	
  
States.	
  Program	
  directors’	
  listed	
  responsibiliAes	
  must	
  include	
  teaching	
  and	
  supervision	
  of	
  the	
  
program’s	
  curriculum	
  and	
  other	
  learning	
  opportuniAes.	
  	
  
[School-based mental health is an] Essential part of our roles in school, whether or not
formally stated. Current science clearly links children's mental health to physical health,
development and educational success. The distinction between physical and mental
health is an artificial one and OTs are uniquely prepared to address obstacles to children's
educational participation holistically. – Participant, phase 2	
  
Number	
  of	
  parAcipants	
  

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Preparing occupational therapy students to address clients mental health needs through promotion prevention intervention in school based practice

  • 1. Preparing  OccupaBonal  Therapy  Students  to  Address  Clients’  Mental  Health  Needs  Through   PromoBon,  PrevenBon  &  IntervenBon  in  School-­‐Based  PracBce   Cindy  DeRuiter,  OTD,  OTR/L;  Andrea  Bilics,  PhD,  OTR/L,  FAOTA   University  of  Illinois  at  Chicago,  Worcester  State  University   Cindy  DeRuiter,  OTD,  OTR/L   University  of  Illinois  at  Chicago   Email:  cderuit2@uic.edu       Contact   1.  AccreditaAon  Council  for  OccupaAonal  Therapy  EducaAon  [ACOTE]  (2014).  Standards  and     Interpre,ve  Guide.  Retrieved  from  hnp://www.aota.org/-­‐/media/Corporate/Files/EducaAonCareers/Accredit/Standards/2011-­‐Standards-­‐and-­‐InterpreAve-­‐Guide-­‐August-­‐2013.pdf   2.  Bazyk,  S.  (Ed.).  (2011).  Mental  health  promo,on,  preven,on,  and  interven,on  with  children  and   youth:  A  guiding  framework  for  occupa,onal  therapy.  Bethesda,  MD:  AOTA  Press.   3.  Milliken,  B.E.,  Goodman,  G.,  Bazyk,  S.,  &  Flinn,  S.  (2007).  Establishing  a  case  for     occupaAonal  therapy  in  meeAng  the  needs  of  children  with  grief  issues  in  school-­‐based  seongs.  Occupa,onal  Therapy  in  Mental  Health,  23(7),  75-­‐100.   4.  Brandenburger-­‐Shasby,  S.  (2005).  School-­‐based  pracAce:  Acquiring  the  knowledge  and  skills.     American  Journal  of  Occupa,onal  Therapy,  59,  88–96.   5.  Nielsen,  S.K.  &  Hektner,  J.M.  (2014).  Understanding  the  psychosocial  knowledge  and  aotudes     of  school-­‐based  occupaAonal  therapists.  Journal  of  Occupa,onal  Therapy,  Schools,  &  Early  Interven,on,  7,  136-­‐150.   6.  Beck,  A.J.,  Barnes,  K.J.,  Vogel,  K.A.,  &  Grice,  K.O.  (2006).  The  dilemma  of  psychosocial     occupaAonal  therapy  in  public  schools.  Occupa,onal  Therapy  in  Mental  Health,  22,  1-­‐17.   7.  American  OccupaAonal  Therapy  AssociaAon  [AOTA]  (2014).  Broader  Scope  in  Schools     (Emerging  Niche).  Retrieved  from  hnp://www.aota.org/PracAce/Children-­‐Youth/Emerging-­‐Niche/Broader-­‐Scope-­‐in-­‐Schools.aspx   8.  American  OccupaAonal  Therapy  AssociaAon  [AOTA]  (2009).  Blueprint  for  Entry-­‐Level     Educa,on.  Retrieved  from  hnps://www.aota.org/-­‐/media/Corporate/Files/EducaAonCareers/Educators/Blueprint_FINAL.pdf     References   Directors  of  Entry-­‐level  occupaAonal  therapy  programs  were  asked  how  their  program   prepares  occupaAonal  therapy  students  to  become  competent  mental  health  pracAAoners  in   schools.  Trends  from  survey  results  are  reported  and  used  to  idenAfy  strategies  to  develop   occupaAonal  therapy  students’  capacity  to  address  their  clients’  mental  health  needs  in   schools.   Abstract   Phase  1   Of  169  potenAal  respondents  from  the  AOTA  Program  Directors’  listserv,  19  responded  to  the   survey  by  answering  the  iniAal  consent  quesAon,  though  only  14  completed  the  survey.    All   parAcipants  noted  that  their  programs  required  coursework  addressing  occupaAonal   therapy’s  role  in  schools;  given  a  5-­‐point  Likert  scale,  50%  of  parAcipants  “strongly  agreed”   that  their  program  prepares  OT  students  to  be  effecAve  school-­‐based  pracAAoners,  while   50%  selected  “agree”.       When  asked  whether  their  program  prepares  students  to  address  mental  health  concerns  of   clients  in  school-­‐based  pracAce,  14%  strongly  agreed,  64%  agreed,  and  21%  provided  a   neutral  response.  Programs  were  most  frequently  addressing  mental  health  from    an   intervenAon  standpoint  (43%),  followed  by  mental  health  promoAon  (36%)  and  intervenAon   for  mental  health  issues  (21%).  The  majority  of  parAcipants  (57%)  agreed  that  their  program   prepares  students  to  advocate  for  their  role  as  mental  health  pracAAoners  in  schools,  while   21%  strongly  agreed  and  21%  provided  a  neutral  response.       QualitaAve  data  from  Phase  1  was  coded  and  the  following  themes  were  idenAfied:   •  Programs  are  sufficiently  addressing  OT’s  role  in  school-­‐based  mental  health–  no   need  to  improve   •  Mental  health  in  school  seongs  is  a  weak  link  in  OT  educaAon   •  ParAcipants  idenAfied  a  need  for  more  instrucAon  in  pediatric  mental  health   •  ParAcipants  idenAfied  a  need  to  shiG  paradigms  for  OTs  to  recognize  their  own  role   as  mental  health  pracAAoners  in  schools   •  Time  and  volume  of  content  were  idenAfied  as  perpetual  barriers.   •  ParAcipants  recognized  the  need  for  exploratory  work  in  this  area   Phase  2   Of  18  randomly  selected  programs,  6  program  directors  responded  to  the  survey.  None   provided  learning  arAfacts  for  coursework  in  their  program.   QualitaAve  data  from  Phase  2  was  coded  and  the  following  themes  were  idenAfied:   •  Programs  embed  minimal  mental  health  content  into  pediatric  courses   •  Emerging  topics  in  school-­‐based  mental  health  (bullying,  trauma  care)  may  be   addressed  via  inter-­‐professional  educaAon   •  ParAcipants  idenAfied  psychosocial  fieldwork  placements  as  integral  to  learning  in   this  area   •  Results  from  phase  2  corroborated  phase  1  results   IntroducBon   This  study  was  conducted  in  two  phases:  the  first  phase  uAlized  a  mixed  methods  design   consisAng  of  quanAtaAve  survey  data  from  program  directors,  as  well  as  qualitaAve   responses  to  structured  survey  quesAons.  A  convenience  sample  was  recruited  via  an  email   to  the  AOTA  Program  Directors’  listserv.      In  the  second  phase,  a  random  sample  of  accredited  entry-­‐level  programs,  straAfied  by   Carnegie  ClassificaAon  of  program,  were  selected  for  survey  and  review  of  descripAve  data   gathered  from  available  learning  arAfacts  (e.g.  syllabi,  presentaAons,  and  assignments).  The   authors  aimed  to  sample  10%  of  all  entry  level  programs  in  the  U.S.;  however,  due  to  low   response  rate,  only  4%  of  programs  in  the  United  States  were  sampled.   Methods   OccupaAonal  Therapy  programs  address  the  role  of  school-­‐based  occupaAonal  therapists  but   provide  limited  didacAc  and  experienAal  learning  opportuniAes  addressing  OT’s  role  in   mental  health  promoAon,  mental  illness  prevenAon  and  intervenAon.  Self-­‐assessment  data   from  program  directors  reveals  that  most  feel  they  are  adequately  addressing  mental  health   in  school  based  pracAce;  yet  few  were  able  to  provide  concrete  examples  of  learning   opportuniAes  (lectures,  assignments,  projects)  addressing  OT’s  role  as  mental  health   pracAAoners  in  schools  and  nearly  all  cited  a  need  to  expand  educaAon  opportuniAes  in  this   area.     Program  directors  cited  school-­‐based  mental  health  as  a  criAcal  role  for  occupaAonal  therapy   and  pointed  to  a  need  for  further  research  and  learning  opportuniAes  in  this  area.     ParAcipants  expressed  a  desire  to  add  inter-­‐professional  educaAon  opportuniAes  in  school-­‐ based  mental  health,  develop  further  didacAc  coursework  specific  to  school-­‐based  pracAce   and  pediatric  mental  health,  and  expand  upon  psychosocial  fieldwork  opportuniAes  in   schools.  Further,  program  directors  felt  a  responsibility  to  help  OT  students  shiG  their   paradigms  on  school-­‐based  pracAce,  i.e.  helping  students  understand  the  varied  roles  of  OT   in  schools  beyond  sensorimotor  concerns.  IdenAfied  barriers  included  linle  Ame  to  address   this  topic,  limited  experAse  of  faculty  members  in  school-­‐based  mental  health,  and  a  high   volume  of  other  topics  to  address  to  meet  pracAce  standards.   Discussion   •  School-­‐based  mental  health  conAnues  to  be  a  criAcal  emerging  pracAce  area  in   occupaAonal  therapy.   •  Program  directors  noted  an  increased  need  for  mental  health  training  for  school-­‐based   pracAAoners   •  OT  educators  must  embed  mental  health  content  into  pediatric  and  school  based  training.   •  Programs  must  highlight  the  systemic  role  of  occupaAonal  therapists  as  providers  of   mental  health  promoAon  and  illness  prevenAon  services,  in  addiAon  to  the  individual   intervenAon  level.   •  OT  educators  must  prepare  students  to  arAculate  OT’s  disAnct  value  as  mental  health   providers  in  schools.   ImplicaBons  for  OT  EducaBon   Mental  health  promoAon,  mental  illness  prevenAon,  and  intervenAon  are  criAcal  emerging   areas  for  occupaAonal  therapy  pracAce  in  school  seongs1.  According  to  research  by  pediatric   mental  health  experts  in  the  field,  school  based  occupaAonal  therapy  pracAAoners  in  the  U.S.   are  not  consistently  and  effecAvely  addressing  the  mental  health  needs  of  children  in  today’s   school  systems2,  3.         Entry-­‐level  OT  pracAAoners  working  in  schools  report  not  feeling  prepared  to  pracAce  in  an   educaAonal  seong,  and  feel  ill-­‐equipped  to  intervene  with  children  who  have  mental  health   difficulAes4,5  .  Findings  from  this  and  other  studies  suggest  that  OT  pracAAoners  possess   pediatric  psychosocial  knowledge  but  struggle  to  integrate  this  knowledge  into  pracAce6.       Both  the  American  OccupaAonal  Therapy  AssociaAon  (AOTA)  Curriculum  Blueprint  and  the   AccreditaAon  Council  for  OccupaAonal  Therapy  EducaAon  (ACOTE)  Standards  point  to  mental   health  promoAon,  mental  illness  prevenAon,  and  intervenAon  as  priority  areas  for   occupaAonal  therapy  educaAon7,  8;  yet  there  is  neither  a  specific  AOTA  requirement  nor  an   ACOTE  standard  for  what  an  entry  level  school-­‐based  therapist  should  know  before  entering   the  field.  ACOTE  standards  provide  each  academic  insAtuAon  the  freedom  to  design  program   content  to  align  with  the  insAtuAon’s  mission  and  values;  therefore,  the  amount  of  school-­‐ based  and  mental  health  content  included  in  each  program’s  curriculum  may  vary.       Program  directors  of  entry-­‐level  Master’s  occupaAonal  therapy  programs  in  the  United  States   were  surveyed  regarding  how  their  program  prepares  OT  students  to  become  competent   mental  health  pracAAoners  in  school  seongs.   Results   Chart  1.  Program  directors’  percepAons  of  their  schools  preparaAon  of  OT  students.   Andrea  Bilics,  PhD,  OTR/L,  FAOTA   Worcester  State  University   Email:  abilics@worcester.edu       Do  not  copy  without  permission.   Research  QuesBon     To  what  extent  do  entry-­‐level  Master’s  occupaAonal  therapy  programs  prepare  students  to   become  entry-­‐level  pracAAoners  in  school  seongs,  with  specific  regard  to  therapists’  ability   to  address  mental  health  concerns  in  school  seongs?   0   2   4   6   8   10   12   14   16   My  program  prepares  students  to   arAculate  mental  health  role  of  OT   in  schools   My  program  prepares  students  to   address  mental  health  in  schools   My  program  prepares  students  for   school  based  pracAce   Neutral   Agree   Strongly  Agree   ParBcipants   For  both  phases  of  the  study,  parAcipants  were  program  directors  of  ACOTE-­‐accredited   professional  (i.e.  Master’s)  level  occupaAonal  therapy  educaAon  programs  in  the  United   States.  Program  directors’  listed  responsibiliAes  must  include  teaching  and  supervision  of  the   program’s  curriculum  and  other  learning  opportuniAes.     [School-based mental health is an] Essential part of our roles in school, whether or not formally stated. Current science clearly links children's mental health to physical health, development and educational success. The distinction between physical and mental health is an artificial one and OTs are uniquely prepared to address obstacles to children's educational participation holistically. – Participant, phase 2   Number  of  parAcipants