WHAT IS OCCUPATIONAL THERAPY?

What is Occupational Therapy?

Angel M. Alvarez

School of Occupational Therapy, Pacific Northwest University

OTH 510: Introduction to Occupational Therapy

Dr. Brandon Imamshah

October 9, 2023
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What is Occupational Therapy?

Part 1

Throughout history, occupational therapy has evolved and adapted to the scope of

practice it is today. An occupation can be looked at as anything and everything that can be done

by an individual, group, or community that holds value or significance to one's overall health and

well-being (American Occupational Therapy Association [AOTA], 2020). Occupations can

impact relationships, affecting one's health positively or negatively, influencing emotions, and a

variety of health and well-being aspects. Occupations can include gardening, working, knitting,

and many other aspects that inspire, motivate, and engage in overall health. Occupations can also

be culturally impactful for communities' well-being and health. Some cultural occupations are

farming, basket weaving, and cooking, essentially an activity that is meaningful. These cultural

occupations can be dated far back and play a vital role when looking at traditions, standards, and

the overall being of those communities. Once an individual's ability to perform an occupation

becomes disrupted, occupational therapy is introduced to overcome those barriers. Occupations

can be restricted by diseases, injuries, Occupational therapy is aiding individuals who have any

physical or mental impairments that hinder their ability to do daily activities, through therapeutic

occupation-based interventions or adaptive measures (AOTA, 2020). Occupational therapy

enhances the client's ability to participate in activities that they want, need, and are expected to

do (AOTA, 2020). One way that an occupational therapist enhances their client’s ability to

perform different tasks is by implementing approaches to intervention. Approaches to

intervention are utilized to assist, prevent, maintain, establish/restore, and promote the clients'

goals. Health promotion can be utilized by an occupational therapist, which allows for the client

to participate in purposeful activities. The second approach is establishing/restoring, which can

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aid in the patient's involvement in a particular occupation by learning or relearning specific

skills. The third approach is maintaining, which can include continuing the intervention plan or

the maintenance to allow for continued involvement in a specific occupation. The fourth

approach is modification, which can include short- or long-term techniques that enhance the

individual's participation. The final approach is prevention, which can be addressed by different

factors preventing barriers from occurring that can hinder the ability to perform occupations.

Another approach occupational therapists use to assist in clients' therapeutic activities is guiding

principles, like using evidence-based practice to ensure that research evidence has been tested

thoroughly for any interventions, rehabilitation, etc., that the patient is using (Boyt Schell

et.,2019). As therapy continues, occupational therapists use a client-centered approach as a

significant factor to ensure the client is motivated to continue therapy. A client-centered

approach builds mutual respect with the client to ensure that the client's needs are being met,

which ultimately creates a better outcome for both the occupational therapist and the client.

Occupational therapy can aid in many areas of life and ranges across a lifespan, from infancy to

geriatrics. Occupational therapy can aid in many areas of life as long it falls under the scope of

practice. Occupational therapists can be seen in school-based settings, aiding in children's fine

motor skills, social participation, self-care, and other areas. Occupational therapists educate

children and provide the necessary skills and tools for their success. Another area of practice

occupational therapists participate in is cardiac rehabilitation. Occupational therapists can aid in

rehabilitating these procedures with therapeutic and adaptive measures to return to their activities

of daily living. Occupational therapy uses five domains that enhance the process that

occupational therapists use to address clients' overall being. The five domains are occupations,
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contexts, performance patterns, performance skills, and client factors. The first domain that can

be seen in the five domains is occupation and that is anything an individual finds meaning or

purposeful when looking at an activity. The second domain is contexts, which can be the

environment the client is in, along with personal factors. The third domain is performance

patterns which can be habits, routines, roles, or rituals that you do on a daily basis or throughout

your life. The fourth domain is performance skills, which involves motor, process, and social

interaction skills. The last domain is client factors, which can include values, beliefs, spirituality,

body functions, and body structures (AOTA, 2020). Occupational therapists can address these

domains and aid in the patients' health and well-being, by incorporating different areas of the

domains to elevate the client’s overall health. Two areas that we can see the domains being used

to elevate the client’s overall health is by addressing the occupation that they are a part of. An

example of this would be if the client suffered a hand injury, the occupational therapist would

use therapeutic activates to aid in the recovery of the patient. The occupational therapist would

evaluate the motor skills over time and modify the therapeutic activities that need to be done to

improve the client’s participation or performance. The second area that the occupational therapist

would evaluate would be the occupation that the client would need and like to participate. The

occupational therapist would assess the client and see if they would benefit from long or short-

term modifications to allow for participation and performance of those occupations (AOTA,

2020).

Part 2

Occupational therapy is the type of healthcare that targets client values, social, cultural, and

environmental context. These factors provide meaning and value to individuals across the life
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span which can start at infancy all the way up to geriatrics. Occupational therapy uses activities

that promote occupation engagement through therapeutic activities.

Part 3

Participation is performing specific roles, activities, and goals fundamental to an

individual's daily life. These activities can range from work-related tasks, exercise routines, self-

hygiene, cooking, or many other activities a client may be involved in throughout their life.

When a specific restriction or barrier impedes their participation, it can impact the client's ability

to perform specific tasks in their life. As these restrictions and barriers continue to affect clients'

lives, they can disrupt an individual's nutritional, physical, social, emotional, mental, and

cognitive abilities. One way to address these challenges is by implementing occupations that can

be identified and incorporated into meaningful activities for the client's self-acknowledgment and

motivation (AOTA, 2020). Along with meaningful activities, occupations can be used to aid in

client-centered goals. Thus, having client-centered goals can create an optimal environment for

them to be motivated to participate in their goals and overall participation (AOTA, 2020).

Meaningful occupations allow for participation from the clients to seek a positive avenue that

enhances and establishes their overall well-being and health. For instance, thinking of a client

diagnosed with a specific disease can compromise their ability to participate in activities that are

personally significant to them. Thus, it can lead to a decline in their overall health and well-

being. In this case, occupational therapists can play a vital role in modifying the client's

perspective and equipping them with the proper tools, resources, and education to facilitate

participation in their daily lives. An example of this would be a stroke victim who has

experienced a loss of specific functions like fine motor skills. Occupations can be tailored to

assist occupational therapists in designing therapeutic activities that address fine motor skills,
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cognitive abilities, and other areas that may affect participation. Through these purposeful

activities, the clients can regain lost functions or use adaptive measures that will ultimately allow

them to actively and purposefully participate in the activities they once could. Lastly,

occupations will allow the client to see an impact on their overall health and well-being

positively. On the other hand, having limited participation in occupation can negatively impact

the older populations' health and well-being. For instance, restrictions on social interaction can

be detrimental to older populations with physical health issues, cognitive decline, emotional

distress, social isolation, and quality of life declines. As restrictions continue to increase, the

client's factors like body functions, mental functions, and many other parts that fall under client

factors decline (AOTA, 2020).

Performance differs from occupational performance where occupational performance

focuses on occupational therapy and the specific skills to carry out meaningful or purposeful

occupations(AOTA,2020). Performance is the ability to have the skills to carry out a task.

Occupational therapy can implement occupations that require the ability to learn or regain

specific skills that allow the client to carry out tasks, activities, or goals. An example of this

would be working with a patient that has suffered a hand injury. The occupational therapist can

implement occupations that require fine motor skills, like gripping, manipulating, reaching,

coordination, and other activates that will allow for recovery. By introducing therapeutic

activities to a patient that has suffered a hand injury, the occupational therapist can assist specific

activities, level, and degree that the client will need to increase performance for those

occupations that they want, need, and are expected to do. Occupational therapy will assist in

creating functional goals with client to create a client centered approach (AOTA, 2020). In some

cases, short or long-term modifications or adaptions to specific areas can be implemented to aid
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the performance for the client’s occupations. With these therapeutic activities and adaptive

measure’s the client will be able to increase performance to those purposeful activities that were

once restricted. Thus, the overall health and well-being will not decline.

Occupational therapists can utilize occupations to implement specific goals that a client

might need to be able to do purposeful activities in their daily living. Having task-oriented goals

can improve different areas in which the client may see restrictions or, oftentimes, barriers that

affect health and well-being. An example would be a worker who suffered a traumatic brain

injury from a work accident. As a result of this type of injury, we will see a negative impact on

the client's health, well-being, participation, and engagement. As this injury continues, we will

see a decline in the client's ADLs, personal factors, motor skills, process skills, social interaction

skills, values, beliefs, spirituality, body functions, body structures, and overall health and well-

being (SIS Quarterly Practice Connections, 2022) Overall, their health and well-being will

significantly decline due to the inability to participate and perform their tasks for that specific

occupation that was due to an injury. Occupational therapists can use a combination of

occupational tasks and therapeutic tools to aid the client's ability to return to performing and

participating in their work-related occupation (American Occupational Therapy Association,

n.d.). An occupational therapist's role in assisting the client is to assess acute injury and illness

management, work conditioning, work hardening, functional capacity, and transitional work

programs. Occupational therapists can use long-term or short-term environmental modifications

(AOTA, 2020). The occupational therapist's approach to address how the client will use the

approaches to intervention can significantly increase the client's health and well-being. With

these roles, we can see an increase in engagement from the client and the ability for them to
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return to their occupation and aid in their self-fulfillment. The ability to participate in

occupations can help prevent many diseases cardiovascular disease, musculoskeletal disease,

mental health diseases, and any other diseases that can hinder the client's overall health and well-

being. An example of an occupation that can prevent disease is grocery shopping for patients

with traumatic brain injuries. Grocery shopping promotes movement, along with adding with

fine motor skills, cognitive learning, and social interaction skills (AOTA, 2020).

Part 4

Reflecting on my application paper, I noticed that my view of occupational therapy has

changed tremendously. In my application paper, I was able to define occupations and

occupational therapy correctly. However, I now realize that my understanding of occupations

and occupational therapy barely touched the surface. At the beginning of my application, I was

still determining what was considered an occupation and the true definition. As my occupational

therapy education grows, my understanding of the word occupation has developed. The

definition of occupation is clear, and my ability to relate occupation to occupational therapy has

improved. As I continue to learn and educate myself through an occupational lens, my

appreciation and understanding of the need for occupational therapy has grown. I will continue

to further my education in the scope of occupational therapy to provide high-level healthcare to

the future areas that I will serve. As the beginning of my academic career for occupational

therapy, I have learned many different areas of occupational therapy that I did not know.

Specifically, an area of occupational therapy I would like to be more educated about is how

evaluations are done with a client and being able to effectively write soap notes. The next area
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that I would like to be educated in is the paperwork aspect and being able to translate once the

evaluation is over. I would also like to be educated more on how to structure treatments after the

evaluation and adapt to the patient's needs. The next area that I want to know more about is how

to effectively communicate with other healthcare professionals to ensure that the client is getting

high-level healthcare. Lastly, I would like to learn more about billing and the proper steps to

handle submitting the paperwork. As I continue to learn more about occupational therapy, I am

constantly reminded that this occupation is very needed to help individuals do what they want,

need, and are expected to do. I think that being able to help individuals do their occupations is a

value to me because you can see the client’s overall health change once they are able to

participate in those specific occupations. One thing that I did not realize that occupational

therapy does that no other healthcare profession takes into account is the occupations that the

client has. The occupations that need to be done are crucial for the health and well-being of the

patient. One thing that was new to me was the long and short term adaptive and modifications

measures that can be done for patients' that need instant or long-term assistance. Another area

that was new to me was the cornerstones and how they aid in distinguishing occupational therapy

from other healthcare professions. Along with the cornerstones, I found the guiding principles a

new concept and how it aids in all aspects of improving the health and well-being of the client.

Lastly, I found the approaches to intervention very important and how it utilizes to assist,

prevent, maintain, establish/restore, and promote the clients' goals. I can explain the general

understanding of occupational therapy and its purpose to aid in the challenges that individuals

may have with restrictions, impairments, accidents, and other factors that may prevent

individuals from participating or performing occupations. I also feel confident on describing the
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role of an occupational therapist has when assessing, planning, and implementing interventions

that will ultimately increase the client’s overall health and well-being.
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References

American Occupational Therapy Association. (n.d.). Work Rehabilitation [Fact sheet].

American Occupational Therapy Association. (2020). Occupational therapy practice framework:

Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2),

Article 7412410010. https://doi.org/10.5014/ajot.2020.74S2001

Ruether, A., & Schweitzer, V. (2022). Can I go back to work? A work re-entry program in a

rehabilitation setting. SIS Quarterly Practice Connections, 7(2), 31–33.

Boyt Schell, B. A., Gillen, G., & Cappola, S. (2019). Contemporary occupational therapy

practice. In B. A. Boyt Schell and G. Gillen (Eds.), Willard & Spackman’s occupational

therapy (13th ed., pp. 56-70). Wolters Kluwer.

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