Date Presented 04/02/2022

OT is an emerging practice area in criminal justice and rarely applied with people sentenced to life as juveniles, who have served more than 25 years and have new potential for parole. A review of 21 OT evaluations revealed 85 different occupational performance goals and related barriers (n = 18) and facilitators (n = 12) to preparing for release. The complexities of setting goals to address prison-to-community transition are explored, along with implications for OT needs in prison reentry services.

Primary Author and Speaker: Lisa Jaegers

Additional Authors and Speakers: Christine Picker, Jessica Neff, Mackenzie Murphy, Serena Blank, Grace Kanary, Natalie Schur

Contributing Authors: Karen Barney

PURPOSE: Over 2,300 individuals in the U.S. were arrested as juveniles serving sentences of life without the option of parole (JLWOP) in prison. Court rulings have held that such sentences are unconstitutional, meaning many JLWOP are now eligible for release. JLWOPs are often not well prepared for release due to only learning roles, habits, and routines of a prison setting and exposure to occupational deprivation at a young age and face challenges associated with securing employment, housing, and healthcare upon release into the community. Goal setting to address community transition with OT interventions is needed. This study explored the needs of JLWOP through the analysis of transition goals to bridge the gap in understanding the unique role OT can have with this population. The purpose of this study was to describe the goals and recommendations that were identified from JLWOP initial OT evaluations by the Occupational Therapy Transition and Integration Services (OTTIS) program. Trends among goals were analyzed to determine what was a priority for clients approaching reentry.

DESIGN: Retrospective, secondary data analysis completed on a population of JLWOP to assess client goals, recommendations, barriers, and facilitators pertaining to reentry.

METHOD: OTTIS evaluations were completed in-person or via telehealth methods to comply with prison safety protocols and limitations due to the COVID-19 pandemic. Occupational performance was measured and analyzed through completion of a thorough occupational profile, which revealed information about a clients’ needs and concerns in relation to occupation (AOTA, 2020). The evaluation covered areas of occupation according to the Occupational Therapy Practice Framework 4th edition (OTPF) including: habits, role, routines, self-care, instrumental activities of daily living, health management, rest and sleep, education, work, leisure, and social participation. Thematic, qualitative coding method was developed based on the OTPF 4th edition to organize client goals and recommendations. Quantitative frequency analyses were performed to calculate prevalence of themes.

RESULTS: JLWOP OT goals, identified barriers, and facilitators to reentry are described for 21 clients. Analysis revealed 84 subcategories of goals with most being instrumental activities of daily living (n = 23) followed by health management (n = 12), work (n = 6), social participation (n = 6), education (n = 5), and leisure (n = 2). There were 18 constructs identified for barriers to reentry such as long-term incarceration and mental health; and 12 facilitators to preparing for release such as access to positive social supports and occupationally balanced routine. Results showed the need for skilled OT intervention for JLWOP approaching reentry most prominently in areas of instrumental activities of daily living (e.g. home, technology, budget) and health management (e.g. behavioral health services) as these individuals identified needing assistance with learning how to complete basic daily activities.

CONCLUSION: JLWOP need additional support to complete tasks within all the major areas of occupation. Occupational therapy in reentry programming is vital in addressing goal setting to facilitate successful community reintegration. This study explored client needs for reentry and related OT recommendations for transition and integration. Future work will describe interventions and impact of OT on prison reentry.


Jaegers, L. A., Skinner, E., Conners, B., Hayes, C., West-Bruce, S., Vaughn, M. G., Smith, D. & Barney, K. F. (2020). Evaluation of the jail-based occupational therapy transition and integration services program for community reentry. American Journal of Occupational Therapy, 74, 7403205030.

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010.

Whiteford, G., Jones, K., Weekes, G., Ndlovu, N., Long, C., Perkes, D., & Brindle, S. (2020). Combatting occupational deprivation and advancing occupational justice in institutional settings: Using a practice-based enquiry approach for service transformation. British Journal of Occupational Therapy, 83(1), 52-61.

Jaegers, L. A., Dieleman, C., Dillon, M. B., Rogers, S., Muñoz, J. & Barney, K. F. (2020). Justice-based occupational therapy initiative: Advancing occupational justice in criminal justice systems. Annals of International Occupational Therapy.