School-based occupational therapy: Perspectives on strength-based assessment and providing related interventions for elementary students with mental health needs

While there has been a call for mental health services for students to shift from a deficit emphasis to a strength-based paradigm (Substance Abuse and Mental Health Services Administration, 2005), school-based services for students with social, emotional, and behavioral needs continues to focus on ameliorating student deficits. The term, strength-based, refers to interventions that capitalize instead on student competencies in order to design supportive programming. The purposes of this dissertation are to explore student strengths and occupational therapists' perspectives on strength-based assessment/intervention as well as on their role in the use of strengths to support students who have mental health needs.

This line of research describes the results of three studies aimed at identifying what strengths/competencies for success in middle school are identified most frequently in a (1) review of related educational and psychology literature; (2) survey of select advocates in the IDEA Partnership's National Community of Practice on Collaborative School Behavioral Health; and (3) focus group of school-based occupational therapists. The occupational therapy perspectives are compared with those from literature and the survey of experts from the National Community of Practice leadership team.

Student strengths were identified across all 3 studies. Grounded theory analysis facilitated their consolidation into 31 strengths, clustered into 5 themes. The themes and strengths were organized into a model to guide strength-based evaluation and intervention, the "Strengths Origins, Process and Effects Network (Strengths-OPEN) Model". This is an initial step in a line of research intended to yield an interdisciplinary instrument that occupational therapists can use which will provide special education and related services with a tool for designing interventions that will empower students with mental health needs to use their strengths to achieve greater success in transitioning from elementary to middle school. Next steps in the development of the instrument and its potential application both for the broader field of children's mental health in schools and occupational therapy are discussed.