The Ambiguity of Parenting Adult Children With Substance Use Disorder.

Background. Substance Use Disorder can impede parent-child relationships. The Theory of Ambiguous Loss provides a structure for occupational therapy practitioners in developing interventions to support the parent-child relationship. Purpose. This study explores the roles of parents of adult children diagnosed with Substance Use Disorder in the context of the Theory of Ambiguous Loss. Method. Volunteer participants were recruited from three urban parental support groups. Inclusion criteria were involved in a support group and having an adult child diagnosed with Substance Use Disorder. Eight mothers and one father participated in semi-structured interviews using a phenomenological approach. Themes and structural descriptions were developed. Findings. Five themes were identified: hopeful coping, occupational interference, changes in social constructs and participation, burdenful caregiving and receiving, and blending of occupations. Themes offer intervention considerations for occupational therapy. Implications. Research provides additional conceptual consideration to build occupation-centered interventions for parents and their adult children in Substance Use Disorder recovery.

Adverse childhood experiences and mental health conditions among multiracial adolescents.

OBJECTIVE: The objective of this study was to verify the factor structure of the household dysfunction type of ACE using data from the National Survey of Children's Health (NSCH), and then examine whether household dysfunction (measured as a latent construct) was associated with mental health conditions among multiracial adolescents. DESIGN: We used cross-sectional data collected in 2016 from caregivers who completed the NSCH and analyzed data from a subpopulation of adolescents (12-17) who reported more than one race (n = 1,231). Mplus 8.4 was used to conduct confirmatory factor analysis and probit models from a structural equation modeling framework. RESULTS: Results from this study indicated that the household dysfunction type of ACE, as a latent construct, had good model fit and was significantly associated with depression [standardized coefficient [B] = .50, 95% confidence interval [CI] .36, .65], anxiety [B = .61, 95% CI .48, .73], behavior problems [B = .58, 95% CI .44, .72], and ADHD [B = .54, 95% CI .38, .69] for multiracial adolescents. CONCLUSIONS: Household dysfunction may result in adolescents being separated (physically or emotionally) from their caregivers, which may hinder adolescents' ability to establish or maintain one of the most important relationships needed to promote racial/ethnic identity development and mental health. Implications for advancements in theory and NSCH are presented.

Comparing narrative-informed occupational therapy in adult outpatient mental health to treatment as usual: A quasi-experimental feasibility study with preliminary treatment outcomes.

This paper describes implementation of a narrative-informed occupation-based service in an outpatient community mental health setting that addressed several gaps, including 1) the need for outcome data on occupational therapy in this setting; 2) an ongoing mental health provider shortage; and 3) a need for innovative approaches to supporting mental health. We found a significant improvement from baseline to post-intervention in occupational participation, and dose of occupational therapy was significantly related to improvements in the areas of roles, habits, values, long-term goals, social environment, and readiness for change. This study suggests future, larger effectiveness studies of narrative-informed occupation-based interventions delivered by occupational therapists in outpatient community mental health are warranted.

Receiving Recognition: A Case for Occupational Therapy Practitioners as Mental and Behavioral Health Providers.

IMPORTANCE: An analysis by the Substance Abuse and Mental Health Services Administration (SAMHSA; 2015a) found that an additional 10,000 mental health care providers will be needed by 2025 to meet the expected growth in demand for treatment of people with mental illness, substance use disorder, or both. Despite being the largest payer of mental health services in the United States, the Medicaid program has extremely low numbers of mental health providers (Frank et al., 2003). OBJECTIVE: This Health Policy Perspectives column is a collaboration among academics, clinicians, and students in the fields of occupational therapy and law in an effort to advance state occupational therapy associations' efforts to gain formal recognition of occupational therapy practitioners as Qualified Mental Health Providers (QMHPs) and/or Qualified Behavioral Health Providers (QBHPs). CONCLUSION: Coordination among states to identify barriers and opportunities in this important advocacy effort are needed for continued successful inclusion of occupational therapy practitioners as QMHPs, QBHPs, or both. What This Article Adds: This column will assist other states in their efforts by providing legislation, strategic advocacy examples, and a course of action.