Occupational Therapy & Benefits

Occupational therapy – Mental health

Mental health and the moral treatment era have been recognized as the root of occupational therapy. According to the World Health Organization, mental illness is one of the fastest growing forms of disability. 

Mental health illnesses that may require occupational therapy include:

• Schizophrenia and other psychotic disorders
• Depressive disorders
• Anxiety disorders
• Eating disorders
• Trauma – and stressor-related disorders

Obsessive-compulsive and related disorders such as hoarding, and neurodevelopmental disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder, and learning disorders.

Productive aging

Occupational therapists work with older adults:

• To maintain independence
• Participate in meaningful activities
• Live fulfilling lives

Some examples of areas that occupational therapists address with older adults are:

• Driving
• Aging in place
• Low vision
• Dementia or Alzheimer’s Disease (AD)

When addressing driving, driver evaluations are administered to determine if drivers are safe behind the wheel. To enable the independence of older adults at home, occupational therapists perform falls risk assessments, assess clients functioning in their homes, and recommend specific home modifications.

When addressing low vision, occupational therapists modify tasks and the environment.

While working with individuals with AD, occupational therapists focus on maintaining the quality of life, ensuring safety, and promoting independence.

Visual impairment

Visual impairment is one of the top 10 disabilities among American adults. Occupational therapists work with other professions, such as optometrists, ophthalmologists, and certified low vision therapists, to maximize the independence of persons with a visual impairment by using their remaining vision as efficiently as possible.

AOTA’s promotional goal of “Living Life to Its Fullest” speaks to who people are and learning about what they want to do, particularly when promoting the participation in meaningful activities, regardless of visual impairment.

Occupational therapy for older adults with low vision includes:

• Task analysis
• Environmental evaluation
• Modification of tasks or the environment as needed

Many occupational therapy practitioners work closely with optometrists and ophthalmologists to address visual deficits in acuity, visual field, and eye movement in people with traumatic brain injury, including providing education on compensatory strategies to complete daily tasks safely and efficiently. 

Adult rehabilitation

Occupational therapists address the need for rehabilitation following an injury or impairment. When planning treatment, occupational therapists address the physical, cognitive, psychosocial, and environmental needs involved in adult populations across a variety of settings.

Occupational therapy in adult rehabilitation may take a variety of forms:

• Working with adults with autism at day rehabilitation programs to promote successful relationships and community participation through instruction on social skills
• Increasing the quality of life for an individual with cancer by engaging them in occupations that are meaningful, providing anxiety and stress reduction methods, and suggesting fatigue management strategies
• Coaching individuals with hand amputations how to put on and take off a myoelectrically controlled limb as well as training for functional use of the limb
• As for paraplegics, there are such things as sitting cushion and pressure sore prevention. Prescription of these aids is the common job for paraplegics.
• Using and implementing new technology such as speech to text software and Nintendo Wii video games
• Communicating via telehealth methods as a service delivery model for clients who live in rural areas
• Working with adults who have had a stroke to regain strength, endurance, and range of motion on their affected side.

Travel occupational therapy

Because of the rising need for occupational therapists in the U.S., many facilities are opting for travel occupational therapists—who are willing to travel, often out of state, to work temporarily in a facility.

Assignments can range from 8 weeks to 9 months, but typically last 13–26 weeks in length. Most commonly (43%), travel occupational therapists enter the industry between the ages of 21–30.

Work and industry

Occupational therapists work with clients who have had an injury and are returning to work. OTs perform assessments to simulate work tasks in order to determine best matches for work, accommodations needed at work, or the level of disability. 

Occupational justice

The practice area of occupational justice relates to the “benefits, privileges and harms associated with participation in occupations” and the effects related to access or denial of opportunities to participate in occupations. Examples of populations that experience occupational injustice include:

• Refugees
• Prisoners
• Homeless persons
• Survivors of natural disasters

For example, the role of an occupational therapist working with refugees could include:

• Addressing developmental delays and psychological trauma of children through participation in the occupation of play
• Training workers at refugee camps who work with children on common issues associated with child forced migration and strategies to address these issues through occupation
• Educating and lobbying politicians and the public on the effects of forced migration on children and what can be done

Occupational injustice

In contrast, occupational injustice relates to conditions wherein people are deprived, excluded or denied opportunities that are meaningful to them. Types of occupational injustices and examples within the OT practice include:

• Occupational deprivation: The exclusion from meaningful occupations due to external factors that are beyond the person’s control. As an example, a person who has difficulties with functional mobility may find it challenging to reintegrate into the community due to transportation barriers.
• Occupational apartheid: The exclusion of a person in chosen occupations due to personal characteristics such as age, gender, race, nationality or socioeconomic status. An example can be seen in children with developmental disabilities from low socioeconomic backgrounds whose families would opt out from therapy due to financial constraints.
• Occupational marginalization: Relates to how implicit norms of behavior or societal expectations prevents a person from engaging in a chosen occupation. As an example, a child with physical impairments may only be offered table-top leisure activities instead of sports as an extracurricular activity due to the functional limitations caused by his physical impairments.
• Occupational imbalance: The limited participation in a meaningful occupation brought about by another role in a different occupation. This can be seen in the situation of a caregiver of a person with a disability who also has to fulfill other roles such as being a parent to other children, a student or a worker.
• Occupational alienation: The imposition of an occupation which does not hold meaning for that person. In the OT profession, this manifests in the provision of rote activities which does not really relate to the goals or the interest of the client.

Within occupational therapy practice, injustice may ensue in situations wherein professional dominance, standardized treatments, laws and political conditions create a negative impact on the occupational engagement of our clients. Awareness of these injustices will enable the therapist to reflect on his own practice and think of ways in approaching their client’s problems while promoting occupational justice.