Here’s a Quick Lesson on Occupational Therapy: The Profession I Love

My Path to Occupational Therapy

I fell in love with the profession of occupational therapy before I knew it existed.

In a psychology class during my junior year of high school, my eyes filled with tears as I watched previously-catatonic patients gain the ability to bounce a ball again. This was in a movie titled “Awakenings” with Robin Williams. I remember very few details of that movie aside from the realization it triggered: I decided I wanted to help people LIVE. I didn’t want to be a nurse, doctor, or teacher. Although each of these professionals do help people live, I wanted to help people do the things that make life worth living, like bounce a ball. I wanted to help people ENJOY their lives! 

Even though we both knew I didn’t want to be a nurse, my mom and I started visiting colleges with nursing programs. We thought that the aspects of a profession I kept describing had to exist within the realm of healthcare. Finally, a nursing professor at one of the colleges we visited asked, “Have you looked into occupational therapy?” 

I hadn’t, because I hadn’t known about it. I’d never even heard of it! Occupational therapy (OT) wasn’t a profession that was ever mentioned to me as a potential career path or plan of study. Thirteen years later, although the need for occupational therapy continues to increase and awareness around its purpose has grown, I’ve found that a large majority of people that I meet and talk to still don’t know what it is. In February of 2020, I delivered a presentation to my medical service unit in the Navy Reserve. As the first OT to be commissioned directly into the Navy Reserve, I explained what occupational therapy is, why occupational therapists do the things we do, and the assets that OTs provide to the Navy Reserve. Afterward, a nurse, who admitted that he works with OTs daily, exclaimed that occupational therapy “finally makes sense!”

Healthcare professionals who work with or alongside occupational therapists daily— including doctors who regularly refer patients to occupational therapy services—acknowledge their lack of understanding of the profession. If you, your child, or your aging parent has been referred to “OT” and you’re not quite sure what it is or what it entails, you’re not alone.

I’m here to break it down for you! And once I do, I hope you’ll fall in love with the profession too.

What is Occupational Therapy?

Let’s start from the beginning by unlayering the meaning of its title: “Occupational Therapy.” “Occupation” is the existing root word within “occupational therapy.” So many people—even healthcare personnel of my naval unit!—assume that “occupational therapy” consists of helping people with “work,” such as helping people find a job or return to work after an injury. Although occupational therapists do frequently help with these things, it’s a very small part of what we do. 

The OT Practice Framework describes “occupations” as:

• goal-directed pursuits that extend over a period of time
• daily activities that reflect values and provide structure to living
• having personal meaning and involving multiple tasks
• meeting the needs for self-care, enjoyment, and participation in society
• everything that people do to occupy themselves¹

My favorite definition of “occupations” is the following: 

Activities that people engage in throughout their daily lives to fulfill their time and give life meaning. Occupations involve mental abilities and skills and may or may not have an observable physical dimension.

American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process (2nd ed). American Journal of Occupational Therapy, 629.

Personally, I define an “occupation” as a goal-directed activity of our daily life that provides personal meaning or value. An occupation is more than an “activity”; it’s goal-directed and meaningful. It’s also more than a “task”; an occupation typically encompasses a set of tasks.  

Occupational therapists categorize occupations into three groups:

1. Pleasurable
2. Productive
3. Restorative 

We further classify them into nine main areas:

1. Activities of Daily Living (aka “ADLs”) are the activities related to taking care of one’s own body.
2. Instrumental Activities of Daily Living (aka “IADLs”) support one’s daily life within the home and community, such as caring for others (including elderly parents, children and pets); financial, home management; shopping and meal preparations; religious observances; and safety and emergency maintenance.
3. Health Management consists of activities related to developing, managing, and maintaining health and wellness routines, including self-management, with the goal of improving or maintaining health to support participation in other occupations.
4. Rest and Sleep includes rest, sleep, sleep preparation, and sleep participation.
5. Education involves both formal educational participation as well as informal personal education or interest exploration.
6. Work includes identifying and selecting work opportunities and interests, seeking and gaining employment, actual job performance, retirement preparation and adjustment, and volunteer exploration and participation.
7. Play includes the activities of both play exploration and play participation. It is defined as “any spontaneous or organized activity that provides enjoyment, entertainment, amusement, or diversion.”¹ (I love that my profession defines, prioritizes and intervenes in the occupation of play! As OTs, we address the engagement in play among both pediatric and adult populations).
8. Leisure is defined as “a non-obligatory activity that is intrinsically motivated and engaged in during discretionary time, that is, time not committed to obligatory occupations such as work, self-care, or sleep”¹ and involves both leisure exploration and participation.
9. Social Participation includes the activities of community, family, friend, and peer engagement and involve the expected behaviors of a position or culture.¹

A specific occupation in someone’s life falls into one of these eight categories according to their own personal experience with the occupation. For example, one person may categorize the occupation of “taking a bath” as an ADL, for the purpose of caring for one’s body, whereas another person may categorize it as “rest,” as they use it to relax after a long day, before bed. 

As occupational therapists, we use occupations—the meaningful, daily activities of a person’s life—as both the intervention and the end means of our client, patient, or student’s therapy goals. We use the daily activities of everyday life therapeutically to promote health and to improve the participation and performance of our clients’ daily activities of everyday life. The OT Practice Framework describes the contribution of our profession as “promoting the health and participation of people, organizations, and populations through engagement in occupation.”¹

Let me give you a couple of examples . . . 

• When I worked at OSU Harding, a psychiatric hospital, I addressed ADLs by helping patients create colorful and meaningful “morning routine checklists.” I addressed leisure by leading patients in the exploration and identification of a wide range of possible interests, and then providing them with the opportunity to engage in a few of them.

• As a school-based occupational therapist, I address students’ occupation of education by improving behavior, self-regulation, executive functioning, sustained attention and focus, the ability to complete tasks with greater independence, and overall academic performance. One major way I facilitate these skills for educational success is through the development of visual and fine motor skills in the context of handwriting. In addition, I frequently address social participation by working with students in small groups to facilitate conversation and social skills. At the middle school and high school levels, OTs frequently address ADLs, in the context of promoting self-hygiene, and work, in the context of using checklists to complete various jobs with reduced adult support.   

I really love my profession. It’s fun, dynamic, individualized, and meaningful. It occurs in a multitude of settings, assists a variety of populations of people, and involves an orchestration between science and art. The occupation-based activities we use as intervention are determined through an analysis of the person’s body functions and structures as well as their values, habits, roles, and routines. While looking at these aspects of a person, we perform a task analysis of the performance skills, context, and environment, and the demands of the activity being pursued as the end goal. We look at both the person and the occupation in tandem, as well as each in isolation, to identify why a breakdown in performance or participation is occurring to determine our intervention. Every day is different; and, every day, even the smallest bits of progress are celebrated. 

Today, I’m doing what I set my sights on as a junior in high school: I’m helping kids gain the skills they need to live their lives—to do the activities they want and need to do in order to live to the fullest. Yes, it requires patience—and yes, a lot of problem-solving and cognitive energy too—but, the joy it elicits with each breakthrough experienced supersedes any challenge faced.  

If your child was recently referred to “OT,” it’s likely because there’s an occupation (or two! or three! or more!) of daily life that is, or has become, difficult. This may be due to (but not limited to) any of the following:

• injury,
• health complications,
• disability,
• cognitive changes, or
• various stressors

Whatever the cause . . . if you choose to follow-up with the referral by initiating occupational therapy services with The ColorfullyEnthused* Therapy Studio, you’ll find your child in the hands of someone whose profession is more than a “job,” and rather a calling. 

P.S. In the state of Ohio (and in many other states as well), your child does not need a doctor’s referral to receive occupational therapy (OT). If you think your child may benefit from occupational therapy, just contact me! Together, let’s determine if the services offered at The ColorfullyEnthused* Therapy Studio are an optimal match for your family—and if not, I’ll do my best to guide you in the right direction. 

Interested in learning more about occupational therapy, its history, and where it established its roots? Check out this post on What Everybody Ought to Know About OT’s Role in Mental Health.

References:

1. American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process (2nd ed). American Journal of Occupational Therapy.
2. American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed). American Journal of Occupational Therapy.