Annals of International Occupational Therapy

Original Research Supplemental Data

Justice-Based Occupational Therapy Initiative: Advancing Occupational Justice in Criminal Justice Systems

Lisa A. Jaegers, PhD, OTR/L, FAOTA; Crystal Dieleman, PhD, OT Reg(NS); Mary Beth Dillon, OTD, MOT, OTR/L; Sandra Rogers, PhD, OTR/L; Jaime P. Muñoz, PhD, OTR/L, FAOTA; Karen F. Barney, PhD, OTR/L, FAOTA

Abstract

Background:

In 2018, the Justice-Based Occupational Therapy (JBOT) initiative was formed to convene a network of key stakeholders in criminal justice reform. The goals of JBOT are to (1) explore the role of occupational therapy in justice-based practice, teaching, and research, identifying which information is critical for sharing with a wider audience; and (2) disseminate resources to articulate the role of occupational therapy in justice-based practice. The JBOT core team performed a needs assessment by developing key areas of focus through a series of networking meetings of key stakeholders.

Methods:

In 2018 and 2019, JBOT held meetings at national (n = 8) and international (n = 2) conferences to explore needs and determine an action plan. The Participatory Occupational Justice Framework conceptual model, described by Whiteford and colleagues, informed the qualitative process that was used to identify meeting themes and key areas of focus.

Results:

Four areas of focus for the JBOT initiative were identified: (1) advocacy and policy, (2) education, (3) research, and (4) resources.

Conclusion:

The contribution of JBOT is important for advancing occupational justice and occupational therapy practice for individuals who are at risk or are involved in criminal justice systems. The goal of this network is to increase and share resources globally as well as to allow occupational therapists to influence policy, advocacy, education, and research in the areas of justice system reform, occupational justice, and health promotion. [Annals of International Occupational Therapy. 2020;3(4):200–208.]

Abstract

Background:

In 2018, the Justice-Based Occupational Therapy (JBOT) initiative was formed to convene a network of key stakeholders in criminal justice reform. The goals of JBOT are to (1) explore the role of occupational therapy in justice-based practice, teaching, and research, identifying which information is critical for sharing with a wider audience; and (2) disseminate resources to articulate the role of occupational therapy in justice-based practice. The JBOT core team performed a needs assessment by developing key areas of focus through a series of networking meetings of key stakeholders.

Methods:

In 2018 and 2019, JBOT held meetings at national (n = 8) and international (n = 2) conferences to explore needs and determine an action plan. The Participatory Occupational Justice Framework conceptual model, described by Whiteford and colleagues, informed the qualitative process that was used to identify meeting themes and key areas of focus.

Results:

Four areas of focus for the JBOT initiative were identified: (1) advocacy and policy, (2) education, (3) research, and (4) resources.

Conclusion:

The contribution of JBOT is important for advancing occupational justice and occupational therapy practice for individuals who are at risk or are involved in criminal justice systems. The goal of this network is to increase and share resources globally as well as to allow occupational therapists to influence policy, advocacy, education, and research in the areas of justice system reform, occupational justice, and health promotion. [Annals of International Occupational Therapy. 2020;3(4):200–208.]

Occupational justice promotes the belief that individuals have the right to engage in occupations to sustain a healthy quality of life (Durocher, Gibson, & Rappolt, 2014). In the absence of occupational justice lies occupational injustice (Townsend & Wilcock, 2004). Occupational injustices occur during incarceration and among those who are at risk for incarceration (Rabuy & Kopf, 2015). Disparities attributed to race, ethnicity, gender, poverty, a history of child abuse and/or neglect, and drug use are predictors of involvement in the justice system (Jones & Sawyer, 2019a). In the United States, the bail system requires people to pay fees to prevent incarceration (time in jail) before they have a court hearing (Rabuy & Kopf, 2016). Those who are unable to pay or post bail are incarcerated, whereas those who can afford to pay are released. Injustices such as this example of debt disparity are common within U.S. justice systems. Similar housing, employment, and educational disparities are common lived experiences for those involved in the justice system (Muñoz, 2019; White, Dieleman Grass, Ballou Hamilton, & Rogers, 2013).

Also met with scrutiny are occupations that include activities that may be considered culturally unacceptable, deviant, unlawful, or taboo, or that violate rules or societal norms. These occupations have been described as nonsanctioned and are defined as follows: “to encompass occupations that, within historically and culturally bound contexts, tend to be viewed as unhealthy, illegal, immoral, abnormal, undesired, unacceptable, and/or inappropriate” (Kiepek, Beagan, Laliberte Rudman, & Phelan, 2019, p. 2). Nonsanctioned occupations often are associated with individuals who are at risk for or who are experiencing incarceration—spending time in jail, prison, juvenile detention, and/or other confinement.

Globally, justice systems that are used to confine individuals are seeking ways to reform their practices of incarceration and community supervision; however, with few countries demonstrating leadership in best practices (Penal Reform International, 2018), reform is elusive. For example, the United States is known for mass incarceration, with more than 11 million individuals cycling through jails and 1.4 million cycling through prisons each year. In addition, each year, 1 in 55 U.S. adults is held in supervision (probation or parole) (Bureau of Justice Statistics, 2016; Kaeble & Glaze, 2016; Minton & Zeng, 2016). In the United States, one in three people has interacted with the criminal justice system (U.S. Department of Justice, 2014). Although some individual states within the United States have made progress, to date, systemic changes have been insufficient (Jones & Sawyer, 2019b).

Despite widespread exposure to the justice system, few occupational therapy practitioners work within and around justice facilities (e.g., jails, prisons, detention centers, transition facilities), courts, or related community-based services (Muñoz, Moreton, & Sitterly, 2016). Information on the scope of practice, the role of occupational therapy, and the effectiveness of occupational therapy in criminal justice in the United States (Muñoz, Moreton, & Sitterly, 2016), Canada (Chui et al., 2016), Europe (Connell, 2016; Hitch, Hii, & Davey, 2016), and South America (Costa, Rocha, Vieira, & Reis, 2016; Garzón-Sarmiento et al., 2017; Goycolea Martinic et al., 2017) is emerging.

Occupationally based programs operate within U.S. corrections settings, although evidence to describe their outcomes is scarce. Exemplars include the Saint Louis University Transformative Justice Initiative, which has implemented programs for both correctional workplace health and Occupational Therapy Transition and Integration Services. The workplace health program for correctional officers and personnel has provided community-based participatory research in rural and urban jails to inform the development of health promotion interventions (Jaegers, Ahmad, et al., 2020). The Occupational Therapy Transition and Integration Services program has reported process evaluation outcomes to establish feasibility for implementing occupational therapy services for those in jail and after release (Jaegers, Skinner, et al., 2020). At Duquesne University, occupational therapists led the development of the Allegheny County Jail Community Reintegration Project, which is focused primarily on employment skills with individuals in jail and after release (Eggers, Muñoz, Sciulli, & Crist, 2006). Since 2011, faculty and Level II students in the occupational therapy program at the University of Findlay have delivered a 5-week, trauma-informed program at the Hancock County Jail that provides holistic assessment and targets interpersonal, communication, employment, budgeting, and leisure issues as well as resource development and links to community services (Dillon, Dillon, Griffiths, Prusnek, & Tippie, 2020; Kidwell & Tippie, 2016). Faculty and students deliver the Indiana University Occupational Therapy Community Living Skills program at a reentry facility that addresses life skills with men who have been in prison for 10 years or more (Crabtree, Wall, & Ohm, 2016). One of the most long-standing examples of occupational therapy in a justice setting is the San Francisco-based occupational therapy training program that serves juveniles. For decades, occupational therapists have provided occupation-based and client-centered interventions with community-dwelling youth who are at risk for incarceration (Shea & Jackson, 2015). Engaging youth who are in detention in occupational therapy training programs that foster play has helped them to develop functional life skills (Shea & Siu, 2016). Other recent examples of innovative programming in juvenile justice, in diversion courts, in federal prisons, and in programs for elders after release or for people with intellectual and developmental disabilities can be found in this special issue and in recent studies (Ferrazzi, 2019; George-Paschal & Bowen, 2019; Jaegers, Barney, & Aldrich, 2019; Muñoz, 2019).

There is a need for justice-based professionals to tackle the challenges of incarceration and seek preventive solutions. Given the foundations of occupational therapy in mental health and post-war trauma rehabilitation in the early 1900s, it is fitting that occupational therapists revisit the roots of the profession. A recent awakening within the profession regarding the inclusion of all individuals and occupations, sanctioned and nonsanctioned (Kiepek et al., 2019), is part of the discourse to reduce the risk and effects of incarceration.

The Participatory Occupational Justice Framework (POJF) is a model that was developed to address occupational injustices through the facilitation of “recognition, capabilities, opportunity, resources, choice, participation, solidarity, rights, and citizenship,” also known as “social inclusion” (Whiteford, Jones, Rahal, & Suleman, 2018; Whiteford, Townsend, Bryanton, Wicks, & Pereira, 2017). As with other established participatory frameworks, such as community-based participatory research and participatory action research, the POJF uses an enabling process to “raise consciousness of occupational injustice, engage collaboratively with partners, mediate on an agreed plan, strategize how to find resources, support implementation and continuous evaluation, and inspire advocacy for sustainability or closure” (Whiteford et al., 2018, p. 498). This project used the POJF to inform a needs assessment that was conducted through convening Justice-Based Occupational Therapy (JBOT) stakeholders to develop strategic planning. This article summarizes the discussions from those meetings to share the current barriers and identify solutions for advancing the practice and visibility of occupational therapy in justice-based work.

Methods

Forming JBOT

The JBOT initiative was formed as a natural, grassroots effort of a small group of occupational therapy practitioners, educators, and researchers who worked in and around jails and prisons and saw the need for occupation-based interventions in the United States. Knowledge of occupational justice, deprivation, marginalization, and related occupational science concepts historically has appeared to be less common among U.S. occupational therapy practitioners (Hooper, Krishnagiri, Taff, Price, & Bilics, 2016). Since 2008, members of the core group presented their experiences individually, and in 2013, at the American Occupational Therapy Association (AOTA) conference in San Diego, the network began to form. The number of justice-based presentations increased in 2014, and for the first time, a few of the members presented together at the AOTA conference in Baltimore. This team continued the work to improve awareness of justice-based practice by delivering additional presentations at the AOTA conference in 2015. In 2016, at the AOTA conference in Chicago, their presentation, “Creating Opportunities: Building Capacity for Occupational Therapy in the Criminal Justice Setting,” was attended by more than 250 occupational therapy practitioners and students, indicating strong interest. The presenters and six original JBOT core members continued to present information on occupational therapy in a criminal justice context at the AOTA conference in 2017. Later that year, a decision was made to focus the core team's attention on identifying the needs of JBOT practitioners and developing a network to mobilize efforts and facilitate action toward advancing practice. Since then, the core team has grown across the United States and internationally to include 6 new members, for a total of 12 core team members.

Convening JBOT Meetings

In 2018, the JBOT core team began to convene key stake-holder meetings at the AOTA Annual Conference, World Federation of Occupational Therapy Congress, Canadian Association of Occupational Therapy Conference, AOTA Mental Health Specialty Conference, and Conference for the Society of the Study of Occupation. The original goals of these meetings were to (1) convene a network of occupational therapists who were key stakeholders in justice reform; (2) explore the role of occupational therapy in justice-based practice, teaching, and research; and (3) identify the information that is critical for sharing with a wider audience (e.g., people with a history of incarceration, criminal justice professionals, correctional facilities, policy makers, community providers, and interprofessional networks). Meeting attendees were recruited internationally through purposive sampling. Invitations were extended to occupational therapy practitioners and key stakeholders who are actively working in or have intermediate-level knowledge related to justice reform, correctional systems, juvenile justice, incarceration, transition, advocacy, and prevention. An invitation was e-mailed to occupational therapy practitioners and students who were identified by the core team and those who previously expressed interest in justice-based topics. An occupational therapy education e-mail listserv also was used to reach program directors across the United States.

This study used qualitative data collection and thematic analysis (e.g., clustering categories and identifying patterns) (Miles, Huberman, & Saldana, 2014). Meeting logs and attendance sheets were used to document the number and affiliation of attendees and the discussions at each meeting. Meeting activities naturally followed the POJF. Collaborative engagement occurred when occupational therapy practitioners were brought together to share their interests and solve problems strategically. The core team and the attendees participated in mediating a plan of agreement. Before the first meeting, the core team developed an agenda to guide general discussions that evolved based on attendees' interests. Meetings began by describing the history of JBOT and how it addresses occupational injustices. Attendees had the opportunity to introduce themselves and identify their interests, share suggestions for meeting discussion topics, and provide input on the agenda (mediating a plan of agreement). Notes taken during the first eight meetings were summarized and shared through a Google Drive folder with the core team and attendees who were interested in working on JBOT activities. After the first four meetings held at AOTA conferences, between 2018 and 2019, two core team members used a consensus process to code and organize the discussion notes into themes. A third core team member reviewed the summary, and attendees at the next two AOTA meetings obtained feedback for group consensus. Collaborative discussion allowed for further grouping of themes into focus areas. Results were shared at the next four JBOT meetings to obtain feedback and input.

Results

Ten meetings were held (Table A, available in the online version of the article). Eight of these were in the United States, and two were international. Of the 73 unique attendees, 47 attended 1 meeting and 26 averaged 3.5 meetings. Attendance at each meeting ranged from 5 to 21, with an average of 14 attendees per meeting. Attendees included faculty instructors and researchers, directors of occupational therapy education programs, practitioners (including occupational therapists and occupational therapy assistants), and students. Meetings were not official conference events and were held at or near the event site. Identified themes included research, advocacy, funding, media (shareable resources), key stakeholders in justice systems, education, assessments, and interventions. The themes were condensed into the focus areas outlined in Table B (available in the online version of the article). The top four areas of focus that emerged and were agreed on by the meeting attendees included: (1) advocacy and policy, (2) education, (3) research, and (4) resources. For each focus area, concerns and potential solutions are described, along with examples demonstrating how JBOT members actively work within this initiative.

Justice Based Occupational Therapy Meetings Convened in 2018 and 2019

Table A.

Justice Based Occupational Therapy Meetings Convened in 2018 and 2019

Summary of Findings from Justice Based Occupational Therapy Meetings, 2018 2019Summary of Findings from Justice Based Occupational Therapy Meetings, 2018 2019

Table B.

Summary of Findings from Justice Based Occupational Therapy Meetings, 2018 2019

Advocacy and Policy

Concerns. One of the main challenges is the limited knowledge and understanding of occupational therapy in society, a recurring theme at all meetings. Lawmakers, policy makers, and representatives of justice facilities typically are not familiar with occupational therapy. Therefore, practitioners face an uphill battle in becoming key players within the policy-making process and being considered for staff roles. Those who work in criminal justice settings are far more familiar with social workers and case managers than with occupational therapists. As a result, occupational therapists need to demonstrate their distinct value to justice-related professionals in an effort to gain a foothold in the conversation, including consideration of hiring and programming. Further, attendees expressed concern about offering volunteer-only services that may not lead to new positions and roles for practitioners. Discussions were held on the pros and cons of unpaid occupational therapy or occupational therapy assistant student-run services and programs in justice facilities and agencies. Nonfunded services can provide an invaluable educational experience and can educate the facility on the value of occupational therapy; however, providing these services at no cost may devalue them (e.g., volunteer only, not reimbursable or salaried).

Solutions. Informing a wide variety of audiences on the role and scope of occupational therapy as a valuable resource in justice settings and reform work is imperative. Participants in JBOT are using advocacy planning resources, such as Sustainable Development 2015 (2014), to identify target audiences, develop advocacy messages, choose messengers, identify opportunities to deliver messages, and monitor the effect of these messages. Identifying and engaging with key audiences and stakeholders is critical to expanding awareness of the value of occupational therapy. Further, individuals with lived experience (e.g., those who have been incarcerated or who have justice-involved parents, siblings, or children) and those who witnessed the benefits of JBOT may serve as credible messengers of JBOT advocacy. Potential proactive methods include professional organization lobbying for occupational therapy in justice-based services, policy, and funding structures, including drafting letter templates for practitioners and organizations to send to their government representatives. Additional approaches include presenting at local, regional, national, and international conferences to share work experiences and educate audiences about the role and distinct value of occupational therapy for justice reform. For programs that are provided as an educational experience for students at no cost to facilities or agencies, implementers could consider expansion and/or future funding, integration of occupational therapists into existing positions at facilities and agencies, and other avenues to gain long-term, sustainable JBOT programming.

To communicate the distinct value of occupational therapy to a broad criminal justice audience, since 2017, the lead author (L.A.J.) has co-planned an annual research and practitioner symposium that brings together community service providers, justice facility representatives, and professionals from occupational therapy, criminology, law, family and community medicine, spirituality (e.g., Jesuit Mission and Identity, Saint Louis University), social work, and related fields (Health Criminology Research Consortium, 2019). Also in 2017 and 2019, the lead author, in partnership with other universities, correctional, and occupational safety and health partners, held a national conference on correctional worker health, convening members of the Association of State Correctional Administrators, prison representatives, researchers, and multidisciplinary professionals (National Corrections Collaborative, 2017, 2019).

Education

Concerns. Educational programs in occupational therapy typically have limited content on occupational justice, nonsanctioned occupations, social determinants of health for criminalized populations, practice in criminal justice settings, and/or prevention and reduction of incarceration. This challenge was a recurring theme at meetings in Canada, and although the U.S. accreditation standards included occupational injustice concepts between 2011 and 2017, the standards did not require programs to include content on occupational therapy assessment, intervention, or program development to address occupational justice issues (Accreditation Council for Occupational Therapy Education, 2011). The latest standards no longer include occupational injustice, deprivation, or disparity (Accreditation Council for Occupational Therapy Education, 2018); this omission is a source of concern because the international occupational therapy literature on this need has continued to increase (Block, Kasnitz, Nishida, & Pollard, 2015; Sakellariou & Pollard, 2013; Wilcock & Hocking, 2015). Position statements by the World Federation of Occupational Therapy (2012) support the concepts of occupational justice (e.g., occupational deprivation, disruption, and apartheid), and efforts to promote occupational justice continue (Whiteford et al., 2018). Volunteering may not be an optimal way to integrate occupational therapists into correctional settings; however, community service is one method for educating students and building a more informed workforce. Community fieldwork experiences occasionally are used to expose students to the criminal justice system. Some occupational therapy programs include fieldwork experiences in jail and prison facilities; however, members of JBOT believe that an occupational therapy presence needs to be expanded, with salaried occupational therapists working in facilities or university/facility contracts that provide for implementation of occupational therapy services that include fieldwork instruction.

Solutions. Teaching students and practitioners how to evaluate and communicate the value of occupational therapy services in justice settings is critical to gain payment sources and reimbursement for skilled evaluation and intervention. Because typical professional staffing in justice settings includes social work, medicine, and nursing, interprofessional education is needed to allow members of other professions to understand the added benefit of occupational therapy intervention. Additionally, intraprofessional education of the next generation of occupational therapists and occupational therapy assistants is important for increasing the understanding of occupational justice and the potential to address experiences of criminalization into general practice. Practitioners of occupational therapy must consider nonsanctioned occupations within occupational profiles, assessments, interventions, and discharge planning. Since 2012, the second author (C.D.) has taught a graduate seminar each year for entry-to-practice occupational therapy students. The content includes working in secure environments, including prisons, forensic mental health facilities, and correctional halfway houses. A key focus is the ideological tensions inherent in occupational justice work within criminal justice settings. These tensions include custody versus care, punishment versus rehabilitation, retribution versus restoration, and vengeance versus justice. Most students will not go on to work within the formal criminal justice system. However, it is necessary to build an informed and equipped workforce that can safely and effectively address the complex effects of nonsanctioned occupations on the everyday lives of clients, regardless of the practice setting. Since 2013, the second author also has worked to establish fieldwork placements for occupational therapy students in criminal justice settings, such as correctional halfway houses and mental health court programs. These placements allow students to develop skills in addressing the individual, community, and societal effects of nonsanctioned occupations. They also provide benefits beyond student learning and workforce development, including services for individuals who appear in courts and may not otherwise have access to occupational therapy as well as staff at halfway houses and court programs, which often are short staffed and operate with limited funds. Through this process, the occupational therapy profession gains exposure and credibility with a new and influential government-based audience.

Research

Concerns. An evidence base for the effect and outcomes of JBOT practice is forming (Eggers et al., 2006; Jaegers, Skinner, et al., 2020), and the availability of assessment and measurement tools specific to JBOT is limited (Jaegers, Daaleman, et al., 2019).

Solutions. Program evaluation is needed to learn from the implementation process (feasibility) and measure the outcomes (impact). Sharing these results will help others to develop programs and reduce barriers to implementation. Dissemination of the results of evaluation can accelerate the research-to-practice process. The JBOT research goals include: (1) promoting evidence-informed practice (e.g., supporting scholarly activities, determining outcome measures, developing methods for pooling JBOT data, and identifying research funding sources); (2) developing a guide to inform lines of inquiry (e.g., identifying occupational risks to incarceration to inform prevention across the life span and conditions; exploring methods to identify and develop interventions to address nonsanctioned occupations that negatively affect the person or place others at risk; testing new and revised assessments that integrate criminogenic and strengths-based approaches; and testing outcome measures of occupational performance and intermediate indicators of progress); (3) developing shared data sets to consider big data and outcomes within and across legal jurisdictions; and (4) implementing longitudinal studies and randomized controlled trials to test interventions. Research must be disseminated to a wide audience through trade publications (professional audience) and peer-reviewed journals. This special issue on JBOT is a direct outcome of the JBOT strategy to reach out directly to journal editors to encourage publication and provide a support network to inspire members to submit articles for publication.

Resources

Concerns. Limited high-quality resources (e.g., fact sheets, media, and promotional materials) are available on the role of occupational therapy in justice work. Descriptions are needed to communicate the effect of this work in nonsanctioned occupations, occupational justice, and direct justice facilities (e.g., correctional workplace health, forensic mental health, and jail and prison before and after release reentry/transition services). Practitioners need resources to stay informed about efforts toward justice reform in the broader community.

Solutions. The JBOT network is building lists of resources and developing fact sheets and e-resources for sharing. Under consideration is the development of a website resource that acts as a clearinghouse for downloadable information. A preliminary website effort can be found at https://www.justicebasedot.com. Professional organization resources, such as the AOTA's online CommunOT, provide a forum for discussion. Participants in JBOT plan to assist with the development and/or revision of position statements that are updated regularly to reflect new evidence, policy, and scope of practice. The JBOT network is especially interested in developing shareable fact sheets on occupational therapy practice and evidence for outside audiences. In addition, JBOT naturally serves as a peer-to-peer network to allow occupational therapists and students to learn from each other and build mentoring relationships. Social media efforts to connect key stakeholders help to link the global JBOT network and connect occupational therapy with outside audiences.

Discussion

The JBOT core team found that a participatory process such as the POJF was useful for engaging key occupational therapy stakeholders, learning more about the needs of JBOT, and mediating agreement on planning. In the future, to address the identified focus areas, additional components of the POJF, such as raising consciousness about occupational injustice, supporting implementation and continuous evaluation, and inspiring advocacy for sustainability, can be used. This collaborative initiative with an organic process enabled the JBOT core team to develop an evidence-informed plan of focus for future meetings and activities. As a result, JBOT meeting attendees took leadership roles and formed task groups to implement the solutions suggested in Table B. Meetings of JBOT are scheduled for 2020 at the AOTA conference in Boston.

Limitations

Although this qualitative report did not provide an empirical study, it was driven by key informants and used a participatory approach to examine and report the needs of JBOT. The meeting attendees had a range of experience and knowledge of a variety of topics in justice-based research and practice.

Implications

There are opportunities for occupational therapists to assist and become co-leaders in justice reform. This article provided examples of ways to take action across multiple strategies. Additional study is needed to track actions taken as a result of JBOT and evaluate its utility for guiding occupational therapists toward justice-based and informed work. Meetings to convene JBOT practitioners are planned.

The JBOT initiative advances awareness of nonsanctioned occupations and occupational therapy practice for the prevention of incarceration and rehabilitation of individuals who are at risk for or involved in criminal justice systems. The goal of the core group is to expand this network and share resources for occupational therapists to influence policy, advocacy, education, and research on justice reform and health promotion.

Conclusion

This article described the activities that sparked the formation of a collaborative initiative to advance teaching, knowledge, and practice in occupational justice and criminal justice reform. Meeting summaries were reviewed to identify themes across the international network. Although concerns were expressed across each area of focus, a variety of solutions were developed.

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  • Kidwell, R. C. & Tippie, M. J. (2016). Collaboration + local universities = successful jail inmate programming. American Jails, 29(6), 29–34.
  • Kiepek, N. C., Beagan, B., Laliberte Rudman, D. & Phelan, S. (2019). Silences around occupations framed as unhealthy, illegal, and deviant. Journal of Occupational Science, 26(3). doi:10.1080/14427591.2018.1499123 [CrossRef]
  • Miles, M. B., Huberman, A. M. & Saldana, J. (2014). Qualitative data analysis: A methods sourcebook (3rd ed.). Thousand Oaks, CA: Sage.
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  • Muñoz, J. P. (2019). Mental health practice in criminal justice settings. In Brown, C., Stoffel, V. C. & Muñoz, J. P. (Eds.), Occupational therapy in mental health: A vision for the future (2nd ed., pp. 241–254). Philadelphia, PA: F. A. Davis.
  • Muñoz, J. P., Moreton, E. M. & Sitterly, A. M. (2016). The scope of practice of occupational therapy in U.S. criminal justice settings. Occupational Therapy International, 23(3), 241–254. doi:10.1002/oti.1427 [CrossRef] PMID: 27094024
  • National Corrections Collaborative. (2017). National Symposium on Corrections Worker Health. Retrieved from https://www.uml.edu/research/cph-new/symposium-corrections-worker-health.aspx
  • National Corrections Collaborative. (2019). National Symposium on Corrections Worker Health. Retrieved from https://www.uml.edu/research/cph-new/resources/2019-corrections-worker-national-symposium.aspx
  • Penal Reform International. (2018). Global prison trends 2018. Retrieved from https://cdn.penalreform.org/wp-content/uploads/2018/04/PRI_Global-Prison-Trends-2018_EN_WEB.pdf
  • Rabuy, B. & Kopf, D. (2015, July9). Uncovering the pre-incarceration incomes of the imprisoned. Retrieved from https://www.prison-policy.org/reports/income.html
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Justice Based Occupational Therapy Meetings Convened in 2018 and 2019

Meeting Activity
EventLocationDates of EventNumber of MeetingsNumber of AttendeesOrient new membersDefine purpose of JBOTExplore topics of interestIdentify themes / focus areasCreate action plansGather feedback
American Occupational Therapy Association (AOTA) ConferenceSalt Lake City, Utah, U.S.A.April, 20183Average 17, range 11–21xxxx
World Federation of Occupational Therapy (WFOT) CongressCape Town, South AfricaMay, 2018113xxxx
AOTA ConferenceNew Orleans, Louisiana, U.S.A.April, 20193Average 18, range 15–19xxxxxx
Canadian Association of Occupational Therapists (CAOT) ConferenceNiagara Falls, Ontario, CanadaMay, 201915xxx
AOTA Mental Health Specialty Conference 2019Chicago, Illinois, U.S.A.September, 2019110xxx
Conference of the Society for the Study of Occupation (SSO)Scottsdale, Arizona, U.S.A.October, 201917xxx

Summary of Findings from Justice Based Occupational Therapy Meetings, 2018 2019

Area of FocusConcernsPotential SolutionsExamples of Actions
Advocacy and PolicyLimited knowledge of OT in general society and among key stakeholders regarding occupational justice and OT's role in justice reform.Inform a wide variety of audiences on the role and scope of OT as a valuable resource

Utilize advocacy planning resources.

Identify key audiences, stakeholders, and credible messengers.

Seek support from professional organizations to lobby for OT in justice-based services, policy, and funding structures.

Draft and share letter templates for practitioners and organizations to send to their government representatives.

Present JBOT content at non-OT conferences.

With an interprofessional team, Jaegers co-coordinated regional and national conferences:

Health Criminology Research & Practice Symposium that has been held the past 3 years (HCRC, 2019).

National Conference on Correctional Worker Health (NCC, 2017).

EducationGaps exist in education: application of relevant theory and theoretical models, assessment, intervention planning, and program development to address occupational injustice, non-sanctioned occupations, social determinants of health of criminalized populations, practice in justice settings, and/or prevention / reduction of incarceration.

Teaching students and practitioners how to provide skilled services and communicate the value of OT in and around justice settings is critical to gain payment sources and reimbursement or salaries for evaluation and intervention.

Since 2012, Dieleman's seminar for entry-to-practice teaches OT students on working in secure environments including prisons, forensic mental health facilities, and correctional halfway houses.

Students develop their skills in addressing the individual, community, and societal impact of non-sanctioned occupations through role emerging fieldwork placements in criminal justice settings.

ResearchEvidence base for impact and outcomes of JBOT practice is still forming. Availability of assessment and measurement tools specific to JBOT are limited.

Perform systematic review of existing literature to establish what is known.

Utilize program evaluation methods to learn from the implementation process (feasibility) and measure the outcomes (impact).

JBOT research goals include:

Promote evidence-informed practice.

Develop a guide for informing lines of inquiry.

Share datasets to look at bigger data sets and outcomes within and across legal and national jurisdictions.

Implement longitudinal studies and randomized controlled trials for intervention testing.

Disseminate findings to a wide audience.

Nearly all members of the current JBOT core team have published findings from scoping reviews, case studies, program implementation, needs assessment and other exploratory research. A special issue of justice based OT is planned for this journal in 2020 in an effort to advance research on JBOT.
ResourcesLimited, quality resources to share the role of OT in justice work exist.For OT audiences

Share existing resources and develop fact sheets and e-resources through an open access website.

Network using online social media and professional organization resources such as AOTA's online CommunOT.

Create a peer-to-peer network for mentoring and teaching.

For non-OT audiences

Develop and/or revise position statements that are updated regularly to reflect new evidence, policy, and scope of practice.

Develop shareable fact sheets on OT practice abilities and evidence.

Engage in active, quality social media.

Currently there are two main web-based resources that are open access.

https://www.justicebasedot.com/ - The website, Occupational Therapy in the Criminal Justice System, provides a wide variety of information on justice, programs, research, education, and resources. The site is managed by JBOT core team members at Duquesne University.

https://www.slu.edu/mission-identity/initiatives/transformative-justice/jbot.php - This website, Justice- Based Occupational Therapy, offers information about JBOT, core team members, and quarterly newsletters that highlight JBOT programs, students, research, and resources.

Authors

Dr. Jaegers is Assistant Professor, Department of Occupational Science and Occupational Therapy, Doisy College of Health Sciences, Saint Louis University, St. Louis, Missouri. Dr. Dieleman is Assistant Professor, School of Occupational Therapy, Faculty of Health, and Research Scholar, Health Law Institute, Schulich School of Law, Dalhousie University, Halifax, Nova Scotia, Canada. Dr. Dillon is Chair and Associate Professor of Occupational Therapy, Department of Occupational Therapy, University of Findlay, Findlay, Ohio. Dr. Rogers is Program Director, Occupational Therapy Program, Rutgers, the State University of New Jersey, Newark, New Jersey. Dr. Muñoz is Department Chair and Associate Professor, Department of Occupational Therapy, Duquesne University, Pittsburgh, Pennsylvania. Dr. Barney is Professor Emerita, Department of Occupational Science and Occupational Therapy, Doisy College of Health Sciences, Saint Louis University, St. Louis, Missouri.

The authors have no relevant financial relationships to disclose.

The authors thank all of the JBOT meeting attendees and collaborators, including but not limited to Cynthia Ballentine, Brittany Conners, Jeffrey Crabtree, Louise Farnworth, Christine Haworth, Christine Hayes, Halley Read, Chi-Kwan Shea, Erica Skinner, Stacy West-Bruce, Selena Washington, and John White, Jr. They also appreciate the students who have supported JBOT efforts, including Serena Blank, Abigail Catalano, Sabrina Nihsen, and Anna Paskvalich.

Address correspondence to Lisa A. Jaegers, PhD, OTR/L, FAOTA, Assistant Professor, Department of Occupational Science and Occupational Therapy, Doisy College of Health Sciences, Saint Louis University, 3437 Caroline Street, St. Louis, MO 63104; e-mail: Lisa.jaegers@health.slu.edu.

Received: June 06, 2019
Accepted: January 23, 2020
Posted Online: March 13, 2020

10.3928/24761222-20200309-02

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