The faculty in Programs in Occupational Therapy have a broad range of research interests reflecting their clinical expertise in neuromusculoskeletal rehabilitation, cognitive and perceptual retraining, and mental health practice—across the entire life span. Two primary research areas in which Columbia OT faculty are actively involved are the (a) assessment of occupational therapy treatment practices and (b) the development and assessment of OT evaluation instruments. These applied research areas are critical to provide evidence for the efficacy of OT practice methods with a variety of patient populations and developmental/age levels. Such evidence is necessary to demonstrate to both society and managed care organizations that the profession’s treatment methods are effective and safe. This evidence will help the profession to maintain its valued role in today’s health care arena.
The following is a compilation of our faculty’s most current research endeavors.
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| Janet Falk-Kessler, EdD, OTR, FAOTA, and Pamela Miller, MA, OTR |
Dr. Falk-Kessler and Professor Miller are currently investigating the relationship between disability, resilience, and occupational therapy rehabilitation practices. Their primary focus of inquiry asks how occupational therapy practices can facilitate resilience after the onset of disability in various patient populations—including spinal cord injury, upper extremity impairment, and acquired visual deficits. Preliminary data has shown that occupational therapists play key roles in fostering specific resilient mechanisms and promoting adaptation as part of the therapeutic process. Ongoing research goals include (a) identifying the level of resilience in individuals with challenges to independent function; (b) examining the relationship between resilience and perceived independence in daily life activities; (c) identifying common factors that influence resilience in the rehabilitation process; and (d) exploring how occupational therapists use therapeutic use of self to enhance the development of resilience in patients. |
| Glen Gillen, EdD, OTR, FAOTA |
Dr. Gillen’s current research involves the assessment of OT interventions designed to enhance functional performance in daily life activities after sustaining neurological insult—such as a cerebrovascular accident (CVA), or stroke. Dr. Gillen’s expertise lies in clinical and research work having a focus on stroke rehabilitation. Specific research includes (a) the use of mental practice to improve mobility skills after stroke, (b) examining the relationships among coping styles and recovery during stroke rehabilitation, and (c) assessing the use of functionally-based interventions to document patient performance outcomes. |
| Christine Chen, ScD, OTR, FAOTA |
| Dr. Chen is currently in the 5th year of an NIH career development grant. Her research focus is the development of the Manual Ability Measure 36—a valid and reliable self-report hand function evaluation for patients with wrist and hand injuries, and neurological (e.g., CVA, MS) and musculoskeletal (e.g., RA, OA) pathologies affecting the hand. In the second phase of her research Dr. Chen examined the relationship between patients' perceived hand function (using the MAM-36) and clinician observed hand function (based on standardized performance measures of grip, dexterity, and simulated daily activities). In the summer of 2007 Dr. Chen traveled to Taiwan to translate and culturally adapt the Manual Ability Measure into Chinese. Once translated, preliminary testing of the MAM-36 was then implemented. Dr. Chen and her Taiwanese collaborators are currently conducting several validation studies with stroke and orthopedic patients in Taiwan. Future research directions include the continuation of test validation of the MAM-36 (e.g., test-retest reliability and responsiveness), and its ability to evaluate rehabilitation and functional outcomes. |
| Sharon Gutman, PhD, OTR |
| In the last years Dr. Gutman has been involved in the development and assessment of supported education services for adults with psychiatric disabilities. Such services are designed to help this population pursue postsecondary educational goals with appropriate accommodations and foundational academic skill training. Dr. Gutman is currently in the process of refining these supported education services to benefit adults who sustained traumatic brain injury and desire to pursue higher education. |
| Patricia Miller, EdD, OTR, FAOTA |
| Dr. Miller is the principal investigator of a grant funded by the Glenda Garvey Teaching Academy, Columbia University (2007-2009) entitled, Facilitating Change to Promote Health in Older Adults: An Interdisciplinary Education Program. Through this work, faculty and clinicians will gain new and improved skills for teaching and practicing collaborative health promotion strategies, guided by Prochaska and DiClemente’s Transtheoretical Model of Change (TTM). Faculty will apply/adapt these skills to older adults’ needs while providing instruction to residents and OT students in academic and clinical settings. A TTM curriculum will be incorporated into the Division of Geriatric Medicine and Aging and Programs in Occupational Therapy, in the Faculty of Medicine, and serve as a model for replication elsewhere. |
| Marianne Mortera, PhD, OTR |
| Dr. Mortera developed the Mortera Cognitive Screening Measure (M-CSM) and has completed initial testing of the screen for content validity and interrater reliability. The M-CSM is a functional screening measure that was designed to be used with individuals having sustained an acquired brain injury such as stroke, traumatic brain injury, tumor, or hemorrhage. The M-CSM, unlike typical paper and pencil assessments, incorporates two kitchen tasks that reflect real-life cognitive challenges that patients will encounter once discharged. The M-CSM is an ecologically valid screening measure that can identify the cognitive deficits (in attention, memory, and executive functions) that patients may exhibit in real-life functional tasks. Testing regarding interrater reliability is currently being conducted to refine the instrument and add to the body of knowledge concerning the profession’s development and testing of functional screening measures. |
| Emily Raphael, MA, MS, OTR |
| Professor Raphael’s research interests include (a) executive functioning and the psychiatric population, (b) homelessness and the transition to housing, (c) projective activities as a means of coping with trauma, and (d) occupational therapy within the context of special education. In collaboration with Project Renewal, Professor Raphael and Dr. Falk-Kessler received funding from the van Ameringan Foundation to establish a Model Apartment Program for homeless individuals. Based on pilot programs run under Professor Raphael's supervision, this program is designed to enhance clients’ ability to compete for housing, increasing overall placements and reducing each clients’ length of stay in a shelter. The program is also designed to demonstrate the long-term efficacy of occupational therapy as a “housing readiness” strategy to enhance the ability of the homeless mentally ill to obtain housing. |
| Sabrina Salvant, EdD, MPH, OTR |
| Dr. Salvant’s current research interests include obesity prevention in adults, children, and minority populations. She has also explored the relationship between occupational therapy services and multiculturalism, cultural diversity, and cultural sensitivity. Presently Dr. Salvant and Professor Tupe are conducting research investigating how effectively occupational therapy services help children with disabilities to participate more fully in their social and/or cultural environments. |
| Debra Tupe, MS, MPH, OTR |
| Professor Tupe is currently exploring how pediatric disability is internationally perceived through social, cultural, and political contexts that influence available health care services. Her work has primarily been carried out in Cuba and Nicaragua where she has begun assisting mothers of children with disabilities to advocate for needed health care for their children. Professor Tupe is also collaborating with Dr. Miller in the design of an educational model that will facilitate the acquisition of cultural competencies in health care providers. |
| Occupational Therapy Consultation to Other Research Teams |
As experts in functional retraining and performance, the Columbia OT faculty are able to serve as consultants to fellow translational researchers in the Columbia University community and beyond. Occupational therapists specialize in maximizing patient performance in functional daily living skills—despite illness, injury, disability, or developmental delays. In today’s competitive health care market, patient treatment that does not consider how well patients can resume functional activities after discharge is perceived as lacking an important measure of effectiveness.
Sequelae that impair patients’ functional performance commonly develop over time after patients have been discharged. Such sequelae often lead to a downward spiral of functional decline resulting in hospital readmissions, increased health care costs, and poorer overall patient health. For example, balance and vestibular problems that appear minor in the clinical environment and are not identified using functional evaluations can lead to multiple falls after discharge. Similarly, cognitive, perceptual, and sensory difficulties—that are not detected on evaluation in the clinical environment—can lead to burns from scalding showers or kitchen fires. Cognitive, perceptual, and sensory problems may cause patients to be unable to accurately feel temperatures or read hot/cold dials once at home. Perceptual and sensory impairment can also lead to the dropping and loss of medication in pill form, causing further decline in health and function.
As part of a translational research team, Columbia OT faculty can help to identify the relationship between specific areas of impairment and likely functional performance deficits—so that such probable deficits can be addressed as part of the clinical research protocol. OT faculty can also help clinical researchers to measure functional performance using ecologically sound evaluations that reflect real-life activities. Participation in such real-life activities is a more accurate indicator of treatment effectiveness and largely determines patients’ perceived quality of life.
If you would like to seek consultation with one of our OT faculty please contact the Director of Programs in Occupational Therapy, Janet Falk-Kessler, EdD, OTR, FAOTA (212-305-1645, jf6@columbia.edu). |
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