What is occupational therapy? Who is it for?

Confusingly, occupational therapy (OT) isn't about a person's occupation or employment. Instead, it's about helping people with health issues to perform important everyday tasks or "occupations." It's a vital healthcare service that can be essential for assisting people to get back to living productive and fulfilling lives. 

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OT is a service that helps people perform everyday activities, sometimes called activities of daily life (ADLs). These activities roughly fall into three categories (Janssen, 2020; Tiwana, 2020):

• Self-care (such as showering, using the toilet, and dressing)

• Work or school time activities (like driving, writing, and communication management)

• Free time (including sexual activity and socializing)  

Occupational therapists (OTs) take a broad, holistic view of the patient, rather than focusing only on the health condition causing difficulty with these ADLs. For instance, while a physician might focus on treating a patient's cancer, an occupational therapist would help that individual deal with the range of daily challenges of having the disease. That might include dressing, bathing, using the toilet, organizing a daily schedule, cooking, and caring for children or aging relatives (Pergolotti, 2016).

People of all ages, from children to the elderly, can be helped by OT.

Often, OT services are helpful for someone who's had an injury, such as a stroke or a traumatic brain injury, that's hurt their ability to do specific tasks. People with a long-term condition that limits their ability to perform ADLs, like chronic pain or a mental illness, can benefit from OT as well.

Children and adults with disabilities, such as autism, cerebral palsy, intellectual disabilities, and motor disorders, frequently receive OT. OT services can also help older adults experiencing challenges with physical and mental tasks (Ikiugu, 2017; Kuhaneck, 2015; Houtrow, 2019).

OT services often take place in long-term care facilities, like nursing homes or group homes. OT is also available in hospitals, health centers, workplaces, schools, and people's homes (Janssen, 2020; Tiwana, 2020).

Occupational therapists act as guides by assisting the individual in establishing goals. The patient and OT then work together to accomplish those goals. Therapists can suggest new practices and habits that make tasks more manageable. If the person is living at home, they may suggest ways to adapt the environment so that activities are more manageable.

For example, someone whose fine motor skills have been damaged, so they're unable to handle a knife, might have a goal of preparing meals for their family. The therapist might suggest buying pre-cut vegetables and fruits or help the individual figure out which utensils they can more easily handle. If it's difficult for the person to reach cookware, the therapist might suggest ways to rearrange the kitchen so that cookware is easily accessible.

For a child, the goal might be something as simple as tying a shoelace. Or it might be a more complex goal, like learning to play with friends.

What happens in an OT assessment?

There are many different types of OT assessments. Often they target specific health conditions. In general, an OT assessment includes (Tiwana, 2020):

• Assessing the situation: The history of the person's health condition, current health status, and which activities are limited

• Goal setting: What's most important to the individual and what's possible to achieve

• Creating a treatment plan: Short- and long-term goals, as well as the treatments and techniques the therapist will use to help achieve them  

During an assessment, the therapist should evaluate the person's psychological status as well. About half of residents in long-term care facilities have depression (Janssen, 2020). Mental health can significantly affect treatment, so identifying it during the OT assessment helps ensure a more straightforward path to recovery.

What happens when OT ends?

When OT ends, called discharge, the therapist often provides an individualized plan to help the person continue OT on their own. This plan could mean training family or home health caregivers to help the individual. It could also mean creating a home exercise plan. Regardless, the program aims to keep the individual from losing ground after completing OT.

The main difference between OT and physical therapy (PT) is that an occupational therapist focuses more on helping the person manage daily activities, while a physical therapist emphasizes improving body movements. An occupational therapist also tries to figure out ways to adapt the environment to fit the person's abilities or find an alternative method for performing particular activities (Tiwana, 2020). Often the occupational therapist and the physical therapist are both parts of a person's therapy team.

OT can help people return to the activities that are most important to them. For some people, that might be playing with their kids. Others might want to return to work or get back to playing a favorite sport.

Occupational therapists try to help make a meaningful difference in people’s lives.

In most cases, for adults, a referral is needed from your healthcare provider for OT services. For school-aged children, OT is sometimes available without a referral or prescription. However, you may find that it will be more fully covered by insurance if you have a prescription. Talk to your health insurance company and your healthcare provider to learn what the best approach will be for you.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

June 21, 2021

Written by

Alison Dalton

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.