Occupational Therapy – what on earth is it?

Throughout my career the definition of Occupational Therapy has seemed somewhat elusive to my conversation partners, even though I am readily able to reply that it aims to help people increase independence, get the most out of life, use and engage in functional activities to overcome and adapt to physical and cognitive difficulties to achieve personal goals, and so forth. The World Federation of Occupational Therapy (WFOT) has a fabulous description on their webpage that I’ve referenced too, but instead I still get linked to Occupational Health (those responsible for checking and supporting health of employees), vocational or work therapists (which forms a part of Occupational Therapy) or linked to human resource management. Sometimes I’m not linked with anything and there’s an awkward pause before I’m asked, “But what does that actually mean?”. Let me try to break this down so that the meaning of Occupational Therapy is a bit clearer.

Some definitions suggest we build skills to enable people to perform activities and some definitions suggest we use activities to build skills and engagement. Both are correct. It’s a bit like the chicken and egg conundrum. Did you develop the skills before you did a task or did doing the task develop your skills? Some tasks only require certain skills. Some skills can be applied to multiple tasks.

This is what Occupational Therapy entails:

  1. We work with any age group to develop the skills within physical, cognitive, social and emotional domains to meet their daily/weekly demands at that specific stage of life. A toddler has different functional demands compared to a child attending school, a college student, a parent, a worker or a retired person.
  2. Each person’s demands are linked to their environment, activities and expectations of engagement. For example:
    • A 15-year-old child must go to school, should have the opportunity to play and socialise, needs to move about within their home and community environments, learn skills required to support crossover into adulthood (physical skills, work/study skills, personal care and independent living skills, domestic skills). These skills may depend on their home environment – if there is no carer to manage the laundry they may have to learn this sooner than their peers, if to get to school they need to use public transport then they may have to learn how to do this safely sooner than their peers who live within walking distance of the school and do not readily use a bus.
    • A 75-year-old lady, previously fit and will has had a stroke. She would have had existing skills that may now be lost or affected by this illness and require greater support and care from others. She was main carer for her grand-daughter and a volunteer in a local charity. Her daily demands are therefore different to a close friend who does not have to look after a child and was, instead, cared for by her family who lives with her.
    • A 35-year-old man, a manager in a company, requires extended time away from work due to stress. He is the main income provider for his family and without his salary they risk losing their home. He is also a key player in the town’s cricket team.
  3. What we need to do and want to do (to meet our demands) are our activities. For example, to get to work you may have to first get washed and dressed before preparing breakfast for a family of four. You may drive to work and may have to drive to multiple locations within your work day, ensuring that you have all your documentation with you so that you can easily discuss and communicate business matters to others. You may then need to shop for food on the way home, before going to the gym for your 60-minute workout. You help with childcare whilst your partner prepares the dinner. After eating you always read bedtime stories to the children and clean the kitchen. You then watch your favourite TV programme before going to bed.
  4. For Occupational Therapists, these activities are synonymous with ‘occupations.’ These are the things that you do. Every day. As part of your lifestyle. These activities allow you to go to work, enjoy your day, socialise, rest, have fun, look after yourself and others.
  5. Doing demands function and function supports doing. You learn how to do the task by doing it. Doing the task helps you build and hone the necessary skills to do it as you need to.
  6. Within these activities there are key skills that you will need to have to perform them successfully. If you need to pick up objects, then you need to have the necessary movement and strength to do so. If you need to manage at work, then you need to have the necessary cognitive skills to effectively do your job. If you are studying, you need to have the necessary physical and cognitive skills to negotiate campus and study to successfully graduate. Every activity requires a variety of skills to be effective, efficient and successful.
  7. When you’ve had an illness or injury activities are more difficult. You may be less able now but could become more able if the activity is adapted, equipment or environment is changed or if you relearn the skills to perform this task. Occupational Therapists are pros at analysing activities to see where adaptation and rehabilitation is required. Ideally, we want to support you being able to do things as you managed before, but if recovery is very slow or not possible then finding new ways of doing mean that you can still perform this activity on your own. Some things may be important to you. You may not care about cooking your favourite curry anymore, but it might still be important for you to have your family over for dinner. You may not want to manage the whole garden because of pain, but you still want to be able to grow and attend to your favourite roses. Occupational Therapists work with you to focus on those things are important to you – it is extremely important that you still live your life to the fullest for your own wellbeing and motivation. You need ‘feel good’ moments every day to balance out the difficult times when physical or cognitive skills are difficulty. Recovery can feel like work (it is!), but it is still important to have fun.
  8. Occupational Therapists are holistic therapists. We assess and treat physical, psychological/cognitive, and environmental factors that affect your engagement. We are solution focused to find the right solution for you. We know the importance of a balanced lifestyle and we support individuals in their recovery to keep a balance between work/study, play/fun, sleep, selfcare, socialisation and looking after others or a home. Everyone is different, and this balance should consider your goals, your lifestyle and your demands. This balance may require specific focus on regaining skills in certain areas (physical, mental, emotional), changing the environment or adapting tasks to accommodate difficulties to enable better engagement and success.
  9. Occupational Therapists can work in hospitals, schools, businesses, charities, hospices, elderly care homes … basically we can be anywhere. We work addressing physical and cognitive illness, but we also work to address social inclusion, for example working with ethnic minorities to support building skills and opportunities to engage and be included in the wider society.
  10. Occupational Therapists love to educate others. We aim to prevent deterioration in health and function as well as to treat this deterioration. We might educate your friends and family about you, if you require that they change or adapt their approach to support you best following an illness or injury. We might educate other clinicians (about you or about how we can support them to provide better healthcare and services to their clients). We might educate employers about what is needed to support someone with an illness or injury to return to work. We educate society about the needs of those with disabilities, so that environments become more accessible and so that work opportunities can be provided and maintained. We will certainly educate you – you will be learning new skills, new ways of doing, how to keep your dreams alive, cope when faced with challenges and set goals when things become difficult.
  11. Occupational Therapists can become specialists in certain areas, for certain age groups, or for certain illnesses. Just like a doctor can specialise in emergency care, elderly care, paediatrics, psychiatry or orthopaedic. Just like a Physiotherapist can specialise in sports injuries, spinal injuries or neurological rehabilitation.
  12. Occupational Therapists are available within statutory services, as well as private services. You can look for a private Occupational Therapists simply by doing a browser search for an independent Occupational Therapist or contact the Occupational Therapy association in your country/state.

For a much more succinct explanation of what Occupational Therapy is, have a look at the following links:

Posted on Jun 27, 2018