Date of Award


Degree Name

Doctor of Philosophy


Interdisciplinary Health Sciences

First Advisor

Dr. Kieran Fogarty

Second Advisor

Dr. Carla Chase

Third Advisor

Dr. Lori Gray


Occupational therapy, integrative health, interdisciplinary, complementary health, holistic health approaches, CHAIH


The use of complementary health approaches and integrative health (CHAIH) is increasing among adults and children in the United States and continues to grow within various health care settings. With Health and Wellness identified as a key practice area for occupational therapists and the American Occupational Therapy Association supporting the use of CHAIH in occupational therapy (OT) practice, practitioners must offer safe, research-driven treatments supporting this movement. Research around CHAIH continues to grow; yet the gaps in the literature make it difficult to determine how CHAIH is being used in OT practice as well as the practitioner’s perspectives on the integration of these therapies. This mixed methods dissertation implements an exploratory, cross-sectional survey design to examine the prevalence of use and practitioner’s perceptions around the integration of CHAIH in OT practice.

The first study explores the prevalence of CHAIH among OT practitioners, which CHAIH therapies are most commonly integrated into OT practice, and whether there are differences in the responses between the practitioners who do and do not integrate CHAIH in practice when self-rating their knowledge of and their general attitudes toward CHAIH. The results found that the majority of practitioners in the United States are using CHAIH in their clinical practice and that the most commonly used therapies include deep breathing, sensory techniques, yoga, mindfulness, and massage. The results also found a statistically significant difference between practitioners who do and do not integrate CHAIH therapies with clients, both when considering their self-rated knowledge of and their general attitudes toward these approaches.

The second study investigates which factors and characteristics of OT practitioners are significant predictors of whether they are integrating CHAIH into their clinical practice. A multiple logistic regression analysis found six significant predictors of whether an OT practitioner is more likely to use CHAIH with clients. These included the practitioner’s: perceived ability to bill for CHAIH services, primary practice setting, primary population served, years of clinical experience, exposure to CHAIH as a student, and personal use of CHAIH.

The third study examines what OT practitioners perceive to be the benefits and the barriers to integrating CHAIH and explores the differences in perspectives based on the primary setting in which they practice. Using a qualitative thematic content analysis, five major themes were derived reflecting the benefits and the barriers to integrating CHAIH. The perceived benefits include: Holistic/Client-Centered, Improve Mental Health, Access, Pain Management/Improved Physical Health, and Adds to “OT Toolbox.” The perceived barriers include: Lack of Knowledge/Formal Education, Reimbursement/Billing Issues, Access, Lack of EBP/Research, and Acceptance/Patient Buy-In.

Having a better understanding of the prevalence and perceptions around the incorporation of CHAIH within the OT profession will help to prioritize future research supporting the safe and consistent professional integration of these therapies. This three-paper dissertation offers a foundation for strategizing how to close the relevant gaps in the evidence-based practices related to CHAIH to help the OT profession tailor their standards more effectively.

Access Setting

Dissertation-Open Access