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What is Occupational Therapy?

Occupational therapy
An occupational therapist helps a patient learn how to use a walker.
Credit: Tyler Olson | Shutterstock

Occupational therapy is often mistaken for something having to do with career counseling. In fact, occupational therapists aren't worried about jobs; they're focused on the activities that give daily life meaning.

Occupational therapy helps patients recover or develop skills needed for the activities of daily living, including self-care, leisure, independent living and work. Therapists work in hospitals, in schools, in nursing homes and with patients in their own homes.

Patients who benefit from occupational therapy, or OT, include people who have had strokes, people with autism and other developmental disorders, people recovering from certain surgeries (including hip replacements), people who suffer from depression or anxiety, as well as veterans and the elderly, according to Virginia Stoffel, president of the American Occupational Therapy Association (AOTA) and assistant professor at the University of Wisconsin-Milwaukee. 

History and goals

Modern occupational therapy has its roots in the late 1800s, when arts and crafts therapists began to work in hospitals, using hands-on activities to engage patients with both mental and physical illnesses. 

"In the decade or so before [1917], occupational therapy was used primarily in mental health institutions, and what they found was patients who engaged in normal, everyday life activities — like crafts, farming or cleaning — seemed to be more healthy," Stoffel said.

These findings led doctors to encourage patients to engage in such activities regardless of their class or social status, Stoffel told Live Science. Soon thereafter, in 1917, a group of professionals formed the American Occupational Therapy Association. In the early days of the organization, much of the focus of occupational therapy was on "reconstruction aid," or rehabilitating soldiers who had been injured during World War I, Stoffel said.

"There was a very strong link from the get-go with medicine and the medical model," Stoffel said. "Occupational therapy became an accepted practice for rehabilitation of mind and body."

This focus on rehabilitating not just the body, but also the mind, sets occupational therapy apart from physical therapy, Stoffel said. Physical therapy focuses on the body's strength and ability to move, whereas occupational therapy is concerned with overall function. The "occupation" part of this therapy simply refers to normal, meaningful life activities — from brushing one's teeth to cooking dinner. 

"Occupational therapists want to help people where they live, where they work, where they learn and where they play," Stoffel said. 

A patient recovering from hip surgery will likely see both a physical and an occupational therapist, who frequently work closely together. The physical therapist would focus on improving the patient's strength and range of motion, while the occupational therapist would teach the patient to navigate his or her environment with a walker, how to get in and out of bed safely and how to get dressed without assistance. They might also evaluate the patient's home for possible dangers, such as rugs that pose a tripping hazard.

Occupational therapists use and develop adaptive technologies for people who need them. A hip replacement patient cannot bend from the waist while healing, so an occupational therapist might give him or her a sock aid, a device that looks like a tube attached to two long cords. With this adaptive device, the person can slip a sock on without bending over.

What does an occupational therapist do?

Occupational therapists work in a variety of settings. About half are employed by hospitals or in offices dedicated to occupational therapy, according to the U.S. Bureau of Labor Statistics. Most of the rest work in nursing homes, in schools, and for home-health services.

In hospitals, OTs help patients with daily activities — such as dressing, bathing and brushing their teeth — that they will need to do successfully to go home. They also help patients in long-term care, such as nursing homes or rehabilitation facilities. An occupational therapist in a nursing home might have a patient practice shooting hoops with a toy basketball and net in order to work on balance and hand-eye coordination, with the goal of improving mobility and reducing falls.

"We first look at a person — their physical, psychological and social abilities —and how they interact with occupation, which are the things a person wants to do throughout the day," Stoffel said. In addition, occupational therapists examine a person's environment to ensure that he or she can carry out these daily activities safely and comfortably, she added.

Occupational therapists work with people who have experienced traumatic brain injuries in both short-term and long-term rehabilitation hospitals. They might develop activities that help stroke victims learn to use their limbs again, or they might help military veterans hurt by improvised explosive devices (IEDs) regain their cognitive facilities. They might take brain-injured people to the grocery store to help them relearn how to shop, or to a crowded mall to help them find strategies to cope with overwhelming situations.

Pediatric occupational therapists work with children in inpatient and outpatient facilities and in schools. You can even find pediatric OTs in the neonatal units of hospitals, where they interact with children born with physical or mental disabilities and train new parents or caretakers on the best ways of ensuring the healthy development of these children, according to Soffel.

Other pediatric OTs specialize in sensory integration therapy, with the goal of helping children with autism and other disorders take in and process information from multiple senses. They might also help children who struggle with fine-motor activities, such as handwriting or using scissors. Such school-based occupational therapists work with children in an entire range of ages, from preschool students to those attending college, according to Soffel.

There are also OTs who work specifically with the elderly, as well as those who work in hospice facilities. For those nearing the end of life, occupational therapy can help provide a continuation of a regular routine and ensure that a person stays involved in daily activities, such as cooking, eating, cleaning or exercising, Stoffel said. 

Occupational therapy is a career with good growth potential. Employment of OTs is expected to rise 29 percent by 2022, according to the Bureau of Labor Statistics.

Staff writer Elizabeth Palermo contributed to this article. Follow Elizabeth Palermo @techEpalermo. Follow Live Science @livescience, Facebook & Google+.

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Stephanie Pappas

Stephanie interned as a science writer at Stanford University Medical School, and also interned at ScienceNow magazine and the Santa Cruz Sentinel. She has a bachelor's degree in psychology from the University of South Carolina and a graduate certificate in science writing from the University of California, Santa Cruz.
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