DOING IN MENTAL-HEALTH PRACTICE - THERAPISTS BELIEFS ABOUT WHY IT WORKS

Objective. The purpose of this study war to explore the beliefs of occ upational therapists working in mental health regarding the therapeuti c value of ''doing'' as a treatment modality. Doing was defined as any activity or action-oriented approach that was identified and used by the participating therapists. Method. Eleven occupational therapists w orking in a variety of mental health areas were observed as they condu cted 3 to 6 regularly scheduled therapy sessions. They were then inter viewed about their activity-related belief. Audiotapes of the 44 treat ment sessions and 11 interviews were transcribed and then coded to ide ntify emergent themes and categories of beliefs about activity. Result s. Participants used a variety of activities in both task-based and ve rbally based treatment sessions. Multiple reasons for activity use wer e cited, particularly in relation to the task-based sessions. Two main themes related to the value of activity were (a) benefits of activity for the client and (b) benefits in facilitating the process of therap y Categories of client-related benefits included skill development; im pairment reduction; self-awareness; positive self-concept; interaction or connection with others; healthy, balanced routines; pleasure; and enhancement of occupational role performance. Perceived effects on the therapeutic process included creating a therapeutic context, enhancin g client readiness, facilitating communication, and providing an organ izing framework. Conclusion. Occupational therapists working in mental health hold diverse beliefs about the value of doing in treatment. Ba sing practice on clearly identified and evidence-based beliefs will as sist in ensuring a viable and valued future for the profession in this important domain of health services.