Occupational therapy and mental health
There are a lot of people who don’t know what occupational therapy is, but even fewer know about the role of OT in mental health. But in fact, the profession of occupational therapy first came to be known within psychiatric hospitals.
This is why the term occupational therapy contains the word occupation. Therapists who worked in behavioral health in the 1950s and 1960s would engage patients in meaningful occupations (or activities) in an attempt to keep them productive, attentive, and generally healthy. Handiwork was thought to have a large impact on the recovery process. The general idea behind this science is helpful, since individuals are often more motivated for rehabilitation if they can stay busy and feel useful.
Of course, the way they went about this is now viewed as overly simplistic and outdated, since the extent of their treatment would be working to complete arts and crafts such as basket weaving, lacing, and coloring.
The context of an OT’s role in mental health is the reason why we now delineate between activities and occupations. The purpose of OT is not simply to give our patients something to do, but rather to tailor treatment to the patient’s preferences, goals, and needs across a range of areas.
For this reason, mental health is thought of as one of the most customizable practice areas. Therapists in these settings are not typically held to the strict productivity standards that therapists in skilled nursing facilities and hospitals are. This means that an occupational therapist can use a high amount of creativity, planning time, and evaluation to understand what their patients need and work to make it happen.
The Role of OT in Mental Health
The role of a mental health occupational therapist varies slightly across inpatient and outpatient settings. But the goals are often shared in that treatment focuses on increasing a patient’s awareness of their condition (also called insight) and expanding the range of skills and tools they regularly use to manage their disorder.
One of the main ways that occupational therapists assist patients in behavioral health settings is through psychoeducational groups. These groups focus largely on education but as it directly pertains to someone’s condition. So rather than a standard educational group that involves telling someone what options they have in a certain area, psychoeducational groups show patients how they can engage in these areas despite symptoms, treatment plans, and more.
Psychoeducational groups in both outpatient and inpatient settings typically address the following topics:
Self-care includes dressing, eating, toileting, bathing, and grooming. Therapists in nursing facilities may practice these skills in a hands-on way with patients. Therapists in mental health settings focus more on the barriers to self-care such as poor motivation, low energy, variable mood, unstable housing, and a lack of financial resources.
Relaxation and stress reduction techniques
Stress reduction techniques can range from hobby engagement, yoga, exercise, and many more strategies to engage in relaxation and therefore reduce levels of stress.
This can differ from stress reduction in that coping skills can often be used in more subtle ways such as on public transportation, in the store, or at work. People can use techniques like deep breathing, brief periods of meditation, or guided imagery to cope with stress in the moment and improve their ability to function within the community.
Ranging from anger management to interpersonal dynamics to conflict resolution, this area is a great way to address uncomfortable feelings that are present with nearly every mental health concern. It is a good idea to focus on emotions that are especially uncomfortable such as abandonment, loneliness, fear of rejection, and unworthiness.
This may also include anger management, conflict resolution, interpersonal dynamics, social skills training, and more.
Education regarding symptom management often includes coping skills, stress reduction techniques, and emotion regulation. But a group solely focused on this topic should include personalized plans to deal with each patient’s symptoms. This makes it more powerful and far more effective for each person.
Instrumental activities of daily living (IADLs)
IADLs cover a wide range of topics intended to focus on those higher level self-care tasks such as health maintenance (including the management of medications, appointments, and other treatment-related requirements), budgeting, and household management such as laundry, driving, and cooking. These groups can be approached much the same as those focused on self-care in that education should crucially cover the factors that impact IADL completion.
Depending on the facility’s rules, funding, and physical treatment space, it may be appropriate or necessary to practice some of these skills in an individual or group atmosphere to assess a patient’s safety, function, and general capabilities in each area.
Community mobility or re-entry
Depending on the setting (inpatient or outpatient), education may cover accessing the community safely and effectively or reentering the community after a hospitalization. Some patients may benefit from instruction on using public transportation or ride shares, maps, medical transportation companies for appointments, online navigation systems, identifying signage, locating important buildings in their community such as the hospital, store, and police station.
Reentry groups can focus on social etiquette when in public settings, personal safety when around others, and some basic community navigation.
Social skills and communication
Along with emotion regulation, social skills are crucial to managing a mental health condition. Depending on the severity of someone’s condition and their level of functioning, some patients will benefit from education on acceptable social behavior such as how to utilize verbal and non-verbal cues, being sensitive around certain topics, giving respectful replies, disclosing an appropriate amount of information, and more.
Far too often, patients don’t receive enough information about their own diagnoses or treatment plan. Education on what to expect with each condition is very helpful, including prognosis, treatment options (as provided by the patient’s doctor), medications, and adjunctive treatments.
It is important to note that, while you can talk about general symptoms that are common with many mental health concerns, it breaks HIPAA to discuss a person’s specific diagnosis or circumstances in a group setting. So if this type of education is indicated or requested by the patient, it is best to provide it during one-on-one time.
Each person has roles to fulfill and mental health concerns can often get in the way of that. It’s possible to complete a psychoeducational group that covers a range of roles in a general sense so that each person can get back to meaningful roles they prioritize. This may include being a daughter or son, grandparent, parent, worker, church member, volunteer, or caregiver. Either way, they should receive education on how to manage their condition while still engaging in these roles in the ways they wish to.
Hobbies and leisure activity are another important area that can assist with recovery. Individuals may not be aware of viable leisure pursuits or they may have trouble participating due to motivation and other factors discussed earlier. For this reason, education should focus on helping patients successfully engage in whatever leisure activities are of interest to them.
The above areas serve as the crux of occupational therapy treatment in both community-based settings such as outpatient clinics, clubhouses, and drop-in centers, as well as inpatient settings such as hospitals and residential facilities. Occupational therapists have a large impact on the rehabilitation process of individuals living with any type of mental health concern.
This is yet another meaningful way that OTs can impact change and assist the movement toward improving our society’s mental health.
What is your favorite way that OTs can address mental health? What would you add about the role of OT in mental health in general? Let us know in the comments!
And for more about mental health occupational therapy, be sure to check out our other article, Occupational Therapy in Mental Health: An Overview of 6 Typical Settings.
Image credit: BD Hypno Plus
Occupational therapy focuses on the therapeutic use of daily activities (or occupations) with individuals or groups. This is to improve their participation in roles, habits, and routines in the home, school, workplace, community, or other settings. An occupational therapist helps you to get back to your customary activities as much as possible. They work with individuals who have physical and cognitive impairments, psychosocial dysfunction, mental illness, and developmental (or learning) challenges. So let’s discuss the significance of occupational therapists and mental health interventions.
Occupational Therapists and Mental Health and Wellness
An occupational therapist assesses each client holistically. For each client, they will consider various factors such as:
Values, beliefs, spirituality, mental function, sensory function, etc.
Performance skills (or motor, process, and social interaction skills)
Environment or context
Performance patterns (or habits, routines, roles, etc.)
Your occupational therapist will work with you to promote, establish (or restore), maintain, or modify tasks to help you participate fully in your daily life. Furthermore, occupational therapists will seek to prevent potential barriers to participation in desired activities.
Is Occupational Therapy Considered Mental Health
Mental health is an essential component of all occupational therapy interventions. Occupational therapists provide mental health treatment and prevention services for all – children, youth, the aged, and people with severe and persistent mental illness. All interventions focus on improving each client’s function and independence.
Occupational therapists work in mental health settings and they focus on enabling persons to re-engage in useful occupations. How do they do this? They help each client build a variety of skill sets, establish good habits and routines, set therapy goals, apply cognitive-behavioral techniques (CBT), and understand and counter physiological influences.
Within the settings of children’s and adolescents’ mental health, occupational therapy focuses on these physiological influences. They teach clients how to identify and utilize self-regulation strategies to get them back to participating in meaningful activities like going to school or work and interacting with family and friends.
Also, occupational therapists serve individuals with sensory processing disorders (SPD) and social-emotional learning dysfunctions. These conditions are usually seen within the children and adolescent segments of the mental health sector.
Occupational Therapy and Community Mental Health
Did you know that occupational therapy has its roots in mental health? It’s true! The creation of the profession coincided with the early 20th century’s mental hygiene movement.
Eventually, the call for deinstitutionalization of people with mental challenges led to the 1963 Community Mental Health Act. This act meant that occupational therapists and their assistants began working in community mental health. Today, occupational therapy within community mental health settings provides services such as:
Community mental health centers
Assertiveness community treatment (ACT) teams
Homeless and women’s shelters
As mental health services have shifted from the hospital to the community, there has also been a paradigm shift in the service delivery philosophy. Traditionally, there was an emphasis on the medical model, but now the focus is on implementing the recovery model.
This latter model acknowledges that recovery is a long-term process and clients are encouraged to keep participating in community activities until they can do so fully. Therefore, occupational therapy activities include finding and keeping employment, going to school, and living independently.
The philosophical foundation of this recovery model is the integration of occupational therapy with community mental health. The goal of this integration is to increase your ability to live independently, as much as possible, in the community as you engage in productive daily activities.
Occupational therapy facilitates your participation and is client-centered. It also plays a significant role in the success of those recovering within the community. Occupational therapists and occupational therapy assistants are educated to deliver mental and physical health and wellness services, rehabilitation, habilitation, and recovery-focused approaches. They are also trained in clinical fieldwork that’s focused on assessing psychosocial issues.
Examples of Occupational Therapy Within Mental Health
Occupational therapy interventions improve the health outcomes of those with mental health challenges. These interventions are found in the areas of education, work, skills training, health, and wellness, as well as cognitive remediation and adaptation. Some examples of occupational therapy interventions in community mental health include:
Evaluating and adapting the home, work, school, and other settings to facilitate your optimal functioning.
Providing educational programs, experiential learning, and treatment groups or classes to address key issues. These issues include assertiveness, self-awareness, interpersonal and social skills, stress management, and role development (for example, parenting).
Helping clients develop leisure or avocational interests and pursuits.
Developing skills for independent living such as using community resources, managing your home, time, and medication, as well as being safe at home and in the community.
Providing training in daily living activities (for example, hygiene and grooming).
Consulting with employers about appropriate accommodations for their clients (as required by the
1990 Americans with Disabilities Act
Conducting functional evaluations and ongoing monitoring for successful job placement.
Guiding and consulting with persons in all employment settings (including supportive employment).
Providing evaluation and treatment for sensory processing deficits.
Occupational therapy benefits individuals of all ages with a variety of mental illnesses. Furthermore, friends and family members also benefit from occupational therapy as they learn how to deal with the stress of caregiving and successfully balance their daily responsibilities in life.
Occupational Therapy Approaches
Occupational therapists use several evidence-based approaches within the mental health environment. They include:
Teaching coping and self-regulation skills that are useful in a variety of contexts.
Educating people about sensory exploration and implementing sensory approaches for self-regulation.
Utilizing CBT approaches to support your participation in desired activities.
Identifying and implementing healthy, positive habits, and structure into daily routines.
Supporting the learning and implementation of key skills. These skills include those related to social competence (like making and keeping friends), coping with anger, solving problems, learning about social etiquette, and following rules.
Evaluating factors that block your success in school, at work, as well as in your home and community.
Modifying your environment to support improved attention, participation, and decrease sensory overload at school and/or at work.
Educating parents about important behavioral and psychosocial approaches to enhance their children’s daily functioning.
Reducing restraints and seclusions within the inpatient setting. This is done via comprehensive assessments to determine what facilitates and bars your participation in:
Self-awareness and skills development
Developing attainable goals
Modifying your environment for optimal fit.
Promoting the use of self-regulation and sensory strategies.
Educating an interdisciplinary team on prevention techniques.
Can an Occupational Therapist Assist With Anxiety?
Occupational therapy plays a significant role in helping clients suffering from anxiety to manage their condition. An occupational therapist will work with you to identify how anxiety is affecting you, teach you valuable coping skills, and help you work towards achieving your future goals.
Can an Occupational Therapist Perform Psychotherapy?
Occupational therapists are authorized to provide psychotherapy services. Furthermore, these psychotherapy services are performed according to the standards of the practice.
What You Can Expect From a Mental Health Occupational Therapist
Many people think of occupational therapy as applicable to pediatric services or physical rehabilitation. So they are often surprised to find occupational therapists working in mental health environments. So if you, a relative, or a friend is seeing a mental health occupational therapist, then keep reading to learn about how they can help you.
An Occupational Therapist’s Contributions to a Mental Health Treatment Team
An occupational therapist undergoes training in holistic approaches that are suitable for work in mental health settings. Their areas of training include:
Participation in activities of daily living (ADLs)
Occupational therapy assists clients to participate in daily activities as independently as possible.
Mental Health Occupational Therapy Interventions
Some of these interventions include:
Occupational therapists are trained to create lead groups in areas that focus on:
Money and time management
Wellness recovery action plans (WRAPs)
Apply Calming Strategies
Occupational therapists use activities of daily living (ADLs) or occupations to aid in optimal mental health and welfare. They may also help you use coping mechanisms like listening to music, playing cards, writing, drawing, cooking, or cleaning.
They are also experts at applying sensory strategies. Your sensory system helps you process information that you gather from your environment. Clients with mental health challenges have a compromised ability to process sensory input, which can lead to them feeling agitated and unsafe.
Sensory strategies activate your basic processing systems like the vestibular, proprioceptive, and deep pressure touch, to help you process information. These strategies help you to feel safe and calm. These sensory strategies may prove very helpful for persons who may not be able to benefit from talk therapies.
Occupational therapists serve as a part of a larger movement to create sensory rooms in mental health facilities. These sensory rooms are safe havens for clients. These rooms also tend to have tools to help them de-escalate and relax.
Evaluate Discharge Preparedness
Occupational therapists use a series of assessments to see if clients are ready to be discharged. These standardized assessments provide valuable information. In turn, this information helps your treatment team understand the level of care that’s required for discharge and to monitor your treatment progress.
Address Physical Wellbeing
Another vital service that an occupational therapist provides is their physical rehabilitation background. Mental health issues are often accompanied by physical health issues.
In a mental health environment, you may find that your occupational therapist:
Addresses general strengthening
Recommends adaptive equipment
Performs any other activity that’s within the scope of occupational therapy
Advocate for Your Safe Independence
Your occupational therapist will assist you in mastering your daily activities. If your mental health condition compromises your ability to fully complete your daily activities, then speak to your occupational therapist about your concerns. Even if your occupational therapist doesn’t have the tools necessary to address your mental health requirements, they can advocate on your behalf and assist you to get the help you need.
Mental Health Specializations
Many occupational therapists are experts in trauma-informed care and the recovery model. They gain this expertise either through their schooling, workplace training, or independent study. Some occupational therapists will then proceed to earn their Certified Psychiatric Rehabilitation Practitioner (CPRP) certification.
Occupational therapists possess unique knowledge and skills that facilitate effective, holistic mental health interventions. Incorporating occupational therapy skills like sensory approaches and psychosocial techniques help clients to effectively function in their daily lives.
How Long is Rehab After a Mental Health Incident?
After a mental health crisis, hospitalization is often necessary for stabilization and treatment. Some of the reasons for hospitalization include any conversations about suicide or death, self-harm, violence toward others, psychosis symptoms (like hallucinations and delusions), or a complete inability to carry out daily life skills.
The length and severity of a mental health episode vary and so the length of stabilization also varies. However, most individuals stabilize within a few days of staying in a hospital. Studies have shown that the average length of hospitalization is 10 days. Hospital stays may also last longer when placed in psychiatric care than when in a regular hospital.
However, rehabilitation is different as this phase occurs after a patient has been stabilized. The length of rehabilitation will also vary according to the individual, their prognosis, and how quickly they can learn and effectively implement coping skills.
How Do I Find a Rehabilitation Program for Occupational Therapy for Mental Health?
We have shown that occupational therapists and mental health are intertwined. Are you wondering how to find an occupational therapy rehabilitation program for mental health? We have an outstanding option for you at Moving With Hope in Shelton, CT.
We provide the best occupational therapists who effectively assist clients with a variety of mental health challenges. At Moving With Hope, we will also work with your medical team to create an effective treatment plan to suit your needs. We invite you to contact us today to begin your journey to health and wellness, inside and out.