What is Occupational Therapy?
Apr 14, 2021
Occupational Therapy Defined

Consider yourself lucky if you happen to know one of the 125,000 occupational therapists (OTs) or occupational therapy assistants currently working in the United States. These rehabilitation professionals dedicate their careers to helping others live life to the fullest despite illness, injury, or disability. When they're not busy finding ways to maximize patient participation at work, OTs are quick to help friends and family brainstorm solutions to everyday problems related to activity engagement or home and community safety.

For those unfamiliar, the term "occupation" can be hard to decode at first glance. In acknowledgement of Occupational Therapy Month this April, this article covers common questions about OT to raise awareness of the valuable helping profession.

pediatric OT working with children
A pediatric outpatient OT addresses social and motor skill development through a group game.

Your OT Questions Answered:

hospital OT long-handled equipment
A hospital-based OT teaches a back surgery patient how to dress using long-handled adaptive equipment.

What is Occupational Therapy?

Occupation is a broad concept that can be simplified into the activities and roles that occupy one's time. Occupations are not the same for everyone, as the things that people want and need to do will differ based upon their age, relationships to others, and inherent capabilities.

Activities of daily living (ADLs) are a key component of occupation. ADLs can be classified from the simple things people do to manage their basic needs to more complex activities that relate to interacting with the environment and community. Here are some examples:

Basic Activities of Daily Living (ADLs):

  • Eating
  • Grooming
  • Dressing
  • Bathing
  • Using the toilet

Instrumental Activities of Daily Living (IADLs):

  • Going to school
  • Working
  • Taking care of others
  • Managing a household
  • Driving
  • Participating in religion
  • Participating in leisure

If a person's occupations are affected by a medical event, an occupational therapist can help them get back to performing their necessary and preferred activities of daily living to the best of their abilities.

hand therapist making a splint for a patient
An certified hand therapist OT creates a splint for a stroke survivor to maximize functional hand use.

Where do occupational therapists work?

Occupational therapists work across the healthcare continuum, at all levels of care within the healthcare system with people of all ages. You can find an occupational therapist working in the following areas:

Hospital Settings
OTs work with people who are unable to participate in their preferred activities due to a medical event. In an acute or inpatient rehabilitation hospital setting, patients get daily occupational therapy prioritizing basic ADL function. The goal of this setting is to ensure that the patient can resume their necessary daily tasks like eating, dressing, and using the bathroom upon discharge, teaching them how to use new strategies or medical equipment to participate fully as needed.

Home and Outpatient Settings
Occupational therapists also work with people who live at home. Home health OTs go to the patient's home to provide treatment, whereas outpatient OTs work at an external facility that receives patients. Patients of these settings get therapy treatment less frequently than in the hospital, usually a few hours per week or month. Home health and outpatient therapies balance basic ADL skills alongside the IADL tasks the patient encounters as they navigate life in their home and community.

Long-Term Care Settings
OTs also work with people who live in residential facilities that provide support for self-care tasks. There are varied levels of support within the long-term care model. Some some facilities assist residents with incidental tasks like cooking and cleaning, while others provide constant, basic self-care assistance in addition to bigger-picture tasks. Even if a long-term care patient is not expected to live on their own, an OT may still provide treatment to promote maximal participation in daily routines for improved quality of life.

ergonomic workstation setup by a home health OT
A home health OT advises about office accessibility for a person with a spinal cord injury.

What do occupational therapists do?

A physician writes a referral for occupational therapy services if he or she identifies that a patient cannot participate in their daily activities optimally. From here, the OT process is divided into the following three components:

During the initial evaluation, an OT will review the patient's medical history and conduct an interview with the patient or their family to clarify perceived performance limitations. The OT will also conduct assessments of domains including strength, balance, upper extremity function, cognitive function, or visual function to gather objective data related to the patient's complaint.

The OT compiles evaluation information into a formal document and determines if follow-up treatment is warranted. If ongoing OT is necessary, the therapist will write a plan of care including short-term and long-term goals that they expect the patient to achieve within a set timeframe.

The intervention component of OT treatment may span a few weeks to a few months depending on the patient's diagnosis, degree of impairment, and the treatment setting. During the intervention phase, the OT provides ongoing treatment targeted to the patient's deficit areas.

Treatment may involve practicing affected daily living activities fully, or performing preparatory exercises or tasks that form the building blocks of affected skills. The OT will adjust intervention difficulty over time and according to patient progress to provide the just-right challenge to maintain engagement.

Outcome Measurement
Throughout the treatment course, the occupational therapist continues to perform assessments to verify whether a patient is making progress. Therapists often revisit the same assessments from the evaluation portion at set intervals; however, they are able to add or change assessments to the therapy plan as needed.

When it is determined that a patient will discharge from occupational therapy services, the OT will perform a final round of assessments and write a summary of patient progress over time.

adaptive pencil grip by a school OT
A school-based OT promotes a child's age-appropriate pencil grasp for improved writing skills.

What is the difference between occupational and physical therapy?

OTs and PTs often work together with the shared goal of improving patient function and quality of life. Both professions perform assessment and treatment and provide patients with education and equipment recommendations. However, the means by which they promote improved performance differs.

Physical therapists are mobility experts. PTs treat physical impairments including musculoskeletal and neurological dysfunction with the end goals of reducing pain, restoring movement, and preventing disability. A physical therapist working with a post-knee replacement patient would promote strength and flexibility of their operative leg as well as mobility skills including getting out of bed, climbing stairs, and walking with an assistive device.

Occupational therapists are ADL experts. OTs work with patients with physical or mental health diagnoses that impact daily task performance. Because patients rely upon mobility skills to accomplish their routines, some aspects of OT and PT appear similar. However, OT will always frame treatment around functional task performance. An OT working with the same knee replacement patient would ensure they are able to dress their lower body, get into their bathtub, and manage cooking with a new rolling walker.

“Occupational Employment and Wages, May 2020.” Occupational Employment and Wage Statistics, U.S. Bureau of Labor Statistics, 31 Mar. 2021, www.bls.gov/oes/current/oes291122.htm#(1).


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