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TITLE: Effectiveness of Occupational Therapy Interventions to Enhance Occupational Performance for Survivors of Domestic Abuse: A Systematic Review
PURPOSE: An average of 20 people per minute experience domestic abuse in the United States (Black et al., 2011). People who experience abuse have poor physical and mental health outcomes which can include depressive symptoms, substance use, developing chronic disease, chronic mental illness, and injury (Coker et al., 2002). Occupational practitioners are equipped to address this issue because they have specific training on life skills, lifestyle management, adaptive coping strategies, time management, and personal values, which can help minimize the negative health outcomes that are derived from abuse (Javaherian et al., 2007). The purpose of this systematic review was to investigate the effectiveness of occupational therapy intervention for improving occupational performance for survivors of domestic abuse.
DESIGN: With assistance from a medical librarian, we conducted a systematic review utilizing MEDLINE, CINAHL, and PsycINFO online databases. Articles were included if they were published between the years 1972 and 2023, written in English, full-text articles in peer-reviewed journals, and if they incorporated occupational therapy-related interventions in relation to domestic abuse, child abuse and neglect, elder abuse, and intimate partner violence.
METHOD: We reviewed 188 titles and abstracts, of which 18 full-text articles were retrieved for review and 10 met inclusion criteria. The U.S. Preventative Services Task Force level of certainty and grade definitions were used to describe the strength of evidence.
RESULTS: We first categorized articles into three themes: health management, vocational interventions, and person-centered/holistic interventions. Interventions addressing health management had moderate strength of evidence from two level 2b studies and two level 3b studies. Vocational intervention had moderate strength of evidence from two level 3b and 3 qualitative studies to improve occupational performance for survivors of domestic abuse. Interventions addressing person-centered/holistic interventions had low strength of evidence from 3 qualitative articles to improve occupational performance for survivors of domestic abuse.
CONCLUSION: When working with survivors of domestic abuse, occupational therapy practitioners may routinely offer and provide interventions on vocational skills and health management to enhance occupational performance. Occupational therapy practitioners may consider providing person-centered/holistic interventions on a case-by-case basis. Occupational therapy literature related to survivors of domestic abuse is somewhat limited; future research should continue to address intervention effectiveness for this marginalized population, and could address the ideal frequency, duration, and specialty intervention within the scope of occupational therapy that would benefit this population.
Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., Chen, J., & Stevens, M. R. (2011). National intimate partner and sexual violence survey: 2010 Summary Report. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. https://www.cdc.gov/violenceprevention/pdf/nisvs_report2010-a.pdf
Coker, A. L., Davis, K. E., Arias, I., Desai, S., Sanderson, M., Brandt, H. M., & Smith, P. H. (2002). Physical and mental health effects of intimate partner violence for men and women. American Journal of Preventive Medicine, 23(4), 260-268. https://www.sciencedirect.com/science/article/pii/S0749379702005147#aep-section-id16
Javaherian, H. A., Underwood ,R.T., DeLany, J.V. (2007) Occupational therapy services for individuals who have experienced domestic violence (statement). The American Journal of Occupational Therapy 61(6):704-709. doi:10.5014/ajot.61.6.704
Post, Mackenzie R.; Hohensee, Aubrianna; Fisher, Taylor; and Malashock, Amanda, "Effectiveness of Occupational Therapy Interventions to Enhance Occupational Performance for Survivors of Domestic Abuse: A Systematic Review" (2023). Student Systematic Reviews: Occupational Therapy. 8.