Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Health and Rehabilitation Sciences

Supervisor

Kinsella, Elizabeth Anne

Abstract

Background: Mindfulness has become popular as a treatment approach for many health conditions and has been taken up by diverse health practitioners in recent years. While research into mindfulness-based interventions is on the rise, much of this research originates in the field of psychology and is aimed toward adult populations. Occupational therapists, including those working with children and youth, have begun to take up mindfulness to support their clients to participate in daily activities, and there is evidence that clinical uptake has outpaced research in this area.

Method: A scoping review was undertaken to understand the breadth of literature regarding mindfulness in paediatric occupational therapy. Then a Heideggerian-informed phenomenological methodology was applied understand the practice experiences of eight North American occupational therapists who utilize mindfulness-based approaches in their clinical work with children and youth. Semi-structured interviews and a metaphor elicitation exercise were undertaken with participants

Results: The scoping review revealed 14 articles relevant to the topic. Overall, included articles heavily relied on quantitative methods, with limited representation of qualitative approaches. Within occupational therapy, mindfulness was identified as a health promotion strategy in addition to offering support for children with developmental disabilities and some physical and mental health conditions.

The results of the phenomenological study revealed occupational therapists’ practice-generated knowledge of mindfulness within their practices. Participants linked mindfulness with enhanced participation and the development of healthy habits in their young clients. Further, participants noted that they made adaptations to mindfulness practices and worked to make the practices playful to enhance interest in mindfulness. Participants also observed a shift in their orientation toward clients because of mindfulness, including their own personal practices. Results revealed that participants perceived mindfulness impacting their therapeutic relationships with clients, noting that mindfulness supported them in creating a safe space, being present, authentic, and accepting of clients. Finally, metaphor analysis revealed participants’ perspectives on mindfulness as a tool, a support and exploration, and themselves as guides and gardeners.

Conclusion: This research offers practice-generated knowledge about the contributions of mindfulness to paediatric occupational therapy practice and therapeutic relationships with children. Further it highlights some key areas for future research.

Summary for Lay Audience

Interest in mindfulness has grown in recent years, with popular media touting the benefits of mindfulness for everything from stress to pain. Research into mindfulness has also expanded significantly, with year over year increases in publications observed. The clinical use of mindfulness by health providers to treat a range of physical and mental health conditions is on the rise. In some areas, the clinical application of mindfulness has outpaced the research. This is particularly true in paediatrics and within the profession of occupational therapy.

Occupational therapists are concerned with enhancing their clients’ performance of daily activities, what are known as occupations. Occupations are broadly understood as anything a person wants to do, needs to do, or has to do. Occupational therapists support people with a wide range of physical and/or mental health conditions. In paediatrics, occupational therapists often focus on supporting clients with engagement at school, to participate in play and leisure activities, and to develop skills to care for themselves. Occupational therapists make use of many treatment approaches and strategies to support occupational performance in their clients, and mindfulness has begun to be taken up within the profession. There is limited research to date regarding the utility of mindfulness in occupational therapy practice, the ways in which mindfulness can support client engagement in daily occupations, and how mindfulness is being utilized by clinicians.

In order to gain an understanding of the research evidence regarding mindfulness within paediatric occupational therapy practice, a literature review was undertaken. This revealed a small number of articles with mixed results. Following this literature review, eight North American occupational therapists working with children and youth who employ mindfulness practices with their clients participated in interviews aimed at understanding their experiences and practice-generated knowledge. The results of this work reveal the potential benefits of mindfulness for enhancing participation in daily activity, developing a positive relationship with clients, and highlight a number of areas in need of further study.

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