Terry M Krupa

Terry M Krupa
Queen's University | QueensU · School of Rehabilitation Therapy

PhD, FCAOT

About

193
Publications
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2,793
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Publications

Publications (193)
Article
Background: Recovery-promoting and occupation-oriented interventions for people with schizophrenia who receive in-patient services are scarcely investigated, limiting our understanding of the factors affecting intervention effectiveness and hindering occupational inclusion. Aims: To investigate the impact of contextual factors on the effectivene...
Article
Objective: Evidence concerning strengths model of case management (SMCM) remains mixed. This study aimed to test the hypotheses that higher fidelity to SMCM is associated with improved quality of life (QoL), hope, community participation, community functioning, more days of competitive employment and of independent living, and fewer days of hospit...
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Objective: The purpose of this study was to examine how the client–case manager working alliance in strengths model case management (SMCM) mediates the relationship between fidelity to the SMCM intervention and clients’ quality of life, hope, and community functioning. Methods: In total, 311 people with severe mental illness, served at seven commu...
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Rationale: Implementation of strengths model case management is increasing internationally. However, few studies have focused on its implementation process, and none have specifically addressed the implementation experience of direct-service practitioners. Objective: This paper presents factors that facilitate and impede the successful implement...
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While strengths approaches are important to recovery-oriented practice, implementation can be challenging. This study implemented the strengths model of case management (SMCM) in 11 CM teams and assessed the fidelity of delivery and staff perceptions of the model after 36 months using the SMCM fidelity scale and the Readiness Monitoring Tool. Paire...
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Purpose This study explored how intermittent work capacity (IWC) presents in workplaces in order to advance conceptual understanding of this phenomenon and establish a set of initial principles to assist in its management. Design/methodology/approach The study followed a grounded theory approach in a multi-stage data collection process. In total,...
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The provision of mental health care for people living in low- and middle-income countries presents a particularly complex problem because of fractured service availability and provision, widespread stigma associated with mental illness, and the economic burden inherent in conventional mental health service delivery. People with serious mental illne...
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Objective: The Patient Generated Index (PGI) is a personalized quality of life (QOL) measure. This secondary analysis examined its psychometric properties with people with severe mental illness. Methods: Three hundred and eleven people with severe mental illness participated in structured interviews at baseline, 9 months, and 18 months. Results...
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Background. Occupational therapists and teachers often collaborate for the benefit of students. Purpose. This work aims to develop a conceptual framework for collaboration between occupational therapists and teachers in a school-based setting. Methods. A multiple method, qualitative methodology was employed. An integrative analysis of findings betw...
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A significant burden and treatment gap associated with serious mental illness (SMI) exists in low- and middle-income countries (LMIC). In order to address these issues, a range of community-based rehabilitation models in alignment with the Capabilities Approach is necessary, including opportunities for people with SMI to be rapidly engaged in meani...
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Background Missing patient reported outcomes data threaten the validity of PRO‐specific findings and conclusions from randomized controlled trials by introducing bias due to data missing not at random. Clinical Research Associates are a largely unexplored source for informing understanding of potential causes of missing PRO data. The purpose of thi...
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Alcohol consumption and associated harms are an issue among emerging adults, and protective behavioral strategies (PBS) are actions with potential to minimize these harms. We conducted two studies aimed at determining whether the associations of at-risk personality traits (sensation-seeking [SS], impulsivity [IMP], hopelessness [HOP], and anxiety-s...
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Students and clinicians with disabilities are underrepresented in the academic health programs and professional clinical settings. Disability studies foregrounds the unique ways of knowing and being that clinicians with disabilities can offer. Based on a larger grounded theory study of the experiences of students and clinicians with disabilities, t...
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Employment is a well-recognized and important indicator of recovery from mental illness. However, a broad range of personally and socially meaningful activity and participation opportunities, beyond paid employment, can be valuable for those in recovery. Facilitating access to these opportunities necessitates pivoting practice toward a broader unde...
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Disabled people are underrepresented within healthcare professions, although their participation has potential benefits for them personally, and for broader society. Disabled peoples’ participation in healthcare professions is limited by assumptions about disability. Little research explores how healthcare professions can be organized to support di...
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Purpose Participation in meaningful occupation is associated with recovery in serious mental illnesses, however, few evidence-based, occupation-focused interventions for hospital settings exist. This study investigated the effectiveness of “Occupational Connections” (OC), a manualized, short-term, group intervention, addressing issues in daily-life...
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There is increasing use of cultural competency models to guide health care interactions with military community members, including families, however, at this time there is no validated model. This study confirms the accuracy of the Military and Veteran Family Cultural Competency Model (MVF-CCM). Using a systems theory-informed qualitative approach,...
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Introduction: Military family life is characterized by frequent relocations, regular periods of separation, and living with the persistent risk of injury or death of their military family member. The cumulative effects of these life events impact the health and wellness of military and Veteran families (MVFs) and may be exacerbated by challenges of...
Article
Date Presented 04/04/19 This presentation introduces Occupational Connections, a structured, short-term, occupation-based in-patient mental-health intervention focused on promotion of participation in community occupations. Findings from an OC effectiveness study investigating the impact on community participation, the experience of the hospital se...
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Purpose The purpose of the present study was to advance a theoretical understanding of the mechanisms by which WISEs can influence the stigma associated with mental illness. Many people with serious mental illnesses want to work, but despite much attention to work entry strategies, unemployment rates remain exceptionally high among this population....
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The Opening Minds Initiative of the Mental Health Commission of Canada has taken a novel approach to reducing the stigma of mental illness by targeting specific sectors. This first article describes Opening Minds’ research and programming initiatives in the workplace target group. This article describes the context of mental illness stigma in Canad...
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Background: Workplace mental health disability claims are rising with concomitant challenges to return-to-work (RTW) success. Cognitive work hardening (CWH) addresses work re-entry issues including fatigue, coping skills, and reduced cognitive abilities which are relevant for people returning to work following an episode of depression. Objective:...
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The Opening Minds Initiative of the Mental Health Commission of Canada has worked with many workplaces to implement and evaluate mental illness stigma reduction programs. This article describes the lessons learned from Opening Minds’ research and programming initiatives in the workplace target group and details some of the most valuable learnings f...
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This report describes the iterative development and implementation of a recovery-oriented psychosocial rehabilitation Toolkit as part of a larger project designed to support the community-based rehabilitation and recovery of people with serious mental illness living in low resource settings. This joint Canadian-Kenyan community based psychosocial p...
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Remoteness in the isolated communities of Nunavut, Canada adversely affects access to mental health services. Mental health initiatives in criminal courts exist in many cities to offer healthcare alternatives to regular criminal court processing for people affected by mental illness. These initiatives do not exist in Nunavut. A qualitative multiple...
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Alcohol intoxication is often involved for both victims and perpetrators of sexual victimization. Yet, alcohol-involved sexual victimization research has mainly focused on female victims, excluding male victims. The current study addresses gaps in the literature by focusing on sex differences in the emotional harms (anxiety and depression symptomat...
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This paper describes the development and psychometric testing of the Substance Use Wellness Tool, created to help raise awareness about alcohol and other substance misuse among university undergraduates. The tool is a self-and peer-reflection guide that students can use to monitor and alter their patterns of substance use. Exploratory and confirmat...
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The social norms approach to changing excessive drinking behaviour is predicated upon findings that overestimations of peer drinking predict one’s own drinking behaviour. Prior studies have yet to examine whether such social norms effects pertain equally to both genders. First-year students from a Canadian university (N = 1,155; 696 males, 459 fema...
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This paper describes a project that took place at three large Canadian universities aimed at engaging male students to address alcohol misuse and associated mental health issues through a gendered and campus culture lens. Although considerable effort has been put into decreasing alcohol misuse on campuses, most of this effort has been aimed at indi...
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The Caring Campus project was a three-year intervention research project funded by Movember Canada that fostered new awareness regarding the interconnection between gender, mental health, and substance (specifically alcohol) misuse on three university campuses in Canada, and encouraged new approaches to promote young men’s health. In this project,...
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Introduction: Military family life is characterized by mobility, separation, and increased risk for injury or death of the military member, which impacts the health and well-being of all family members. Additional stress is experienced when accessing and navigating a new health care system. Unknown to most Canadians is the reality that military and...
Book
This education program is relevant for inpatient psychiatric organizations and mental health providers working in the inpatient psychiatric settings, including acute units and rehabilitation units. It is relevant for any provider such as managers, nurses, occupational therapists, peer providers, personal support workers, psychiatrists, psychologist...
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Background: Organizations have become increasingly concerned about mental health issues in the workplace as the economic and social costs of the problem continue to grow. Addressing employees' mental health problems and the stigma that accompanies them often falls to supervisors, key people in influencing employment pathways and the social climate...
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Background. Studying the occupations of formerly homeless persons as they transition to becoming housed following long-term homelessness has the potential to offer a meaningful contribution to the ongoing dialogue on homelessness. Purpose. Occupational transition was explored with a sample of persons with a history of chronic homelessness to contr...
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Purpose The aim of this exploratory, mixed methods study was to develop and test a tool that identifies foundational dimensions of work integration social enterprises (WISEs) for use in empirical studies and enterprise self-assessment. Construction of the initial prototype was based upon a review of the literature and prior qualitative research by...
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Background: Work absences due to depression are prevalent; however, few interventions exist to address the return-to-work challenges following a depressive episode. Purpose: This mixed-methods study aimed to (a) evaluate the effectiveness of cognitive work hardening in preparing people with depression to return to work and (b) identify key eleme...
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It has been broadly acknowledged that supported, inclusive employment can promote independence, quality of life and social integration for people with intellectual and developmental disabilities (IDD). Despite the ongoing development of the individual placement and support model of supported employment, competitive employment rates for this populat...
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Teachers must meet the educational needs of diverse students. Occupational therapists (OTs) assist some of these students through the provision of school-based occupational therapy (SBOT). However, there can be challenges to collaboration between OTs and teachers, and this can engender difficulty in achieving desired results. This scoping review wa...
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Date Presented 4/1/2017 The Substance Use Wellness Tool raises awareness of the links among occupation, substance use, and mental health to support the well-being of young people in postsecondary settings. This study addresses how to apply the tool to facilitate early intervention. Primary Author and Speaker: Shu-Ping Chen Contributing Authors: Ter...
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Objectives Mental health conditions (MHC) have been associated with restrictions in daily life participation and functioning affecting health and well-being. Substantial numbers of people with MHC experience hospitalizations, however, there is limited evidence supporting functional interventions in the in-patient setting to promote recovery. The OC...
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Background: Chronic homelessness is a growing problem in many Western nations. Few studies have explored the occupations of chronically homeless persons, and most of this research has sampled from large metropolitan areas. Purpose: This research sought to explicate the meaning and experience of occupational engagement for homeless persons in a mid-...
Chapter
Mental illnesses continue to gain awareness as a global health problem. Within this international context, Canada has also paid closer attention to mental illnesses and their related stigma. The Mental Health Commission of Canada was formed in 2007 as a federal government initiative to be a catalyst for improving the mental health system. Since the...
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Objective: There is a paucity of research on the prevalence and consequences of secondhand harms from alcohol. The current study (a) investigated whether secondhand harms can be clustered into latent factors that reflect distinct but related types of harms and (b) examined the associations between experiencing secondhand harms and mental health out...
Book
Die Möglichkeit zur Teilnahme und Teilhabe an Aktivitäten des täglichen Lebens ist der besondere Stoff, der unseren Alltag zusammenhält. -Wie können insbesondere Menschen mit schweren psychischen Erkrankungen motiviert werden, sich Ziele zu setzen und aktiv zu werden? -Wie können Menschen für mehr Balance in ihrem Alltag sorgen? -Wie können alle...
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People with mental health conditions (MHCs) frequently experience participation and functional restrictions. Today, hospitals still serve a significant number of people with MHCs. However, there is little evidence for occupation-oriented interventions to support participation, health, and well-being in these hospital settings. This article describe...
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Canadian health promotion campaigns directed towards healthy living have traditionally emphasized discrete behaviours that influence health and wellbeing, such as diet, physical activity and smoking. Although this traditional approach is important and supported by evidence, it does not account for broader determinants of health. The purpose of this...
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Rationale: Rehabilitation-oriented criminal court mental health initiatives to reduce the number of people with mental illness caught in the criminal justice system exist in many North American cities and elsewhere but not in the mainly Inuit Canadian Arctic territory of Nunavut. Objective: This study explores whether the therapeutic aims of the...
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Legal scholarship relevant to criminal court mental health initiatives that divert people with mental illness from prosecution to treatment has created the concept of therapeutic jurisprudence (TJ), an approach that seeks to maximize the law's potential for therapeutic outcomes. Despite recognition that TJ includes a rehabilitative response as a ke...
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Social businesses use market strategies to advance the employment and economic situation of people with mental illness who have experienced high levels of social marginalization. They have the potential to achieve these goals by fostering the work identity of the workers within the business, and to themselves acquire an identity as a viable commerc...
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This study evaluated eighteen Canadian anti-stigma programs targeting high-school students. The purpose was to identify critical domains and develop a program model of contact-based interventions. Three steps were implemented. The first step involved collecting program information through twenty in-depth interviews with stakeholders and field obser...
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Objective: This study examined employer perceptions of employability of job candidates working in a social business for people with mental illnesses. Method: Using an analogue research design, 99 employers participated in a simulated job hiring process, rating 2 applicants on potential to do the job, fit with workplace culture and likelihood of...
Article
For those committed to ensuring that people with lived experience of mental illness are provided with the rightful opportunities to meet their full potential and to live a quality life with meaning, the inspiration, achievements, and guidance of recognized leaders is important. This brief essay describes how the legacy of one such leader, John S. S...
Chapter
Contemporary views of recovery in mental illness highlight that people with serious mental illness value employment and that their participation in work is an important element of living a meaningful life beyond the constraints presented by the illness experience. Yet the unemployment rates of people with serious mental illness are very high and th...
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This chapter provides a brief description of an intervention designed to address the time use and activity patterns of individuals with serious mental illness, living in the community, with a view to improving their health and well-being and promoting recovery through occupation. The intervention uses (1) a client-centered practice approach, (2) ev...
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Purpose A number of key issues related to employment of persons with disabilities demand ongoing and effective lines of inquiry. There is evidence, however, that work researchers struggle with recruitment of participants, and that this may limit the types and appropriateness of methods selected. This two phase study sought to identify the nature of...
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People with serious mental illness experience high levels of unemployment but also typically have weak labor market attachments. This chapter presents principles underlying contemporary practice focused on accessing, supporting, and creating real work opportunities as the foundation of best practice. Three approaches to employment support and vocat...
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Studies that seek to understand and improve health care systems benefit from qualitative methods that employ theory to add depth, complexity, and context to analysis. Theories used in health research typically emerge from social science, but these can be inadequate for studying complex health systems. Mental health rehabilitation programs for crimi...
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To summarize the background and rationale of the approach taken by the Mental Health Commission of Canada's Opening Minds (OM) Anti-Stigma Initiative. The approach taken by OM incorporates a grassroots, community development philosophy, has clearly defined target groups, uses contact-based education as the central organizing element across interven...
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To summarize the ongoing activities of the Opening Minds (OM) Anti-Stigma Initiative of the Mental Health Commission of Canada regarding the 4 groups targeted (youth, health care providers, media, and workplaces), highlight some of the key methodological challenges, and review lessons learned. The approach used by OM is rooted in community developm...
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Objective: Mental health system transformation toward a recovery-orientation has created a demand for education to equip providers with recovery competencies. This report describes the development of a recovery education program designed specifically for inpatient providers. Method: Part 1 of the education is a self-learning program introducing...
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This qualitative study employed an arts-based methodology to explore the intersection of gender and ethnicity with the recovery experiences of six racialized women with severe mental illness in a large and highly diverse Canadian urban centre. The study was designed to address a gap in the recovery literature, which has minimally accounted for gend...
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Occupational therapists can bring a unique and valuable perspective to the national dialogue on health promotion. Current approaches have a narrow focus on diet and exercise; a broader focus on occupation has the potential to enrich understanding regarding forces that contribute to health and well-being. A new "Do-Live-Well" framework will be prese...