What is the purpose and approach of occupational therapy (OT) for individuals with injuries, illnesses, or disabilities?

Purpose and Approach of Occupational Therapy for Individuals with Injuries, Illnesses, or Disabilities

Occupational therapy (OT) focuses on enabling individuals with injuries, illnesses, or disabilities to participate in their desired daily roles, habits, and routines in the home, school, workplace, community, and other settings through the therapeutic use of meaningful activities. 1

Core Purpose of Occupational Therapy

• OT helps individuals develop skills and strategies to use their remaining abilities as effectively as possible to complete daily occupations (activities that have meaning and importance) 1
• Primary goal is to achieve maximum possible autonomy and complete integration into society, family, and work environments 2
• Focuses on improving function and quality of life rather than solely on symptom reduction 3

Assessment Process

The OT assessment typically includes:

1. Evaluating the patient's current ability to complete desired and necessary activities of daily living 1
2. Identifying multiple factors influencing performance (visual, physical, cognitive, psychosocial, environmental) 1
3. Assessing the person's understanding of their diagnosis and agreement with treatment approach 1
4. Taking detailed social history to explore usual roles, responsibilities, and meaningful activities 1
5. Analyzing 24-hour routines to identify symptom-perpetuating factors (poor sleep hygiene, boom-bust activity patterns, lack of structure) 1
6. Setting explicit, achievable goals in collaboration with the patient 1

Intervention Approaches

Environmental and Task Modifications

• Enhancing lighting, contrast, and organization
• Minimizing patterns and glare
• Removing potential hazards to reduce fall risk
• Adapting tasks to enable independence in self-care, cooking, cleaning, and home maintenance 1

Functional Activity Training

• Retraining normal movement patterns within functional activities 1
• Graded reintroduction to daily activities with progressive load increases 4
• Establishing structure and routine 1
• Training in strategies to improve specific functional tasks (reading, writing, etc.) 1

Assistive Technology and Adaptive Equipment

• Training in the use of optical devices and assistive technology for specific daily tasks 1
• Teaching use of non-optical devices to complete specific activities 1
• Careful consideration before implementing splints or immobilizing devices that may lead to muscle deconditioning 1, 3

Cognitive and Psychological Support

• Addressing unhelpful thoughts, beliefs, and behaviors that may impede recovery 3
• Teaching anxiety management and distraction techniques 1
• Implementing relaxation techniques to minimize stress 3

Specialized OT Applications

For Neurological Conditions

• For conditions like stroke: Activities specifically geared to promote cerebral reorganization (brain plasticity) 5
• For functional neurological disorders: Focus on education, functional activity, and self-management strategies 3
• For visual field deficits: Training in compensatory scanning strategies and environmental modifications 1

For Orthopedic Conditions

• Progressive recovery of movement and muscle strength using kinesiotherapeutic techniques 2
• Recovery of basic functions (clasping, pulling, pushing, lifting, etc.) 2
• Retraining work movements with compensatory methods when necessary 2

Delivery Model

• OT is typically delivered as part of a multidisciplinary rehabilitation team 5, 4
• Services may be provided in acute care, rehabilitation facilities, or outpatient settings 4
• Treatment follows a client-centered approach that sees the patient as a full member of the team 4
• Intervention phases often include: initial education, active rehabilitation, and maintenance/self-management 3

Key Principles

• Focus on function rather than impairment
• Use of meaningful activities as therapeutic tools
• Client-centered approach that incorporates patient goals
• Consideration of the whole person within their environmental context
• Emphasis on participation in valued life roles

Occupational therapy's unique contribution to rehabilitation is its focus on enabling participation in meaningful daily activities through a combination of remediation techniques and compensatory strategies, all tailored to the individual's specific needs, goals, and environmental contexts.