Annals of International Occupational Therapy

Guest Editorial Free

Toward a Critical Mass: Justice-Based Occupational Therapy

Jaime P. Muñoz, PhD, OTR/L, FAOTA

In most nations, the role of the criminal justice system is to protect society, prevent a criminal from repeating crime, and punish a person for their behavior. Rehabilitation is often a secondary goal (Beckett, 2018). Few nations can boast that their criminal justice system substantially reduces crime, justly upholds the rule of law, or meets the needs of victim and perpetrator (Vogler, 2017). Incarceration is particularly ineffective as a method of rehabilitation (Dunrose et al., 2014). It often has a negative effect on a person's future employability, destabilizes families, and can devastate communities (Alexander, 2010). Incarceration, probation, and parole all restrict occupation. Specific restrictions can include limits on freedom of association, freedom to move from place to place, freedom to vote, and eligibility for certain housing, employment, or educational opportunities (Drucker, 2018). Should the primary purpose of a nation's justice system be to offer a person clear opportunities for treatment and rehabilitation?

This special issue reflects occupational therapy's growing expertise in addressing the multiple and complex challenges in criminal justice systems. In these settings, occupational therapy is growing steadily toward a critical mass of practitioners and researchers who can facilitate the change needed in criminal justice systems. Collectively, the authors in this special issue believe that occupational therapy is positioned to take a transformative role in creating change. Now is the time to redouble our efforts in this practice arena and ask several questions: What is next? What will be the standard for evaluating whether occupational therapy is having an impact in criminal justice? Can we help replace justice-based systems that too often focus on punishment with systems that focus on rehabilitation? How can we market occupational therapy as a valued alternative to imprisonment and create the evidence that demonstrates that occupational therapy has a consistently positive impact on the person, the community, and public safety? More broadly, if mass incarceration is a public health problem, then what is occupational therapy's role in prevention? In what ways do we direct our efforts to ensure occupational justice in communities most impacted by crime?

The five articles in this special issue reflect the growing sophistication of the collaboration and research efforts by occupational therapists in justice-based settings. Muñoz, Catalano, Wang, and Phillips provide a broad review of the literature that describes occupational therapy practices and processes in these settings. They categorize the literature in an effort to inform and encourage others to grow occupational therapy practice in this arena. Stelter and Evetts model the way for developing an evidence base. They used occupational adaptation theory to design and evaluate a program for women with intellectual and developmental disabilities incarcerated in a prison. This program resulted in sustained improvements in occupational performance and participation after a 12-week intervention. Dillon and colleagues provide a detailed overview of a life skills program designed for men and women incarcerated in a U.S. jail that has been sustained for nearly a decade. This hands-on community reintegration program, grounded in concepts from the Model of Human Occupation and the Kawa model, reflects occupational therapy's distinct value in a jail setting. Washington, Jaegers, and Katz examine the self-reported vocational aspirations and interests of women who were incarcerated in prison and their barriers to community reentry. In addition to challenges related to stigma, these women, most of whom were mothers, expressed anxiety and apprehension about overcoming these barriers and managing work and the demands and stressors of everyday life. Finally, Jaegers and colleagues use the Participatory Occupational Justice Framework to qualitatively analyze meeting summaries of a growing international network called the Justice-Based Occupational Therapy (JBOT) initiative. They inspire a shared vision of what could be by describing the goals and activities of this network. The JBOT initiative was formed to enhance the capacities of occupational therapists to influence criminal justice policy, advocate for transformative change, contribute to occupational therapy education, and engage in collaborative research that helps to bring about justice system reform, occupational justice, and health promotion. Because of page limitations, a sixth article will appear in the January 2021 issue. This case study by Koenig introduces a paradigm that was developed and used to create a viable Level II fieldwork program in a juvenile detention center. Elements of this paradigm can be used by occupational therapy professionals and occupational therapy entrepreneurs to establish sustainable Level II fieldwork programs in juvenile detention facilities or other emerging practice settings that address the psychosocial, health, and wellness needs of children and adolescents. Together, these articles constitute evidence that we are building a critical mass that can bring an occupational perspective to rehabilitation in justice-based settings.


  • Alexander, M. (2010). The new Jim Crow: Mass incarceration in the age of colorblindness. The New Press.
  • Beckett, K. (2018). The politics, promise and peril of criminal justice reform in the context of mass incarceration. Annual Review of Criminology, 1(1), 235–259 doi:10.1146/annurev-criminol-032317-092458 [CrossRef]
  • Drucker, E. (2018). Decarcerating America: From mass punishment to public health. The New Press.
  • Dunrose, M. R., Cooper, A. D. & Snyder, H. N. (2014, April). Recidivism of prisoners released in 30 states in 200: Patterns from 2005 to 2010.Bureau of Justice Statistics.
  • Vogler, R. (2017). A world view of criminal justice. Routledge Taylor and Francis Group doi:10.4324/9781315263557 [CrossRef]

Dr. Muñoz is Department Chair and Associate Professor, Department of Occupational Therapy, Duquesne University, Pittsburgh, Pennsylvania.

The author has no relevant financial relationships to disclose.

Address correspondence to Jaime P. Muñoz, PhD, OTR/L, FAOTA, Department Chair and Associate Professor, Department of Occupational Therapy, Duquesne University, 600 Forbes Avenue, Room 211, Pittsburgh, PA 15282; e-mail:


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