What Is Occupational Therapy Anyway?
Photo image by Karen Eisenlord
Occupational Therapy is a relatively new field since World War I, or the early 1900‘s. Many still don’t know what type of therapy service it is or provides. I am an occupational therapy practitioner, and I find that although more know what this field entails as time goes on, many are still at a loss to understand it’s function. Since it is rather a broad field, this also contributes to the general confusion and lack of clarity regarding the type of therapy it is.
In general Occupational Therapy addresses a patient or person's function and Activities of Daily Living (ADL's) and a healthy balance of this being achieved through appropriate work, play, rest and recreation. This can further be broken down into four main, wide-spectrum areas of the population that is serviced. Adults, Pediatrics, the elderly (Geriatrics,) and Mental Health. There are almost endless sub-groups of therapy that each area addresses. Some pertain to and apply to all of the main areas and some are exclusive and specific to one area. For example, ADL’s are addressed in adults, children and the mental health areas, however the needs in each area varies and changes. A balance of work, play, rest and recreation applies to all, but again this is variable according to the area/population being served.
For example, adults' needs in their ADL’s are quite different than a child’s. The obvious reason is that children are in the process of developing and adults (although still developing through stages of life) are quite different in their developmental needs. This is further complicated by the condition or conditions that are being treated. A premature baby with Cerebral Palsy is certainly given a different treatment plan than an adult with let’s say Carpal Tunnel Syndrome. This brings us to the many specialties within the category of Occupational Therapy. Hand Therapy would be one area of which Carpal Tunnel Syndrome falls under. Occupational Therapists can specialize in a multitude of endless areas, much too many to go into detail here.
Before I proceed any further, I would like to give a brief history about the development of Occupational Therapy as a profession and it’s basic philosophy. Occupational Therapy’s goal is to help patient’s reach their maximum potential and function in life in the general areas mentioned above, simply put, the ADL’s. The very name 'Occupational Therapy' implies the act of occupying oneself. The basic theory and philosophy of Occupational Therapy is the process of restoring or reaching one’s functional ability through occupying acts. The basic premise of O.T. is that a balance of work, rest, play and recreation brings about, maintains and improves ADL’s and optimal quality of life.
Historically, Occupational Therapy’s theory/philosophy developed during World War I to help disabled veterans return to work, and it continues to develop. The word “disabled” in itself can imply many conditions, not excluding mental health illnesses, such as Post Traumatic Stress Disorder. It was discovered by Occupational Therapists that one very critical aspect of recovery from any disability is through meaningful occupation. The term 'occupation' used in this sense means many things. Doing crafts is a form of 'occupational' therapy. Preparing a meal or getting dressed is another one. Most of us take these things for granted, but people with disabilities often need to re-learn to do these things that most of us do not give a second thought to.
Many confuse Occupational Therapy with Physical Therapy, and there is overlap - yet they are two very distinct and separate fields. An Occupational Therapist works on improving physical and cognitive function as it addresses ADL’s and a Physical Therapist focuses on the restoration of injured body function through physical exercises. Both forms of therapy are similar in many ways, but in the process they address different areas. Both PT and OT are very important fields and work together well and compliment one another.
Since my area of expertise has been mainly in Pediatrics, it would be obviously easier for me to explain what Occupational Therapy is in context to that. I have also worked in Geriatrics, Physical Disabilities and the Mental Health Field. Depending on interest in this topic, I will add another article in terms of my own practice and experience as an Occupational Therapist. Please upvote below if you found this article interesting and want more! Thank you.
By Karen Eisenlord (c) 2018
Really interesting article :-) I think ways like this need to be massively increased to help people, I don't think many people have yet made the connection that its the content of someones life that makes them ill or certainly contributes to it, this is a really practical form of therapy and empowers the end user which is great, have you seen many successes with it in how it has changed people and there lives?
If you're talking about the field of occupational therapy as a whole, yes I've seen peoples lives improved by it across the board. In mental health also because ot addresses the entire person holistically and recognizes the interplay between nature/nurture, that is, both environmental and genetic factors. Occupational therapy treats the entire person, psychologically, physically and spiritually, taking into consideration both environmental and intrinsic factors that have contributed to their illness. OT treats the person with dignity and respect, recognizing that person can be empowered to bring about change in their own lives. I definitely see how it changes lives even in the terminally ill because it strives to give them the best quality of life while they are alive, and to achieve and maintain their fullest function as long as possible, and comfort. I hope this answers your question. With children, I always saw improvement with occupational therapy which is mainly accomplished through play therapy to address gross and fine motor skills, social, language and cognitive skills. Occupational Therapy covers a broad range of patients, as my article explains. There was never a situation where it didn't benefit the patient even if they were dying. I can safely say that without exception, occupational therapy changes lives for the better in every case. :)
Thats excellent :-) It must be great to be involved in a field where you can see that the work you do helps others in this way, do you think practical change in day to day life is the most revolutionary way forward for someone who is stuck? I have had first hand evidence of this in the past, when I have done practical things in my life to make my day to day living better my overall mental health has improved, generally however I have found it is usually cyclical and ends up that the original mental health issue although improved by the change usually rears up again and destroys the practical change that is helping it improve, if that makes sense? What do you do in this situation?
If not applying practical change, what other way would you suggest? Some conditions are ongoing throughout life, and one can hope to manage the symptoms as best they can. I know from first-hand experience through my work and personally, that applying occupational therapy techniques does help at least manage symptoms in the long-run, even in the worst conditions. I have applied it to myself for depression and ptsd. Some things get better with time, such as ptsd, if it's not exascerbated; but unfortunately life is full of stress and often compounded by further traumatic events. Coping skills are important and learning ways of managing and avoiding stress triggers. Yes, people do get stuck and symtoms can tend to reoccur. Sometimes we can seem to be managing just fine and then it rears it's head in all of it's force and strength. It's a difficult process to change what has been wired within us, but it can be done. I personally have found that a spiritual, meditative approach has helped me the most. That, and occupying myself with activities that are meaningful to me and help divert my mind to constructive, creative endeavors. I know that in time, the episodes do pass, but if they didn't I would get help. It usually and eventually works for me when I apply the methods that I know. Famous last words, I know. It can be very challenging at times but I know that I never want to let myself get as depressed as I did at my worst, which was years ago and I've been managing well myself. Relapse can be an issue of course, and some things are definitely cyclical. We learn to work with it and try to manage the symptoms. Sometimes it's two steps forward and one step back but at least we're trying. Thank you for your interesting conversation. :) Karen
Thanks for replying :-)
Yes I agree with all of that, I think the problem I have often is that I build things up a lot and get a lot better but then it comes tumbling down again, I do have several issues though that all feed into each other such as OCD, social anxiety and depression and off, I tend to get a bit better but then it falls away, practical change has made a big difference over the years and sometimes it is circumstantial too depending on whats going on, I think perhaps my PTSD probably is the worst one though as when you have traumatic memories inside it can be hard to let them go because it creates learned behaviour that can be quite self destructive at times, this can be a hard cycle to break, I have found even although I have now gotten to a point where I like myself these old habits remain, and even although I now want to take care of myself well I am am unable to do so sometimes and that can incredibly frustrating to be held a hostage to the failings of your own mind or emotions.
What would you suggest from an occupational therapy point of view to do as specifics in day to day life to break those types of cycles?
My main suggestion is to stay 'occupied' with activities that you enjoy but don't overdo any one thing. For myself when I am 'down in the dumps' which still happens to me and some days I just feel crappy; I'll give myself a break and just relax or do whatever I want -- but if it gets out of control where I getting to a point where it's difficult to function, one thing that really helps me is doing something that needs to be done and then rewarding myself with what I really feel like doing, whether it be a nap, watching a movie, a treat or whatever. Alternating this usually snaps me out of it. OCD is something I have always dealt with also and I think it's part of the ptsd of which the good news is it gets better in time; but it takes just that -- time. I do find that stress triggers ocd and it can be a vicious circle. Trying to be logical about it and think the worst thing that can happen is usually insignificant or not as bad as you're feeling subconsciously. It's a 'control' issue and sometimes we have to admit to ourselves that we cannot control everything. A little faith helps, I find -- spiritually. Spiritual practices has helped me a lot -- meditation, tarot, kabbalah, etc. Kabbalah is a big one for me too. What helps is different for everyone. I was feeling really bad several months ago and getting depressed and doing guided meditations from 'youtube' based on some of my problems helped me a lot. One thing that was beneficial is the mantra "You are enough!" In other words that we need to love and accept ourselves. Positive thinking is very crucial and yes, ptsd can catch us offguard. All I can say is that mine has gotten better, but it is from childhood trauma and other situational things (complex ptsd) and now that I'm in complete control of my own life, and time has passed -- I'm better. The last bad episode happened about 10 years ago, so I think that's a good record. Yes, it can be cyclic, and I found that was the case for me. It even is now, but less intense. I try to stay conscious of what's going on within me and flow with it a little, like I stated above. Each person has to find their own path really when it comes down to it.
That is all very interesting, can I ask how the OCD effects you? for me it is mainly contamination based and it really has a terrible impact on my day to day life, really need to find a way to overcome it somehow.
Hi George. It affected me differently and evolved since I was a teen, although I suspect the causes were rooted way before that. Symptoms began with an eating disorder I had all through my teens, between 13 to 18. It had a lot to do with controling my food intake and exercise. You can look up 'eating disorders' as I had all the symptoms and ocd is a common development and part of it. When my mom got sick I was 20 and although I had worked through my eating disorder to some degree, my ocd continued to manifest through concerns of contamination being that my mom was in the hospital for long periods and when she was home, I was always afraid of her getting sick. It involved a lot of hand-washing that became compulsive. It also manifested as a fear of something bad happening, like a fire or other catastrophe. I remember while I was at work, I would go home to check on her or to make sure nothing was left on like an iron. It's far too much to go into a lot of detail here, but now it seems to have settle down a bit since I don't have all of the same stressors in my life. It was triggered a little when my granddaughter was born, more through the concern of contamination and protecting her. I still have to check things multiple times before I go to bed or go out, but it's far better than it used to be as I try to be logical about it, think it through and have some faith in myself and the Divine. I was thinking just yesterday that a 'checklist' might help. Printing out copies of all the things one checks before going out and check it off each time. It's worth a try ... My daughter has it too so there is probably a genetic component but I'm sure part of it is environmental factors as well. She also has the same thyroid issue, though not as bad as mine, and fibromyalgia.