The effectiveness of occupational therapy in enabling adults with a diagnosis of depression to improve their function and meaningful participation; a mixed methods study

Background: Depression is a leading cause of disability and is characterised by a loss of interest inactivities as well as difficulty carrying out everyday activities. Occupational therapy aimsto enable people to participate in the daily activities they want or need to do to improvehealth and well-being, however there is a limited evidence base relating to theeffectiveness and impact of occupational therapy in depression.PurposeThis mixed-methods study aimed to (a) evaluate the effectiveness of individualisedoccupational therapy in enabling individuals with a diagnosis of depression to improvetheir occupational functioning and participation in everyday activities and (b), identifythe most effective components of occupational therapy from the perspective of serviceusers.Method: A single group pretest-posttest study design was used utilising the following outcomemeasures: Canadian Occupational Performance Measure (COPM), Beck DepressionInventory II (BDI II), Work and Social Adjustment Scale (WSAS), Utrecht Scale forEvaluation of Rehabilitation-Participation (User-P) and the Short Form-36 Health Survey(SF-36). Semi-structured interviews were undertaken at completion of the intervention.Methods of data analysis included correlations, paired t tests and descriptive statisticsfor the quantitative data, and thematic analysis for the interview data.FindingsQuantitative findings show statistically significant improvements in the COPM-P, COPMS, BDI II, WSAS, two scales of the USER-P and three scales of the SF-36 outcome measure.In addition, correlation analysis suggested a tendency for those participants who hadmore occupational therapy to have better outcomes suggesting preliminary indicationof a ‘dose-response’ relationship relating to the amount of occupational therapy peoplereceive