What is the primary purpose of occupational therapy (OT) for individuals with physical or cognitive disabilities, mental health conditions, or those recovering from injury or illness?

What is the Purpose of Occupational Therapy?

The primary purpose of occupational therapy is to enable people with impairments to participate in the activities they want, need, or are expected to do in their daily lives—optimizing occupational performance across self-care, work, leisure, and social roles to maximize independence, quality of life, and meaningful engagement. 1

Core Framework and Approach

Occupational therapy operates on the fundamental premise that everyday activities (occupations) have restorative and normalizing effects on health and function. 2 The profession uses a person-environment-occupation model that examines the relationship between:

• The person's capabilities and characteristics (physical, cognitive, psychosocial)
• The environment (physical, social, cultural contexts)
• The target occupation (specific activities the person needs or wants to perform) 1

Primary Goals and Outcomes

The overarching goals focus on outcomes that directly impact morbidity, mortality, and quality of life:

• Restore or maintain function in activities of daily living (ADL), with moderate-level evidence supporting improvements in ADL performance 1
• Reduce problem behaviors and enhance quality of life, particularly in populations with dementia and cognitive impairment 1
• Prevent decline through health promotion and maintenance of existing skills 3, 4
• Decrease risk for depression and social isolation by enabling participation in valued leisure and social activities 1

The Evaluation and Intervention Process

Assessment Phase

The occupational therapist determines the patient's current ability to complete desired and necessary activities while identifying multiple influencing factors including visual, physical, cognitive, psychosocial, and environmental elements. 1 This assessment identifies strengths and weaknesses to establish explicit, achievable goals collaboratively with the patient. 1

Intervention Strategies

Occupational therapy intervention incorporates several evidence-based approaches:

• Environmental and task modifications to enhance safety and enable activity completion—including optimizing lighting, contrast, and organization while minimizing hazards to reduce fall and injury risk 1

• Independence in home management—enabling patients to manage self-care, cooking, cleaning, financial management, and home maintenance 1

• Compensatory strategy training—when remediation is not possible, implementing adapted techniques and compensatory approaches to promote independence 5, 3

• Skills training and re-education—using task-specific activities to promote neuroplasticity and facilitate cerebral reorganization, particularly important in stroke and neurological rehabilitation 5

• Assistive technology and device training—teaching use of optical devices, electronic readers, smartphones, and other assistive technology for specific daily tasks 1

Specific Clinical Applications

Neurological Conditions

For patients with stroke, traumatic brain injury, hemianopia, Parkinson's disease, or multiple sclerosis, occupational therapists address limitations in daily activities through compensatory scanning strategies, environmental modifications, and training to adapt to visual and motor deficits. 1 This is particularly critical as stroke is the largest single cause of severe physical disability, making rehabilitation the most effective treatment. 5

Vision Impairment

Occupational therapists help individuals develop skills and strategies to use remaining vision effectively, provide medically-based rehabilitation services (typically reimbursed by Medicare), and address reading, mobility, medication management, and community participation. 1

Functional Neurological Disorder

In FND, occupational therapy uses symptom-focused interventions, addresses hypersensitivity and fatigue, implements graded activity approaches, and develops relapse prevention plans to manage symptom exacerbation. 1

Critical Implementation Considerations

Common pitfalls to avoid:

• Occupational therapists do not address street crossing or outdoor mobility training—this requires orientation and mobility specialists (not Medicare-reimbursed) 1
• Driver training, while within OT scope, is not reimbursed by Medicare 1
• Addressing psychological trauma requires additional training and accreditation; less experienced clinicians should seek supervision and establish clear referral pathways 1

Key success factors:

• Client-centered approach—the person must be actively involved in tasks rather than receiving passive care 1
• Therapeutic use of self—the relationship and therapeutic rapport are fundamental to intervention success 6
• Supported positive risk-taking—helping patients re-engage in activities despite perceived safety concerns through graded exposure 1
• Relapse prevention planning—preparing patients to independently manage symptom fluctuations with written self-management strategies 1

Evidence Base and Ongoing Challenges

The evidence supporting occupational therapy shows moderate-quality support for improvements in ADL, quality of life, and behavior reduction, with multiple high-quality RCTs demonstrating efficacy. 1 However, key challenges remain in determining optimal treatment characteristics, dosing, service delivery methods, and identifying subgroups most likely to benefit. 1

The profession continues to emphasize the need for increased presence in health promotion and wellness, shifting focus from performance to participation to optimize health, well-being, and quality of life at individual, community, and population levels. 4