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