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Occupational therapy refers to the use of meaningful occupations to assist people who have difficulty in achieving occupationally balanced lives. Occupational therapists work with a variety of individuals who for whatever reason have difficulty in accessing or performing meaningful occupations.
Most commonly, Occupational Therapists work with people following mental or physical ill health or disability to enable them to maximize their skills and abilities. Occupational therapy gives people the “skills for the job of living” necessary for living meaningful and satisfying lives.
Services typically include:
Customized treatment programs to improve one’s ability to perform daily activities
Comprehensive home and job site evaluations with adaptation recommendations
Performance skills assessments and treatment
Adaptive equipment recommendations and usage training
Guidance to family members and caregivers
Information from the American Occupational Therapy Association, Inc. 5/05
1 History of occupational therapy in the United States of America
2 Occupational therapy practitioners
3 Philosophy of occupational therapy
4 Benefits of occupational therapy
5 Areas of occupational therapy
5.4 Mental Health
6 Case studies
6.1 Bipolar disorder
6.2 First episode psychosis – New Zealand
6.3 Gunshot wound
6.4 Hip replacement
6.5 School Based Practice – New Zealand
6.6 Anterograde amnesia following hypoxic brain injury – New Zealand
6.7 Multiple Sclerosis – New Zealand
9 External links
9.1 Occupational Therapy Associations and Institutions
9.2 Occupational Therapy Communities, Discussion Boards, Mailing Lists
History of occupational therapy in the United States of America
Occupational therapy began as a profession in the United States in 1917 with the founding of the Society for the Promotion of Occupational Therapy (now, The American Occupational Therapy Association, Inc.). The creation of the society was impelled by a belief in the curative properties of human occupation (or everyday purposeful activity). It had previously been employed as part of the moral treatment movement in the large state supported institutions for mental illness that were widespread in the United States. Occupational therapy has played a prominent role in epidemics, providing treatment for patients with tuberculosis, polio, and HIV/AIDS. In 1975, following the enactment of legislation known as the Education for All Handicapped Children Act (PL 94-142), thousands of occupational therapists were employed by public schools to provide therapeutic services (known as related services) to enable children with disabilities to participate in regular school settings. Originally, therapists from approved training programs were certified, or registered by the American Occupational Therapy Association. A baccalaureate degree was required for certification beginning in the 1940s. Fifty years later, accredited programs were required to be at the Master’s degree level. The 1990s saw the evolution of doctoral programs in occupational therapy. Educational programs in occupational therapy are now accredited by the Accreditation Council for Occupational Therapy Education, and national certification is granted under the auspices of the National Board for Certification in Occupational Therapy. More recently, a new discipline within occupational therapy has opened up known as occupational science. Many students in 5-year masters program now receive their undergraduate degree in this discipline and go on to receive a Masters degree in occupational therapy during their 5th year.
Occupational therapy practitioners
Occupational therapy practitioners are skilled professionals whose education includes the study of human growth and development with specific emphasis on the physical, affective, cognitive and environmental components of illness and injury.
Most registered occupational therapists (OTR) practicing in the field today possess a Bachelor of Science degree in occupational therapy. However, in recent years, the entire profession has advanced its educational standards to post-professional levels. By 2007, all OTRs will enter the field with a Masters (M.S. or MOT) or Doctoral degree (OTD). A certified occupational therapy assistant (COTA) generally earns an associate degree.
To become eligible for the national examination for certification, students must complete a minimum of two (three maximum) supervised clinical internships in physical disabilities, pediatrics or mental health. Many college programs encourage students to pursue a third internship in an area of OT of their choosing. Upon successful completion of at least two internships, graduates must pass a national examination (NBCOT or National Board for Certification in Occupational Therapy). Most U.S. states also regulate occupational therapy practice (OTs must possess a license within their state).
Philosophy of occupational therapy
Occupational therapists focus on making independence a reality. While complete independence may not occur depending on the extent of the disability, occupational therapists will work with the patient or client to come up with strategies, techniques, or adaptations so that they can be as independent as possible. Occupational therapists use occupations to enable this. In the context of occupational therapy, occupation refers to meaningful activity. Occupational Therapy helps people to achieve independence in all areas of their lives
Benefits of occupational therapy
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A wide variety of people may benefit from occupational therapy, these may include people with:
work-related injuries including lower back problems or repetitive strain injuries
physical, cognitive or psychological limitations following a stroke, brain injury or heart attack
rheumatoid and age-related conditions such as arthritis
neurodegenerative movement disorders such as multiple sclerosis, amyotrophic lateral sclerosis, or Parkinson’s disease
birth injuries, learning difficulties, or developmental disabilities
mental health difficulties Alzheimer’s, schizophrenia, ADHD and post-traumatic stress
substance abuse problems or eating disorders
Fetal alcohol syndrome due to central nervous system damage from prenatal alcohol exposure
obsessive compulsions, or diagnosed obsessive compulsive disorder (OCD)
burns, spinal cord injuries, or amputations
fractures or other injuries from falls, sports injuries, or accidents
visual, perceptual or cognitive impairments
developmental disabilities such as autism or cerebral palsy
domestic abuse issues
refugees and asylum seekers
sensory processing disorders
Areas of occupational therapy
Occupational therapists work in a vast array of settings, these include:
Orthopedics (outpatient clinics)
Rehabilitation centers (TBI, Stroke (CVA), spinal cord injuries, etc.)
Hospitals (ranging from inpatient, subacute rehab, to outpatient clinics)
Industrial therapy (work hardening, work conditioning, job demand analysis)
There is a current shift within the profession towards community based practice. Essentially this vision encourages practitioners to expand into previously uncharted territory. Thus, moving away from hospitals and rehabilitation clinics and begin working with atypical populations such as the homeless or at risk populations. This change in vision is meant to expand the capabilities and impact of the profession. As the fundamental ideologies of occupational therapy are promoting independence, the profession is beginning to realize there are many more populations that would benefit from OT services. Occupational Therapists can continue the rehabilitation process in clients homes etc, they can assist clients with returning to previous life roles and activities.
Examples of community-based practice settings:
Health promotion and lifestyle change
Child development centers
People’s own homes, carrying out therapy and providing equipment and adaptations
Implementing gradual return to work programmes which include workplace and work station assessments
Traumatic brain injury
Child and adolescent mental health services (CAMHS)
Mental health clinics
Psychiatric rehabilitation programs
Early Intervention for Psychosis services
Because of the wide range of services that occupational therapists provide, the following case studies will help provide insight into the role of an occupational therapist in each specific case.
Robby is a 43 year old male with Bipolar disorder. Due to his alternating episodes of mania and depression, Robby is challenged cognitively. He has difficulty doing anything that requires more than 3 steps and often forgets the order of the steps. He avoids social interaction, preferring to keep to himself. With Robby’s occupational therapist, he began attending a social skills group twice a week. Additionally, the occupational therapist made a laundry checklist outlining the steps for doing laundry individually and put labels on all the but