April is National Occupational Therapy (OT) month. I love being an OT. Since I am now up in the proverbial Foundry blog rotation it seemed like the perfect opportunity for me to promote my chosen profession. I think the best way to do that is to simply explain what Occupational Therapy is (and does) and why it such a unique profession.
It is safe to say that I have not gone more than a week or two in the past twenty years without having to explain my profession to someone. There are few professions more misunderstood than OT. There are some good reasons for that; clearly its name alone is probably the most confusing. When people hear the word occupation they immediately think about what someone does for a living. But, if you look up the definition of the word occupation online it has multiple meanings, the most common definitely being the vocation someone chooses to be employed. Another meaning for the word occupation, the definition relevant to OT is “an activity in which one engages in” or in other words, the activities a person performs and participates in daily that “occupy” their life.
Every OT I know has their own way explaining exactly what OT is. I recently came across the American Occupational Therapy Association’s (AOTA) updated definition of Occupational Therapy on their website. Their definition is: “Occupational Therapy is the only profession that helps people across the lifespan to do the things they want and need to do through the therapeutic use of daily activities (occupations). Occupational therapy practitioners enable people of all ages to live life to its fullest by helping them promote health, and prevent—or live better with—injury, illness, or disability.”
I actually think that’s one of the best definitions I have ever read. It encompasses the entire scope of Occupational Therapy practice which is broad and ever changing. It also addresses the core of every OT treatment intervention no matter where it takes place, the age of the patient or what the reason is they are being treated: OT is a completely client centered profession; the focus in OT intervention isn’t the disease, illness, injury or disability, it is what can we do as clinicians to help that patient do what they want and need to do in their daily lives. This brings me to another issue that leads many people to not fully understand our profession. OT can look very, very different depending on the age of the patient, what is interfering or preventing them from fully engaging in the occupations of their life and what their goals are.
To better understand how different OT can look let me give you some examples: Here at Foundry, our hand therapy clinic is staffed by Occupational Therapists, we rehabilitate patients with orthopedic diagnoses of the elbow, wrist and hand. Our goal is to help them return to being able to do all the “occupations” in their life the way they did them before their injury or illness. We do this through the use of therapeutic activities, therapeutic exercise, enabling activities like thermal modalities, work simulation, task simulation and we teach them how to adapt to the environment (ergonomic training is a good example) or adapt how they perform activities so they can be successful completing them.
Now if you were to see an OT working with children in a school system, children’s hospital, a NICU, pediatric specialty facility or in an early intervention agency, it would look very different. While pediatric OT practitioners can treat orthopedic issues in the upper extremity, their focus in treatment tends to be deficit areas such as sensory integration issues, visual perceptual (eye-hand coordination is a good example) deficits, developmental delays, autism, birth defects and feeding issues - just to name a few. Typically OT’s use play as a therapeutic intervention with children to help them develop the skills they need to succeed in their “occupations”. They also make environmental adaptations and provide adaptive techniques and/or devices such as special feeding bottles for preemie babies, sensory diets for children with sensory processing issues, or something as simple as a triangle pencil grip for kids with handwriting difficulties.
The OT’s working in hospitals, rehabilitation units and home care agencies work with patients who may have suffered a trauma, illness, disease or simply the aging process which has made it difficult or impossible for them to perform the more simple normal everyday activities they need to do every day. The common “occupations” for an OT to work with those patients on is increasing their independence in bathing, toileting, dressing, cooking and home management tasks. This can involve building up strength and endurance, teaching activity modification to make tasks easier to perform, and introducing adaptive equipment like "reacher’s" long handled sponges, built up utensils and other types of adaptive devices to increase the patient’s ability to perform these tasks on their own. Sometimes it is as simple as teaching a patient with chronic respiratory problems the proper breathing techniques to perform during their daily bathing and dressing activities so they don’t get so short of breath they can’t complete the task.
OT’s who work in the mental health field can see patients in psychiatric hospitals, adult day care programs, Alzheimer’s units, community mental health clinics and group homes as well as other types of facilities specializing in caring for psychiatric populations. They work with patients to help them lead lives that are as fulfilling as possible, by working with them on different components of their occupation: including self-care, productive roles in volunteering or education, and leisure pursuits. These OT’s focus much of their treatment interventions in life skills training, social and interpersonal skills training (OT activity groups are a good example), job coaching, community integration activities, health and wellness training.
With the elderly dementia population, OT’s focus their interventions to not only the patient but educating caregivers in coping skills to deal with their loved one's issues, they work on maximizing the patient's strengths and simplifying tasks which cause them difficulty (for example having clothes laid out for dressing rather than the patient struggling to remember where they are), safety awareness and engaging patients in purposeful activities they find meaningful and enjoyable.
OT is a very unique profession. It has many faces and looks very different depending on the treatment setting, the patient’s age and what is interfering with the ability of the patient to perform what they need and want to do. There are very few health care setting’s OT’s can’t be found. No matter where an OT treatment takes place, all OT’s use purposeful activities or “occupations” in treatment to help patients reach their optimal ability to be fully engaged in their daily lives. So, to all my colleagues in this wonderful and unique profession, Happy OT Month!!!