Factors influencing the use of aquatic therapy: perspectives from occupational therapists

Aquatic therapy has been identified as more conducive than land-based treatment options to improve health and quality of life in some patient populations. However, the prevalence of occupational therapists who implement aquatic therapy in practice is low. The aim of this study was to understand the perceptions of barriers and facilitators to aquatic therapy use by occupational therapists in the USA. Individual semi-structured interviews were completed (via Skype) with four occupational therapists who held an ‘aquatic therapeutic exercise certificate’ from the Aquatic Therapy and Rehab Institute. Interviews were audio recorded and manually transcribed verbatim. Inductive thematic analysis was employed to identify themes and sub-themes in the data. The following three overarching themes were identified: institutional constraints and resources impact aquatic therapy implementation; the perceived lack of unity within the occupational and aquatic therapy communities; and implications of aquatic therapy's low prevalence within the occupational therapy profession. Institutional factors including pool accessibility, insurance coverage, and employer support are determinants of practitioners' abilities to use aquatic therapy. The research identified a desire for support through networking and the need to build the authority of occupational therapists in aquatic therapy to offset the barriers implicated with being a minority profession.