Julie McLaughlin Gray PhD, OTR/L, FAOTA
Associate Chair of Curriculum & Faculty, Professor of Clinical Occupational Therapy
Room: CHP 133
Phone: (323) 442-2877
Julie McLaughlin Gray, an occupational therapist for more than 30 years, has extensive clinical experience in stroke and brain injury rehabilitation. She received her BS degree in Occupational Therapy from San Jose State University. She later received a master's degree in occupational therapy and a PhD in occupational science from the University of Southern California. Her doctoral research in occupational science examined the personal experience and complex process of recovery from stroke, and their relationship to occupation. Her publications within occupational therapy and occupational science literature address dynamic systems and occupation, a definition of occupation, occupation-centered practice and the relevance of the International Classification of Functioning, Disability and Health to occupational therapy and occupational science. Dr. McLaughlin Gray has also done extensive training and teaching in the Neurodevelopmental Treatment Approach for adults with hemiplegia, and has presented on interdisciplinary professional education and evidence-based practice in rehabilitation. She was named a Fellow of the American Occupational Therapy Association in 2015.
Dr. McLaughlin Gray is interested in stroke and brain injury rehabilitation and recovery, particularly concerning the survivor's experience and the emotional consequences of stroke, as well as the multiple ways in which occupation can be used to promote recovery.
Doctor of Philosophy (PhD) in Occupational Science
University of Southern California
Master of Arts (MA) in Occupational Therapy
University of Southern California
Bachelor of Arts (BA) in Occupational Therapy
San Jose State University
Schultz-Krohn, W., Pope-Davis, S. A., Jourdan, J. M., & Gray, J. M. (2013). Traditional sensorimotor approaches to intervention. In H. M. Pendleton & W. Schultz-Krohn (Eds.), Pedretti's occupational therapy: Practice skills for physical dysfunction (7th ed.). (pp. 796-830). St. Louis, MO: Mosby Elsevier. Link to full text
Flinn, N. A., Jackson, J. M., Gray, J. M., & Zemke, R. (2008). Optimizing abilities and capacities: Range of motion, strength, and endurance. In M. V. Radomski & C. A. T. Latham (Eds.), Occupational therapy for physical dysfunction (6th ed.). (pp. 573-597). Philadelphia, PA: Lippincott Williams & Wilkins. Link to full text
Gray, J. M. (2001). Optimizing abilities and capacities: Range of motion, strength, and endurance. In C. A. Trombly & M. V. Radomski (Eds.), Occupational therapy for physical dysfunction (5th ed.). (pp. 463-480). Philadelphia, PA: Lippincott Williams & Wilkins.
Gray, J. M., Kennedy, B. L., & Zemke, R. (1996). Application of dynamic systems theory to occupation. In R. Zemke & F. Clark (Eds.), Occupational science: The evolving discipline. (pp. 297-324). Philadelphia, PA: F. A. Davis.
Gray, J. M., Frank, G., & Roll, S. C. (2016). Integrating musculoskeletal sonography into rehabilitation: Therapists' experiences with training and implementation. OTJR: Occupation, Participation and Health, 37, 40-49. http://dx.doi.org/10.1177/1539449216681275. Link to full text Abstract →
Musculoskeletal sonography is rapidly extending beyond radiology; however, best practices for successful integration into new practice contexts are unknown. This study explored non-physician experiences with the processes of training and integration of musculoskeletal sonography into rehabilitation. Qualitative data were captured through multiple sources, and iterative thematic analysis was used to describe two occupational therapists' experiences. The dominant emerging theme was competency, in three domains: technical, procedural, and analytical. In addition, three practice considerations were illuminated: (a) understanding imaging within the dynamics of rehabilitation, (b) navigating nuances of interprofessional care, and (c) implications for post-professional training. Findings indicate that sonography training for rehabilitation providers requires multi-level competency development and consideration of practice complexities. These data lay a foundation on which to explore and develop best practices for incorporating sonographic imaging into the clinic as a means for engaging clients as active participants in the rehabilitation process to improve health and rehabilitation outcomes.
Gray, J. M., Coker-Bolt, P., Gupta, J., Hissong, A., Hartmann, K. D., & Kern, S. B. (2015). Importance of interprofessional education in occupational therapy curricula. American Journal of Occupational Therapy, 69, 6913410020p1-6913410020p14. http://dx.doi.org/10.5014/ajot.2015.696S02.
Roll, S. C., Gray, J. M., Frank, G., & Wolkoff, M. (2015). Exploring occupational therapists' perceptions of the usefulness of musculoskeletal sonography in upper-extremity rehabilitation [Brief report]. American Journal of Occupational Therapy, 69, 6904350020p1-6904350020p6. http://dx.doi.org/10.5014/ajot.2015.016436. Link to full text Abstract →
OBJECTIVE: To identify the potential utility of musculoskeletal sonographic imaging in upper-extremity rehabilitation.
METHOD: Two occupational therapists in an outpatient hand rehabilitation clinic were recruited by convenience, were trained in the use of sonography, and implemented sonographic imaging in their clinical practice. Qualitative data were obtained during and after the implementation period by means of questionnaires and interviews. Data collection, analysis, and interpretation were completed in an iterative process that culminated in a thematic analysis of the therapists' perceptions.
RESULTS: The data indicate four potential areas of utility for musculoskeletal sonography in upper-extremity rehabilitation: (1) mastering anatomy and pathology, (2) augmenting clinical reasoning, (3) supplementing intervention, and (4) building evidence.
CONCLUSION: Numerous potential uses were identified that would benefit both therapist and client. Further exploration of complexities and efficacy for increasing patient outcomes is recommended to determine best practices for the use of musculoskeletal sonography in upper-extremity rehabilitation.
Gonyea, J. S., & Gray, J. M. (2012). Making the transition to career in occupational therapy: Student perspectives. The Advisor: Journal of the National Association of Advisors for the Health Professions, 32(4), 20-23. Link to full text
Gray, J. M. (2001). Discussion of the ICIDH-2 in relation to occupational therapy and occupational science. Scandinavian Journal of Occupational Therapy, 8, 19-30. http://dx.doi.org/10.1080/110381201300078465. Link to full text
Gray, J. M. (1998). Putting occupation into practice: Occupation as ends, occupation as means. American Journal of Occupational Therapy, 52, 354-364. http://dx.doi.org/10.5014/ajot.52.5.354. Link to full text Abstract →
This article addresses a difficulty that many occupational therapists experience: maintaining occupation as the core of their therapeutic intervention. This difficulty not only results from but also contributes to occupational therapy's struggle with professional identity. Current manifestations of the problem are described as component-driven practice and the narrowing of occupation to basic activities of daily Living. The concepts of occupation as ends and occupation as means are proposed as a practical solution to guide treatment planning and merge remediation and adaptation within a single occupational session. Each concept is investigated in terms of its history within the profession and its usefulness for analyzing and solving therapeutic problems. These concepts are discussed as useful guidelines to help occupational therapists not only in their clinical decision making but also in their understanding and expression of the field's unique expertise. A case example, applying occupation as ends and occupation as means to evaluation and treatment, is presented.
Gray, J. M. (1997). Application of the phenomenological method to the concept of occupation. Journal of Occupational Science, 4, 5-17. http://dx.doi.org/10.1080/14427591.1997.9686416. Link to full text Abstract →
Phenomenology began as a movement in philosophy that deals with the essences of objects, or phenomena as they present themselves in human consciousness. The founding father of phenomenology, Husserl, believed that through rigorous examination of objects, as they are presented in one’s consciousness, a person could come to intuitively know the essence of those objectivities, or realities. He proposed that other disciplines might benefit from phenomenology as a way of identifying the main objectivities with which the discipline deals, before undertaking other inquiry. The phenomenological method outlines the steps of such an investigation. This paper uses the steps of the phenomenological method to explore the essence of occupation.
Roll, S. C., McLaughlin-Gray, J., & Frank, G. (2015). Competency development and complexities of clinical integration of musculoskeletal sonography by non-physician rehabilitation providers. In Ultrasound in Medicine and Biology. Paper presented at the 2015 AIUM Annual Convention and Preconvention Program Hosting WFUMB Congress. (pp. S20). doi:10.1016/j.ultrasmedbio.2014.12.124. Link to full text Abstract →
OBJECTIVES: Non-physician rehabilitation providers (e.g., occupational/physical therapists) have requisite expertise for effective use of point-of-care musculoskeletal sonography (MSKUS); however, professional curriculums provide only introductory-level image interpretation, at best. This multi-method study evaluated post-professional competency development and the complexities of clinical integration of MSKUS by non-physician rehabilitation providers.
METHODS: Three occupational therapists (OTs) received weekly, 2-3 hour, hands-on training from a RMSK-credentialed OT for 3 months. Training included ultrasound physics, imaging protocols, image acquisition, optimization and analysis. Prior to implementing MSKUS in the hand therapy clinic, minmum competency for selecting protocols, acquiring and interpreating images was determined using patient scenerios. During a 10-month implementation, therapists self-rated competency in image acquisition and interpretation on a 10-point visual analogue scale following each MSKUS use. Data were divided into early, mid, and late time periods to evaluate competency development. Semi-structured interviews throughout and following implementation provided deeper understanding of the complexities of clinical integration. Three researchers identified themes through interative anlaysis of interview transcripts and multiple consensus meetings.
RESULTS: Competency for acquiring images significantly increased (p<.05) between the early and mid phase (4.9 to 6.9), whereas competency for image interpretation did not show a significant increase until the late phase (5.8 to 7.6). Qualitative themes included numerous technical competencies nested within real-time interaction with the client, as well as perceived clinical use and professional constraints.
CONCLUSIONS: Utilization of MSKUS by non-physician rehabilitation providers diverged from diagnostic techniques to patient-centered applications (e.g., education, biofeedback). Post-professional MSKUS training programs for these providers will require an unique approach to address the various nested competencies and clinical considerations that differ from training provided to physicians and sonographers.