Effectiveness of Interventions in the Scope of Occupational Therapy for Mental Health in Children and Adolescents: A Systematized Review

Importance: 1 in 5 children in the US have a mental health disorder (Larson et al., 2017) which affects health across the lifespan, including engagement in school and play (Rizvi et al., 2024). Objective: This systemized review explored literature about the effectiveness of mental health interventions for children and adolescents within the occupational therapy (OT) scope of practice. Data Sources: A medical librarian searched articles from 2019-2024 that were retrieved from PubMed, CINAHL, and PsycINFO. Study Selection and Data Collection: Studies were included if the outcome measures addressed mental health, interventions were within the scope of OT, participants were children ages birth to 18 years, if the study was conducted in the US, and if the article was published in the last five years. The results from these articles were synthesized and graded using the U.S. Preventive Taskforce (2018) definitions. Findings: Five RCTs met inclusion criteria. School-based group interventions included mindfulness and relaxation, and motivational interviewing and CBT with one-on-one coaching. Individual interventions in clinical settings included between-session messaging and parent education on adolescence. There is moderate evidence to support these interventions, with mixed results for use of CBT and motivational interviewing with one-on-one coaching. More evidence is needed to make clinical recommendations for treatment dosage. Conclusion & Relevance: OTPs should consider school-based group intervention such as mindfulness and relaxation, and individual interventions in clinical settings such as parent education on adolescence and technology reminders on a routine basis. School-based group CBT and motivational interviewing practices with one-on-one coaching are recommended on a case-by-case basis when addressing mental health symptoms in children due to mixed results in mental health outcomes. References: Merikangas, K., He, J.-p., Burstein, M., Swanson, S., Avenevoli, S., Cui, L., . . . Swendsen, J. (2011). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980-989. 10.1016/j.jaac.2010.05.017 Larson, S., Chapman, S., Spetz, J., & Brindis, D. C. (2017). Chronic childhood trauma, mental health, academic achievement, and school-based health center mental health services. Journal of School Health, 87(9), 675-686. https://doi.org/10.1111/josh.12541 U.S. Preventive Services Task Force. (2018). Grade definitions. https:// www.uspreventiveservicestaskforce.org/Page/Name/grade-definitions