The impact of an occupation-based program for incarcerated women with intellectual and developmental disabilities

Abstract

Incarcerated individuals with IDD and their preparation to successfully re-enter the community represent a significant concern within the criminal justice system. Occupational therapy, with its knowledge of occupational performance within forensic and IDD intervention contexts, has a considerable, unrealized role in addressing this concern. Across relevant disciplines, the literature dealing with the experiences and intervention needs of this population is limited. No known, previous OT studies exist that are specifically focused on incarcerated women with IDD. This dissertation research conducted a systematic evaluation of the impact of an occupation-based intervention for incarcerated women with IDD using a mixed methods design. The mixed methods design included a randomized control trial which is rarely found in the related literature. The manualized OT program utilized in this study, grounded in occupational adaptation and participatory occupational justice theory, was designed to provide meaningful, prosocial occupational role opportunities to offenders with IDD. The study’s mixed methods design incorporated three research strategies to discover the impact of the OT program on offenders’ occupational performance and participation. The stepped wedge randomized control design strategy revealed that program participants had significantly fewer adverse behavioral incidents than a delayed intervention control group. Results of the within-participants repeated measures strategy demonstrated statistically significant improvement in Goal Attainment Scale, Volitional Questionnaire, and Social Profile ratings and generally high relative mastery ratings. The final strategy, qualitative phenomenology, triangulated findings supporting the positive, holistic influence of the program on offender occupational performance patterns and the occupational environment. The outcomes of this study have strong potential utility for enhancing the rehabilitation of incarcerated individuals with IDD and advocating for the consistent inclusion of occupational therapy within criminal justice service provider teams.