| 1. |
- Eklund, Mona, et al.
(författare)
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Satisfaction with Daily Occupations : Construct validity and test-retest reliability of a screening tool for people with mental disorders
- 2007
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Ingår i: Australian Occupational Therapy Journal. - : Wiley. - 0045-0766 .- 1440-1630. ; 54:1, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aim: In occupational therapy research and in clinical practice there is a need for valid, reliable and easily administered measures. For research and screening purposes, the Satisfaction with Daily Occupations (SDO) instrument was developed. It addresses work, leisure, domestic tasks and self-care and generates a satisfaction and an activity level score. This study investigated its construct validity, internal consistency and test–retest reliability in 55 clients visiting occupational therapists in outpatient mental health care. Methods: The SDO was administered on two occasions with a 1-week interval, and data on the Canadian Occupational Performance Measure (COPM), psychosocial functioning and self-rated health were collected on the first of these occasions. Results: In contrast to what was expected, the relationships between the SDO scores and the COPM scores were low. The strongest relationship between the SDO satisfaction score and any other variable was to psychosocial functioning. These variables shared 23% of the variance. Internal consistency for the satisfaction score was acceptable, alpha = 0.75 on the second occasion, and the test–retest reliability was good; rs = 0.84 for the satisfaction score and rs = 0.92 for the activity level. Conclusions: The results indicated that the SDO has satisfactory reliability. The instrument targets a specific construct, as compared to the COPM and the measurements of self-rated health and psychosocial functioning. Thus, the SDO and the COPM satisfaction scale seem to assess different phenomena, probably because the SDO has predefined items, not specifically targeting a certain client's problematic occupations, whereas the COPM is based on self-defined problems. The instruments may therefore supplement each other.
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| 2. |
- Gunnarsson, A Birgitta, 1958, et al.
(författare)
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A study protocol of the photo-supported conversations about the well-being intervention (Be Well (TM)) for people with stress related disorders
- 2021
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Ingår i: Bmc Psychology. - : Springer Science and Business Media LLC. - 2050-7283. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stress-related illnesses constitute a huge problem in society. The primary care services in Sweden form the first line of care whose role is to coordinate interventions for reducing symptoms, as well as health-promoting interventions. There is lack of knowledge concerning health-promoting interventions for these illnesses. The aim of this study is to evaluate whether photo-supported conversations about well-being (Be Well (TM)) as an intervention, in addition to care as usual within the primary care services, improves health and well-being for patients with stress-related illnesses. The intervention will be compared to a control group, who receive care as usual. A further aim is to conduct a process evaluation. Methods/Design: This ongoing project has a quasi-experimental design, using quantitative and qualitative methods, and includes patients from primary care centres in two Swedish counties. Seventy patients, 20-67 years, with stress-related illnesses will be recruited. They constitute an intervention group, which receive the intervention together with care as usual, and a control group, which receive care as usual. The intervention, photo-supported conversations about well-being, involves 12 sessions. Care as usual entails medication, occupational therapy, physiotherapy and/or psychotherapy. Data collection is carried out at baseline, and outcomes are assessed directly after the intervention, as well as six months after completion of the intervention. The outcomes are evaluated based on factors related to health, well-being and everyday occupations. Furthermore, data concerning experiences of well-being and perceptions of the intervention will be collected in interviews. The therapists will also be interviewed about their experiences of performing the intervention. Data will be analysed with non-parametric statistics, and qualitative methodology. Discussion: The project is based on the concept that focusing on well-being despite living with stress-related illness may positively impact health and well-being as well as activity-related aspects, and that photo-supported conversations about well-being can contribute a complement to other treatment and rehabilitation. A strength is the use of a wide range of methods: such as quantitative measures, photographs, and qualitative interviews with participants and therapists. The results will thus provide knowledge about potential effects of this health-promoting intervention.
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| 3. |
- Gunnarsson, Anna Birgitta, 1958-, et al.
(författare)
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Client perceptions of the Tree Theme Method™ : a structured intervention based on storytelling and creative activities
- 2010
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 17:3, s. 200-208
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Tidskriftsartikel (refereegranskat)abstract
- The Tree Theme Method (TTM) is an intervention based on sessions involving creative activities and life storytelling/story-making, in which the client paints trees representing various periods of his/her life. The aim of this study was to investigate clients' experiences of participating in a TTM intervention and their perceptions of the therapeutic relationship. Thematic interviews were undertaken. Twenty clients attending general outpatient mental healthcare units were recruited after having participated in the intervention. A qualitative content analysis resulted in six categories: “From feeling a pressure to perform to becoming focused and expressive”, “Expressing oneself and one's life situation led to awakening of memories and feelings”, “New perspectives of self-image, everyday life and relations to others”, “Story-making led to shaping and reconstructing one's life story”, “Interaction was of importance when reconstructing one's life story” and, finally, “The attitude of the occupational therapist was of importance for the development of the therapeutic relationship”. There seemed to be a close association between the intervention and the therapeutic relationship in starting a process of opening up new perspectives on everyday life, but there is a need for further studies including therapists' experience of using the TTM and their perception of the client–therapist relationship.
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| 4. |
- Gunnarsson, A Birgitta, 1958, et al.
(författare)
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Outcomes of the Tree Theme Method versus regular occupational therapy: A longitudinal follow-up
- 2022
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Ingår i: Australian Occupational Therapy Journal. - : Wiley. - 0045-0766 .- 1440-1630.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Depression and anxiety disorders affect individuals' everyday lives, and treatments that can help them to perform everyday occupations are needed. Occupational therapy for this group has been evaluated from a short-term perspective but not from a long-term perspective; further research is thus warranted. The aim of the study was to investigate the longitudinal outcomes of the Tree Theme Method (TTM) compared with care as usual, provided by occupational therapists, in terms of everyday occupations, psychological symptoms, and health-related aspects. Methods This randomised controlled trial comprised a follow-up 3 and 12 months after an intervention. A total of 118 participants (19-64 years) with depression or anxiety disorders and problems with everyday occupations completed the base line questionnaires, 100 completed the follow-up at 3 months, and 84 completed the follow-up at 12 months. Imputations of missing data were performed using the last observation, and parametric analysis was used. Results Both groups showed significant improvements (P value <= 0.01) in everyday occupations, psychological symptoms and health-related aspects after 3 and 12 months. No significant differences were found between the groups. Conclusion This study contributes with knowledge about the outcomes of occupational therapy for clients living with depression and anxiety disorders. Both TTM and care as usual lead to significant improvements over time concerning everyday occupations, psychological symptoms, and health-related aspects. The fact that both occupational therapy methods were associated with improvements for clients with depression and anxiety supports client-centredness in enabling an occupational therapist to choose the method best suited for the individual.
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| 5. |
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| 6. |
- Gunnarsson, Birgitta, 1958-, et al.
(författare)
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Occupational therapists’ perception of the Tree Theme Method™ as an intervention in psychosocial occupational therapy
- 2011
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Ingår i: Occupational Therapy in Mental Health. - 0164-212X .- 1541-3101. ; 27:1, s. 36-49
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated how occupational therapists experience utilization of the Tree Theme Method, an intervention based on creative activities and life-story telling and making. The Tree Theme Method is comprised of five sessions in which the therapist asks the client to paint symbolic trees, with specific themes representing their present life situation, childhood, adolescence, adulthood, and the future. Nine occupational therapists in mental health care were asked about their experiences when using the Tree Theme Method. The informants formed two focus groups and each group was interviewed twice. Qualitative content analysis was used to identify five categories including: (1) therapeutic frames, (2) therapist requirements, (3) client requirements, (4) the therapeutic relationship, and (5) the Tree Theme Method as a multi-dimensional process. Overall the informants were satisfied with the intervention with some variation as to therapists' perception about the helpfulness of the tool. The Tree Theme Method was experienced as a structured method of starting a therapeutic process and initiating a therapist-client relationship. The therapeutic attitude, self-knowledge, and expert knowledge seemed to be important prerequisites for the therapists when using the Tree Theme Method intervention.
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| 7. |
- Gunnarsson, Birgitta, 1958-, et al.
(författare)
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The Tree Theme Method as an intervention in Psychosocial Occupational Therapy : Client acceptability and outcomes
- 2009
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Ingår i: Australian Occupational Therapy Journal. - : Wiley. - 0045-0766 .- 1440-1630. ; 56:3, s. 167-176
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Tidskriftsartikel (refereegranskat)abstract
- Background/aim: The Tree Theme Method (TTM) is an intervention in which the client paints trees representing certain periods in his/her life. The intervention comprises five sessions, using trees as a starting point to tell one's life story. This study, which is part of an implementation project, aimed to examine the therapeutic alliance and client satisfaction, in relation to perceptions of everyday occupations and health-related factors, with clients going through a TTM intervention. Methods: Nine occupational therapists recruited 35 clients, at general outpatient mental health care units, for the TTM intervention. Self-rating instruments, targeting therapeutic alliance (HAq-II), different aspects of daily occupations (Canadian Occupational Performance Measure, Satisfaction with Daily Occupations), health-related factors (Sense of Coherence measure, Mastery Scale, Symptom Checklist-90-R) and client satisfaction (Client Satisfaction Questionnaire), were administrated before and after the intervention. Results: A good initial therapeutic alliance, experienced by both therapists and clients, was correlated to increased changes regarding occupational performance and self-mastery. According to the therapists’ ratings, a good initial therapeutic alliance was correlated to increased sense of coherence and a decreased level of psychiatric symptoms. The results showed positive significant changes in occupational performance and health-related factors. High ratings of the therapeutic alliance by the therapists were also related to high client satisfaction. Conclusions: The TTM seemed to function well in psychosocial occupational therapy, but there is a need for further implementation studies to deepen our understanding of the treatment process, comprising both technique and formation of the therapeutic alliance.
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| 8. |
- Gunnarsson, Birgitta, 1958-, et al.
(författare)
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The Tree Theme Method in psychosocial occupational therapy – a case study
- 2006
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 13:4, s. 229-240
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to describe the Tree Theme Method (TTM) as a method for intervention in psychosocial occupational therapy. The TTM is based on theories concerning creative activities and occupational storytelling and story making. In order to exemplify the method a case study of a treatment process with follow up was undertaken. The participant was a female client suffering from anxiety and depression. During an interview the client painted symbolic trees on five different occasions with specific variations of the tree theme: a tree symbolizing her present life, her childhood, adolescence, adulthood, and, finally, a tree representing her future. The trees were used as starting points for the client to tell her life story. The intention was that she would find new strategies for how to change her daily life. Three years later there was a follow up stage where the client painted new trees and told her story. Some life themes were identified. The TTM appears suitable for intervention in psychosocial occupational therapy. In future studies the TTM should be subjected to evaluation research based on several clients in order to develop a deeper understanding of the process and what kind of results changes in the TTM intervention may provide.
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| 9. |
- Gunnarsson, Birgitta, 1958-, et al.
(författare)
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Treatment of depression and/or anxiety - outcomes of a randomised controlled trial of the tree theme method® versus regular occupational therapy
- 2018
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Ingår i: BMC psychology. - : Springer Science and Business Media LLC. - 2050-7283. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Depression and anxiety disorders are a major concern in western countries, and because these often have a negative affect on everyday life interventions based on activities in everyday life are needed. The Tree Theme Method® (TTM) is a client-centred occupational therapy intervention designed to increase the ability to cope with, and to enhance satisfaction with, everyday life, both at home and at work. The aim of this study was to compare the short term outcomes of the TTM intervention with regular occupational therapy treatment for people with depression and/or anxiety disorders. Methods: This randomised controlled trial included patients from three counties in Sweden. Men and women with depression and/or anxiety disorders, ages 18 to 65, were randomised to either TTM or regular occupational therapy. Assessment data were collected at baseline and the follow-up directly after completing the intervention. Non-parametric and parametric statistical methods were used. Results: The questionnaires were answered by 118 patients at baseline and by 107 patients after completing the intervention. No significant differences in short term outcomes were found between the groups. Both groups showed positive significant outcomes regarding almost all aspects of activities in everyday life, psychological symptoms, and health-related and intervention-related aspects. Conclusions: Despite the lack of differences between the groups, the positive outcomes regarding activities in everyday life, psychological symptoms, and health-related aspects after completing the intervention indicates the need for further research on the long-term perspective of TTM compared to regular occupational therapy.
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| 10. |
- Wagman, Petra, et al.
(författare)
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Factors associated with higher occupational balance in people with anxiety and/or depression who require occupational therapy treatment
- 2021
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 28:6, s. 426-432
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anxiety and depressive disorders are associated with problems with everyday occupations, including difficulties achieving occupational balance. The aim of this cross-sectional study was to describe occupational balance in people suffering from anxiety and/or depression and the factors that are associated with better self-rated occupational balance. Material: One hundred and eighteen participants were recruited from outpatient mental health care and primary health care. The participants were 18-65 years, had a diagnosis of anxiety and/or depression, and had problems in everyday occupations. They answered questionnaires on occupational balance, psychological symptoms, quality of life and everyday occupations. Results: A generally low rating of occupational balance was found; however, the scores differed depending on the participants' degree of anxiety and depression, their quality of life, their occupational performance and satisfaction with their occupational performance. Logistic regression analyses revealed that high quality of life, high satisfaction with occupational performance and low level of depression were associated to occupational balance. Conclusion: The results indicate that enhanced satisfaction with life and with performance of everyday occupations are relevant factors for achieving occupational balance in clients diagnosed with anxiety and/or depression.
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