You’ve Got Time: Occupational Therapy’s Role in the Juvenile Justice System

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Primary Focus: Children and Youth

Learning Objectives:

  1. State one economic and two population health implications of juvenile incarceration in the United States.
  2. Identify two occupation-based interventions implemented in the juvenile justice system.
  3. Recognize two areas of opportunity for occupational therapy intervention in the juvenile justice system to promote occupational justice and reduce recidivism.


This is an introductory level presentation for occupational therapists (OTs), occupational therapy assistants, and students intended to provide insight to areas of opportunity for OT intervention to reduce recidivism in the juvenile justice system. A systematic review of the literature was conducted to answer the question: What is the evidence to support the effectiveness of interventions within the scope of occupational therapy practice to prevent recidivism of juvenile offenders?

There is a high rate of recidivism in Pennsylvania; 20% of juvenile offenders in Pennsylvania were reincarcerated within two years of their case closure in 2007 (Fowler, Anderson, Bender, & Green, 2013). Juvenile correctional facilities can encourage youth to continue to engage in delinquent behaviors (Holman & Zeidenberg, 2006). Although interventions within the scope of OT exist in the juvenile justice system, there are few OTs working in this practice area.

Research articles were drawn from five databases: PubMed, CINAHL, PsychINFO, OT Seeker, and OT Search. Headings/key terms included in our search were (P) variations of juvenile/adolescent offenders, ex offenders (I) variations of interventions included in the scope of OT (O) variations of recidivism, re-incarceration. The search was confined to peer reviewed, full-text studies published in English from 2006 and later. Criterion for the inclusion of studies were: individuals 21 and under who have previously been detained and/or incarcerated, participated in interventions within the scope of OT practice during or after their incarceration, and prevention of re-incarceration as an outcome. This method yielded 18 studies for inclusion. Articles were critiqued with Law & McDermott’s Critical Review Form for Quantitative Studies and Quality of an Intervention Study, as well as the AOTA Guidelines for Systematic Reviews (American Occupational Therapy Association, 2015; Law & McDermott, 2012).

There is moderate to mixed evidence for interventions within the scope of occupational therapy practice to recidivism. Four themes emerged regarding interventions: talk therapy, location of services, involvement of family, and life skills and occupation-based intervention. This systematic review did not yield any articles specifically from the OT literature, implicating the need for OTs to practice in this emerging area and conduct research demonstrating efficacy of occupation-based interventions.


American Occupational Therapy Association. (2015). Guidelines for Systematic Reviews. Retrieved from http://ajot.submit2aota.org/journals/ajot/forms/systematic_reviews.pdf

Fowler, J., Anderson, R., Bender, L., & Green, T. (2013). Juvenile Court Judges’ Commision. The Pennsylvania Juvenile Justice Recidivism Report: Juveniles with a 2007 Case Closure. Retrieved from: http://www.jcjc.pa.gov/Publications/Documents/Recidivism/Pennsylvania%20Recidivism%20Report_Juveniles%20with%20Cases%20Closed%20in%202007-2010.pdf

Holman, B., & Zeidenberg, J. (2006). Dangers of detention: The impact of incarcerating youth in detention and other secure facilities. Retrieved from http://www.justicepolicy.org/research/1947

Law, M. C., & McDermott, J. (2012). Evidence-based rehabilitation: A guide to practice. Thorofare, NJ: Slack.

Presentation: 42:44