As of recent, the role of occupational therapy within PrairieCare has transitioned from the inpatient setting to a solely outpatient consultation basis. The purpose of this blog is to identify the role of occupational therapy in the mental health setting and to highlight the plethora of evidence-based approaches with children and adolescents.
What is Occupational Therapy (OT)?
To start, the profession of occupational therapy is defined as “the therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of enhancing or enabling participation in roles, habits, and routines in home, school, workplace, community, and other settings” (American Occupational Therapy Association [AOTA], 2014, p. S1). To put it more simply, occupational therapists help individuals get back to doing what they want to do. Occupational therapists can work with individuals with physical injuries, cognitive impairments, psychosocial dysfunction, mental illness, and developmental or learning disabilities. Occupational therapists evaluate the whole individual by looking at the transaction between client factors (values, beliefs, spirituality, mental function, sensory function, etc.), performance skills (motor skills, process skills, social interaction skills), environment/context, and performance patterns (habits, routines, roles, rituals) in order to promote, establish/restore, maintain, or modify the task to enable participation in desired life activities. In addition, occupational therapists can focus on prevention of the potential barriers to participation in desired activities (AOTA, 2014).
Occupational therapists working in the mental health settings focus on enabling individuals to re-engage in meaningful occupations through a variety of skill sets such as skills development, establishing positive habits and routines, setting therapy goals, using cognitive-behavioral techniques (CBT), and understanding underlying physiological influences (AOTA, 2016b). Specifically, occupational therapy within the setting of child and adolescent mental health focuses on those underlying physiological influences and teaching patients to identify and utilize self-regulation strategies in order for patients to get back to participating in meaningful occupations such as going to school, being with friends, and participating within the family system (AOTA, 2016a). In addition, occupational therapists can work with individuals with sensory processing disorders (SPD) and social-emotional learning dysfunction, which are commonly seen within the child and adolescent setting of mental health (AOTA, 2016b).
What approaches do OT’s use with clients/patients?
The following evidence-based approaches support the profession of occupational therapy within this child and adolescent mental health setting. These evidence-based approaches include:
- Providing education on coping skills and self-regulation skills to use in a variety of contexts
- Providing education on sensory exploration and implementation of sensory approaches for self-regulation
- Incorporating yoga and movement interventions to provide sensory input and achieve self-regulation
- Utilizing CBT approaches to facilitate participation in desired activities
- Identifying and implementing healthy, positive habits and structure into daily routines
- Providing education and implementation of skills related to social competence, such as making and keeping friends, coping with anger, solving problems, learning about social etiquette, and following school rules
- Evaluating factors interfering with success in school, home, community, etc.
- Modifying the environment to support improved attention, participation and decrease sensory overload in the classroom
- Providing parents with education on behavioral and psychosocial approaches to enhance the child’s daily functioning
- Reducing restraints and seclusions in the inpatient setting by conducting comprehensive assessments to determine facilitators and barriers to participation in life tasks, promoting the use of self-awareness and skills development, collaborating with the client to develop attainable goals, modifying the environment for optimal fit, promoting use of self-regulation and sensory strategies, and educating the interdisciplinary team on prevention techniques.
Overall, it is clear that occupational therapists have the distinct knowledge and skill sets to provide effective, holistic interventions within the mental health setting. There is strong evidence to support the incorporation of occupational therapy skills such as sensory approaches and psychosocial techniques within psychiatric settings to facilitate daily life functioning.
Alison Tonsager, Occupational Therapy Student
Madonna Mitzel, MS, OTR/L, Outpatient Occupational Therapist
References
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1– S48. doi: 10.5014/ajot.2014.682006
Image credit: BD Hypno Plus
Occupational therapy focuses on the therapeutic use of daily activities (or occupations) with individuals or groups. This is to improve their participation in roles, habits, and routines in the home, school, workplace, community, or other settings. An occupational therapist helps you to get back to your customary activities as much as possible. They work with individuals who have physical and cognitive impairments, psychosocial dysfunction, mental illness, and developmental (or learning) challenges. So let’s discuss the significance of occupational therapists and mental health interventions.
Occupational Therapists and Mental Health and Wellness
An occupational therapist assesses each client holistically. For each client, they will consider various factors such as:
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Values, beliefs, spirituality, mental function, sensory function, etc.
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Performance skills (or motor, process, and social interaction skills)
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Environment or context
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Performance patterns (or habits, routines, roles, etc.)
Your occupational therapist will work with you to promote, establish (or restore), maintain, or modify tasks to help you participate fully in your daily life. Furthermore, occupational therapists will seek to prevent potential barriers to participation in desired activities.
Is Occupational Therapy Considered Mental Health
Assistance?
Mental health is an essential component of all occupational therapy interventions. Occupational therapists provide mental health treatment and prevention services for all – children, youth, the aged, and people with severe and persistent mental illness. All interventions focus on improving each client’s function and independence.
Occupational therapists work in mental health settings and they focus on enabling persons to re-engage in useful occupations. How do they do this? They help each client build a variety of skill sets, establish good habits and routines, set therapy goals, apply cognitive-behavioral techniques (CBT), and understand and counter physiological influences.
Within the settings of children’s and adolescents’ mental health, occupational therapy focuses on these physiological influences. They teach clients how to identify and utilize self-regulation strategies to get them back to participating in meaningful activities like going to school or work and interacting with family and friends.
Also, occupational therapists serve individuals with sensory processing disorders (SPD) and social-emotional learning dysfunctions. These conditions are usually seen within the children and adolescent segments of the mental health sector.
Occupational Therapy and Community Mental Health
Did you know that occupational therapy has its roots in mental health? It’s true! The creation of the profession coincided with the early 20th century’s mental hygiene movement.
Eventually, the call for deinstitutionalization of people with mental challenges led to the 1963 Community Mental Health Act. This act meant that occupational therapists and their assistants began working in community mental health. Today, occupational therapy within community mental health settings provides services such as:
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Community mental health centers
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Assertiveness community treatment (ACT) teams
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Psychosocial clubhouses
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Homeless and women’s shelters
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Correctional facilities
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Senior centers
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Consumer-operated programs
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After-school programs
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Homes
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Worksites
As mental health services have shifted from the hospital to the community, there has also been a paradigm shift in the service delivery philosophy. Traditionally, there was an emphasis on the medical model, but now the focus is on implementing the recovery model.
This latter model acknowledges that recovery is a long-term process and clients are encouraged to keep participating in community activities until they can do so fully. Therefore, occupational therapy activities include finding and keeping employment, going to school, and living independently.
The philosophical foundation of this recovery model is the integration of occupational therapy with community mental health. The goal of this integration is to increase your ability to live independently, as much as possible, in the community as you engage in productive daily activities.
Occupational therapy facilitates your participation and is client-centered. It also plays a significant role in the success of those recovering within the community. Occupational therapists and occupational therapy assistants are educated to deliver mental and physical health and wellness services, rehabilitation, habilitation, and recovery-focused approaches. They are also trained in clinical fieldwork that’s focused on assessing psychosocial issues.
Examples of Occupational Therapy Within Mental Health
Occupational therapy interventions improve the health outcomes of those with mental health challenges. These interventions are found in the areas of education, work, skills training, health, and wellness, as well as cognitive remediation and adaptation. Some examples of occupational therapy interventions in community mental health include:
Evaluating and adapting the home, work, school, and other settings to facilitate your optimal functioning.
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Providing educational programs, experiential learning, and treatment groups or classes to address key issues. These issues include assertiveness, self-awareness, interpersonal and social skills, stress management, and role development (for example, parenting).
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Helping clients develop leisure or avocational interests and pursuits.
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Developing skills for independent living such as using community resources, managing your home, time, and medication, as well as being safe at home and in the community.
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Providing training in daily living activities (for example, hygiene and grooming).
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Consulting with employers about appropriate accommodations for their clients (as required by the
1990 Americans with Disabilities Act
).
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Conducting functional evaluations and ongoing monitoring for successful job placement.
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Guiding and consulting with persons in all employment settings (including supportive employment).
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Providing evaluation and treatment for sensory processing deficits.
Occupational therapy benefits individuals of all ages with a variety of mental illnesses. Furthermore, friends and family members also benefit from occupational therapy as they learn how to deal with the stress of caregiving and successfully balance their daily responsibilities in life.
Occupational Therapy Approaches
Occupational therapists use several evidence-based approaches within the mental health environment. They include:
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Teaching coping and self-regulation skills that are useful in a variety of contexts.
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Educating people about sensory exploration and implementing sensory approaches for self-regulation.
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Utilizing CBT approaches to support your participation in desired activities.
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Identifying and implementing healthy, positive habits, and structure into daily routines.
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Supporting the learning and implementation of key skills. These skills include those related to social competence (like making and keeping friends), coping with anger, solving problems, learning about social etiquette, and following rules.
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Evaluating factors that block your success in school, at work, as well as in your home and community.
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Modifying your environment to support improved attention, participation, and decrease sensory overload at school and/or at work.
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Educating parents about important behavioral and psychosocial approaches to enhance their children’s daily functioning.
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Reducing restraints and seclusions within the inpatient setting. This is done via comprehensive assessments to determine what facilitates and bars your participation in:
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Life tasks
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Self-awareness and skills development
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Developing attainable goals
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Modifying your environment for optimal fit.
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Promoting the use of self-regulation and sensory strategies.
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Educating an interdisciplinary team on prevention techniques.
Can an Occupational Therapist Assist With Anxiety?
Occupational therapy plays a significant role in helping clients suffering from anxiety to manage their condition. An occupational therapist will work with you to identify how anxiety is affecting you, teach you valuable coping skills, and help you work towards achieving your future goals.
Can an Occupational Therapist Perform Psychotherapy?
Occupational therapists are authorized to provide psychotherapy services. Furthermore, these psychotherapy services are performed according to the standards of the practice.
What You Can Expect From a Mental Health Occupational Therapist
Many people think of occupational therapy as applicable to pediatric services or physical rehabilitation. So they are often surprised to find occupational therapists working in mental health environments. So if you, a relative, or a friend is seeing a mental health occupational therapist, then keep reading to learn about how they can help you.
An Occupational Therapist’s Contributions to a Mental Health Treatment Team
An occupational therapist undergoes training in holistic approaches that are suitable for work in mental health settings. Their areas of training include:
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Physical wellbeing
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Cognitive assessment
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Sensory strategies
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Therapeutic alliances
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Group activities
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Participation in activities of daily living (ADLs)
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Socio-emotional skills
Occupational therapy assists clients to participate in daily activities as independently as possible.
Mental Health Occupational Therapy Interventions
Some of these interventions include:
Lead Groups
Occupational therapists are trained to create lead groups in areas that focus on:
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Life skills
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Job readiness
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Therapeutic cooking
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Money and time management
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Wellness recovery action plans (WRAPs)
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Therapeutic leisure
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Nutrition
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Sensory groups
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Independent living
Apply Calming Strategies
Occupational therapists use activities of daily living (ADLs) or occupations to aid in optimal mental health and welfare. They may also help you use coping mechanisms like listening to music, playing cards, writing, drawing, cooking, or cleaning.
They are also experts at applying sensory strategies. Your sensory system helps you process information that you gather from your environment. Clients with mental health challenges have a compromised ability to process sensory input, which can lead to them feeling agitated and unsafe.
Sensory strategies activate your basic processing systems like the vestibular, proprioceptive, and deep pressure touch, to help you process information. These strategies help you to feel safe and calm. These sensory strategies may prove very helpful for persons who may not be able to benefit from talk therapies.
Sensory Rooms
Occupational therapists serve as a part of a larger movement to create sensory rooms in mental health facilities. These sensory rooms are safe havens for clients. These rooms also tend to have tools to help them de-escalate and relax.
Evaluate Discharge Preparedness
Occupational therapists use a series of assessments to see if clients are ready to be discharged. These standardized assessments provide valuable information. In turn, this information helps your treatment team understand the level of care that’s required for discharge and to monitor your treatment progress.
Address Physical Wellbeing
Another vital service that an occupational therapist provides is their physical rehabilitation background. Mental health issues are often accompanied by physical health issues.
In a mental health environment, you may find that your occupational therapist:
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Addresses general strengthening
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Adjusts wheelchairs
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Recommends adaptive equipment
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Performs any other activity that’s within the scope of occupational therapy
Advocate for Your Safe Independence
Your occupational therapist will assist you in mastering your daily activities. If your mental health condition compromises your ability to fully complete your daily activities, then speak to your occupational therapist about your concerns. Even if your occupational therapist doesn’t have the tools necessary to address your mental health requirements, they can advocate on your behalf and assist you to get the help you need.
Mental Health Specializations
Many occupational therapists are experts in trauma-informed care and the recovery model. They gain this expertise either through their schooling, workplace training, or independent study. Some occupational therapists will then proceed to earn their Certified Psychiatric Rehabilitation Practitioner (CPRP) certification.
Occupational therapists possess unique knowledge and skills that facilitate effective, holistic mental health interventions. Incorporating occupational therapy skills like sensory approaches and psychosocial techniques help clients to effectively function in their daily lives.
How Long is Rehab After a Mental Health Incident?
After a mental health crisis, hospitalization is often necessary for stabilization and treatment. Some of the reasons for hospitalization include any conversations about suicide or death, self-harm, violence toward others, psychosis symptoms (like hallucinations and delusions), or a complete inability to carry out daily life skills.
The length and severity of a mental health episode vary and so the length of stabilization also varies. However, most individuals stabilize within a few days of staying in a hospital. Studies have shown that the average length of hospitalization is 10 days. Hospital stays may also last longer when placed in psychiatric care than when in a regular hospital.
However, rehabilitation is different as this phase occurs after a patient has been stabilized. The length of rehabilitation will also vary according to the individual, their prognosis, and how quickly they can learn and effectively implement coping skills.
How Do I Find a Rehabilitation Program for Occupational Therapy for Mental Health?
We have shown that occupational therapists and mental health are intertwined. Are you wondering how to find an occupational therapy rehabilitation program for mental health? We have an outstanding option for you at Moving With Hope in Shelton, CT.
We provide the best occupational therapists who effectively assist clients with a variety of mental health challenges. At Moving With Hope, we will also work with your medical team to create an effective treatment plan to suit your needs. We invite you to contact us today to begin your journey to health and wellness, inside and out.
