Generalization of occupational therapy effects in psychiatric rehabilitation.

Psychoeducation procedures dominate the treatment used by occupational therapists in psychiatric rehabilitation. The underlying assumption of skills training is that the skills taught generalize, that is, they persist beyond the treatment session and are used by the client in the community. This paper surveys occupational therapy literature to evaluate the generalization of skills taught to adult psychiatric clients by occupational therapists. Of the 77 studies reviewed, only 13 (17%) mentioned anything related to generalization. Seven of these articles statistically evaluated the outcome of skills training, but only four specifically assessed generalization of therapy. It is concluded that occupational therapists in psychiatry predominantly do not assess generalization of therapy. Discussion focuses on how four classes of generalization strategies (modifying the community environment, modifying the therapy environment, altering the style of therapy, and promoting client involvement) can enhance the effectiveness of occupational therapists in psychiatry.