The mental health treatment journey requires a collaborative effort by many people — the individual, his or her caregivers, support providers, doctors, nurses, teachers, aides, counselors, therapists, and social workers. This collaborative process allows everyone to work together to reach a specific goal: improving the individual’s quality and enjoyment of life by identifying and meeting appropriate behaviors and skills.
Occupational therapy often is misunderstood in this process. According to the American Occupational Therapy Association, the primary goal of occupational therapy is to support and enable each person’s “health and participation in life through engagement in occupation.”
“Occupation” does not solely mean work. Some examples of occupations include time spent on personal hygiene, preparing a meal, managing finances, painting a picture, attending a community leisure course, and socializing with others. Occupational therapists enhance people’s ability to live meaningful and satisfying lives.
The purpose of occupational therapy can best be described by the profession’s motto, “Occupational therapy: living life to its fullest.” All individuals have a right to live life to its fullest. An occupational therapist can help people consider not only their needs, strengths, abilities, and interests, but also their physical, social, and cultural environment.
Origins of Occupational Therapy
While many commonly think of occupational therapy as physical rehabilitation after injury or illness, it actually has roots in mental health.
Occupational therapy’s emergence can be found as far back as eighteenth-century Europe. At a time when mentally ill people were treated like prisoners, a “moral treatment movement” began to evolve. While the previous treatment model was associated with punishment, brutality and idleness, the moral treatment movement sought to encourage kindness and the therapeutic value of engagement in purposeful activities.
The first occupational therapy treatment model, called Habit Training, began at Johns Hopkins in the early twentieth century. This approach proposed that in mentally ill people, occupational activities such as work, rest and play had become unbalanced. Early occupational therapists introduced therapeutic occupations such as weaving, art, and bookbinding. These goal-directed activities were used to help individuals learn new skills to be productive, and derive therapeutic benefits of a balanced daily schedule.
The occupational therapy profession grew as wounded soldiers returned from World War II, and then surged again in the 1970s with the medical field’s increase in specialized skills and knowledge.
Occupational therapists always have believed in treating the whole person, whether the primary problem relates to physical or mental health. They practice in diverse settings, including hospitals, outpatient clinics, skilled nursing facilities, intermediate care facilities, home health, neonatal intensive care units, community programs and the workplace. Those who work in mental health can do so in residential hospitals, community-based mental health settings and outpatient private practice clinics.
Assessments and Treatments
When working with someone with a mental health condition, occupational therapists employ a variety of assessments. Once the necessary information has been obtained, the therapist creates a personalized occupational profile. This profile is used for goal-setting and treatment planning.
Common areas of assessment include:
- Activities of daily living (e.g., bathing, dressing, eating)
- Instrumental activities of daily living (e.g., driving, money management, shopping)
- Education
- Work (paid and volunteer)
- Play
- Leisure
- Social participation
- Motor processing skills
- Mental and cognitive processing skills
- Communication and interaction skills
- Habits, roles and routines
- Performance contexts (e.g., cultural, physical, spiritual)
- Activity demands
- Client factors (e.g., difficulties due to body structures or functions)
- Occupational self-assessment
For example, an occupational therapist may assess a client with schizophrenia who is living in a residential hospital in order to help to determine the best placement in the community. The assessment may include standardized evaluation tools, individual interview, and observation to determine ability to function and live alone safely, and identify important roles and occupations. This information is then used to determine the skills, supports, and environmental modifications the person may need to live as independently as possible.
Occupational therapy can be vitally important in the overall mental health treatment process. Following are some common interventions:
- Life skills training
- Cognitive rehabilitation
- Supported employment
- Supported education
- Social and interpersonal skills training
- Life balance intervention
- Modalities such as biofeedback and mindfulness-enhanced therapy
Part of Collaborative Process
As noted in the beginning of this article, occupational therapists collaborate with many other professionals to help individuals on their road to recovery. While the role of the occupational therapist may overlap with other team members, the occupational therapist provides a unique theoretical and clinical contribution to the recovery and treatment team; thus, occupational therapy should be considered a vital part of a comprehensive and integrated treatment program.
Occupational Therapists (OT) are very important fixtures in the overall wellness machine. When we aren’t able to go about our daily routine, due to injury, illness or old age, our quality of life can suffer in immense ways. In general, when we think of occupational therapists, their relationship with improving the physical well-being of their patients is probably the first thing that comes to mind. However, they also play a vital role in improving the mental health of many people.
Read on for some insight into how the work that OTs do is greatly beneficial in the mental health space.
Occupational Therapists Help Manage Symptoms of Mental Health Disorders
Some mental health issues will never completely go away, but they can be managed effectively. Mental health occupational therapy is a common route for handling many of the symptoms of these kinds of issues. For example, a patient suffering from schizophrenic delusions may need help with sensory therapy; a patient with major depressive disorder could benefit from learning different, easier methods of basic home self-care.
OTs can also help to provide patients, and those around them, with an understanding of situational awareness, which can go a long way in ensuring that the patient suffering is safe.
Mental health OT Brittany Ferri explains: “If a therapist who has good situational awareness notices a patient is beginning to get agitated, they may use their verbal interpersonal skills to diffuse the situation before it worsens. This recognition is invaluable and can go a long way in preventing verbal altercations from potentially escalating to the point of physical violence.”
They Aid in Trauma and Mental Health Recovery
Similar to how they help patients recover from physical trauma, occupational therapists also play a role in helping patients overcome mental trauma, so that they can live their lives to their fullest potential.
According to the American Occupational Therapy Association (AOTA), “OT practitioners work collaboratively with people in a manner that helps to foster hope, motivation, and empowerment, as well as system change. Educated in the scientific understanding of neurophysiology, psychosocial development, activity and environmental analysis, and group dynamics, OT practitioners work to empower each individual to fully participate and be successful and satisfied in his or her self-selected occupations.” Recovering from trauma such as abuse or addiction rarely follows a simple path, so having a professional on your side can be very comforting.
They Allow Us to Do What Makes Us Happy
Remaining physically independent is directly linked with being mentally stable, and occupational therapy can empower patients to achieve this. In situations where a patient isn’t currently suffering from a mental illness, it is often the case that not being able to participate in activities that we enjoy can lead to feelings of depression and hopelessness. Providing exercises and resources that may allow their patients to do the things that they enjoy, occupational therapists play a vital role in improving and retaining their quality of life.
Whether it means adapting the way we perform actions or tasks, or changing them to something completely different, occupational therapists have a deep understanding of both how illness and injury can affect an individual’s participation in daily life, as well as the side effects that accompany that inability to participate.
Even when injury or illness isn’t a factor, certain life transitions such as going to school far away from home can be eased by the work that OTs do. They employ a ‘strengths-based, hands-on, practical approach to helping [students] manage’ their symptoms. Overall, by restoring our ability to do the things that make us happy, or even just the things that we need to be able to do to function, OTs improve our mental health.
Are you looking for a great position in occupational therapy? Rehabilitative therapy is one of our specialties, along with advanced practice, healthcare management, pharmacy, medical imaging and lab science. Reach out to Radius to see how we can help you find your next great OT position.
Did you know that occupational therapy originated in the mental health setting? The profession developed from the mental hygiene movement of the early 20th century. The first occupational therapists worked with American soldiers who came back home “shell shocked” after World War I, teaching them crafts and vocational skills that would improve their morale. From there, occupational therapy continued into community health centers after the deinstitutionalization movement in the mid-20th century. In fact, most occupational therapists once worked in mental health. That number has decreased over the years, but new opportunities are arising with recent changes in the mental health field.
Mental illness is the leading cause of disability in the world. According to the World Health Organization, these are defined as “illnesses characterized by abnormal thoughts, perceptions, emotions, behavior, and relationships with others.” People may be diagnosed with depression, bipolar disorder, schizophrenia and other psychoses, dementia, as well as developmental disorders including autism (WHO). These illnesses can be debilitating and lead people to struggle with the normal activities of daily life. They can also cause significant disruption to a patient’s life and the return to a “normal life” may take a deliberate process of recovery.
The World Health Organization defines these major mental health conditions:
Depression: A common mental health condition characterized by “sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, tiredness, and poor concentration.”
Bipolar Disorder: A mental health condition characterized by alternating elevated moods, with an inflated sense of self-esteem, and depressed moods.
Schizophrenia and other psychoses: Severe mental health disorders resulting in “distortions in thinking, perception, emotions, language, sense of self and behavior.”
Dementia: A mental health condition affecting older people that leads to a deterioration of cognition beyond what is normal for aging.
Developmental disorders including autism: Intellectual disability and pervasive developmental orders that impair cognitive function, behavior, language, and communication.
Doctors may first prescribe medication and talk therapy to patients with mental illnesses. However, medication and talk therapy may not address the significant changes to the patient’s life that their mental illness may have brought about. That’s where the benefits of occupational therapy come in.
Today, occupational therapy is more widely practiced in rehabilitation and pediatric settings, but it’s still present in mental health recovery. The Substance Abuse and Mental Health Administration (SAMHSA) defines recovery as “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” Occupational therapy in the mental health setting is a collaborative effort between the client and the practitioner. Occupational therapists teach clients useful skills and strategies that can assist them on the road to recovery.
Occupational therapists will first seek to understand the activities that the client needs to do in addition to the activities that are most meaningful to them. It’s a holistic therapy that considers not only the health and wellness of the patient, but also the “occupations” that enable them to participate fully in life, including education, work, social activities, and leisure. Occupational therapy also focuses on instilling hope, motivation, and empowerment in clients, as well as helping them build resilience. OT can lead to lasting benefits for patients who are recovering from mental health issues.
Mental illness can be an extremely devastating medical condition. Not only can the symptoms lead to challenges in the activities of daily life, patients who suffer from mental illness often lose motivation and a sense of self-esteem. They often isolate themselves. The illness can be painful, something they suffered for an extended period of time, and that has profoundly disrupted their lives. Depression, for example, causes people to lose energy and motivation, which in turn can make them isolated. The isolation may lead to further negative thoughts and exacerbate their depression. An illness such as schizophrenia can lead to a significant deviation from the lives of the people around them, causing them to drop out of school, stop working, and potentially become ostracized from society.
Yet as many occupational therapists might explain, the need to do things is an essential part of being human. People do things that are necessary, and they do things because they want to do them. These are called the “occupations.” People who are suffering from depression may need help from a professional to regain the ability and motivation to participate in many activities. Occupational therapists work with patients to build skills and adapt their environment in ways that make it easier for them to do the things they both need and want, helping patients regain a sense of accomplishment and pleasure from taking action to help themselves.
When working with mental health clients, occupational therapists may carry out the following interventions:
- Teaching clients the skills of living independently
- Teaching interpersonal and social skills
- Educating clients on stress management
- Educating clients on assertiveness
- Educating clients on hygiene
- Collaborating with clients on career choices
- Collaborating with clients on job placement and career skills
- Helping clients develop and accomplish leisure activities
- Providing cognitive behavioral therapy to help clients think more realistically
- Providing cognitive rehabilitation to address cognitive deficits
Occupational therapy can be an important part of a holistic program to treat mental illness. OTs collaborate with psychiatrists, therapists, social workers, and families to guide their clients along the journey to recovery. During treatment, they will communicate with the other healthcare workers in the program regarding how other aspects of the treatment are affecting the client’s ability to participate in the activities of daily life. They might observe and document whether a change in medication is creating more side effects than expected or whether the program is helping the client improve in cognitive ability, concentration, and morale.
At Rehab Select, occupational therapists work with the other members of the treatment to gain a detailed picture of the patient as a whole person. Throughout the course of treatment, each of the disciplines will meet weekly to discuss each patient and their progress, sharing ideas, observations, and strategies that help move the treatment plan forward. Learn more about Rehab Select’s occupational therapy program by scheduling a tour.
