Practice development efforts impact on mental health rehabilitation: results-based health care implications

Aim: The central aim of this study was to measure the extent of utilization of the Model of Human Occupation (MOHO) according to an existing conceptual framework (Melton et al, 2010) and to examine whether professional development efforts aimed to support the use of this model were associated with a higher degree of incorporation of this model into everyday practice. A secondary aim was to determine whether certain pre-identified contextual and personal variables influenced the use of MOHO in everyday mental health practice. Methods: The authors solicited participation from 429 occupational therapy practitioners from six NHS mental health trusts in England using an online survey method and 262 (61.1%) responded. Findings: A vast majority (92.1%) of the respondents indicated that they used MOHO as a primary treatment approach. Moreover, therapist participation in professional development efforts aimed to increase MOHO use were associated with higher levels of MOHO use, and the extent of MOHO use was associated with positive client (r=0.33, P<0.01), and professional outcomes (r=0.31, P<0.01 and r=0.33, P<0.01). Characteristics of the immediate team context and personal characteristics were linked to the extent of MOHO use among practitioners (r=0.30, P<0.01). Similarly, causal mechanisms that involve MOHO use in building confidence, finding flow, constructing know-how, accumulating reward, conferring with others, and channeling time were also linked with the extent of MOHO use among practitioners (r=0.55, P<0.01). Conclusion: Findings suggest that there may be a significant payoff for professional development efforts that aim to support client-centered, occupation-focused approaches to mental health rehabilitation practice.