In 2016, the American Occupational Therapy Association (AOTA) released “AOTA’s Societal Statement on Youth Violence” to address the prevalence of youth violence in society today. David-Ferdon and Simon (2014) state that violence is the second leading cause of death among youth. AOTA defines violence to include bullying, verbal threats, physical assault, domestic abuse, use of weapons to harm another person, and gunfire. The Societal Statement highlights a key point, that violence negatively impacts individual perpetrators, victims of violence, and larger societal structures. As a result of the dual nature of this problem, occupational therapists (OTs) can have an influential role in working towards a solution by understanding the lives of individual youth impacted by violence, and also by developing population level strategies to resolve the larger systemic issues. The Societal Statement addresses the general youth population, as well as smaller subsets of youth such as perpetrators of violence, victims of violence, and those at risk for experiencing violence. The distinction between groups is important because each may have different needs as a result of their relationship with violence. Youth violence can ultimately affect all aspects of an individual’s life; therefore, it affects all areas of occupation, including activities of daily living, instrumental activities of daily living, education, work, leisure, play, social participation, and rest and sleep. The statement on youth violence influences traditional practice settings such as inpatient psychiatry, partial hospitalization, long term mental health care, schools, community mental health programs, groups homes, sheltered workshops and vocational training, because youth affected by violence may need special attention in any of these settings (Roberts & Evenson, 2014). Given the negative impact on multiple areas of occupation, response to and prevention of youth violence can be an important emerging area of practice for OTs.
Purpose
It is likely that AOTA published the Societal Statement about youth violence because they recognized the negative impact that acts of violence have at an individual and population level, and they identified that occupational therapy (OT) can contribute to the solution. The intended audience is widespread. The Societal Statement educates OTs about this emerging need in society, as well as parents, educators, policy makers, health care practitioners, and moreover anyone who interacts with youth. It appears that AOTA hoped the statement would help create an entry point for OTs in this emerging practice area and furthermore, create opportunity for interprofessional collaboration between OTs and other professionals currently working with this population. There are current events and trends that may have compelled AOTA to write this statement, including shootings at schools and at public events. The pervasiveness of school shootings is a frightening reality in the United States, and it sheds light on the need for increased mental health services and prevention to stop the behavior before it occurs.
Evidence
The Societal Statement is evidence based and is supported by secondary sources and empirical evidence. One source titled Preventing Youth Violence: Opportunities for Action, provides data and statistics about the incidence of youth violence in the United States and it speaks to the need for a population level change and proposes evidence-based intervention for targeting violent behavior (David-Ferdon & Simon, 2014). An additional secondary source titled Morbidity and Mortality Among Adolescents and Young Adults in the US, provides further information about the various causes of morbidity in adolescent populations (Blum & Qureshi, 2011). As highlighted in the report by David-Ferdon and Simon, one of the most pivotal ways to address the problem of youth violence in society is through prevention and working towards stopping the violent behavior before the problem magnifies. Hildenbrand and Lamb (2015) also discuss the demand for prevention to make change in society. They state that while OT has always been rooted in maintaining health of individuals and groups, given the current political and healthcare climate, there is a greater shift towards OTs involved in prevention and wellness, in addition to the current established practice of treatment and intervention. This is an opportune time for interprofessional collaboration between OTs and other professionals. For example, the authors discuss how in order to contribute to reducing the incidence of youth violence, collaboration is needed among parents, teachers, afterschool programs, among others, in order to instill in youth positive life habits and to keep them away from exposure to violence. An additional study about bullying during childhood revealed that the act of bullying is a serious risk factor for violent behavior later in life (Nansel, Overpeck, Haynie, Ruan & Scheidt, 2003). The results of the study are relevant to the field of OT because as OTs enter the domain of helping individuals affected by violence, it will be increasingly important to observe and identify bullying behavior and to develop evidence-based interventions. An OT may also address potential mental health challenges, help foster positive social relationships, and connect a child to additional resources to help prevent involvement in violence later in life.
Community Involvement
The Center for Teen Empowerment is a local organization, based in Boston and Somerville, MA, that employs urban teens affected by youth violence. The teens and adults work together to cultivate leadership skills, identify problems in communities, develop strategies, and take action to improve those issues and create peace through dialogue, workshops, and community involvement (Center for Teen Empowerment). One component that contributes to the success of the Center for Teen Empowerment is that they educate youth about problems facing society, engage them in the solution, and as a result help reduce involvement in crime and violence. This model allows teens to be part of the positive change in society by engaging in a meaningful cause, developing healthy life skills, and working to combat violence. This is an example of an organization that is following the call to action made in the Societal Statement. While the organization heavily focuses on leadership, skill development, and social justice education for youth, they do not have an OT on staff. OTs help youth engage in meaningful and purposeful occupations, as well as support individual health and well-being through full participation in their lives. Given that the Center for Teen Empowerment works with teens affected by violence, one should consider the unique needs of this population and the contributions an OT could make. For example, if someone suffered physical or emotional trauma due to violence, he or she may need help reintegrating back into society due to mental health challenges. An OT could then facilitate dialogue about what is important to the individual and create an intervention to develop routines so the individual can return to his or her occupational roles. This could be valuable to the organization so that the teens can fully engage in their responsibilities with the organization and other aspects of their lives. In addition, OTs could also facilitate various life skills groups, decision making and education planning, mindfulness practice, or stress management strategies. The success of the Center for Teen Empowerment is a promising example of a community working to diminish the problem of youth violence through positive engagement and healthy participation in life. In addition to community involvement, AOTA’s Societal Statement and the emerging role of OT to address youth violence offers encouraging prospects to meet the unique needs of the youth population.
References
American Occupational Therapy Association. (2018). AOTA’s societal statement on youth violence. The American Journal of Occupational Therapy, 72, 7212410090p1- 7212410090p2. https://doi.org/10.5014/ajot.2018.72S209
Blum, R., & Qureshi, F. (2011). Morbidity and mortality among adolescents and young adults in the US [AstraZeneca fact sheet]. Baltimore: Johns Hopkins University, Bloomberg School of Public Health.
Center for Teen Empowerment. (n.d.) About Us. Retrieved from https://teenempowerment.org/about-us/
David-Ferdon, C., & Simon, T. R. (2014). Preventing youth violence: Opportunities for action. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
Hildenbrand, W. C., & Lamb, A. J., (2013). Occupational therapy in prevention and wellness: Relevance in a new health care world. The American Journal of Occupational Therapy, 67(3), 266-271. doi:10.5014/ajot.2013.673001
Nansel, T., R., Overpeck, M., D., Haynie, D., L., Ruan, W., J., & Peter C. Scheidt, (2003). Relationships between bullying and violence among US youth. Arch Pediatrics Adolescent Medicine, 157, 348-353). www.archpediatrics.com
Roberts, P., S., & Evenson, M., E. (2014). Continuum of Care. In B. A. B. Schell, G. Gillen, & M.E. Scaffa (Eds). Willard and Spackman’s occupational therapy (12th ed., pp. 896-910).