Since the 1970s, a national effort through federal policies has been implemented to develop secondary transition practices and improve postsecondary outcomes for students with disabilities. Despite the increasing emphasis on enhancing transition programs, transition outcomes for high school students with disabilities continue to be poor, marked by limited access to paid work experience in their communities, limited participation in postsecondary education, and independent living compared to their peers. While multiple factors can impact the effectiveness of program instruction, based on the literature review and the author’s experience, one aspect of the transition program, the implementation of life skills instruction, will be the focus of this project. CoTeaching for Life Skills Instruction is a program that emphasizes a collaborative approach with the school-based occupational therapist and special education teacher that dually serves as an embedded professional development opportunity and instructional practice. The program aims to bridge teacher knowledge gaps and meet the instructional needs of students requiring high support, such as students with intellectual disability, autism, and orthopedic impairment. Through an improved understanding of developmental levels and how cognitive and physical disability can impact task performance, the classroom teacher will develop lesson plans and activities that align with the student’s functional level leading to active rather than passive participation and increased opportunities to meet transition goals. Incorporated in the author’s work is a program evaluation plan to study the effectiveness of the pilot co-teaching approach. Positive results from the program implementation and evaluation can influence the school district to enact a policy that includes occupational therapy services as embedded support within moderate to severe classrooms. Occupational therapy practitioners in a co-teaching capacity provide an opportunity to expand the school-based occupational therapy practitioner’s role as a valued member of the transition planning team while supporting the needs of special education teachers.

Human trafficking has evolved as a heinous crime and a violation of human rights worldwide. The needs of survivors are “complex and often challenging to those who are trying to provide assistance” (Dell et al., 2019, p. 184). In 1962, the World Federation of Occupational Therapy (WFOT) declared human trafficking as an emerging area where the profession can impact, as it is a large form of occupational injustice. However, limited research on occupational therapy involves survivors of human trafficking. Occupational therapists have a distinctive skill set to treat this population as the profession looks at the individual holistically and aims to achieve function. Esperanza is a 12-week program created for survivors of human trafficking. The goals of the program are to increase independence, quality of life, and executive functioning skills in the survivors, decrease the survivors’ lengths of stay at the safe homes, and increase the knowledge of the role of occupational therapy. Esperanza was created because all survivors of human trafficking deserve occupational justice and hope.

In Saudi Arabia, occupational therapy services are not recognized in schools. There is a gap and a need for school-based occupational therapists in Saudi Arabia. Some students in Saudi Arabia are not getting the help they need at schools and that might be one reason behind the poor academic performance and the difficulty succeeding in schools. The lack of OTs in schools negatively impacts students because their problems and difficulties in the areas of motor-planning, sensory integration, muscle tone, and emotional regulation are not going to be addressed. The lack of occupational therapy services in schools in Saudi Arabia is an issue that needs to be addressed. The proposed program is a practical guide for implementing OT services for students in schools in Saudi Arabia to improve the academic performance and to facilitate their learning journey by addressing needs with handwriting, fine motor skills, transitioning from one task to another, lack of self-regulation or emotional regulation, poor attention, disorganization, behavior management issues, social participation, academic issues (reading, writing, math, etc.). This guide will result in initiating the process to add OT services to schools in Saudi Arabia. Implementing an OT school program in Saudi Arabia will be very beneficial to help students overcome difficulties in the school environment.

Traditional health care systems have a long history of marginalizing clients experiencing stress-related conditions with complex symptoms. Stress symptoms fall into the gap between physical or psychological diagnoses from providers who cannot identify their etiology and generate effective treatment plans. Whether stress is a predisposing factor contributing to a health condition or the sequelae of a health event, failure to address its impact on clients’ overall physical, emotional, and cognitive abilities contributes to their decreased function and quality of life. Occupational therapists (OTs) often treat individuals with stress- and anxiety-related conditions. Unfortunately, few studies provide measurable, objective data indicating improvement from evidence-based interventions for this population. Biofeedback and self-regulation, also called psychophysiology, can provide objective data in the form of feedback (e.g., lights, sounds, numbers, or graphs) to demonstrate individuals’ real-time status, improving their self-regulation and sense of control over their stress response. These techniques are used with the model of human occupation (MOHO), a client-centered framework that pairs well with integrative approaches such as biofeedback. The proposed “A Time for Change: Improving Occupational Performance for Clients With Stress-Related Conditions Using Biofeedback and Self-Regulation to Enhance Function in Adult Roles” program is an online education program for OTs using self-regulation and two types of biofeedback (temperature and heart rate variability) as part of an integrative treatment protocol for clients with stress-related conditions. The program includes the Functional Continuum Questionnaire (based on the MOHO), a program protocol, recommendations for a companion workbook, and a postimplementation evaluation plan.

There is a growing need within the primary healthcare setting regarding necessary proactive treatment of productive aging and health literacy strategies amongst the aging population. Elderly individuals diagnosed with many chronic health conditions, or multimorbidity, are at risk for decreased health and well-being, poor quality of life, and decreased ability to age in place. Help Older Adults Live Their Healthiest Life (HEALTH) is a holistic continuing education unit (CEU) educational program with the goal of educating occupational therapy practitioners (OTPs) on productive aging and health literacy topics to implement within the primary care setting. Implementation of HEALTH within the primary care setting will promote improved quality of life and improved health outcomes amongst elderly individuals.

Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable respiratory disease that was the third leading cause of death in 2019, accounting for 3.2 million people globally. An exhaustive literature review indicates that treating COPD is a long, ongoing, multisystem process. Three central factors influencing COPD care and the resulting morbidity, including the heath care service model and access to care, professionals’ knowledge and behaviors, and each patient’s personal factors. Without proper care, shortness of breath and dyspnea progress leading to deterioration in activity tolerance and participation. The COVID-19 pandemic led to suspending or reducing outpatient and primary care services in Hong Kong and worldwide. The resulting restrictions in patient access to care lead to poor COPD management, including deterioration of quality of life, increased frequency of acute conditions, hospital readmission, and mortality. Healthy Living With COPD is a 6-month telehealth-based self-management program for people with COPD. The theoretical basis of Health Living With COPD draws from two main models: the social cognitive theory and the electronic health-enhanced chronic care model. It is designed to empower participants in managing their health and wellness by improving their access to, knowledge in, and self-efficacy for managing their health, wellness, and quality of life. The program has four essential components to generate clinical evidence: Self-management education, supervised health qigong (baduanjin), online health coaching, and virtual community. This doctoral project includes a plan for the target audience, dissemination activities, and budget to magnify the program's visibility and enhance the implementation scale.

Family engagement in occupational therapy (OT) can reduce caregiver burden, improve child skill, participation, or behavior, and increase parental empowerment and quality of life. Although OT practitioners (OTPs) and receiving families recognize the importance of family engagement, participation in the service delivery model remains limited. A thorough literature review reveals three primary barriers to effective family engagement: (a) systemic factors, including insufficient administrative support, limited funding to provide training, current service delivery models and standards, (b) therapist factors, including high caseload demand, limited family engagement training, negative experiences or perceptions on the adopted service delivery model, and (c) family-related barriers including an invitation for involvement, time and energy, reported level of knowledge and confidence, and life context. The Engaged Family program was developed to mitigate these barriers necessary to improve family engagement in OT services. This is a theory-driven, evidence-based, and web-based program for families of children receiving pediatric OT. The Engaged Family will directly serve the guardians and caregivers of children aged birth to 18, receiving OT services in any pediatric setting for any diagnosis. The program aims to engage and empower families through prioritization of families' need for information, skill development, and connection to support the health and wellness of families and children. Sample topics include understanding their child's diagnosis, communicating with their child's healthcare team, and advocating for their child. The website also consists of The Family Academy: monthly online family workshops which provide education and support through virtual conferencing. The website and family workshop topics will be based on family-identified needs. The website will offer free content and resources and allow the option to purchase a three-month subscription service to receive more targeted information. While educational websites currently exist, they may be challenging to navigate and discern the level of evidence supporting the information and resources. For this reason, The Engaged Family was developed using motivational, learning, and family-centered models. Evidence regarding the Hoover-Dempsey and Sandler model of parent involvement, Ryan and Deci's self-determination theory, and Malcolm Knowles' adult learning theory informed the content and structure provided, as well as King's framework showing a continuum of family-oriented services. The program evaluation includes constant connection with the participants to assess their needs and how they are met. Content is designed according to the participant families' prioritization of needs gathered from the Occupational Therapy Family Profile. Pre-post participation changes will be captured using the Efficacy to Connect subscales of the Parent Empowerment and Efficacy Measure (PEEM), participant surveys, and individual interviews. The Engaged Family program and the program evaluation findings will be disseminated among families of children receiving OT services and OTPs in the United States. The author hopes that The Engaged Family will foster family engagement in pediatric OT services by guiding families in the skills and confidence needed to improve participating family’s and child’s health and well-being.

Burnout is widespread among mental health clinicians, including Occupational Therapists (Morse et al., 2012; Scalan & Hazelton, 2019). Newer mental health clinicians tend to be at higher risk of burnout than experienced clinicians (McCombie & Antanavage, 2017). This risk of burnout has been heightened during the recent COVID-19 pandemic, as demands for mental health services in Canada have increased and healthcare staffing shortages have reached critical levels (Statistics Canada, 2022a; Statistics Canada 2022b). There are multiple factors that contribute to increased burnout for mental health OTs, including the demands of the job, nature of the work, lack of rewards, limited opportunities for training, resource shortages and decreased professional identity/discipline-specific supports (Abendstern et al., 2017; Devery et al., 2018; Gupta et al., 2012; Lloyd et al., 2005; Scanlan & Still, 2013). Burnout prevention literature, though limited, indicates that a multi-pronged approach can be helpful (Morse et al., 2012). The New Hire Support Program for Mental Health OTs provides a multi-intervention approach to help reduce burnout risk and bolster professional resilience for OTs who are new to mental health. This supportive, comprehensive program involves three evidence-based components: i) a resource support toolkit; ii) professional development and self-care plans; iii) a mentorship program. This program is positioned to not only directly address the issue of burnout and resilience for mental health OTs, but is also projected to have an important impact on retention rates and patient care. It will also add to a limited body of existing literature focused on clinician burnout prevention.

The loss of identity is felt by many collegiate student athletes transitioning out of the sports arena and into life after sport. Per the NCAA, in the United States about eight million high school students participate in sports and more than 480,000 transition into competing at the collegiate level (NCAA, 2020). A small amount of athlete's transition to the professional level from each sport (NCAA, 2020). Miller and Buttell (2018) report, 2% of collegiate athletes will transition into professional sports leaving 98% of collegiate athletes transitioning into retirement. Due to the small number of athletes transitioning to the professional level, that leaves a large population of student athletes without a structured plan moving forward into new occupations. Much of the literature notes that there has been little research completed and program implementation regarding student athlete retirement and encourages the need for future research to be completed. Smoot & Martella (2017) note that occupational therapy practitioners have the tool set to assist the student athletes transitioning out of their sports careers. Occupational therapy uses a holistic approach to their clients including the mental health setting, therefore, can be an instrumental partner in addressing the loss of identity in athletes. AthleteID is an educational program created by an occupational therapist to aid in addressing the loss of identity in student athletes who are transitioning out of the sports arena and into new, meaningful occupations. AthleteID is designed to collaborate with Augusta University’s athletic department and occupational therapy department to optimally facilitate the program. The educational program consists of five modules that can be completed on-line or in-person depending on the student athletes preferred learning style. The module's content includes how the student athlete identifies themselves in their current occupations, personal interests, work-life balance, transferable skills, goal-setting skills, future planning, and career skills. The intended outcome of this project is to prepare student athletes for their transition out of the athletic arena and into retirement.

Caregivers’ involvement in therapy is integral to the child’s engagement in therapy and their occupational performance outcomes (D’Arrigo et al., 2020b). Access to cost-effective, culturally relevant educational programs for caregivers of children with disability, who are oftentimes burdened with anxiety and stress due to society’s stigma, are limited in low-income and -resource settings like rural India (Angelin et al., 2021). Also compounding the problem are caregiver personal factors, environmental and contextual factors, and health care system factors (Brassart et al., 2017; Vadivelan et al., 2020). Caregiver Resilience Education (Ca.R.E.) is a group-based program comprising five modules that include approaches such as role-modeling, coaching, group discussions, collaborative goal-setting, and therapist modeling. The Ca.R.E. program culminates in the demonstration and formation of a caregiver support group to be facilitated by an occupational therapy practitioner. The mission of the Ca.R.E. program is to improve caregiver engagement and self-efficacy. Through the Ca.R.E. program, the author envisions empowered caregivers coming together to advocate for their children and themselves to combat occupational injustice in a community with the odds stacked against them.