The rate of adolescent psychiatric hospitalization has been rapidly increasing alongside shorter lengths of stay and risks for poor continuity of care. While youth are often ready for discharge from a psychiatric hospital, they may be unprepared for re-entry to school. Occupational therapists, with training to promote participation in both school and mental health settings, are well suited to address the needs and barriers associated with adolescent school reintegration. This project is informed by the bioecological model of human development which posits that an individual’s ability to develop and participate in meaningful life activity is shaped by multiple levels of interwoven contexts. The Double ABCX Model posits that there are three characteristics associated with a family’s risk for, and adaptation to a family crisis. These factors are stressors, resources, and perception of stressors. The capstone project included the following objectives: a) gain an advanced knowledge of OT’s role in school reintegration for adolescents who have been recently hospitalized; b) develop a thorough understanding of needs, barriers, supports to school reintegration following hospitalization; c) identify feasible therapeutic supports (i.e., coping strategies, environmental adaptations) for youth to utilize during school routine; d) advocate for the role of occupational therapy in inpatient child and adolescent psychiatric settings; e) generate patient education content for caregivers and youth in order to facilitate transition from psychiatric hospital to school routine. To evaluate the aims listed, a combination of quantitative and qualitative data were collected from a variety of stakeholders.

More adolescents are surviving cancer and being treated outside the hospital-setting, allowing them to return to typical activities of development like attending school. Effective preparation for school re-entry is an important aspect of easing the transition back-to-school following a cancer diagnosis. Previous research has used the terms school re-entry, school re-entry preparation, and school reintegration interchangeably. For the purposes of the current study, school re-entry refers to going back-to-school. School re-entry preparation or interventions refers to the preparatory process implemented for the initial return to school following a cancer diagnosis. Conversely, school reintegration refers to the ongoing or long-term adjustment of the child or adolescent with cancer to the school environment. Research in school re-entry preparation began in the late 1970s, but much is still not well understood about appropriate school re-entry preparation in terms of application, outcome, or the adolescent's needs. The adolescent with cancer's perspective has been grossly neglected in research. Furthermore, current research lacks an operational definition of "successful school re-entry" and knowledge of specific factors associated with positive school re-entry outcomes. Identifying variables that positively impact the school re-entry process is critical to improving and individualizing school re-entry interventions. The current study used an adaption of the Disability-Stress Coping Model (DSC; Wallander & Varni, 1998) to both define school re-entry success and identify potential predictors that may impact school re-entry success. In addition, to obtain a more comprehensive picture of re-entry success, adolescents with cancer rated the success of their back-to-school experiences. The current study asked 85 adolescents with cancer (ages 11 - 19 years) to complete a web-based survey asking about their re-entry experiences and daily functioning. Results provided tentative support for a discrepancy between professional and adolescent re-entry needs/goals. Findings suggest that a subset of adolescents with cancer may be at risk for poor school re-entry/reintegration outcomes, including females, being of lower SES, having certain types of cancer (brain tumors, leukemia), undergoing specific treatments (radiation, chemotherapy), being out of school for longer periods of time, having pre-morbid academic difficulties, and/or having poor social support. Adolescents who demonstrate these risk factors may warrant increased, specialized attention when preparing to return to school. In addition to systemic and within-person factors from the adapted DSC model, findings suggest that developmental characteristics of adolescence must be considered in planning re-entry intervention. Appropriate modifications to school re-entry preparation for adolescents may include utilizing electronic and social media, implementing peer mentors, focusing on reinforcing appropriate social circles, and emphasizing autonomy. More research is needed to understand how to best assist the adolescent with cancer in returning to school.

The purpose of this linear-analytic exploratory case study is to illustrate the reintegration process from acute care and rehabilitative care to the traditional school setting after one has sustained a Traumatic Brain Injury (TBI). TBI is an unrecognized educational challenge. Few educational professionals are aware of the divarication of TBI. Traumatic Brain Injury is the leading cause of death and disability in children and adolescents in the United States. The review of literature reveals there is a void between the requirements of the law and educator preparedness regarding TBI. There is a need for a proactive means to enhance transition and reintegration of a TBI student from rehabilitation to the traditional school setting. The research study showed the schematic efforts of one school division to integrate a TBI student. This exploratory case study emphasized the importance of a proactive education treatment planning process that facilitates the transition to the school setting. The study is qualitative in design and examined the sequence of subtopics of the problem, a review of relevant literature, methods used, findings of the data collected and analyzed, and conclusions and implications from the findings. This case study is analogous to a single experiment. Data were gathered from archival records, educational records, medical records, teachers and therapists comments, friends' perceptions, family histories, recollections, and interviews with participants in the reintegration process. There were three major domains that have been extracted from the case study. The first domain, the strengths and weakness of the student in the post traumatic brain injury environment were collated, collected, and analyzed. The second domain, the adaptation of Larry involved three general sub sets: (1) Larry's self adaptation, (2) the participants' roles in the student's adaptation, and (3) other influential factors in Larry's adaptation. The third domain centers on the strengths and weaknesses of the strategies used by the school division in the reintegration process. The strengths fell into five general categories; (1) caring professional (2) existing structure for disabled students, (3) cooperation, (4) willingness of general education teachers to make accommodations, and (5) willingness of school-based clinicians to try a variety of approaches. The weaknesses consisted of seven categories; (1) little knowledge of TBI, (2) no in-house pro-active plan,(3) no historical data on TBI, (4) no written records, (5) not central structure (scattered resources), (6) no written plan, and (7) no roster teacher/case manager with authority to direct staff with TBI scenario. The study will enhance the understanding of TBI and will provide a meaningful guide to parents, educators, and school based clinicians. The results illustrated that the data base of this study contained the critical pieces of evidence, this evidence was presented neutrally, and the evidence is valid. A holistic overview of the findings included the major domains and data sources that were explored. Additionally, the integrant building blocks that support this holistic overview are provided. In conclusion this case study discusses implications and recommendations. Of note is the reconciliation of this case study with the literature on TBI. / Ed. D.

This study focuses on the sense of self of adolescents when they are reintegrated into schools after dropping out. Dropout is a global phenomenon and yet very little research has been undertaken regarding reintegration and especially the successful reintegration of adolescents and how this reintegration affects their sense of self. The goal of the study was to determine how reintegrated adolescents experience their reintegration into schools, and how this has affected them in terms of how they see themselves. The research hoped to discover what personal difficulties the adolescents had overcome in their return to school as well as the motivating factors that would keep the reintegrated adolescents in school. The research was conducted from a phenomenological Gestalt, field approach and followed a qualitative research design within an interpretivist framework. This research design allows the participants to give meaning to their own experiences. A total of six adolescent boys between the ages of 13 and 17 were purposefully selected from the informal settlement of Groenheuwel, Paarl in the Western Cape. Five of the six adolescents had been reintegrated into schools in 2011 and 2012 by the Khula Development Group. One adolescent participant was a peer educator and although he had never dropped out, he contributed meaningful data on how reintegrated adolescents are experienced as seen from his role as a peer educator. Other participants in the research included the Headmaster of Groenheuwel Primary School and the President and Project leader of the Khula Development Group. The qualitative data were collected in the form of individual open-ended interviews with the adolescents, project leader and headmaster. The researcher’s objective was to understand and interpret the meanings the participants gave to their own experiences, which was further done through observation, member checking, and a reflective group discussion including the application of an art technique. The interviews were recorded on DVD. The reflective group discussion was held with the adolescent participants two weeks after the individual interviews. The group discussion included an art technique, where the adolescents were asked to create their experiences of their return to school in clay. This session was also recorded on DVD. Recordings were transcribed by the researcher to ascertain certain emerging themes and categories. Thematic data analysis was used to transform the transcribed data into meaningful information. The principles and strategies for enhancing the trustworthiness of the data were done through crystallisation. The findings of the study revealed the unrealistic expectations with which the adolescents view their sense of self. / Thesis (MA (Psychology))--North-West University, Potchefstroom Campus, 2013

This study focuses on the sense of self of adolescents when they are reintegrated into schools after dropping out. Dropout is a global phenomenon and yet very little research has been undertaken regarding reintegration and especially the successful reintegration of adolescents and how this reintegration affects their sense of self. The goal of the study was to determine how reintegrated adolescents experience their reintegration into schools, and how this has affected them in terms of how they see themselves. The research hoped to discover what personal difficulties the adolescents had overcome in their return to school as well as the motivating factors that would keep the reintegrated adolescents in school. The research was conducted from a phenomenological Gestalt, field approach and followed a qualitative research design within an interpretivist framework. This research design allows the participants to give meaning to their own experiences. A total of six adolescent boys between the ages of 13 and 17 were purposefully selected from the informal settlement of Groenheuwel, Paarl in the Western Cape. Five of the six adolescents had been reintegrated into schools in 2011 and 2012 by the Khula Development Group. One adolescent participant was a peer educator and although he had never dropped out, he contributed meaningful data on how reintegrated adolescents are experienced as seen from his role as a peer educator. Other participants in the research included the Headmaster of Groenheuwel Primary School and the President and Project leader of the Khula Development Group. The qualitative data were collected in the form of individual open-ended interviews with the adolescents, project leader and headmaster. The researcher’s objective was to understand and interpret the meanings the participants gave to their own experiences, which was further done through observation, member checking, and a reflective group discussion including the application of an art technique. The interviews were recorded on DVD. The reflective group discussion was held with the adolescent participants two weeks after the individual interviews. The group discussion included an art technique, where the adolescents were asked to create their experiences of their return to school in clay. This session was also recorded on DVD. Recordings were transcribed by the researcher to ascertain certain emerging themes and categories. Thematic data analysis was used to transform the transcribed data into meaningful information. The principles and strategies for enhancing the trustworthiness of the data were done through crystallisation. The findings of the study revealed the unrealistic expectations with which the adolescents view their sense of self. / Thesis (MA (Psychology))--North-West University, Potchefstroom Campus, 2013