Date Presented 04/01/2022

The United States is witnessing a significant rise in school shootings. Students exposed to school shootings often develop emotional disturbances that negatively affect their meaningful participation in daily activities. The purpose of this qualitative study was to explore the self-efficacy of OTs who may encounter students exposed to a school shooting and explore perceived treatment strategies that practitioners may use to positively influence their clients’ mental health.

Primary Author and Speaker: Bridget Scheidler

Additional Authors and Speakers: Nancy E. Carson

Contributing Authors: Karen Snyder

The United States is witnessing a phenomenon of a rise in school shootings with 118 school shootings in 2019 and 112 school shootings in 2020 (Riedman & O’Neill, 2021). To date (June 15, 2021), 69 school shootings have been reported in 2021, continuing this disconcerting spiraling trend in the United States (Riedman & O’Neill, 2021). Students exposed to school shootings often develop emotional disturbances including post-traumatic stress disorder, depression, and anxiety that negatively impact the students’ meaningful participation in their daily activities (Lowe & Galea, 2017). Unfortunately, Arthur and Decleene (2014) noted an overall lack of research on perceived competence levels of occupational therapists (OTs) working in the mental health sector, with no found studies on OTs efficacy to work with students struggling with the aftermath of a school shooting, nor on which theoretical frameworks or treatment strategies to utilize with this growing population.

PURPOSE: The purpose of this qualitative study was to explore the self-efficacy of occupational therapists who may encounter students exposed to a school shooting and explore perceived treatment strategies that practitioners may utilize to positively influence the client’s mental health outcomes.

DESIGN: This qualitative research utilized a grounded theory study design with purposeful sampling. The researchers used social media boards and snowballing to recruit participants who possess direct knowledge of the research problem.

METHOD: Using a semi-structured, secured virtual interviews, 11 OTs who work with the K-12 student population revealed emotions and efficacy related to the uncertainty of working with a student exposed to a school shooting. The following research questions guided the study, (a) RQ1: What perceived factors impact OTs’ self-efficacy when potentially working with clients exposed to a school shooting? (b) RQ2: What perceived treatment strategies might OTs employ to improve the mental health outcomes of clients exposed to school shootings? Common themes of experience and practice among OTs were coded while maintaining researcher objectivity through reflexivity and bracketing. The software program, Dedoose, supported the transcribed interview text to create the audit trail for coding, theme development, and a validation tool of the study.

RESULTS: Results of RQ1 resulted in two major themes: factors that positively impact clinicians’ self-efficacy and factors that negatively impact their self-efficacy to work with clients exposed to school shootings. Both factors included four individual sub-themes. Results of RQ2 for perceived treatment strategies included four major themes: interprofessional care, client-centered care, acknowledgement of trauma, and sense of safety. These results included participant statements supporting the need for further education needed to address the lack of referral to occupational therapists about issues related to mental and emotional health in the K-12 setting. In addition, occupational therapists require increased education and exposure to trauma care to understand their role within pediatric mental health.

CONCLUSION: This focused education may improve the therapists’ self-efficacy to choose appropriate client-centered treatment strategies when working with students exposed to school shootings.

IMPACT STATEMENT: This research study provides preliminary data on which factors may impact a practitioner’s self-efficacy when working with students exposed to school shootings which are increasing nationwide, and it highlights the significance of this topic as there is a lack of research on perceived competence levels of OTs working in the mental health sector overall (Arthur & Decleene, 2014).

References

Arthur, P. B., & Decleene, K. E. (2014). Behavioral health competence: An exploration of army reserve occupational therapists. Occupational Therapy in Mental Health, 30(1), 69-89. http://dx.doi.org/10.1080/0164212X.2014.878531

Lowe, S. R., & Galea, S. (2017). The mental health consequences of mass shootings. Trauma, Violence, & Abuse, 18(1), 62-82. http://dx.doi.org/10.1177/1524838015591572

Riedman, D., & O”Neill, D. (2021). Shooting incidents at K-12 schools 1970-present. Retrieved from Center of Homeland Defence and Security: https://www.chds.us/ssdb/charts-graphs/#incedentsbyyear

World Federation of Occupational Therapists. (2019). Position statement: Occupational therapy and mental health. Retrieved from https://www.wfot.org/resources/occupational-therapy-and-mental-health