Interventions to Promote and Support Development of Client Self-Advocacy: A Narrative Review of the Literature

PURPOSE: Self-advocacy revolves around concepts of knowledge of self and knowledge of one's rights (Test, Fowler, Wood, Brewer, & Eddy, 2005) and is a relatively new addition within the OTPF. We use the OTPF (2014) definition of self-advocacy as "advocating for oneself, including making one's own decisions about life, learning how to obtain information to gain an understanding about issues of personal interest or importance, developing a network of support, knowing one's rights and responsibilities, reaching out to others when in need of assistance, and learning about self-determination" (p. S45). These skills can contribute to access and full participation in society and therefore there is an ever-increasing need for therapeutic interventions in OT that address the development of these skills. However, what are the components and research evidence of interventions that address the self-advocacy skills? To answer this, a narrative review of literature on interventions targeting self-advocacy development is critical to inform and promote self-advocacy interventions within the profession. DESIGN: A narrative review of the literature was performed to identify self-advocacy interventions within the profession. Due to the limited literature from OT, the study analyzed interventions from other allied health professions. We used PRISMA guidelines (Moher, Liberati, Tetzlaff, Altmann, The PRISMA Group, 2009) to search abstracts. Included articles were: peer-reviewed, published 2005 to present, from OT or allied health professions, and addressed self-advocacy or empowerment skills. Exclusion articles were: non-English, dissertations, and interventions related to self-determination instead of self-advocacy as defined above. METHOD: Multiple databases were searched using key phrases and combinations. These included PubMed, Ebscohost, PsycINFO, Google Scholar, and Sagepub. Professional journals were also searched: American Journal of Occupational Therapy, the Canadian Journal of Occupational Therapy, the Scandinavian Journal of Occupational Therapy, the Australian Occupational Therapy Journal, the British Journal of Occupational Therapy, and the Japanese Association of Occupational Therapy. Search terms included: self-advocacy, self-determination, occupational therapy, advocacy, empowerment, interventions, and allied health. The search resulted in 1184 reviewed abstracts. Using the inclusion/exclusion criteria 17 articles were identified. The study utilized the Feasibi