Improving Function and Quality of Life Through Occupation: The Role

of Occupational Therapy in Recovery

Presented by:Sean M. Getty, MS, OTR/L

Rehab DirectorRoads to Recovery PROS/ Pathways to Recovery PROS

Learning Objectives

• Identify the role of the occupational therapist in facilitating recovery for people with mental illness

• Identify the fundamentals of occupational therapy and how these align with the core components of mental health recovery.

• Identify treatment approaches utilized by occupational therapists utilized at various stages of recovery.

• Identify some of the recovery-based, client-centered assessments utilized by occupational therapists to facilitate recovery.

• To understand the importance of meaningful occupation in the recovery process.

What is Occupational Therapy?

“The practice of occupational therapy means the therapeutic use of occupations, including

everyday life activities with individuals, groups, populations, or organizations to support

participation, performance, and function in roles and situations in home, school,

workplace, community, and other settings.” (AOTA, 2004)

“Occupational therapy services are provided for habilitation, rehabilitation,

and the promotion of health and wellness to those who have or are at risk for developing an illness, injury, disease,

disorder, condition, impairment, disability, activity limitation, or

participation restriction.” (AOTA, 2004)

“Occupational therapy addresses the physical, cognitive, psychosocial,

sensory-perceptual, and other aspects of performance in a variety of contexts and environments to support engagement in

occupations that affect physical and mental health, well-being, and quality of

life.” (AOTA, 2004)

Basic Tenets of OT

• Occupation-Based Practice

• Empowerment

• Client-Centered Approach

• Holistic Approach

• Strengths-Based

• Context-Based Practice

• Cultural Diversity

What is Recovery

• 10 Fundamental Components of Recovery– Self-Direction– Individualized and Person-Centered– Empowerment– Holistic– Non-Linear– Strengths-Based– Peer Support– Respect– Responsibility– Hope

- U.S. Department of Health and Human Services (2005)

Areas of Assessment & Treatment• Areas of Occupation

1. Activities of Daily Living2. Instrumental Activities of Daily Living3. Rest and Sleep4. Education5. Work6. Play7. Leisure8. Social Participation

• Activity Demands

• Client Factors- 1. Values, Beliefs, & Spirituality2. Body Functions3. Body Structures

• Performance Skills1. Motor & Praxis Skills2. Sensory-Perceptual Skills3. Emotional Regulation Skills4. Cognitive Skills5. Communication & Social Skills

• Performance Patterns1. Habits 2. Roles3. Rituals4. Routines

• Context and Environment1. Cultural2. Personal3. Temporal4. Virtual5. Physical6. Social

Intervention Approaches1. Create or Promote

– Creating intervention strategies without assuming that a disability is present or that any factors would interfere with performance

– Resembles health promotion model

2. Establish or Restore – Leads to re-establishment of a lost skill or ability– Examples: money management, parenting,

leisure skills

3. Maintain– Preservation of performance

4. Modify– Revise the current context or task demands to support performance in the natural setting– Examples: social networks can be changed; temporal modifications like duration or sequence of a

task can be changed; backward chaining– Match a context or task to the person’s abilities– Nothing is changed about the person

5. Prevent

Assessments

• Activities of Daily Living

• Behavioral Assessments

• Cognitive Behavioral Assessments

• Evaluations of Social Interactions

• Vocational Assessments

• Sensory Processing Assessments

Treatment Settings

• Acute & Long Term Care Facilities

• Residential and Day Programs

• Skilled Nursing Facilities

• Community-Based Mental Health Centers

• Schools

• Military Installations

• Employment Practice

OT in an Acute Facility

• Evaluation

• Managing Symptoms through Occupation

• Alternatives to Restraints

OT in Community Settings

• Evaluation– Identifying the underlying skills impeding goal

acquisition

• Improve Function– Carrying out a plan to

improve function and achieve the individual’s goals

• Wellness

• Social• Environmental• Physical• Emotional

• Spiritual• Occupational• Intellectual• Financial(Swarbrick, 2006)

• American Occupational Therapy Association (2004) Definition of occupational therapy practice for the AOTA Model Practice Area. Bethesda, MD: Author. (Available from the State Affairs Group, 4720 Montgomery Lane, PO Box 31220, Bethesda, MD 20824-1220)

• Dornan, D.H., Felton, C., Carpinello, S. (November 14, 2000) Mental Health Recovery from the Perspectives of Consumer/Survivors. Presentation at the American Public Health Association Annual Meeting, Boston, MA.

• New York State Office of Mental Health (2010). Part 512 PROS Regulations. Retrieved from http://www.omh.state.ny.us/omhweb/pros

• Substance Abuse and Mental Health Services Administration. (2010). Mental Health, United States, 2008. HHS Publication No. (SMA) 10-4590, Rockville MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration

• Swarbrick, M. (2006) A Wellness Approach. Psychiatric Rehabilitation Journal, 29(4) 311-314

• U.S. Department of Health and Human Services (2005) National Consensus Statement on Mental Health Recovery. Retrieved from http://store.samhsa.gov/shin/content//SMA05-4129/SMA05-4129.pdf