Graduation Year


Document Type


Degree Type

Open Access Capstone

Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy


Background: Due to numerous changes in reimbursement, healthcare delivery and the field of occupational therapy in recent years, the health care arena is now driven by efforts to improve the quality and cost effectiveness of interventions. Therapists, specifically, are challenged by multiple factors, particularly cost-containment, that influences their ability to deliver occupational therapy services. However, in an attempt to promote best practice, occupational therapists must incorporate occupation-based interventions into daily treatment in all practice settings. Occupation-based activities are defined as activities that allow clients to engage in valued occupations in their own context (Rogers, 2007).

Purpose: This program development model was designed (1) to explore the perceptions, ideas, and incorporation of occupation-based treatment approaches for Occupational therapy practitioners working in a skilled nursing facility, (2) to increase the use of evidence-based research into practice and increase the implementation of occupation-based interventions in a skilled nursing facility, (3) demonstrate increased awareness of resource/techniques for implementing OBP in SNF’s.

Theoretical Framework/Scientific Underpinnings: Constructivist Paradigm and Person, Environment, Occupation (PEO) Model.

Methods: Pretest/Post test design with a constant comparative method

Results: Based on key findings in this study, lack of education regarding the role of Occupational Therapy among nursing, certified nursing assistants and administration was the greatest barrier to implementing occupation based practice. It was also determined that environmental constraints such as lack of space and supplies were a barrier to providing OBP in SNF. Other barriers and challenges were discussed, such as, funding for supplies, the amount of time it takes to set up OBP interventions and ongoing support from administrators and managers as well as productivity standards. Despite the barriers and challenges mentioned, participants in this study are in fact implementing OBP interventions. Lastly, as a result of this program participants reported they felt more confident in their ability to advocate for the profession and for the use of OBP. Participants also reported they had received new strategies and techniques to increase their ability to implement OBP.

Conclusion: The results of this project offers new insight and implications for future practice in regards to OBP, and challenge the perception that productivity is the greatest barrier to OBP. Based on the results of this project, it is apparent that more interdisciplinary training regarding the role of occupational therapy is essential to minimize the reported lack of knowledge among other professionals. It was noted during this study that other professionals did not understand the role and unique skill set of occupational therapy practitioners therefore, advocacy is essential. Lastly, the results of this project support the move toward doctoral level education for occupational therapy practitioners.

Faculty Mentor

Shirley P. O'Brien

Department Affiliation

Occupational Science and Occupational Therapy

Committee Member

Renee Causey-Upton

Department Affiliation

Occupational Science and Occupational Therapy

Committee Member

Wanju Huang

Department Affiliation

Justice Studies

IRB Approval Number (if applicable)