Download Pacific University Recommended Therapeutic Competencies in OT

Pacific University
Recommended Therapeutic Competencies in OT within Criminal Justice Settings
(from Cara & McRae, 2013).
Therapeutic competencies are the skills that are essential and will support occupational therapy
practitioners working in a correctional institution and include knowledge of the criminal justice
setting in which they work, risk assessment (i.e., risk perception and interpretation, fundamental
information, risk behaviors, and occupations), and environmental modifications that are possible
within a restricted setting. Knowledge of the current models of practice in occupational therapy
and knowledge of occupational science concepts (e.g., occupational justice, occupational
alienation, occupational imbalance, and occupational enrichment) support the practitioner in
developing client-centered and occupation-based interventions that are rich and meaningful even
within a restricted environment. Other skills include knowledge of risk assessment, appropriate
assessment tools, and interviewing techniques. Practitioners will be able to provide patient care
in the forensic setting that is compassionate, appropriate, and effective for the treatment of
psychiatric disorders. Additionally, practitioners need to demonstrate an awareness of and
responsiveness to the larger context and system of health care and the ability to effectively call
on system resources that are of optimal value.
Risk Assessment and Environmental Assessment
The process of choosing an assessment is based on a variety of factors: needs (condition and
goals), setting, and the model of practice used are typically important aspects. An occupational
therapist views every client through a lens of what they need to do, want to do, are expected to
do, or a combination of one or more of these. Specifically, therapists ought to have the following
skills.
1. Demonstrate the ability to perform and document a comprehensive forensic history and
examination of a forensic patient in a forensic setting, including obtaining or conducting
the following assessments, which are particularly relevant to this population:

A violence risk assessment.

A suicide risk assessment

An assessment of malingering. (Note: it is incumbent on the client-centered
practitioner to examine the motivations for malingering and address the underlying
issues when possible to improve occupational performance For example, what
secondary benefits does the client gain from exhibiting symptoms and how can the
therapist assist the client to progress in more productive ways?)
2. Demonstrate the ability to develop and implement an appropriate treatment plan in a
correctional or forensic psychiatric setting that considers the environment. Awareness of
the special clinical and legal considerations in a forensic setting includes:

Safety and security measures

Levels of care and therapeutic privilege

Collecting necessary historical and current information for the development of an
appropriate treatment plan in a forensic setting, including sexual history when
appropriate

Use of appropriate pharmacotherapy in a forensic setting

Use of appropriate psychotherapies in a forensic setting
3. Demonstrate knowledge and application of the relevant legal standard(s) and
development of a rational and logical forensic opinion regarding current and predicted
levels of judgment and safety related to occupational performance.